Post op respiratory complications are the focus of this piece. How can they be anticipated, detected early and dealt with appropriately? What about objective neuromuscular monitoring? Should you revese every single patient? If so, how do you do it? What about the risk of pulmonary complications? Presented by Desiree Chappell with her guest Frances Chung, Professor, Department of Anesthesiology and Pain Medicine, University of Toronto.
Learn about the Perioperative Anesthesia and Surgical Screening Clinic (PASS Clinic), do you need one at your practice? What is pain control for a perioperative patient? Hear also about the 'subacute period' and how you can incorporate it into your practice. Also, how do we keep patients 'opioid free' once they leave our care? Finally, how does individualised pain management and pain education fit into this picture? Presented by Desiree Chappell and Vicki Morton, with their guests; Professor Pad...
This piece is a fascinating overview of Australia and New Zealand's Emergency Laparotomy Audit - Quality Improvement (ANZELA-QI). It works as an update on the initiative, provides all the background you need including explanations regarding, structure, organisation and additional support as well as answering key questions such as: Do we need it? How do you join and what happens when you do? A link to the slides for this talk is here: http://www.anzca.edu.au/documents/03-ben-griffiths_anzela-qi-a...
"ERAS in Obstetric Surgery" - was originally streamed live from the Charles Sammons Cancer Center, Dallas, during EBPOM-USA 2019 on www.topmedtalk.com Hear this excellent talk, for free, on this podcast. If you'd like to attend an event like this ensure your next click is here: www.ebpom.org/meetings This piece is presented by Attila Kett, anaesthesiologist and Chairman at St Peter's University Hospital at New Jersey, he is introduced by Vicki Morton, Doctor of Nursing Practice and Director of C...
We learn more about what the Perioperative medicine summit is and have a quick fire review of the current literature related to Perioperative Medicine. Discussions in this piece include the use of ACE inhibitors and ARBs, Hypotension, the Measurement of Exercise Tolerance before Surgery (METS) Trial and the improving fortunes of asprin. The SPAQI website is here: https://www.spaqi.org Presented by Desiree Chappell with Monty Mythen and their guests Barbara Slawski, Professor of Medicine and Orth...
What simple things can we do in the operating room which might make a difference to the issue of post operative delirium? Should preoperative sedation be, generally speaking, withheld from people over 60? How do we explain the risks of this procedure to those who need it? Also - are we seeing a rise in post operative delirium and if so why? And finally - what should we make of the "triple low" story where patients with low blood pressure, a low bispectral index, and a low minimum alveolar concen...
A special edition of TopMedTalk recorded at The Institute of Sport Exercise and Health (ISEH) live from an Enhanced Recovery After Surgery (ERAS) leadership forum. How can cold water adaption help people deal with medical issues? There's evidence to suggest that cold water adaption reduces inflamation, can open water swimming help with issues such as chrohn's disease? On the other hand how important is it to ensure patients do not become cold while in our care? Hypothermia is never good, how imp...
This piece ploughs into some of the academic papers that have provoked discussion recently in the perioperative community. We discuss the following papers: Risk factors for opioid-induced respiratory depression in surgical patients: a systematic review and meta-analyses. https://www.ncbi.nlm.nih.gov/pubmed/30552274 Increased Postoperative Glucose Variability Is Associated with Adverse Outcomes Following Total Joint Arthroplasty. https://www.ncbi.nlm.nih.gov/pubmed/29975266 Effect of A1C and Gluc...
Shared decision making is key to any perioperative enhancement team, this piece is a fascinating debate between various interesting positions. For more on the (Perioperative Optimization of Senior Health) POSH clinic mentioned in this piece look here: https://medicine.duke.edu/divisions/geriatrics/patient-care/duke-perioperative-optimization-senior-health Presented by Monty Mythen with his guest Mike Grocott, Professor of Anaesthesia and Critical Care Medicine, University of Southampton and cont...
Live from 'The Society of Cardiovascular Anesthesiologists' (SCA) annual conference, 2019, the TopMedTalk team takes you right to the heart of the debate. Presented by Desiree Chappell with Sol Aronson, tenured Professor at Duke University and Executive Vice Chairman in the Department of Anesthesiology and their guest Davinder Ramsingh, Director of Research and Perioperative Ultrasound at Loma Linda University Medical Center, Department of Anesthesiology.
Live from Anaesthesia 2019, on day two of the conference; a 'must-attend event' for the specialty where world-renowned experts present the latest advances in perioperative medicine, critical care and pain medicine. The "Fitter, Better, Sooner" toolkit can be found here: https://www.rcoa.ac.uk/fitterbettersooner The excellent video we mention is here: https://www.youtube.com/watch?v=0NMHMX-nFgY Presented by Nick Margerrison with his guest Dr Hilary Swales, lead for Patient Information at The Roya...
This piece is a chance to hear how and why an emergency laparotomy can work as part of the perioperative process. Ideally perioperative medicine involves preparation, consideration, shared decision making and 'enhanced recovery'; which of these elements can be incorporated into a procedure which is unplanned? Can your practice be adjusted to improve outcomes for patients who might have as little as a few hours before big decisions about their treatment and future are made? Presented by Michael C...
Live from Anaesthesia 2019, on day two of the conference; a 'must-attend event' for the specialty where world-renowned experts present the latest advances in perioperative medicine, critical care and pain medicine. You can find the OSIRIS website here: https://osiris-programme.org/ Presented by Monty Mythen with Mike Grocott, Professor of Anaesthesia and Critical Care Medicine, University of Southampton and Rupert Pearse, Professor of Intensive Care Medicine at Queen Mary, University of London....
Live from Anaesthesia 2019, on day two of the conference; a 'must-attend event' for the specialty where world-renowned experts present the latest advances in perioperative medicine, critical care and pain medicine. If you're looking for the hugely popular debate regarding direct laryngoscopy we mention in the podcast go here: https://www.topmedtalk.com/sunday-special-should-direct-laryngoscopy-be-consigned-to-the-history-books/ Presented by Monty Mythen with Tim Cook, Consultant in Anaesthesia a...
Live from Anaesthesia 2019, on day two of the conference; a 'must-attend event' for the specialty where world-renowned experts present the latest advances in perioperative medicine, critical care and pain medicine. A powerful and wide ranging conversation with one of our most popular contributors. We mention this piece here, one of TopMedTalk's most downloaded podcasts: https://www.topmedtalk.com/topmedtalks-to-dr-paul-wischmeyer/ Presented by Monty Mythen with Paul Wischmeyer, Professor of the ...
"Pain strategies" - was originally streamed live from the Charles Sammons Cancer Center, Dallas, during EBPOM-USA 2019 on www.topmedtalk.com Hear this excellent talk, for free, on this podcast. If you'd like to attend an event like this ensure your next click is here: www.ebpom.org/meetings Presented by Dr. Ryan Hanson, Anesthesiologist in Boston, Massachusetts, affiliated with Brigham and Women's Hospital, received his medical degree from Penn State College of Medicine....
Live from Anaesthesia 2019, on day two of the conference; a 'must-attend event' for the specialty where world-renowned experts present the latest advances in perioperative medicine, critical care and pain medicine. This piece focuses on The Centre for Perioperative Care. Presented by Monty Mythen and Mike Grocott with their guest David Selwyn, Deputy Medical Director at Nottingham University Hospitals NHS Trust and Director of The Centre for Perioperative Care (CPOC).
Live from 'The Society of Cardiovascular Anesthesiologists' (SCA) annual conference, 2019, the TopMedTalk team takes you right to the heart of the debate. Presented by Desiree Chappell with Sol Aronson, tenured Professor at Duke University and Executive Vice Chairman in the Department of Anesthesiology and their guests Robert and Shanari, poster presenters and residents at Temple University.
Live from Anaesthesia 2019, on day two of the conference; a 'must-attend event' for the specialty where world-renowned experts present the latest advances in perioperative medicine, critical care and pain medicine. The piece mentioned regarding developmental neurotoxicity is here: https://www.topmedtalk.com/anaesthesia-2019-developmental-neurotoxicity/ For lots more on the METS trial go here: https://www.topmedtalk.com/?s=mets Presented by Monty Mythen, TopMedTalk's Editor in Chief with Nick Mar...
Live from 'The Society of Cardiovascular Anesthesiologists' (SCA) annual conference, 2019; the TopMedTalk team takes you right to the heart of the debate. Presented by Desiree Chappell and Monty Mythen with Sol Aronson, tenured Professor at Duke University and Executive Vice Chairman in the Department of Anesthesiology and Michael Eaton, Professor and Chair of Anesthesiology and Perioperative Medicine at the University of Rochester, New York.
How does one go about becoming a Master of Perioperative Medicine? This piece takes a look at the growing movement which all TopMedTalk listeners are at the forefront of. Further debate covers, "NPO after midnight", getting buy in from the institution to practice perioperatively and keeping the momentum going after one leaves a conference. Presented by Desiree Chappell and Monty Mythen with their guests, Marc Koch President & CEO of Somnia Inc and Gregory Pato, internal medicine physician as...
The TopMedTalk team brings you more of our live coverage of 'The Society of Cardiovascular Anesthesiologists' (SCA) annual conference, 2019. This piece highlights four papers recently published in the May edition of the (British Journal of Anaesthesia) BJA. Find them on www.poqi.org Furthermore, there's an interesting piece about the Perioperative Quality Initiative (POQI) here: https://www.topmedtalk.com/anesthesia-and-analgesia-go-big-on-poqi/ Presented by Desiree Chappell with Monty Mythen an...
The TopMedTalk team bring you coverage of 'The Society of Cardiovascular Anesthesiologists' (SCA) annual conference, 2019. This piece focuses on the question of looking after yourself as a practitioner and interlinking into your team. Presented by Desiree Chappell, Sol Aronson and Monty Mythen with their guest Sasha Shillcutt, Vice Chair of Strategy and Innovation, Department of Anesthesiology, UNMC Founder, Brave Enough LLC. Find Sasha's excellent website (and podcast) here: https://www.becomeb...
How will the profession evolve as the years pass? Change is inevitable and the direction of change is becoming clearer but how will we adapt to the new roles and requirements we can see coming towards us in the near future? Will Anaesthetists be able to tackle the leadership role which many expect to become commonplace? Also, what is the "technological singularity"? Should we be concerned about it? Finally, some thoughts on what it really means to work in healthcare, how are we different to the ...
This conversation covers one of the conference's talking points; developmental neurotoxicity. Can human infants exposed to anaesthesia early in their early development really be facing risks which we were previously unaware of? There's a lack of evidence at the moment but outcomes for young animals have raised concern. Given the complexities of human neurodevelopment how can such issues be reliably detected? Presented by Joff Lacey with his guest Hugh Hemmings Senior Associate Dean for Research,...
TopMedTalk is at Anaesthesia 2019. It's one of the big events of the global perioperative calendar. Find out what the hot topics and big talking points are. What else can we expect to come from the conference this year? Presented by Dr Joff Lacey with his guest Mike Grocott, Professor of Anaesthesia and Critical Care Medicine, University of Southampton and Royal College of Anaesthetists Council Member.
Discussion initially focuses upon fluid management in the operating room. We then take a wider view as discussion moves to concerns about diabetic patients undergoing surgery. Presented by Monty Mythen with Desiree Chappell featuring their guests Mike Grocott, Professor of Anaesthesia and Critical Care Medicine, University of Southampton and Tim Miller, Associate Professor of Anaesthesiology from Duke University Medical Centre. The Henrik Kehlet piece mentioned in this episode is available here:...
Twitter is ablaze with talk of the Society for Perioperative Assessment and Quality Improvement (SPAQI). How did they do it? This piece is a thought provoking discussion about new media and the consequences of our online world for medicine. 'The democratisation of education' is a phrase we've heard here on TopMedTalk in the past. How does direct access to information and experts in our field alter the state of play in the perioperative field? Desiree Chappell and Monty Mythen are presenting with...
Most people are familiar with ultrasound these days, next to the stethoscope and thanks largely to baby photographs, it's one of the most frequent public facing technologies in medicine. New developments in transesophageal echocardiography have brought about huge advancements in its use as a technology; not to mention the incredible images now available from three dimensional echocardiography. As ultrasound becomes more available and more portable this conversation gives you an idea of where, wh...
The need for patient education is a constant theme on TopMedTalk, many are keen to soak up information and become and active team player in their operation, how can we make the most of their patricipation? For example, do you let your patients go to "surgery school"? Presented by John Moore, Adult Critical Care Clinical Director and Consultant Critical Care & Anaesthesia at Manchester. The fuller version of the original talk is here: http://topmedtalk.libsyn.com/poetts-2018-pre-operative-ins...
