The team aspect of perioperative care is an essential element, this piece gets into the details as thought leaders and key opinion makers engage with the debate regarding how that actually works in practice. Moderated by Ross Kerridge, John Hunter Hospital, Newcastle, Australia, often cited as 'the father of Modern Perioperative Medicine'; the panel consists of, Charlie Corke, Associate Professor, Senior Intensive Care Specialist, Barwon Health, Kerin Fielding, Associate Professor, University of...
Nov 21, 2019•29 min
Quality initiatives are all about connecting people, this piece gives you real life experiences which show you how and why that can work alongside some of the challenges that come with it. Can an organisation reach a point where it does not need to improve? How can an "external stakeholder" pick things up? What is "psychological safety"? Can a pure focus on rules and tools become misleading? How can quality improvement address the culture of an institution and how important is that? Presented by...
Nov 20, 2019•21 min
"About a year ago our chief CRNA sent me a podcast from TopMedTalk about fluid management" - this podcast is a fascinating insight into how Enhanced Recovery continues to reach out across the world to the bedside of patients. How do you take your institution from where you're at now to where you need to be tomorrow? What are the essential ingredients? How do you work, through education, towards real patient engagement and empowerment? How do you manage a sensible quality improvement programme? P...
Nov 19, 2019•22 min•Season 2Ep. 40
The Cleveland Clinic London Hospital opens to inpatients in early 2021. Here you can hear what it is about, how it is going to work and how it intends to improve healthcare in the UK. In addition to his clinical commitments he was President of the Association for Cardiothoracic Anaesthesia and Critical Care, and is an editor of British Journal of Anaesthesia Education. Dr Fletcher has published more than 70 articles and has been invited to lecture around the world; he is recognised for his natio...
Nov 18, 2019•16 min
This piece focuses upon a new report from the World Health Organisation (WHO) looking at Arts and Health. The first of its kind, the report demonstrates the relationship between the arts, health and wellbeing. Are there ways you could incorporate the arts into your practice? Can it help with issues such as brain health, addiction and pain relief? A link to the report, "What is the evidence on the role of the arts in improving health and well-being? A scoping review (2019)" is here: http://www.eu...
Nov 17, 2019•14 min
Speaking with a legend in the world of anaesthesia; this piece allows us to explore some of the bigger issues and milestones in the profession. How has it evolved, particularly in relation to the simultanious evolution of perioperative practice? Where are we now and where do things look set to go in the future? This piece was originally streamed live on www.TopMedTalk.com under the title: "Educational Dinner Symposium: In God we trust, all others must bring data" as part of the EBPOM USA Dallas ...
Nov 16, 2019•30 min
This piece is a question and answer session regarding the care of elderly patients undergoing surgery. Discussion topics include; The RELIEF trial, e health tools, gathering and accessing data, whether it is better to over estimate risks and which risk calculator is most appropriate to use where you are? It features; Professor Jacqueline Close, Geriatrician, Prince Of Wales Hospital, Clinical Director, Falls, Balance and Injury Research Centre, David Storey, Head of Anaesthesia, Perioperative an...
Nov 15, 2019•20 min
This piece features a short informative presentation from our Editor in Chief Monty Mythen regarding Artificial Intelligence and the HPI Monitor developed by Edwards Life Sciences. It is followed by question and answer session faciliated by both our online presence, studio audience and invited guests. The "Perioperative Quality Initiative consensus statement on the physiology of arterial blood pressure control in perioperative medicine" piece mentioned is here: https://bjanaesthesia.org/article/...
Nov 14, 2019•56 min
This piece gives you a wider perspective on perioperative medicine over the years. How have institutions risen to this challenge and what can we learn from them? How do systems and cultures change over time? When implimenting change have you asked the following questions; Is it scientifically rational? Is it clinically reasonable? What are the risks? What are the resource implications? Are there any ethical considerations? What does the evidence advise? What are the emotional and political issue...
Nov 13, 2019•30 min
The results of the Enhanced Peri-Operative Care for High-risk patients (EPOCH) trial are a huge talking point in the perioperative sphere; this stand alone piece follows on from "EBPOM Conference Highlight | Lessons on EPOCH in the UK". To hear that click here: https://www.topmedtalk.com/ebpom-conference-highlight-1-21-lessons-on-epoch-in-the-uk/ Originally streamed live from the Charles Sammons Cancer Center, Dallas, during EBPOM-USA 2019 on www.topmedtalk.com If you'd like to attend an event l...
Nov 12, 2019•23 min•Season 2Ep. 39
Preoperative risk stratification; what is are the risks and controversies behind preoperative exercise testing and the six minute walk test? This piece looks at the evidence behind both and some practical guidance for informing clinical care. Does the six minute walk test predict complications? What is the true value for cardiopulminary exercise testing (CPET)? For more on the METS study go here: https://www.topmedtalk.com/the-measurement-of-exercise-tolerance-before-surgery-mets-trial/ Presente...
Nov 11, 2019•18 min
Preoperative optimisation and prehabilitation are key areas where your institution can increase value for patients. How do you negotiate the different pitfalls presented by the various core stakeholders? Smoking cessation, nutrition, exercise; all are proven to help produce better outcomes for a patient. How do we express this in such a way that we get buy-in from everyone concerned? When it comes to a deeper dive into preoperative optimisation, what's in it for the hospital, the practitioner an...
Nov 10, 2019•45 min
Can artificial intelligence drive new changes in care and the value of big data? We're already comfortable with using tools that help us to do our job better, what are the opportunities and pitfalls related to this new technology? Are we ready yet for big data? The changes it may cause are staggering but equally; nuance is the friend of truth, do we have enough 'data literacy' to handle it all? Also - can the way you pronounce 'scone' give you an idea of your life expectancy? How do we balance p...
Nov 09, 2019•18 min
How do we convince patients that prehabilitation is safe? What forms of certification are available for the accreditation of a balanced multidisciplinary team? How do you monitor home based patients? How do we tap into the wider 'exercise industry' on behalf of perioperative prehabilitation? Panel discussion, featuring; Daniel Santa Mina, Assistant Professor at University of Toronto & Scientist in ELLICSR at the Princess Margaret Cancer Centre; Stefan van Rooijen, surgical resident in Maxima...
Nov 08, 2019•12 min
Why has 'prehabilitation' suddenly picked up pace in terms of both practice and interest? This piece takes a serious look at the widening interest in an idea familiar to many sportsmen. Learn how the marginal gains we get through the application of science to optimise the moment of surgery as a real opportunity to apply everything we know. Also; what are ketones and how can they be used to promote health? Presented By Desire Chappell and Monty Mythen with their guests Gerard Danjoux, consultant ...
Nov 07, 2019•12 min
"Colloid vs Crystalloid - Goal Directed Therapy" - originally streamed live from The Institute of Engineering and Technology (IET) in London during EBPOM 2018 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 If you have any comments or questions you'd like to send to the team email: contact@topmedtalk.com Presented by Monty Mythen, Smiths Medical Professor of Anaesthesia an...
Nov 06, 2019•10 min
This standalone piece allows us to explore further some of the issues raised in this podcast "TopMedTalks to... | Rick Dutton". If you missed it follow this link here: https://www.topmedtalk.com/topmedtalks-to-rick-dutton/ Originally streamed live on www.TopMedTalk.com under the title; "Educational Dinner Symposium: Q&A Session" as part of our coverage of the EBPOM USA Dallas Master's Course. Presented by Monty Mythen and Desiree Chappell with Rick Dutton, Chief Quality Officer at United Sta...
Nov 05, 2019•21 min•Season 2Ep. 38
How can a multidisciplinary group collectively define and maintain what they do while maintaining a patient centred approach? How focused can prehabilitation become? Should personal trainers be more widely involved in perioperative medicine? What is the correct terminology when it comes to expertise in the various areas of your team? Should practitioners be expected to apply lifestyle behaviour changes which other members of our team advocate to patients? Why is a collaborative approach so impor...
Nov 04, 2019•25 min
The Grenfell fire was a national tragedy for Great Britain. In this piece one of the founders of TopMedTalk, Martin Howe, explains the story behind the fire and what is now being done to make sure nothing like it is allowed to occur again. This is the complete presentation. Presented by Martin Howe of Howe and Co Solicitors at The 21st Current Controversies in Anaesthesia & Peri-Operative Medicine and SIAA Autumn Congress, Dingle, Ireland, 2019. Please note: This podcast contains information...
Nov 03, 2019•52 min
Why do anaesthetists suffer from mental health problems, what help is there available for them? Learn here about 'The Practitioner Health Programme' and hear why anaesthetists are uniquely placed to deal with the inevitable pressures related to healthcare and how they can become leaders, helping to destigmatise and tackle mental health issues. Presented by Desiree Chappell and Monty Mythen with their guest Dr Clare Gerada, Medical Director, Physician Health, Practitioner Health Service....
Nov 02, 2019•6 min
The Centre for Perioperative Care (CPOC) is a cross-specialty centre dedicated to the promotion, advancement and development of perioperative care. Led by the Royal College of Anaesthetists to facilitate cross-organisational working on perioperative care for the benefit of patients. A partnership between patients and the public, other professional stakeholders including Medical Royal Colleges, NHS England and the equivalent bodies responsible for healthcare in the other UK devolved nations. The ...
Nov 01, 2019•14 min
The Grenfell fire was a national tragedy for Great Britain. In this piece one of the founders of TopMedTalk, Martin Howe, explains the story behind the fire and what is now being done to make sure nothing like it is allowed to occur again. This is part 3 of 3. Presented by Martin Howe of Howe and Co Solicitors at The 21st Current Controversies in Anaesthesia & Peri-Operative Medicine and SIAA Autumn Congress, Dingle, Ireland, 2019. Please note: This podcast contains information younger liste...
Oct 31, 2019•19 min
The Grenfell fire was a national tragedy for Great Britain. In this piece one of the founders of TopMedTalk, Martin Howe, explains the story behind the fire and what is now being done to make sure nothing like it is allowed to occur again. This is part 2 of 3. Presented by Martin Howe of Howe and Co Solicitors at The 21st Current Controversies in Anaesthesia & Peri-Operative Medicine and SIAA Autumn Congress, Dingle, Ireland, 2019. Please note: This podcast contains information younger liste...
Oct 30, 2019•19 min
The Grenfell fire was a national tragedy for Great Britain in 2017. In this piece one of the founders of TopMedTalk, Martin Howe, explains the story behind the fire and what is now being done to make sure nothing like it is allowed to occur again. This link takes you to an article on the BBC's website about the fire: https://www.bbc.co.uk/news/uk-england-london-40272168 Presented by Martin Howe of Howe and Co Solicitors at The 21st Current Controversies in Anaesthesia & Peri-Operative Medici...
Oct 29, 2019•18 min
The historical focus in prehabilitation has been on exercise, how can the insights of psychology and behaviour change techniques be applied to the field? Should psychosocial outcomes and behaviour change be factored into your practice? There's consistent evidence that anxiety around the time of diagnosis is predictive of post operative pain; depression increases the risk of chronic pain; psychological factors also impact on wound healing and functional recovery. Meanwhile low confidence and depr...
Oct 28, 2019•17 min
What is the scope of the problem? What about lesions and risks? What are the general principles of management? What should we expect when it comes to outcomes? Presented by Fiona Walker, Cardiologist, trained in grown-up congenital heart disease (GUCH) and maternal cardiology in Toronto and at UCLH. She is the Service lead for GUCH (2005 – present) and head of the maternal cardiology programme at University College London Hospitals (UCLH).
Oct 27, 2019•21 min
Here we feature a central figure in the ongoing Great World Fluid debate. He was sadly unable to attend EBPOM 2018 so we wanted to get a very important contribution from him: What are the big takeaways from some of the larger trials such as Saline versus Albumin Fluid Evaluation (SAFE)? What about the long term implications of Crystalloid versus Hydroxyethyl Starch Trial (CHEST)? What new trials should be on the horizon - given the information we now have? Monty Mythen speaks with his guest Prof...
Oct 26, 2019•38 min
What are the opportunities presented to a perioperative practitioner when political devolution becomes a reality? What can we learn from the experiences of a team leading the introduction of ERAS+ and prehabilitation across Greater Manchester with a 'Spread and Scale innovation grant' from the Health Foundation? How do you demonstrate benefits which patients and fee payers can understand? How do you go about leading a prehab transformation program, which aims to provide prehab for more than 2000...
Oct 25, 2019•22 min
Here we explore the detail behind Brian Woods’ talk "Leading a large, multi-state group to achieve excellence", which was streamed live on TopMedTalk (link at the foot of these notes) from the EBPOM USA Dallas Master's Course 2019. Enhanced Recovery is about pathways and then compliance with those pathways; there is usually an approximate compliance rate of 60%, how can that be increased? What are the most efficient dataset and reporting protocols that an instituition can use? Can personal prima...
Oct 24, 2019•16 min
Surgery may represent a "teachable moment" should we try to exploit that for only short term, prehabilitation purposes? What is the difference between being motivated and being confident when it comes to success in these areas? How do patients feel about changing multiple behaviours at the same time? Presented by Suzanne Mcdonald, Research Associate at The University of Queensland (Australia), Visiting Researcher at Newcastle University (UK) and registered Chartered Health Psychologist....
Oct 23, 2019•12 min
