Originally broadcast live from Anesthesiology 2019, this piece is a chance to hear from a couple of Temple University residents who presented on two different cases: The first being a critical care case in the ICU involving acute respiratory distress; the second involving a case of surgery for a pheochromocytoma in a patient with neurofibromatosis type 1 and severe pulmonary hypertension and right ventricular failure. What challenges do the residents describe in these cases and how were they ove...
Jul 16, 2020•12 min
After a quick chat about the immediate aftermath of the incredibly successful EBPOM LIVE from London and its accompanying online Perioperative Care Festival, The POCAPALOOZA , this piece is a conversation with friends of ours at Medtronic. Now is an interesting and resource scarce time for everyone in medicine; Medtronic made huge waves here with their support of the Ventilator Training App, today we ask them about where it's at and how things are changing in the world of medical technology. How...
Jul 15, 2020•32 min
This panel discussion is an honest and challenging look at blood pressure management. Questions include but are not limited to: How should practitioners maintain blood pressure in patients and where is the threshold? How much precaution is inspired by eminence rather than actual evidence? What is the best and safest way to attenuate sympathetic responses intraoperatively? If harmful hypotension occurs between induction and incision should we refuse to induce anaesthesia until the surgeon is scru...
Jul 14, 2020•41 min
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...
Jul 13, 2020•25 min
This piece focuses on the work of our guest and her impact upon the crucial area of gender and racial diversity in the US Anesthesia and Critical Care Workforce. How can we advocate for diversity within this field? What do we make of the Athena SWAN (Scientific Women's Academic Network) charter? Can social media help to raise awareness and build communities that can tackle these issues? Also in this piece we discuss Implementation Science, the study of methods to promote the adoption and integra...
Jul 12, 2020•12 min
"Surgery and anaesthesia; you very much recognise right away that that is considered a luxury in many place of the world" Do you work in a low-resource setting or support partners and organizations that do? The Lifebox pulse oximeter is specifically designed for high-use, low-resource environments. Hear about how Lifebox came into existence and discover how you can help. The World Health Organisation's Surgical Safety Checklist is here: https://www.who.int/patientsafety/safesurgery/checklist/en/...
Jul 11, 2020•30 min
This piece is a much needed contribution to a conversation about how we should be caring for the transgender patient within the scope of perioperative care. Our guest's excellent article, “Anesthesia Inclusive Practices Amidst Adversity: Caring for the Transgender Patient”, is here: https://cms.aana.com/docs/default-source/pr-aana-com-web-documents-(all)/anesthesia-inclusive-practices-amidst-adversity-caring-for-the-transgender-patient-may-2019.pdf?sfvrsn=d810a34d_4 The NHS's guidelines are here...
Jul 10, 2020•23 min
When it comes to blood pressure, hypotension is associated with poor outcomes for patients, how do we react to this? How do we manage and avoid hypotension where possible? How has technology caught up with this challenge? Could automated closed loop systems be helpful here? The bottom line is simple; "If we measure blood pressure properly, we can predict it". Presented by Dr Simon Davies, Consultant Anaesthetist at York Teaching Hospital NHS Foundation Trust.
Jul 09, 2020•22 min
This piece outlines some of the topics related to the third Perioperative Quality Initiative (POQI). What is 'perioperative blood pressure'? What have been the major developments in this area? Also, should we be looking at increasing monitoring of patients, particularly regarding their blood pressure, in hospital? The Perioperative Quality Initiative (POQI) is discussed here: https://www.topmedtalk.com/anesthesia-and-analgesia-go-big-on-poqi/ The POQI website is here: http://poqi.org/ The INPRES...
Jul 08, 2020•19 min
This piece argues that troponin screening might be overused, "it's not all about the heart". Myocardial injury after noncardiac surgery (MINS) is seen as a relatively common issue driving post-operative harm. This piece gets into the detail and asks some important questions as to how focused practitioners should be upon troponin screening. It's part 2 of 3 from The EBPOM 2019 TopMedTalk session which debated the issue. Presented by Mike Grocott, Professor of Anaesthesia and critical care at the ...
Jul 07, 2020•13 min
"I did a study back in 2002 where I was able to count a grand total of forty patients above the age of eighty in our (Intensive Care Unit) ICU and our (High Dependency Unit) HDU, nowadays I'd count close enough to a hundred and sixty" How do we refine our diagnostic tools? How can teaching in this area help to save lives? Should you consider a 'geriatric intensive care unit'? Is this an area where true perioperative practice and surgery is a guarantee we can immediately see improvement in an ins...
Jul 06, 2020•28 min
"Perioperative medicine is an opportunity; it's multidisciplinary and its developing around a culture of trust between anaesthetists, surgeons and perioperative physicians" The future of perioperative medicine embraces the full scope of medical advancement and is therefore difficult to predict, as a result truly informed shared decision making is both crucial and more complex. Variability of practice is a key factor; usually caused by the overuse or underuse of a facility and its resources. The ...
Jul 05, 2020•32 min
This piece argues that troponin screening is useful, if used appropriately. Is it the case that this test has been 'over sold' and as a result has provoked unhelpful pushback from practitioners? It's part 1 of 3 from The EBPOM 2019 TopMedTalk session which debated the issue. Presented by Duminda Wijeysundera, Professor in the Department of Anaesthesia and the Institute of Health Policy Management and Evaluation at the University of Toronto, and a Staff Anesthesiologist at St Michael’s Hospital....
Jul 04, 2020•16 min
This is an Edwards Lifesciences Sponsored Lecture which was originally streamed live on TopMedTalk from the hugely successful EBPOM USA 2019 in Dallas. In this piece we hear about the ongoing need for institutions and healthcare professionals to recognise the damaging consequences of intraoperative hypotension. Evidence has been mounting here on TopMedTalk over the last couple of years; there's no doubt hypotension is an area of concern for many of our experts and contributors. Listen to more on...
Jul 03, 2020•22 min
"Monty - we've done it!" This piece wraps up one of our more ambitious experiments, the POCAPALOOZA. 24 hours around the world, combining powerful practice changing information and inspiration alongside entertainment from artists and supporters. We hope you have enjoyed this year's conference, look forward to hearing some of the talks in full and entirely for free over the next few months here on TopMedTalk. If you are one of the thousands of our listeners who signed up early for EBPOM Live From...
Jul 03, 2020•3 min
This piece is a fascinating in-depth conversation moving through various medical perspectives on perioperative medicine from Australia and New Zealand. A real highlight of the festival. How has perioperative medicine evolved over the years around the world? What's the status of Perioperative Care as a specialty? How does one specialise in this area, in terms of education? Discussing the development of the International Board:- "We decided perioperative education should not only be available for ...
Jul 02, 2020•54 min
This entertaining piece is designed to be a fun listen which also manages to convey a sense of where Perioperative Medicine is as a discipline. It also contains a large number of exciting and exclusive announcements, make sure you listen and enjoy. Presented here "as live" by Desiree Chappell with Monty Mythen and Sol Aronson, tenured Professor at Duke University with Jeanna D. Blitz, Associate Professor of Anesthesiology, Medical Director, Duke PASS Clinic Director, Perioperative Medicine Fello...
Jul 02, 2020•49 min
The two co-vice presidents of the international board of perioperative medicine join Desiree's POCAPALOOZA. This conversation is global in its context with perceptive reflections upon the US healthcare market. "Towards high‐quality peri‐operative care: a global perspective" - the paper we begin by discussing - is here: https://onlinelibrary.wiley.com/doi/full/10.1111/anae.14921 As anesthesiologists "we are part of teams" and "anesthesia and intensive care have developed a much higher profile aft...
Jul 02, 2020•23 min
This episode of the Pocapalooza* is provided here for free in the hope you can help us raise money for a cause that will immediately appeal to perioperative practitioners, the African Perioperative Research Group (APORG): https://www.justgiving.com/crowdfunding/protea-live?utm_id=1&utm_term=ZKW35J94X This piece traces the story of perioperative medicine, through the lens of the contributors and Evidence Based Perioperative Medicine (EBPOM). Hear how pioneers in our field used evidence as the...
Jul 02, 2020•29 min
This piece is a short conversation with two guests we spoke with during the hugely successful Pocapalooza of EBPOM 2020, Live from London. Presented by Desiree Chappell with her guests Bruce Biccard, consultant anaesthetist at the University of Kwazulu-Natal, Director, Perioperative Research Unit, Department of Anaesthetics, Nelson R Mandela School of Medicine and Salome Maswime, Obstetrician and Gynaecologist and Professor of Global Surgery at the University of Cape Town. If you have enjoyed co...
Jul 02, 2020•6 min
The Pocapalooza begins! "Poc" standing for "perioperative care" and "palooza" meaning festival. Join us as we travel around the world promoting life changing healthcare. Go to ebpom.org for entertainment throughout the day as we celebrate the success of our first fully virtual conference, EBPOM 2020, Live from London! Regular listeners will be delighted to discover this piece is an update on a project which has been close to our hearts here on TopMedTalk; The African Surgical Outcomes Study (ASO...
Jul 02, 2020•29 min
This piece covers the fascinating upside to the recent global pandemic we have been facing in medicine; increased application of innovation and better time efficiency. "We have learned that we can move very quickly" How have innovations in times of crisis meant that technology has been able to be used which has 'upscaled' remote patient monitoring? How has the value of this innovation become clear during this recent resource stretched period? "People reached out for innovation, why would we go b...
Jul 01, 2020•29 min
This piece focuses on procedural sedation and questions regarding, who delivers it, is there a standard for monitoring what is the correct approach to capnography? Further discussion also includes questions regarding sedation; is there room for compromise in the debate surrounding propofol? If so where does responsibility lie for that? Is it wrong to sell this as a "general anaesthetic"? Is there room for sedation teams who can find a compromise position? Presented by Desiree Chappell with Monty...
Jul 01, 2020•53 min
"Everyone is aware of the opioid crisis outside of hospital, tragic opioid crisis, but we've had one on the wards for a long time". This piece focuses on opioid toxicity, depth of anaesthesia, patient monitoring and pain management. "We've all had situations where we give too much or too little"; either can be serious concerns, "it's essential we get the analgesia right". Presented by Desiree Chappell and Monty Mythen with Frank Overdyk, Professor of Anaesthesiology, Charleston, South Carolina....
Jul 01, 2020•23 min
Go now to EBPOM.org This piece is a guide to just some of today's main events. Please go to EBPOM.org now to register for an incredible 3 days of life changing and life saving information. If you don't sign up in time for today don't forget, after the huge success of EBPOM Live from London our next big event is EBPOM - Chicago!
Jul 01, 2020•2 min
The welcome return of Desiree's Roundtable is just one of the treats made possible by the groundbreaking virtual conference, EBPOM Live From London, which is taking place now. If you missed out on tickets stay with us here on TopMedTalk where you will soon be hearing selected highlights through the rest of the year. Also, make sure you are one of the first to hear exclusive content from EBPOM Chicago now by going to EBPOM.org and registering for FREE. This exclusive offer is for a limited time o...
Jun 30, 2020•48 min
Go now to EBPOM.org This piece is a guide to just some of today's main events. Please go to EBPOM.org now to register for an incredible 3 days of life changing and life saving information. If you don't sign up in time for today don't forget, after the huge success of EBPOM Live from London our next big event is EBPOM - Chicago!
Jun 30, 2020•2 min
"The predominant emotion was fear..."; this piece is essential listening for every TopMedTalk listener who really cares about the experience of their patients. Hear what it was like to participate in the pioneering, tailored exercise training programme, The Encourage Trial. Also, find out about "the Buddy Scheme" and how becoming a member of a local support group: SPICOS (Support for People Impacted by Cancer of the Oesophagus and Stomach) led to it. Could a 'Buddy', volunteers who have been in ...
Jun 29, 2020•18 min
This talk is a powerful look at a new world where we commit your institution and practice to achieving an end goal of "zero preventable deaths". The Patient Safety Movement Foundation (PSMF) has generated an enormous amount of global news media coverage as it promotes that aim; celebrities, statesmen, politicians and industry leaders are all getting behind an ambition which, after hearing this talk, you are likely to want to see come to pass as much as they do. The clips used in this presentatio...
Jun 28, 2020•1 min
This piece is a reminder to all attendees at EBPOM Live From London that you should check the website now for details and content: www.ebpom.org If you are looking for your usual fix of perioperative medical education but didn't manage to get tickets in time here are three excellent pieces from the archives: The Brain Health Initiative: https://www.topmedtalk.com/the-topmedtalk-top-ten-the-brain-health-initiative/ The National Emergency Laparotomy Unit and Shared Decision Making: https://www.top...
Jun 27, 2020•53 sec
