For part one of this series go here: https://topmedtalk.libsyn.com/part-1-know-aki-and-say-no-to-acute-kidney-injury-for-patients-perioperative-renal-injury This piece is a series of recommendations from the Acute Disease Quality Initiative (ADQI-24) and the Perioperative Quality Initiative (POQI-7). The article mentioned in this piece is here: https://www.nature.com/articles/s41581-021-00418-2 Originally part of the Evidence Based Perioperative Medicine (EBPOM) World Congress this presentation ...
Jan 24, 2022•16 min
"We have to decide; if it's safe, how do we do it, and how do we do it right?" This piece provides a much needed overview of anesthesia in the USA, clinical innovation, best practice and enhanced recovery. How do we deliver on the value proposition safely and efficiently? What is the responsibility of practitioners to patients when measuring the impact of new products, medications and equipment? How do we mitigate cost, need and quality? Supported in part through an unrestricted educational gran...
Jan 17, 2022•24 min
This deep dive into intraoperative hypotension provides an essential update on this area. Does the cause of hypotension reveal more about the specifics of the condition and therefore treatments? How can we understand what it is that we are doing well when it comes to prevention? Presented by Desiree Chappell and Monty Mythen with their guests Thomas Scheeran, Professor of Anaesthesiology, University Medical Centre, Groningen, Netherlands and Ashish Khan, Associate Professor, Department of Anesth...
Jan 11, 2022•33 min
This piece has been supported by the "Know AKI campaign" – a bioMérieux global campaign to raise awareness about acute kidney injury. It features a wide selection of clips on the subject of acute kidney injury, restrictive versus liberal fluid therapy and the trials we've seen in recent years which have revitalized debate and learning. The clips used come from the following podcasts: Michelle Chew's clip comes from here: EUROANAES2019 | Michelle Chew http://www.topmedtalk.com/euroanaes2019-miche...
Jan 10, 2022•53 min
"Our top priority must be safety" A real stand out piece from this year's incredible Evidence Based Perioperative Medicine (EBPOM) Dingle/Chicago conference. This piece dives into the realities of sedation from the point of view of a patient focused practitioner. For more conversations along these lines make sure you listen to our coverage of the annual general meeting of the American Society of Anesthesiologists (ASA) on October the 9th. TopMedTalk will be live streaming from the event, checkou...
Jan 03, 2022•25 min
"There are so many, many studies on prophylaxis, but very few on treatment" Post operative nausea and vomiting, secondary nausea, how can we put the danger of these unfortunate moments behind us in a modern practice? This piece focuses upon nausea and treatment in particular as part of an Enhanced Recovery practice. Fourth Consensus Guidelines for the Management of Postoperative Nausea and Vomiting: https://journals.lww.com/anesthesia-analgesia/fulltext/2020/08000/fourth_consensus_guidelines_for...
Dec 27, 2021•22 min
What are the known challenges for patients and practitioners who face anemia preoperatively? How do you set up and run an anemia clinic? Is there any need for this to be considered an essential part of the perioperative process? This piece follows on from a presentation regarding how to set up and run an anemia clinic, follow this link here to hear that presentation: https://topmedtalk.libsyn.com/how-to-set-up-and-run-a-perioperative-anemia-clinic-ebpom-chicago For more on this topic listen to o...
Dec 20, 2021•47 min
This piece continues the discussion regarding blood pressure regulation, moving from the brain to the kidney, heart and lungs via a number of distinguished experts in the field. How do we safely cut through the opinions on these areas and focus instead on relevant data? How do these organs interact in terms of auto regulation? How closely do our clinical tools allow us to infer accurately what a particular patient's needs are? This piece is part two of two, the first part is advised listening an...
Dec 17, 2021•48 min
The focus of this conversation is auto regulation in the brain, it leads into a longer conversation - part 2 - where the subject is discussed more broadly. What tools do we now have and how are they changing the way we see and understand this area? Are there hard and fast rules when it comes to blood pressure or is there still significant debate? Although this works as a stand alone listen it is in reference to the talk "Redefining Hypotension based on Real-time Cerebral Autoregulation Monitorin...
Dec 17, 2021•19 min
"Choosing Wisely is an initiative of the American Board of Internal Medicine started about 10 years ago to advertise important aspects of medicine ... their number one recommendation was to not proceed with elective surgery in patients with properly diagnosed and correctable anemia, until the anemia has been appropriately treated." Taken from the hugely popular EBPOM Chicago meeting this piece explains how and why you need an anemia clinic as part of your perioperative practice. For more of this...
Dec 13, 2021•32 min
Near infrared spectroscopy (NIRS) ... 'a variation of pulse oximetry; it transmits red and infrared light into tissue' measures information from arterial venous and capillary blood simultaneously to deduce tissue saturation; an aggregate estimate of arteriovenous capillary blood and whatever tissue you're shining the light into. 'So typically, we're using it in on the brain at least in the cardiac and vascular space, but people also in other areas like the surgical ICU, can use it to measure mus...
Dec 06, 2021•40 min
Originally recorded during Evidence Based Perioperative Medicine (EBPOM)'s London conference this piece focuses upon pulmonary complications in the perioperative period. What do the data say, what are the key trials? Presented by Denny Levett, Professor in Perioperative Medicine and Critical Care at Southampton University Hospital NHS Foundation trust and Honorary Associate Professor at the University of Southampton with Mark Hamilton, Consultant and Honorary Senior Lecturer in Anaesthesia &...
Nov 29, 2021•54 min
One of the standout moments of Evidence Based Perioperative Medicine (EBPOM) 2021 this piece is a bonus podcast for the holiday season which looks in detail at oxygen from a perioperative medicine perspective, amongst other things this talk throws up some troubling and challenging observations about pulse oximetry. The piece is introduced by Mike Grocott, Professor of Anaesthesia and critical care at the University of Southampton. Presented by David Story, Professor and Foundation Chair of Anaes...
Nov 25, 2021•37 min
"We have seen a very significant transition (in respiratory care) through COVID" What have we learned about how to treat lung and breathing issues over the last few years? Away from alarming headlines and looking instead at data - is there a consensus on how COVID-19 should be treated? How has ventilation improved and developed? This podcast focuses on respiratory intervention and was originally broadcast as part of the hugely successful EBPOM Dingle/Chicago 2021 conference. For more details on ...
Nov 22, 2021•28 min
Amisulpride is an antiemetic medication used at lower doses intravenously to prevent and treat postoperative nausea and vomiting; what does it look like in practice? Can it work as a 'rescue therapy'? What does the data tell us? Could a treatment for post-operative nausea and vomiting be a way to really enhance value based care and enhanced recovery? Supported in part through an unrestricted educational grant from Acacia Pharma, Inc. Presented by Desiree Chappell and Monty Mythen with their gues...
Nov 15, 2021•31 min
"Precision anesthesia [...] where we can give patients the anesthetic and the doses that they require on a patient specific basis" This piece looks at nociception, the neural processes of encoding and processing "noxious" stimuli. By monitoring this anesthetic practitioners can deploy a level of precision not previously possible. Regular listeners may wish to refer back to previous podcasts on this subject: EBPOM LIVE from London | Pain monitoring - with Frank Overdyk, Professor of Anaesthesiolo...
Nov 08, 2021•28 min
The Hypotension Prediction Index is rapidly gaining a well deserved place in the hands of modern perioperative practitioners. Here we look at the history of this tool, why it is needed so badly and how it has developed. Many of the conversations referenced in this piece are worthy of further attention. The clips used are taken from the following TopMedTalk programmes: Live from Boston ASA 2017 – The Elephant In The Room – intraoperative hypotension: https://www.topmedtalk.com/live-from-boston-as...
Nov 01, 2021•41 min
With a global focus this piece moves into obstetric anesthesia, perioperative medicine and anemia management. Covering iron deficiency, hemoglobin, post-partum management and how to improve outcomes for all. For more on this go now to www.ebpom.org where you will find the pre-recorded video contributions made by our speakers in anticipation of this discussion. Presented by Sam Bampoe, Tripom Co-Founder, Consultant in Anaesthesia and Perioperative Medicine at University College London NHS Foundat...
Oct 25, 2021•48 min
"I think it really comes down to teamwork" How rapidly should you perform a tracheostomy? When do you "start the conversation" about the procedure? What about when it comes to patients with COVID19? Where does a data driven approach take us to? This essential piece is provided to TopMedTalk listeners as a sneak preview of EBPOM Dingle and Chicago; recorded in advance of the meeting and shared with you as a preview of this year's Evidence Based Perioperative Medicine's global conference offering....
Oct 18, 2021•19 min
Welcome to TopMedTalk's exclusive - as live - coverage of The American Society of Anesthesiologists (ASA) annual general meeting; join Desiree Chappell, TopMedTalk's lead presenter, Monty Mythen TopMedTalk's Editor in Chief and Sol Aronson, tenured Professor, Duke University speak with their guest, Mary Dale Peterson, M.D., MHA, FACHE, FASA, ASA Immediate Past President.
Oct 13, 2021•27 min
Welcome to TopMedTalk's exclusive - as live - coverage of The American Society of Anesthesiologists (ASA) annual general meeting; join Desiree Chappell, TopMedTalk's lead presenter, Monty Mythen TopMedTalk's Editor in Chief and Sol Aronson, tenured Professor, Duke University speak with their guest, TJ Gan, MD, MHS, FRCA, MBA, Professor and Chairman of the Deptartment of anesthesiology at Stony Brook Medicine in Stony Brook, New York. For more on this topic check out our exclusive min-series here...
Oct 13, 2021•13 min
Welcome to TopMedTalk's exclusive - as live - coverage of The American Society of Anesthesiologists (ASA) annual general meeting; join Desiree Chappell, TopMedTalk's lead presenter, Monty Mythen TopMedTalk's Editor in Chief and Sol Aronson, tenured Professor, Duke University speak with their guest, Alex Lewis, Founder of The Alex Lewis Trust. More here: https://www.alex-lewis.co.uk/innovation-technology/koalaa/...
Oct 13, 2021•26 min
Welcome to TopMedTalk's exclusive - as live - coverage of The American Society of Anesthesiologists (ASA) annual general meeting; join Desiree Chappell, TopMedTalk's lead presenter, Monty Mythen TopMedTalk's Editor in Chief and Sol Aronson, tenured Professor, Duke University speak with their guest, Richard Dutton, M.D., M.B.A., Chief Quality Officer US Anesthesia Partners.
Oct 13, 2021•35 min
Welcome to TopMedTalk's exclusive - as live - coverage of The American Society of Anesthesiologists (ASA) annual general meeting; join Desiree Chappell, TopMedTalk's lead presenter and Sol Aronson, tenured Professor, Duke University speak with their guests; Beverly Philip, M.D., FACA, FASA, President of The American Society of Anesthesiologists and Randall Clark, M.D., FASA, President-Elect of the American Society of Anesthesiologists.
Oct 13, 2021•30 min
Welcome to TopMedTalk's exclusive - as live - coverage of The American Society of Anesthesiologists (ASA) annual general meeting; join Desiree Chappell, TopMedTalk's lead presenter, Monty Mythen TopMedTalk's Editor in Chief and Sol Aronson, tenured Professor, Duke University speak with their guest, Stephanie Byerly, M.D. Chair of the ASA Committee on Women Anesthesiologists, Professor of Anesthesiology and Pain Management, UT Southwestern, Dallas, Cheif, Obstetrical Anesthesiology, Clements Univ...
Oct 13, 2021•29 min
Welcome to TopMedTalk's exclusive - as live - coverage of The American Society of Anesthesiologists (ASA) annual general meeting; join Desiree Chappell, TopMedTalk's lead presenter, Sol Aronson, tenured Professor, Duke University speak with their guest, Evan Kharasch, Chair of the ASA Committee on excellence in research, Professor and Vice Chair for Innovation in the Department of Anesthesiology at Duke University, and Director of Academic Entrepreneurship in Duke University School of Medicine....
Oct 13, 2021•29 min
Welcome to TopMedTalk's exclusive - as live - coverage of The American Society of Anesthesiologists (ASA) annual general meeting; join Desiree Chappell, TopMedTalk's lead presenter, Sol Aronson, tenured Professor, Duke University speak with their guest, Lee Fleisher, Emeritus Professor of Anesthesiology and Critical Care, University of Pennsylvania.
Oct 13, 2021•29 min
Welcome to TopMedTalk's exclusive - as live - coverage of The American Society of Anesthesiologists (ASA) annual general meeting; join Desiree Chappell, TopMedTalk's lead presenter, Monty Mythen TopMedTalk's Editor in Chief and Sol Aronson, tenured Professor, Duke University speak with their guest, Adam Striker, MD FASA. Chair, ASA Committee on Communications, Associate Professor, Anesthesiology, University of Cincinnati and University of Kentucky.
Oct 13, 2021•23 min
Welcome to TopMedTalk's exclusive - as live - coverage of The American Society of Anesthesiologists (ASA) annual general meeting; join Desiree Chappell, TopMedTalk's lead presenter, Monty Mythen TopMedTalk's Editor in Chief and Sol Aronson, tenured Professor, Duke University speak with their guest Chris Steel, MD, In Patient CMO, White River Health System, Batesville Arkansas. More here: https://www.asahq.org/psh
Oct 13, 2021•30 min
Welcome to TopMedTalk's exclusive - as live - coverage of The American Society of Anesthesiologists (ASA) annual general meeting; join Desiree Chappell, TopMedTalk's lead presenter, Monty Mythen TopMedTalk's Editor in Chief and Sol Aronson, tenured Professor, Duke University speak with their guest Bonnie Milas, Cardiac anesthesiologist, University of Pennsylvania. More info here: https://www.asahq.org/advocating-for-you/reviveme...
Oct 13, 2021•28 min