TopMedTalk

TopMedTalks to Eduardo Robertis and Patricio Gonzalez-Pizarro | TMT at EA24 Nov 04, 2024

TopMedTalk at Euroanesthesia 2024 in Munich; organised by the European Society of Anesthesiology and Intensive Care (ESAIC).

This episode highlights a conversation about the organisation’s achievements and challenges in the wake of COVID-19, leading to a discussion about the crucial nature of sustainability and professional well-being. We underscore the importance of adapting to climate change and mitigating the environmental impact of medical practices with ESAIC's “Glasgow Declaration of Sustainability” and concrete recommendations for daily practices.

Presented by Desiree Chappell with her guests Eduardo Robertis, immediate past president of the European Society of Anesthesiology and Intensive Care (ESAIC), and Patricio Gonzalez-Pizarro Chair of ESAIC Sustainability Committee.

Enhanced Recovery in practice | TMT Down Under Nov 01, 2024

The Australian ERAS+ Conference and 2024 World Congress of Prehabilitation and Perioperative Medicine is an essential event for practitioners around the world. TopMedTalk were there and we will be bringing you a series of interviews with some of the key players and speakers.

This piece is presented by Kate Leslie and Mike Grocott with their guest, David Watters, Alfred Deakin Professor of Surgery at Deakin University in Geelong, Victoria, Australia, based at the University Hospital Geelong, he is also Director of Surgery at Safer Care Victoria.

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TopMedTalk has ramped up its release schedule recently in response to growing demand for our recent conference coverage. Expect to see releases more frequently over the next few months.

Ensure you are subscribed to us, so you don't miss out, and while you're here why not check out some of our new recent releases:

ASA Presidents pass the baton | #ANES24

https://topmedtalk.libsyn.com/asa-presidents-pass-the-baton-anes24

The evolution of the Impella device in anesthesia, critical care, and perioperative medicine | #ANES24

https://topmedtalk.libsyn.com/the-evolution-of-the-impella-device-in-anesthesia-critical-care-and-perioperative-medicine-anes24

The evolution of the Impella device in anesthesia, critical care, and perioperative medicine | #ANES24 Oct 28, 2024

The American Society of Anesthesiologists (ASA)'s annual general meeting; Anesthesiology 2024. Exclusive cutting edge conversations recorded at the conference with some of the key speakers, guests and delegates.

The discussion highlights the growing use of the Impella device in anesthesia and critical care, particularly for high-risk patients with severe heart failure or cardiogenic shock.

Presented by Desiree Chappell, Monty Mythen and Mike Grocott with their guest Asad Usman, Anesthesiologist, critical care specialist and physician with Penn Medicine, Pennsylvania.

Advancements in cardiac support devices | #ANES24 Oct 28, 2024

Join TopMedTalk at Anesthesiology 2024 in Philadelphia, we’re bringing you exclusive conversations with the experts and thought leaders recorded live at the conference.

The conversation discusses advancements in cardiac support devices; is it time for a shift from relying on potentially harmful medications, like inotropes and vasopressors, to more targeted mechanical support? Where does a more data based approach take us?

Mike Grocott and Desiree Chappell sit down with their guests, Andy Shaw, Chairman, Department of Intensive Care and Resuscitation at The Cleveland Clinic, Cleveland, Ohio and Courtney Maxey-Jones, Cardiovascular Services Consultant, CNY Medical Services, PLLC, Director of the CCU and Cardiogenic Shock program at SUNY Upstate University Hospital in Syracuse, NY.

ASA Presidents pass the baton | #ANES24 Oct 24, 2024

TopMedTalk brings you exclusive, cutting-edge conversations from Anesthesiology 2024, the American Society of Anesthesiologists (ASA) annual general meeting; as is traditional, we always speak with the outgoing and incoming Presidents of the ASA.

This podcast is taken from the final day of our coverage. Make sure you are subscribed to TopMedTalk so you can hear all of our coverage -as we release it- over the next few months.

Presented by Desiree Chappell and Mike Grocott with their guests, Donald Arnold, MD, FACHE, FASA, Incoming ASA President president of Western Anesthesiology Associates, Inc., chair of anesthesiology at Mercy Hospital St. Louis and Ronald Harter, MD, FASA, Outgoing ASA President, Jay J. Jacoby professor and chair of the Department of Anesthesiology at The Ohio State University College of Medicine in Columbus, and physician anesthesiologist at the University’s Wexner Medical Center.

Top 7 Ways to Drive Success for Independent Anesthesia Groups | #ANES24 Oct 23, 2024

Join us at Anesthesiology 2024, The American Society of Anesthesiologists (ASA)'s annual general meeting. We're gathering exclusive cutting edge conversations recorded at the conference with some of the key speakers, guests and delegates.

In this piece our guests share their in-depth expertise on running a successful independent anesthesia practice and cover the key elements on how practices can proactively manage their financial health.

Presented by Mike Grocott, with his guests, Ventra’s Chief Client Officer, Jason Greenberg, MD, and Scott Healthcare Consulting’s CEO, Shena Scott, MBA, FACMPE, serve together on the ASA Committee on Practice Management and the Small to Medium Sized Practices subcommittee.

Day 2 of Anesthesiology 2024 begins | #ANES24 Oct 20, 2024

The American Society of Anesthesiologists (ASA)'s annual general meeting; Anesthesiology 2024. We're gathering exclusive cutting edge conversations recorded at the conference with some of the key speakers, guests and delegates.

TopMedTalk is your chance to hear what’s happening at the largest gathering of anesthesiologists in the world. Here Desiree Chappell sets the tone and tells you what to expect as our coverage continues.

FIND TOPMEDTALK ON:

#Spotify

https://open.spotify.com/show/6QBeVwycajg4SBB9Ou2bfZ

#ApplePodcasts

https://podcasts.apple.com/gb/podcast/topmedtalk/id1271358212

#YouTube

https://www.youtube.com/@topmedtalk

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Video Laryngoscopy—The New Gold Standard | #ANES24 Oct 20, 2024

TopMedTalk brings you exclusive, cutting-edge conversation from Anesthesiology 2024, the American Society of Anesthesiologists (ASA) annual general meeting; the world’s largest gathering of anesthesiologists. The conference brings us all together to discuss the latest advances in the field.

This piece presents a strong case for video laryngoscopy. It’s the preferred method but is the evidence there and if so what is it? Why has it become “the new gold standard”?

Desiree Chappell and Mike Grocott speak with Kurt Ruetzler, staff anesthesiologist at Cleveland Clinic, associate Professor of Anesthesiology, Lerner College of Medicine at Case Western Reserve University.

Introducing Medtronic Acute Care and Monitoring | #ANES24 Oct 20, 2024

The American Society of Anesthesiologists (ASA)'s annual general meeting; Anesthesiology 2024. Building on our reputation for exclusive cutting edge conversations recorded at the conference with some of the key speakers, guests and delegates, TopMedTalk is your chance to hear what’s happening at the largest gathering of anesthesiologists in the world.

Patient monitoring has been a theme on TopMedTalk this year. How do we facilitate the use of new technology, AI and big data into our practices? What are the big new developments coming up?

Desiree Chappell and Mike Grocott speak with Frank Chan, President of Acute Care and Monitoring (ACM) at Medtronic.

Introduction to Anesthesiology | #ANES24 Oct 19, 2024

TopMedTalk’s Co-editors in Chief, Desiree Chappell and Mike Grocott get proceedings underway with a conversation about this year’s Anesthesiology 2024, the largest gathering of anesthesiologists in the world and the annual general meeting of the American Society of Anesthesiologists (ASA).

We’re here and we’re bringing you exclusive conversations from the conference. Ensure you are subscribed to TopMedTalk to hear all our pieces from #ANES24 as they become available.

Getting ready for the ASA | TopMedTalk Oct 17, 2024

This piece is designed to get you in excited about the The American Society of Anesthesiologists (ASA)'s annual general meeting; Anesthesiology 2024, being held this month October 18 - 22 in Philadelphia.

As usual TopMedTalk will be there; building on our reputation for exclusive cutting edge conversations recorded at the conference with some of the key speakers.

On today's program we intend to whet your appetite for the future with some clips taken from conversations of our coverage from last years conference.

The fuller conversations from which the clips in this piece come are to be found on our YouTube channel here:

https://youtu.be/V6RomXG3JpM?si=fmlYi0HlFv6aNb3L

https://youtu.be/vmdhEeIKv5g?si=bzuQ789vMI01TGbq

https://youtu.be/Yhd5mmBnlH8?si=eAK4kXXnrIzFQbtY

Hot Topics in Anaesthesia | TMT at Prato Oct 14, 2024

Recorded at the 7th Collaborative Clinical Trials in Anaesthesiology Conference, Prato, Italy this piece is a conversation about the current hot topics and research in Anaesthesia.

Desiree Chappell speaks with Kate Leslie, Professor, specialist anaesthetist and head of research in the Department of Anaesthesia and Pain Management, Royal Melbourne Hospital, and honorary professorial fellow at the University of Melbourne and Monash University in Australia.

Monitoring Patient Safety | TopMedTalk Oct 10, 2024

Patient safety and patient monitoring seem to go hand in hand, in the wake of the lockdowns, COVID-19 and the AI revolution we now have a new world of data and reliable information that we can unlock the potential of. Where does this leave us?

This compilation piece contains clips taken from the following pieces:

The Anesthesia Patient Safety Foundation | Anesthesiology 2022

https://topmedtalk.libsyn.com/the-anesthesia-patient-safety-foundation-anesthesiology-2022

The priority: Patient Safety | TopMedTalk General

https://topmedtalk.libsyn.com/the-priority-patient-safety-topmedtalk

Perioperative patient safety and post-operative ward monitoring | TopMedTalk General

https://topmedtalk.libsyn.com/perioperative-patient-safety-and-post-operative-ward-monitoring-topmedtalk

Monitoring the Unmonitored | Anesthesiology 2022

https://topmedtalk.libsyn.com/monitoring-the-unmonitored-anesthesiology-2022

Patient monitoring and beyond | TopMedTalk General

https://topmedtalk.libsyn.com/patient-monitoring-and-beyond-topmedtalk

An Update On The Perioperative Quality Initiative | EBPOM24 Oct 07, 2024

Evidence Based Perioperative Medicine (EBPOM)'s annual global conference in London was a huge success this year. TopMedTalk were there and this is one of the conversations we recorded for you.

The Perioperative Quality Initiative (POQI) continues to address the implementation gap between perioperative research and clinical practice, offering clinicians synthesized, accurate recommendations. Since its inception in 2016, POQI has conducted 16 conferences, focusing on various perioperative topics like fluid management, blood pressure control, and nutrition.

Presented by Andy Cumpstey with his guests Andy Shaw, Chairman, Department of Intensive Care and Resuscitation at The Cleveland Clinic, Cleveland, Ohio, Denny Levett, Professor in Perioperative Medicine and Critical Care at the University of Southampton and a Consultant in Perioperative Medicine at Southampton University Hospital NHS Foundation trust (UHS) and Imogen Fecher-Jones, lead nurse and project manager for the Perioperative Medicine Service and Preassessment at University Hospital Southampton.

TopMedTalks to... Michel Struys Scientific Committee Chair for ESAIC | TMT at EA24 Sep 30, 2024

Euroanaesthesia, one of the most important and inﬂuential annual congresses in anaesthesiology and intensive care. This year, TopMedTalk was there in Munich, Germany, bringing you exclusive coverage.

How does a conference of this scale achieve results? How does Euroanaesthesia work with trainees? How do they select topics?

Presented by Desiree Chappell and Kate Leslie with their guest Michel Struys, Professor of Anaesthesiology and Pharmacology, Chair of the Department of Anaesthesiology, Peri-operative pharmacology and medical care, Scientific Committee Chair for ESAIC.

Leaders and mentors in perioperative medicine | EA24 Sep 23, 2024

More from this year’s coverage of the European Society of Anesthesiology and Intensive Care (ESAIC).

This piece focuses on perioperative and intensive care medicine, the importance of evidence-based guidelines over expert opinion. Why do we need a European perioperative database? How important is mentorship in medicine? How do we take the lead with leadership?

Presented by Desiree Chappell and Kate Leslie with their guests Wolfgang Buhre, President of the European Society of Anaesthesiology and Intensive Care Medicine and Carolina Romero Garcia, Research Mentorship Programme Leader for the European Society of Anesthesiology and Intensive Care (ESAIC), Consultant Anesthesiologist, Consorcio Hospital General Universitario de Valencia.

The importance of intraoperative hypotension | AANA 2024 Sep 16, 2024

Recorded at the recent American Association of Nurse Anesthesiology meeting this piece focuses upon the importance of addressing intraoperative hypotension (IOH) and its broader implications for patient outcomes, such as surgical site infections (SSI), postoperative cognitive dysfunction, and other complications. We also discuss the need for continuous education and the use of goal-directed therapy (GDT) to improve patient care.

Presented by Desiree Chappell and Monty Mythen with their guest Amy Yerdon, DNP, CRNA, Assistant Professor of Nursing, Nursing Acute, Chronic & Continuing Care, University of Alabama, Birmingham.

Our guest previously featured on TopMedTalk here: https://www.topmedtalk.com/podcasts/intraoperative-hypotension-killing-them-softly-topmedtalk-at-the-aana/

Navigating the business of Anesthesiology | AANA2024 Sep 09, 2024

TopMedTalk broadcasted from the annual meeting of the American Association of Nurse Anesthesiology in San Diego.

This wide-ranging conversation explores the challenges and dynamics of the field, including staffing issues, hospital efficiency, and the financial pressures on healthcare providers. The discussion also delves into the evolving anesthesia market, the impact of COVID-19, and the importance of efficient management and collaboration, even among competitors.

The episode is presented by Desiree Chappell, TopMedTalk’s Co-Editor-in-Chief and Lead Anchor, as well as Vice President of Clinical Quality for NorthStar Anesthesia, alongside Randy Moore, DNP, MBA, CRNA, Chief Anesthetist Officer at NorthStar Anesthesia. Their guests include Adam Spiegel, Chief Executive Officer of NorthStar Anesthesia, and Tracy Young, MBA, CRNA, Co-Founder and Chief Operating Officer of Essential Anesthesia Management.

Cardiovascular risk evaluation for non-cardiac surgery, guidelines | EBPOM 24 Sep 02, 2024

Guideline evolution is driven by ongoing research; recent studies like PeriOperative ISchemic Evaluation-3 Trial (POISE-3) and trials such as OPtimisation of Peri-operaTive CardIovascular Management to Improve Surgical outcomE II (OPTIMISE II) trial may influence recommendations on hemodynamic management and the use of tranexamic acid. Future guidelines are expected to integrate machine learning models for risk prediction, addressing complex patient phenotypes and interactions. Discontinuation vs. continuation of renin–angiotensin system inhibition before non-cardiac surgery: the SPACE trial has challenged existing practices regarding the discontinuation of ACE inhibitors or ARBs, highlighting the dynamic nature of medical guidelines and the continuous incorporation of new evidence to enhance patient care.

Presented by Andy Cumpstey and Joff Lacey with Mark Edwards, Consultant in Anaesthesia and Perioperative Medicine, University Hospital Southampton Honorary Senior Clinical Lecturer, University of Southampton and John Whittle, Clinical Academic working in Perioperative Translational Medicine at UCL and Honorary Consultant in Perioperative Medicine, Anaesthesia and Critical Care at University College Hospitals London.

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More on POISE-3 here: https://clinicaltrials.gov/study/NCT03505723

More on OPTIMISE II here: https://optimiseii.org/

More on the SPACE trial here: https://doi.org/10.1093/eurheartj/ehad716

TopMedTalk talks to Sam Azijian | TMT at EA24 Aug 26, 2024

Euroanaesthesia is one of the most important and inﬂuential annual congresses in anaesthesiology and intensive care. This year, TopMedTalk was there in Munich, Germany, bringing you exclusive coverage.

In this piece we find out how laryngoscopy has moved forward, where AI might take us and why sustainability important in medicine.

Presented by Desiree Chappell with Sam Azijian, Chief Medical Officer, Acute Care & Monitoring, Medtronic.

Perioperative medicine in focus | EBPOM 24 Aug 19, 2024

This episode underscores the evolution of perioperative medicine, the importance of innovation, teamwork, and data. The conversation reflects on past achievements and looks forward to future advancements in medical care. Our guest, a seasoned medical professional with a 40-year career, reflects on his journey from a young doctor in London to a consultant in Sydney. His plenary session at the Evidence Based Perioperative Medicine (EBPOM) congress highlighted key experiences and innovations in his career.

Presented by Andy Cumpstey with Ross Kerridge, Senior Staff Anaesthetist at the John Hunter Hospital, Newcastle, Australia and Associate Professor at the University of Newcastle.

Is Trauma Informed Care part of your perioperative process? | TopMedTalk Aug 12, 2024

In this piece our guest shares her journey from general anesthesiology to focusing exclusively on obstetrics, driven by her training as a sexual assault counselor. She highlights the prevalence of trauma among patients and the need for trauma-informed care practices.

Presented by Desiree Chappell with her guest Tracey Vogel, Obstetric Anesthesiologist, Allegheny Health Network and Founder of The Empowerment Equation, LLC.

More here: https://www.theempowermentequation.com/

Talks to... Bruce Biccard | Prato 2024 Aug 05, 2024

More from our coverage of the 7th Collaborative Clinical Trials in Anaesthesiology Conference, Prato, Italy.

The South African Perioperative Research Group (SAPORG) is a multidisciplinary group of researchers interested in improving perioperative outcomes in South Africa, through collaborative research

Presented by Monty Mythen and Desiree Chappell with their guest Bruce Biccard, Professor and Second Chair at Groote Schuur Hospital and University of Cape Town, Chair of the South African Perioperative Research Group (SAPORG).

Bruce’s book is here: https://www.amazon.co.uk/Safer-Surgery-Africa-Challenges-Solutions/dp/0796153116

Earth Cast is here: https://podcasts.apple.com/gb/podcast/earth-cast/id1548400137

Freedom Challenge is here: https://www.freedomchallenge.org.za/

The Protect Platform trial | Prato 2024 Jul 29, 2024

More from our coverage of the 7th Collaborative Clinical Trials in Anaesthesiology Conference, Prato, Italy.

This piece discusses trials in the wake of COVID-19 specifically we focus upon the PROTECT Platform Trial.

Presented by Monty Mythen and Kate Leslie with their guests Tom Abbott, anaesthetist and clinical lecturer at Queen Mary University of London and James Glasbey, NIHR Academic Clinical Lecturer in Global Surgery, University of Birmingham and General Surgery Registrar.

The DanGer Shock Trail | EBPOM World Congress 2024 Jul 26, 2024

This piece looks at the DanGer Shock Trial which examines the efficacy of the Impella device in reducing mortality in patients with acute myocardial infarction and cardiogenic shock. We explain how the device works, its implantation process, and the significant findings from the trial, including a notable reduction in six-month mortality with a number needed to treat (NNT) of eight. Despite higher rates of bleeding and renal filtration therapy in the Impella group, the trial provides strong evidence supporting its use in high-volume centers with trained personnel, emphasizing the importance of careful patient selection and timely intervention.

Presented by Andy Cumpstey and Joff Lacey with their guest Vasileios Panoulas, an interventional cardiologist at Brompton and Harefield Hospitals and an honorary senior clinical lecturer at Imperial College London.

Innovation and leadership in anaesthesia | Euroanesthesia 2024 Jul 22, 2024

This year TopMedTalk were at Euroanesthesia 2024, Munich, Germany.

In this piece we discuss anesthesia leadership, sustainability in healthcare, and innovations like Portrait Mobile and low-flow anesthesia. Our guest also shares her personal story as an immigrant and woman in industry, emphasizing the importance of mentorship, sponsorship, and balancing one’s personal and professional life.

Presented by Desiree Chappell and Kate Leslie with their guest Alla K. Woodson, Global GM, Anesthesia, Respiratory Care, and PCS Services, GE Healthcare.

TRACTION trial and the B-Free trial in focus | Prato 2024 Jul 15, 2024

This conversation was recorded at The 7th Collaborative Clinical Trials in Anaesthesiology Conference, Prato, Italy.

This piece focuses upon the TRACTION trial and the B-Free trial.

The TRACTION trial is here: https://tractiontrials.org/

The B-Free trial is here: https://www.phri.ca/research/b-free/

Desiree Chappell and Andy Cumpstey speak with their guests Jessica Spence, Assistant Professor at McMaster University and the Principal Investigator of the B-Free Cluster Crossover Trial and Ryan Zarychanski Professor of internal medicine at the Max Rady College of Medicine, Hematologist, critical care physician and clinician-scientist at the University of Manitoba and CancerCare Manitoba.

Equity, decolonisation and medical research | Prato 2024 Jul 08, 2024

The team bring us more interviews from The 7th Collaborative Clinical Trials in Anaesthesiology Conference, Prato, Italy.

This piece focuses upon the importance of global and equitable research partnerships, highlighting guidelines like TDR's Essence and the Trust Code. The conversation also touches on the need to decolonize health research and the necessity of systemic changes to support women in science and medicine.

Presented by Desiree Chappell, Kate Leslie and Mike Grocott with their guest Jocelyn Clark, the international editor of BMJ.

Four Approaches to Supporting Equitable Research Partnerships:

https://tdr.who.int/docs/librariesprovider10/essence/four-approaches-to-supporting-erps.pdf?sfvrsn=c3aa83ea_12

The Trust Code:

https://www.globalcodeofconduct.org/

How do we intelligently use artificial intelligence? | EBPOM World Congress 2024 Jul 04, 2024

Evidence Based Perioperative Medicine (EBPOM)'s incredible World Congress in London continues and TopMedTalk is there bringing you exclusive interviews with delegates, guests and key opinion leaders.

Here we have a much needed discussion regarding regulating artificial intelligence (AI) at the point of care, and the need for proper regulatory frameworks to ensure its safe and effective use.

We stress the importance of clear policies and clinician training for AI implementation, highlighting the potential risks of misusing AI tools due to insufficient understanding of their outputs. How do we get transparency from AI manufacturers regarding the data sets used and the intended applications of their algorithms? Is there a need for independent verification bodies to assess the robustness of AI tools?

The conversation concludes with a call for collaboration among clinicians, manufacturers, and regulators to harness the power of AI in healthcare while safeguarding patient outcomes, underscoring the exciting yet challenging future of AI in medicine.

Presented by Andy Cumpstey and Joff Lacey with their guest Lee Fleisher, Emeritus Professor of Anesthesiology and Critical Care and Professor of Medicine at the University of Pennsylvania Perelman School of Medicine, Founder and Principal at Rubrum Advising, LLC, Senior Advisor of the Bipartisan Policy Center and FasterCures of the Milken Institute, Senior Fellow of the Leonard Davis Institute of Health Economics and Visiting Fellow of the Duke-Margolis Center.

From July 2020-July 2023, he was the Chief Medical Officer and Director of the Center for Clinical Standards and Quality for the Centers for Medicare and Medicaid Services.

Poster Presentations | EBPOM World Congres 2024 Jul 04, 2024

Evidence-Based Perioperative Medicine (EBPOM)'s World Congress in London is an vital point in the perioperative calendar. This year was no exception. In this piece we speak to some of the poster presenters about hypotension and also, an app that helps with preparation for major surgery.

Presented by Andy Cumpstey with Alexander (Sandy) Jackson, Clinican Data Scientist, Royal College of Anaesthetists, NIHR Doctoral Fellow, Anaesthetics and Intensive Care Doctor, University of Southampton, NHS Foundation Trust and Miriam van der Velde, Researcher at the Innovation of Exercise Care Lectorate & University Lecturer in Master of Geriatric Physiotherapy.

High-Intensity Interval Training and the future of experimental medicine | EBPOM World Congress 2024 Jul 04, 2024

Recorded exclusively at this year’s Evidence Based Perioperative Medicine (EBPOM) World Congress in London this piece looks in detail at High-Intensity Interval Training (HIIT).

HIIT can significantly enhance physical fitness and resilience in cancer patients, reducing complications and improving quality of life. Hear how HIIT can positively impact mitochondrial performance, thus improving cardio-respiratory fitness. The discussion also explores the integration of experimental medicine from bench to bedside, emphasizing the multidisciplinary approach involving surgeons, scientists, and anesthetists.

Presented by Andy Cumpstey and Joff Lacey with their guests Colleen Dean, Lecturer in Muscle Cell Biology and Malcolm West, Associate Professor in Colorectal Surgery and Prehabilitation Medicine at the University of Southampton, an honorary appointment as a consultant colorectal and complex cancer surgeon at University Hospitals Southampton NHS Foundation Trust.

Shared decision making | EBPOM World Congress 2024 Jul 03, 2024

This conversation gets our coverage of the Evidence Based Perioperative Medicine, World Congress, (EBPOM) 2024 off to a great start. Shared decision making is a topic which cuts right to the centre of perioperative medicine with a focus upon patients and patient perspectives.

Presented by Andy Cumpstey with his guests, Bob Evans, a retired Chartered Town Planner and local authority director, a board member of the Centre for Perioperative Care (CPOC), founder member of the Patient, Carer and Public Involvement and Engagement (PCPIE) group, Debra Leung, staff specialist anesthetist at the Peter MacCallum Cancer Centre, Melbourne, Australia and Alf Collins, Freelance health consultant, communication skills trainer and former National Clinical Director of Personalized Care and Shared Decision Making for NHS England.

EBPOM World Congress Begins | EBPOM World Congress 2024 Jul 03, 2024

Evidence Based Perioperative Medicine (EBPOM) is at the heart of what we do and their annual world conference in London always delivers.

TopMedTalk, the broadcasting arm of EBPOM, is there bringing you conversations and adding to the discussions at the conference. Presented by Andy Cumpstey, NIHR clinical lecturer in anaesthesia and intensive care medicine at Southampton University with Joff Lacey, consultant anaesthetist at St George's Hospital NHS Foundation Trust in London.

The British Journal of Anaesthesia | Euroanaesthesia 2024 Jul 01, 2024

This piece is part of our coverage of Euroanaesthesia, one of the most important and inﬂuential annual congresses in anaesthesiology and intensive care. Organised by The European Society of Intensive Care Medicine (ESICM).

The British Journal of Anaesthesia (BJA) publishes high-impact original work in all branches of anaesthesia, critical care medicine, pain medicine and perioperative medicine. This piece gets into AI generated content, sustainability and the Editorial Fellowship Program.

Presented by Kate Leslie with Desiree Chappell and their guests Hugh Hemmings, Editor in Chief of the BJA, Senior Associate Dean for Research, Anesthesiologist at New York Presbyterian Hospital, Professor and Chair of Anesthesiology at Weill Cornell Medicine and Beatrijs Valk, Resident Göttingen University Medical Center, Editorial Fellow BJA.

Perioperative patient safety and post-operative ward monitoring | TopMedTalk General Jun 24, 2024

Perioperative patient safety and post-operative ward monitoring is an important topic. Could continuous monitoring potentially improve patient outcomes and reduce rapid response team activations? Can 24/7 monitoring for high-risk patients provide meaningful data and improve patient safety? With a focus upon “meaningful” how do we avoid “alarm fatigue”? Where is the research and what do the data tell us?

The paper we mention is here: https://doi.org/10.1080/13696998.2023.2219156

Presented by Desiree Chappell with Sadia Khan, Consultant Cardiologist at West Middlesex University Hospital and Marco Luchetti, Anesthesiologist and Medical Director for Patient Care Solutions at GE Healthcare, EMEA.

Like this? Check out our interview with Meera Joshi, Specialist registrar at Ashford and St Peter's Hospital NHS Foundation Trust and clinical research fellow in the department of surgery cancer at Imperial College London here:

https://topmedtalk.libsyn.com/patient-monitoring-and-beyond-topmedtalk

TopMedTalks to... Jonathan Tan | IARS 2024 Jun 17, 2024

This piece is part of our coverage of The International Anesthesia Research Society (IARS) annual meeting.

Here our guest discusses his dual roles in patient safety and quality improvement and his research in spatial sciences; focusing on how environmental and social factors impact health. Can the integration of environmental data into electronic health records allow us to better understand and address health determinants like air quality? What are the practical applications for healthcare providers?

Presented by Desiree Chappell, TopMedTalk co-editor in Chief and Monty Mythen, TopMedTalk’s founder, with their guest Jonathan Tan, Vice Chair of Analytics and Clinical Effectiveness, Department of Anesthesiology Critical Care Medicine, Assistant Professor of Clinical Anesthesiology and Spatial Sciences, Keck School of Medicine of USC.

ROCKet Trial and PANDOS | Euroanaesthesia 2024 Jun 12, 2024

Euroanaesthesia is organised by The European Society of Intensive Care Medicine (ESICM). This year, TopMedTalk was there in Munich, Germany, bringing you exclusive coverage.

What are the effects of up to 72 hours of perioperative ketamine on the risk of development of chronic post-surgical pain? How can we improve pain management and perioperative opioid use after surgery?

More about the ROCKet Trial here: https://medicine.unimelb.edu.au/research-groups/critical-care-research/critcare/appmu/the-rocket-study

More about PANDOS here: https://esaic.org/research/research-groups/pandos/

Presented by Desiree Chappell and Kate Leslie with their guests Patrice Forget, Professor, Clinical Chair in Anaesthesia at the University of Aberdeen (UK), and Honorary Consultant at the NHS Grampian, Chair of the PANDOS (Pain AND Opioids after Surgery) ESAIC Research Group and Philip Peyton, Head of research in the department of anaesthesia at Austin Health and Professorial Fellow in the Anaesthesia, Perioperative and Pain Medicine Unit, Melbourne Medical School, University of Melbourne, Australia.

The role of scientific journals in 2024 | Prato 2024 Jun 11, 2024

Welcome to a conversation we recorded at The 7th Collaborative Clinical Trials in Anaesthesiology Conference, Prato, Italy.

What is the role of a journal in 2024? Why are platform trials so exciting at the moment? How have things moved forward in research?

Presented by Desiree Chappell with her co-hosts Mike Grocott, Kate Leslie and their guest Kirsten Bibbins-Domingo the 17th Editor in Chief of the Journal of the American Medical Association and the JAMA Network.

TopMedTalks to... Ruthi Landau | SOAP 2024 Jun 10, 2024

Our coverage of the Society for Obstetric Anesthesia and Perinatology (SOAP) continues.

Developing clinical guidelines, fostering education, and conducting multi-center research to improve maternal health are all part of the SOAP mission. Also in this piece we discuss the General Anesthesia Registry, which collects data to improve anesthesia outcomes, and the Center of Excellence program.

Presented by Desiree Chappell and Monty Mythen with their guest, Ruthi Landau, Virginia Apgar, Professor of Anesthesiology, Columbia University Medical Center and SOAP Past President.

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Check back through our TopMedTalk timeline for more:

Trauma informed care in obstetrics | TMT at SOAP: https://topmedtalk.libsyn.com/trauma-informed-care-in-obstetrics-tmt-at-soap

TopMedTalks to... Mark Zakowski | TMT at SOAP: https://topmedtalk.libsyn.com/topmedtalks-to-mark-zakowski-tmt-at-soap

Maternal Fetal Anaesthesia | TMT at SOAP: https://topmedtalk.libsyn.com/maternal-fetal-anaesthesia-tmt-at-soap

Obstetric Anesthesia | TMT at SOAP: https://topmedtalk.libsyn.com/obstetric-anesthesia-tmt-at-soap

The Changing Landscape of Anesthesia and Healthcare | TMT at SOAP: https://topmedtalk.libsyn.com/the-changing-landscape-of-anesthesia-and-healthcare-tmt-at-soap

TopMedTalks to... Pervez Sultan | TMT at SOAP: https://topmedtalk.libsyn.com/topmedtalks-to-pervez-sultan-tmt-at-soap

Perioperative care improves maternal outcomes | TMT at SOAP: https://topmedtalk.libsyn.com/perioperative-care-improves-maternal-outcomes-tmt-at-soap

Advancements in technology; monitoring and managing hemodynamic parameters during childbirth | TMT at SOAP: https://topmedtalk.libsyn.com/advancements-in-technology-monitoring-and-managing-hemodynamic-parameters-during-childbirth-tmt-at-soap

Obstetric anaesthesia | TMT at SOAP: https://topmedtalk.libsyn.com/obstetric-anaesthesia-tmt-at-soap

Conversation with The President and Vice President | TMT at SOAP: https://topmedtalk.libsyn.com/conversation-with-the-president-and-vice-president-tmt-at-soap

TopMedTalks to... Barbara Orlando | TMT at SOAP: https://topmedtalk.libsyn.com/topmedtalks-to-barbara-orlando-tmt-at-soap

The Effect of Perioperative Music on Medication Requirement and Hospital Length of Stay | Euroanaesthesia 2024 Jun 07, 2024

“We are seriously scientifically evidence-based looking for solutions on the non-pharmacological side and music has turned out to be one of them”

This fascinating piece takes its cue from an excellent paper; “The Effect of Perioperative Music on Medication Requirement and Hospital Length of Stay: A Meta-analysis” which you can read here: https://pubmed.ncbi.nlm.nih.gov/31356272/

Presented by Desiree Chappell with her guest Marcus Klimek, Director Residency Training Program, Vice-Chairman, Associate Professor bij, Erasmus MC, Deptartment of Anesthesiology.

Music as medicine: https://erasmusmcfoundation.nl/muziekalsmedicijn/projects/

The Mozart effect: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1281386/

This piece is part of our coverage of Euroanaesthesia, one of the most important and inﬂuential annual congresses in anaesthesiology and intensive care. Organised by The European Society of Intensive Care Medicine (ESICM).

Patient monitoring and beyond | TopMedTalk General Jun 05, 2024

Patient monitoring has made some significant strides forward over the last decade. Nowadays most people are familiar with the idea. Where are we now with this essential aspect of healthcare? How far should we take the commitment to monitoring a patient? What about “wearable” technology both inside and outside the institution?

Desiree Chappell speaks with Meera Joshi, Specialist registrar at Ashford and St Peter's Hospital NHS Foundation Trust and clinical research fellow in the department of surgery cancer at Imperial College London.

FURTHER LISTENING:

We mention Sadia Khan, one of her recent contributions to TopMedTalk is here: https://topmedtalk.libsyn.com/monitoring-the-unmonitored-topmedtalk

More on “The Value of Information” here: https://topmedtalk.libsyn.com/the-value-of-information-ebpom-usa

AI's unique hemodynamic insights - HPI in focus | TopMedTalk General May 31, 2024

This piece focuses upon the Hypotension Predictive Index (HPI) technology. We look at the validation process of HPI, addressing criticisms and clarifying its predictive ability for hemodynamic instability. How important is it to understand the underlying causes of instability rather than solely relying on blood pressure readings? What is the role of HPI in early detection and proactive management? The discussion also touches on the limitations of traditional mean arterial pressure (MAP) monitoring and the need for a holistic approach to hemodynamic assessment.

Presented by Desiree Chappell, TopMedTalk’s co-editor in Chief, speaking with Monty Mythen, Senior Vice President Medical Affairs, Edwards Lifesciences, Critical Care, Emeritus Professor of Anaesthesia and Critical Care, University College London, Thomas Sheeran, Senior Director Medical Affairs, Edwards Lifesciences, and Simon Davies, Consultant Anaesthetist at York Teaching Hospital NHS Foundation Trust.

The paper 'Comparison of Differences in Cohort (Forward) and Case Control (Backward) Methodological Approaches for Validation of the Hypotension Prediction Index' is here: https://pubs.asahq.org/anesthesiology/article/doi/10.1097/ALN.0000000000004989/139987/Comparison-of-Differences-in-Cohort-Forward-and?searchresult=1

Here’s the link to the Physiology Lab section of last year’s ASA symposium on YouTube: https://youtu.be/yfl1VMMgIRs?si=YxGfOs-pdlIVVGt1

Here are publications relating HPI to hemodynamic instability at a microcirculation level:

https://pubmed.ncbi.nlm.nih.gov/33755645/

https://pubmed.ncbi.nlm.nih.gov/36335548/

Welcome to the 7th Clinical Trials in Anaesthesiology Conference | Prato 2024 May 29, 2024

It’s one of our busiest times of the year. This piece is the first of a series from The 7th Collaborative Clinical Trials in Anaesthesiology Conference, Prato, Italy.

Presented by Desiree Chappell and her co-hosts; Mike Grocott, Monty Mythen, Andy Cumpstey and Kate Leslie.

Please ensure you are subscribed to TopMedTalk and check back regularly as we have more from this conference (and others) to come.

We mention our piece with Paul Myles, you can listen to it here: https://topmedtalk.libsyn.com/prato-2019-paul-myles

Hemodynamics, intraoperative hypotension and its implications | IARS 2024 May 29, 2024

This piece is part of our coverage of The International Anesthesia Research Society (IARS) annual meeting.

This wide ranging conversation tackles hemodynamics, intraoperative hypotension and its implications. We also discuss finance for medical practitioners and patient-centered research.

Presented by Desiree Chappell, Vice President of Clinical Quality at NorthStar Anesthesia and TopMedTalk co-editor in Chief and Monty Mythen, TopMedTalk’s founder and Senior Vice President Medical Affairs, Edwards Lifesciences with their guest Wael Saasouh, Anesthesiologist and Director of Research for NorthStar Anesthesia.

Anesthesia and Analgesia's new Editor-in-Chief | IARS 2024 May 29, 2024

This piece is part of our coverage of The International Anesthesia Research Society (IARS) annual meeting.

Hear us discuss the prestigious journal "Anesthesia and Analgesia", affiliated with the International Anesthesia Research Society (IARS). Listen to how it maintains its status as one of the top-ranked journals in its field, the importance of its readability and accessibility. Learn about the journal’s rapid review process and diverse editorial board that reflects global and thematic diversity. Also; transitioning to digital formats, the evolving nature of manuscript submissions, the integration of AI and the journal's commitment to gender and intellectual diversity.

We also discuss peer review workshops and an editorial fellowship scheme, allowing early career researchers to learn about manuscript handling and review.

Visit the online edition here: https://journals.lww.com/anesthesia-analgesia/pages/default.aspx

Presented by Desiree Chappell, TopMedTalk co-editor in Chief and Monty Mythen, TopMedTalk’s founder with Jaideep Pandit, Professor of Anaesthesia, University of Oxford and Editor-in-Chief, “Anesthesia and Analgesia”.

Post operative delirium | Euroanaesthesia 2024 May 27, 2024

Euroanaesthesia is recognised worldwide as one of the most important and inﬂuential annual congresses in anaesthesiology and intensive care. This year, TopMedTalk is there in Munich, Germany, bringing you exclusive coverage.

This conversation focuses upon perioperative neurocognitive disorders and the significance of biomarkers in predicting and managing these conditions.

The paper mentioned, “Examining Subjective Psychological Experiences of Postoperative Delirium in Older Cardiac Surgery Patients” is here: https://pubmed.ncbi.nlm.nih.gov/36201368/

Audre Curtis’s experiences on YouTube are interesting: https://www.youtube.com/watch?v=CHA2Hzg5Kkk

And the American Geriatrics Society is here: https://www.americangeriatrics.org/

Presented by Desiree Chappell and Kate Leslie with their guests David Scott, Professor, University of Melbourne and Lis Evered, Associate Professor of Neuroscience in Anaesthesiology at Weill Cornell Medicine, Scientific Head of Research in the Department of Anaesthesia and Acute Pain Medicine at St. Vincent’s Hospital in Melbourne, Australia, Associate professor at the University of Melbourne.

Respiratory Prehabilitation | EBPOM World Congress 2023 May 27, 2024

This talk “Respiratory Prehabilitation” was originally given at The World Congress of Prehabilitation in London by Linda Denehy, Head of the Melbourne School of Health Sciences and Professor of Physiotherapy at The University of Melbourne, Australia

It is the third in a series of talks given under the title, “Non-cancer Prehabilitation”, which also includes a fascinating panel discussion. The first talk is available for you to listen to here: https://topmedtalk.libsyn.com/prehabilitation-in-aneurysm-surgery-prehab-world-congress

The second talk was published here: https://topmedtalk.libsyn.com/cardiac-prehabilitation-trial-prehab-world-congress

Ensure you are subscribed to TopMedTalk to guarantee you get to hear the full series.

Welcome to Euroanaesthesia | Euroanaesthesia 2024 May 26, 2024

Euroanaesthesia is recognised worldwide as one of the most important and inﬂuential annual congresses in anaesthesiology and intensive care. With a history of international participants from more than 100 countries and over 130 exhibitors, Euroanaesthesia is truly an outstanding international platform. This year, TopMedTalk is there in Munich, Germany, bringing you exclusive coverage.

Make sure you subscribe to ensure you hear all our podcasts from this incredible event.

This piece introduces you to our hosts; Desiree Chappell and Kate Leslie.

Artificial intelligence in perioperative medicine | IARS 2024 May 23, 2024

This piece is part of our coverage of The International Anesthesia Research Society (IARS) annual meeting.

What exactly is artificial intelligence (AI)? How could generative AI be used in perioperative medicine? How is AI currently used? Why is there a need for more “granular data”?

Presented by Desiree Chappell, TopMedTalk co-editor in Chief and Monty Mythen, TopMedTalk’s founder, with their guest Hannah Lonsdale, Assistant Professor in Pediatric Anesthesiology at Vanderbilt UMC.

TopMedTalks to... Mark Zakowski | SOAP 2024 May 23, 2024

Our coverage of the Society for Obstetric Anesthesia and Perinatology (SOAP) continues with this essential piece.

What is being done in the field of pain management during C-sections? Are there ways to improve clear communication between patients and medical professionals?

The statement on Pain During Cesarean Delivery from the American Society of Anesthesiologists (ASA) is here: https://www.asahq.org/standards-and-practice-parameters/statement-on-pain-during-cesarean-delivery

The conversation also touches on guidelines for oral intake during labor and the ongoing debate about safety and patient comfort during labor and delivery.

Presented by Desiree Chappell, TopMedTalk co-editor in Chief and Monty Mythen, TopMedTalk’s founder, with their guest, Mark Zakowski, Chief of Obstetric Anesthesiology at Quantum Birthing, LLC.

Maternal Fetal Anaesthesia | SOAP 2024 May 20, 2024

More of our coverage of the Society for Obstetric Anesthesia and Perinatology (SOAP).

This piece discusses maternal fetal anesthesia, fetal surgery, the importance of minimizing risk for the pregnant patient while gaining benefits for the fetus.

What are the latest advancements in fetal surgery, including minimally invasive techniques and the use of robotics?

Presented by Desiree Chappell, TopMedTalk co-editor in Chief and Monty Mythen, TopMedTalk’s founder, with their guest, Caitlin Sutton, Chief, Division of Maternal Fetal Anesthesia, Texas Children's Hospital, Houston, Texas.

Like this? More of our SOAP coverage can be found here:

https://topmedtalk.libsyn.com/topmedtalks-to-pervez-sultan-tmt-at-soap

https://topmedtalk.libsyn.com/perioperative-care-improves-maternal-outcomes-tmt-at-soap

https://topmedtalk.libsyn.com/advancements-in-technology-monitoring-and-managing-hemodynamic-parameters-during-childbirth-tmt-at-soap

https://topmedtalk.libsyn.com/obstetric-anaesthesia-tmt-at-soap

https://topmedtalk.libsyn.com/conversation-with-the-president-and-vice-president-tmt-at-soap

https://topmedtalk.libsyn.com/topmedtalks-to-barbara-orlando-tmt-at-soap

https://topmedtalk.libsyn.com/trauma-informed-care-in-obstetrics-tmt-at-soap

Obstetric Anesthesia | SOAP 2024 May 20, 2024

Part of our coverage of the Society for Obstetric Anesthesia and Perinatology (SOAP) meeting, this piece looks at the excitement and challenges of obstetric anesthesia; the importance of academic and community practice collaboration; the impact of sharing updated protocols and research. We also discuss artificial intelligence, managing the overwhelming volume of medical literature to improve patient care and outcomes.

Presented by Desiree Chappell, TopMedTalk co-editor in Chief and Monty Mythen, TopMedTalk’s founder, with their guest Rebecca Minehart, Associate Professor of Anesthesiology at Brown University Warren Alpert School of Medicine and Vice Chair for Faculty Development, Department of Anesthesiology, Lifespan Physician Group and Chief of OB Anesthesia, at Women and Infants Hospital, Providence Rhode Island.

The Changing Landscape of Anesthesia and Healthcare | SOAP 2024 May 20, 2024

Part of our coverage of the Society for Obstetric Anesthesia and Perinatology (SOAP).

How have healthcare projects evolved? Where are we with safety and innovation in healthcare? What’s the role of non-physician providers? How do we cope with staff shortages in the field? How do we maximise patient safety and education?

For more on the National Audit Projects go here: https://topmedtalk.libsyn.com/topmedtalks-to-tim-cook-of-the-national-audit-project-wca-2024

To hear the popular interview we did with Kevin Fong go here: https://topmedtalk.libsyn.com/kevin-fong-broadcaster-and-medical-practitioner-wca-2024

Presented by Desiree Chappell, TopMedTalk co-editor in Chief and Monty Mythen, TopMedTalk’s founder, with their guest Nuala Lucas, MBE, Consultant Anaesthetist, Northwick Park Hospital, Harrow, Middlesex.

Cardiac Prehabilitation Trial | EBPOM World Congress 2023 May 20, 2024

This talk “Cardiac Prehabilitation Trial” was originally given at The World Congress of Prehabilitation in London by Enoch Akowuah, Chair of cardiac surgery at Newcastle University and a consultant cardiac surgeon and at South Tees Hospitals NHS Foundation Trust in the UK.

It is the second in a series of talks given under the title, “Non-cancer Prehabilitation”, which also includes a fascinating panel discussion. The first talk is available for you to listen to here: https://topmedtalk.libsyn.com/prehabilitation-in-aneurysm-surgery-prehab-world-congress

Ensure you are subscribed to TopMedTalk to guarantee you get to hear the full series.

TopMedTalk were lucky enough to get some time with Professor Akowuah where we discuss his work in more detail: https://topmedtalk.libsyn.com/prehabilitation-evidence-over-hype-prehabilitation-ebpom-2023

The priority: Patient Safety | TopMedTalk General May 16, 2024

Desiree Chappell hosts Dr. Steven Greenberg, Vice Chair of research and education at the anesthesia department, Endeavor Health, Chicago and Vice President of the Anesthesia Patient Safety Foundation at Anesthesia Patient Safety Foundation (APSF).

What are the mission and activities of the Anesthesia Patient Safety Foundation (APSF)? What are their ongoing research initiatives, international collaborations, and emerging technologies in perioperative care?

Additionally, what is the role of artificial intelligence and machine learning in enhancing patient monitoring and safety? How do we foster a culture of safety and patient engagement in our practice?

Find out more here: https://www.apsf.org/

Listen to more here: https://topmedtalk.libsyn.com/anesthesia-patient-safety-foundation-intraoperative-hypotension-and-hemodynamic-stability-anes23

Prehabilitation in aneurysm surgery | EBPOM World Congress 2023 May 13, 2024

This talk, “Prehabilitation in aneurysm surgery”, was originally presented at the World Congress of Prehabilitation in London. It is part of a series of talks given under the title, “Non-cancer Prehabilitation”, which also includes a fascinating panel discussion.

Ensure you are subscribed to TopMedTalk to guarantee you get to hear the full series.

Heather Gill is a vascular surgeon at McGill University and Research Chair for the Canadian Society of vascular surgery.

TopMedTalk were lucky enough to get some time with Dr Gill where we discuss her work in more detail here: https://topmedtalk.libsyn.com/prehabilitation-evidence-over-hype-prehabilitation-ebpom-2023

TopMedTalk Down Under - that's a wrap! | ANZCA 2024 May 10, 2024

"TopMedTalk Down Under" presents more 'as live' coverage of the 2024 Australian and New Zealand College of Anaesthetists (ANZCA) and Faculty of Pain Medicine's Annual Scientific Meeting.

This piece looks back at some of the great guests and moments from this year's scientific meeting. If you'd like to learn more go here: https://www.anzca.edu.au/

Presented by Andy Cumpstey, Clinical lecturer, University Hospital Southampton NHS Foundation Trust and the University of Southampton, England, and Kate Leslie, Professor, Specialist Anaesthetist and Head of Research at the Royal Melbourne Hospital and the University of Melbourne.

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DOWNLOAD THE ENTIRE TOPMEDTALK DOWN UNDER SERIES NOW:

TopMedTalk Down Under - exclusive coverage of the ANZCA meeting | #ASM24BRIS: https://traffic.libsyn.com/topmedtalk/ANZCA_TopMed_Talk_Day_1.mp3

TopMedTalk Down Under talks to... Chris Cokis and Kieran Davis | #ASM24BRIS: https://traffic.libsyn.com/topmedtalk/Current_ANZCA_President_and_FPM_Dean.mp3

Pain medicine, cannabis, ketamine and psilocybin in focus | #ASM24BRIS: https://traffic.libsyn.com/topmedtalk/Pain_Medicine.mp3

Sustainability in healthcare | #ASM24BRIS: https://traffic.libsyn.com/topmedtalk/Sustainability.mp3

Breaking Trials on TopMedTalk down under | #ASM24BRIS: https://traffic.libsyn.com/topmedtalk/Breaking_Trails.mp3

TopMedTalk Down Under Day 2 Begins | #ASM24BRIS: https://traffic.libsyn.com/topmedtalk/Day_1_Recap_TMTDU.mp3

Oxygen and Altitude | #ASM24BRIS: https://traffic.libsyn.com/topmedtalk/Oxygen_and_Altitude.mp3

Are you ready for a leadership position in healthcare? | #ASM24BRIS: https://traffic.libsyn.com/topmedtalk/xLeadership.mp3

Continuing professional development | #ASM24BRIS: https://traffic.libsyn.com/topmedtalk/Workshops_and_CPD.mp3

Global Health | #ASM24BRIS: https://traffic.libsyn.com/topmedtalk/Global_Health.mp3

TopMedTalk down under - day 3 begins | #ASM24BRIS: https://traffic.libsyn.com/topmedtalk/Recap_3.mp3

Publishing online and in print | #ASM24BRIS: https://traffic.libsyn.com/topmedtalk/Publishing.mp3

Anaesthesia training in Mongolia | #ASM24BRIS: https://traffic.libsyn.com/topmedtalk/Anaesthesia_in_mongolia.mp3

Paediatric Trials | #ASM24BRIS: https://traffic.libsyn.com/topmedtalk/Paediatric_Trails.mp3

The new President of the Australian and New Zealand College of Anaesthetists and Dean of the Faculty of Pain Medicine | #ASM24BRIS: https://traffic.libsyn.com/topmedtalk/President_and_FPM_Dean.mp3

Delirium | #ASM24BRIS: https://traffic.libsyn.com/topmedtalk/TMTDU_Delirium.mp3

Delirium | ANZCA 2024 May 10, 2024

"TopMedTalk Down Under" presents more 'as live' coverage of the 2024 Australian and New Zealand College of Anaesthetists (ANZCA) and Faculty of Pain Medicine's Annual Scientific Meeting.

This piece looks at the complexities of anesthesia management and ongoing efforts to improve patient outcomes, particularly in terms of cognitive function and delirium prevention in the postoperative period.

Presented by Andy Cumpstey, Clinical lecturer, University Hospital Southampton NHS Foundation Trust and the University of Southampton, England, and Kate Leslie, Professor, Specialist Anaesthetist and Head of Research at the Royal Melbourne Hospital and the University of Melbourne with their guests Deborah Culley, Chair of Anesthesiology and Critical Care at the University of Pennsylvania and Jamie Sleigh, Professor of Anesthesia at Waikato Clinical Campus, of the University of Auckland in New Zealand.

TopMedTalks to... Pervez Sultan | SOAP 2024 May 09, 2024

Our ‘as live’ coverage of the Society for Obstetric Anesthesia and Perinatology (SOAP) continues.

This conversation highlights the importance of research in improving maternal and neonatal health, highlighting issues such as maternal mortality rates, disparities in healthcare access, and the need for targeted interventions.

Presented by Desiree Chappell, TopMedTalk co-editor in Chief and Monty Mythen, TopMedTalk’s founder, with their guest Pervez Sultan, Professor of Obstetric Anesthesiology at Stanford University School of Medicine and an Honorary Professor at University College London in the department of Targeted Intervention.

Perioperative care improves maternal outcomes | SOAP 2024 May 09, 2024

Our coverage of the Society for Obstetric Anesthesia and Perinatology (SOAP) brings a conversation about the importance of perioperative care to improve maternal outcomes. Key aspects include preoperative patient preparation, multimodal pain management, postoperative nausea and vomiting prevention, and early mobilization.

Presented by Desiree Chappell, TopMedTalk co-editor in Chief and Monty Mythen, TopMedTalk’s founder, with their guest with their guest Brendan Carvalho, Department of Anesthesiology, Perioperative and Pain Medicine Stanford University School of Medicine.

The new President of the Australian and New Zealand College of Anaesthetists and Dean of the Faculty of Pain Medicine | ANZCA 2024 May 07, 2024

"TopMedTalk Down Under" continues 'as live' coverage of the 2024 Australian and New Zealand College of Anaesthetists (ANZCA) and Faculty of Pain Medicine's Annual Scientific Meeting.

This piece is essential listening for anyone who has an interest in the future of both the meeting and the organisation. It was recorded the day before our guests took their titles; Incoming ANZCA President David Story, Professor and Foundation Chair of Anaesthesia at the University of Melbourne, Head of the University Department of Critical Care; and the Incoming Dean of the Faculty of Pain Medicine, Dilip Kapur, Specialist Pain Medicine Physician, Adelaide.

It is presented by Presented by Andy Cumpstey, Clinical lecturer, University Hospital Southampton NHS Foundation Trust and the University of Southampton, England, and Kate Leslie, Professor, Specialist Anaesthetist and Head of Research at the Royal Melbourne Hospital and the University of Melbourne with their guests Amanda Baric, Order of the Polar Star, Deputy Director of the Department of Anaesthesia and Perioperative Medicine at Northern Health and Debra Devonshire, visiting medical officer at Monash Health, Cabrini and Peninsula private hospitals.

Find out more about the ANZCA here: https://www.anzca.edu.au/

Paediatric Trials | ANZCA 2024 May 07, 2024

"TopMedTalk Down Under" continues 'as live' coverage of the 2024 Australian and New Zealand College of Anaesthetists (ANZCA) and Faculty of Pain Medicine's Annual Scientific Meeting.

This piece focuses upon paediatric trials.

Presented by Andy Cumpstey, Clinical lecturer, University Hospital Southampton NHS Foundation Trust and the University of Southampton, England, and Kate Leslie, Professor, Specialist Anaesthetist and Head of Research at the Royal Melbourne Hospital and the University of Melbourne with their guests Paul-Lee Archer Staff Specialist Anaesthestist at The Queensland Children's Hospital, Susan Humphries, Anaesthetist at The Queensland Children's Hospital and Britta Regli-von Ungern, Chair of Paediatric Anaesthesia, The University of Western Australia.

Anaesthesia training in Mongolia | ANZCA 2024 May 07, 2024

"TopMedTalk Down Under" continues 'as live' coverage of the 2024 Australian and New Zealand College of Anaesthetists (ANZCA) and Faculty of Pain Medicine's Annual Scientific Meeting.

This piece explores the challenges and rewards of working in global health and the importance of collaboration and education in improving healthcare systems.

Presented by Andy Cumpstey, Clinical lecturer, University Hospital Southampton NHS Foundation Trust and the University of Southampton, England, and Kate Leslie, Professor, Specialist Anaesthetist and Head of Research at the Royal Melbourne Hospital and the University of Melbourne with their guests Amanda Baric, Order of the Polar Star, Deputy Director of the Department of Anaesthesia and Perioperative Medicine at Northern Health and Debra Devonshire, visiting medical officer at Monash Health, Cabrini and Peninsula private hospitals.

Publishing online and in print | ANZCA 2024 May 07, 2024

"TopMedTalk Down Under" continues 'as live' coverage of the 2024 Australian and New Zealand College of Anaesthetists (ANZCA) and Faculty of Pain Medicine's Annual Scientific Meeting.

What are the pressures and rewards in publishing, in a world where the internet is nearly ubiquitous and when large language models driven by artificial intelligence can be used to write copy for you?

Presented by Andy Cumpstey, Clinical lecturer, University Hospital Southampton NHS Foundation Trust and the University of Southampton, England, and Kate Leslie, Professor, Specialist Anaesthetist and Head of Research at the Royal Melbourne Hospital and the University of Melbourne with their guests Matt Wiles, Editor-in-Chief of Anaesthesia, consultant in anaesthesia and intensive care at Sheffield Teaching Hospitals NHS Trust and Dr Jim Rathmell, Editor-in-chief for Anesthesiology, Harvard University, Chief, Enterprise Anesthesiology, Mass General Brigham and Chair, Department of Anesthesiology, Perioperative and Pain Medicine at Brigham and Women's Hospital.

TopMedTalk down under - day 3 begins | ANZCA 2024 May 06, 2024

"TopMedTalk Down Under" continues 'as live' coverage of the 2024 Australian and New Zealand College of Anaesthetists (ANZCA) and Faculty of Pain Medicine's Annual Scientific Meeting.

Here we recap on what we've seen and look forward to day three.

If you'd like to catch up with our coverage here's the output from the previous day:

Oxygen and Altitude | #ASM24BRIS - https://traffic.libsyn.com/topmedtalk/Oxygen_and_Altitude.mp3

Are you ready for a leadership position in healthcare? | #ASM24BRIS - https://traffic.libsyn.com/topmedtalk/xLeadership.mp3

Continuing professional development | #ASM24BRIS - https://traffic.libsyn.com/topmedtalk/Workshops_and_CPD.mp3

Global Health | #ASM24BRIS - https://traffic.libsyn.com/topmedtalk/Global_Health.mp3

Presented by Andy Cumpstey, Clinical lecturer, University Hospital Southampton NHS Foundation Trust and the University of Southampton, England, and Kate Leslie, Professor, Specialist Anaesthetist and Head of Research at the Royal Melbourne Hospital and the University of Melbourne.

You can find out more about ANZCA here: https://www.anzca.edu.au/

Advancements in technology; monitoring and managing hemodynamic parameters during childbirth | SOAP 2024 May 06, 2024

Our ‘as live’ coverage of the Society for Obstetric Anesthesia and Perinatology (SOAP) conference continues. This piece focuses upon advancements in medical technology, particularly in monitoring and managing hemodynamic parameters during childbirth and surgeries like C-sections.

What are the latest advancements? How should we now understand hemodynamics? What new findings have we made in this area and how should we best go about tailoring our interventions?

Presented by Desiree Chappell, TopMedTalk co-editor in Chief and Monty Mythen, TopMedTalk’s founder, with their guest Andrew Geller, Medical Director Cedars-Sinai.

More about SOAP here: https://www.soap.org/

Obstetric anaesthesia | SOAP 2024 May 06, 2024

Our ‘as live’ coverage of the Society for Obstetric Anesthesia and Perinatology (SOAP) continues. Here we get into a conversation about the ever developing field of Obstetric Anesthesia.

Presented by Desiree Chappell, TopMedTalk co-editor in Chief and Monty Mythen, TopMedTalk’s founder, with Grace Lim, Chief, Obstetric and Women's Anesthesia at UPMC, Pittsburgh.

Screening and Assessment for Prehabilitation - panel discussion | EBPOM World Congress 2023 May 06, 2024

This panel discussion covers ground discussed in the preceding talks released recently on TopMedTalk and linked to below. Screening and assessment for prehabilitation being the umbrella theme of each of those presentations.

Chaired by Franco Carli, Professor of Anesthesia at McGill University and Associate Professor in the School of Dietetics and Human Nutrition at McGill University, with panelists Sandy Jack, Professor of Prehabilitation Medicine in Clinical and Experimental Sciences Dept., Faculty of Medicine, at the University of Southampton, Chelsia Gillis, Assistant Professor in the School of Human Nutrition in the Faculty of Agricultural and Environmental Sciences at McGill University, Raquel Sebio García, physiotherapist and clinical researcher at Hospital Clinic in Barcelona, Spain, Carol Keen, Consultant AHP, Physiotherapist, Sheffield Teaching Hospitals NHS Foundation Trust and Lee Ingle, Professor in Sport Health and Exercise Science at the University of Hull.

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We think this works as a standalone piece but the presentations it relates to are here in your TopMedTalk feed:

Carol Keen's presentation is here: https://topmedtalk.libsyn.com/psychological-screening-and-assessment-tools-for-prehab-world-congress-of-prehabilitation

Chelsia Gillis is here: https://topmedtalk.libsyn.com/nutritional-screening-and-assessment-tools-for-prehab-world-congress-of-prehabilitation

Lee Ingle is here: https://topmedtalk.libsyn.com/exercise-screening-and-assessment-tools-for-prehab-world-congress-of-prehabilitation

Global Health | ANZCA 2024 May 06, 2024

"TopMedTalk Down Under" continues 'as live' coverage of the 2024 Australian and New Zealand College of Anaesthetists (ANZCA) and Faculty of Pain Medicine's Annual Scientific Meeting.

This subject is one that touches everyone in the world; global health.

Presented by Andy Cumpstey, Clinical lecturer, University Hospital Southampton NHS Foundation Trust and the University of Southampton, England, and Kate Leslie, Professor, Specialist Anaesthetist and Head of Research at the Royal Melbourne Hospital and the University of Melbourne with their guests Chris Bowden, Consultant Anaesthetist, Gold Coast University Hospital, Chair of the Asian Australasian Regional Section of the World Federation of Societies of Anaesthesilogists (WFSA) and Rob McDougall, Pediatric Anaesthetist at The Children's Hospital in Melbourne, Board Member of Lifebox's Global Governance Council.

More on Lifebox here: https://topmedtalk.libsyn.com/asa-2019-lifebox

Continuing professional development | ANZCA 2024 May 06, 2024

"TopMedTalk Down Under" continues 'as live' coverage of the 2024 Australian and New Zealand College of Anaesthetists (ANZCA) and Faculty of Pain Medicine's Annual Scientific Meeting.

Here we discuss some of the various workshops at the meeting and its commitment to continuting professional development (CPD).

Presented by Andy Cumpstey, Clinical lecturer, University Hospital Southampton NHS Foundation Trust and the University of Southampton, England, and Kate Leslie, Professor, Specialist Anaesthetist and Head of Research at the Royal Melbourne Hospital and the University of Melbourne with their guests James Marckwald, Anaesthetist, Queen Elizabeth II Jubilee Hospital, Brisbane and Debra Devonshire, Anaesthesia Specialist at Monash Health, Cabrini.

You can find out more about ANZCA here: https://www.anzca.edu.au/

Are you ready for a leadership position in healthcare? | #ASM24BRIS May 05, 2024

"TopMedTalk Down Under" continues 'as live' coverage of the 2024 Australian and New Zealand College of Anaesthetists (ANZCA) and Faculty of Pain Medicine's Annual Scientific Meeting.

This piece tackles the subject of leadership, the importance of mentors, the benefits of networking and the challenges emerging practitioners.

Presented by Andy Cumpstey, Clinical lecturer, University Hospital Southampton NHS Foundation Trust and the University of Southampton, England, and Kate Leslie, Professor, Specialist Anaesthetist and Head of Research at the Royal Melbourne Hospital and the University of Melbourne with their guests Claire Maxwell, Staff Specialist Anaestetist, Brisbane Mater Hospitals, Brisbane and Co-convenor of the Emerging Leaders Conference, Shannon Morrison, Pediatric Anaesthetist at Queensland Children's Hospital in Brisbane and co-convener of the Emerging Leaders Conference, Mark Priestley, Head of the Anaesthetic Department, Westmead Hospital, Sydney.

You can find out more about ANZCA here: https://www.anzca.edu.au/

Oxygen and Altitude | #ASM24BRIS May 05, 2024

"TopMedTalk Down Under" continues 'as live' coverage of the 2024 Australian and New Zealand College of Anaesthetists (ANZCA) and Faculty of Pain Medicine's Annual Scientific Meeting.

This piece sees us ascend into the world of early human flight and the use of oxygen.

Presented by Andy Cumpstey, Clinical lecturer, University Hospital Southampton NHS Foundation Trust and the University of Southampton, England, and Kate Leslie, Professor, Specialist Anaesthetist and Head of Research at the Royal Melbourne Hospital and the University of Melbourne with their guests Christine Ball, Honorary Curator at Geoffrey Kaye Museum; Anaesthetist, Alfred Hospital; Adjunct Associate Professor, Monash University and Dan Martin, OBE, Professor of Perioperative and Intensive Care Medicine, University of Plymouth, Consultant in anaesthesia and intensive care medicine, Derriford hospital.

You can find out more about ANZCA here: https://www.anzca.edu.au/

Dan has previously appeared on TopMedTalk and we highly reccomend this piece here if you want more: https://topmedtalk.libsyn.com/asa-life-at-the-extremes-trials-on-everest-adapting-to-hypoxia

TopMedTalk Down Under Day 2 Begins | #ASM24BRIS May 05, 2024

"TopMedTalk Down Under" continues 'as live' coverage of the 2024 Australian and New Zealand College of Anaesthetists (ANZCA) and Faculty of Pain Medicine's Annual Scientific Meeting.

Here we recap on what we've seen so far and anticipate what is yet to come.

If you're at the meeting and have been supporting us on social media, thank you. Keep spreading the word for us!

If you'd like to catch up with our coverage here's what we've done so far:

TopMedTalk Down Under - exclusive coverage of the ANZCA meeting | #ASM24BRIS - https://topmedtalk.libsyn.com/topmedtalk-down-under-exclusive-coverage-of-the-anzca-meeting-asm24bris

TopMedTalk Down Under talks to... Chris Cokis and Kieran Davis | #ASM24BRIS - https://topmedtalk.libsyn.com/topmedtalk-down-under-talks-to-chris-cokis-and-kieran-davis-asm24bris

Pain medicine, cannabis, ketamine and psilocybin in focus | #ASM24BRIS - https://topmedtalk.libsyn.com/pain-medicine-cannabis-ketamine-and-psilocybin-in-focus-asm24bris

Sustainability in healthcare | #ASM24BRIS - https://topmedtalk.libsyn.com/sustainability-in-healthcare-asm24bris

#Breaking Trials on TopMedTalk down under | #ASM24BRIS - https://topmedtalk.libsyn.com/breaking-trials-on-topmedtalk-down-under-asm24bris

Presented by Andy Cumpstey, Clinical lecturer, University Hospital Southampton NHS Foundation Trust and the University of Southampton, England, and Kate Leslie, Professor, Specialist Anaesthetist and Head of Research at the Royal Melbourne Hospital and the University of Melbourne.

You can find out more about ANZCA here: https://www.anzca.edu.au/

#Breaking Trials on TopMedTalk down under | #ASM24BRIS May 05, 2024

"TopMedTalk Down Under" continues our 'as live' coverage of the 2024 Australian and New Zealand College of Anaesthetists (ANZCA) and Faculty of Pain Medicine's Annual Scientific Meeting.

This conversation highlights the complexities and challenges of conducting clinical research, the need to navigate unexpected results and limitations in study design.

Find out more about the ANZCA foundation here: https://www.anzca.edu.au/research/anzca-foundation

Presented by Andy Cumpstey, Clinical lecturer, University Hospital Southampton NHS Foundation Trust and the University of Southampton, England, and Kate Leslie, Professor, Specialist Anaesthetist and Head of Research at the Royal Melbourne Hospital and the University of Melbourne with their guests Jai Darvall, Associate Professor, Anaesthetist and intensive care specialist at the Royal Melbourne Hospital, co-lead of the perioperative medicine service within the Department of Anaesthesia and Pain Management, and senior lecturer in critical care education at the University of Melbourne, Lachlan Miles, Associate Professor, Staff Specialist and Head of Research in the Department of Anaesthesia at Austin Health, an Honorary Principal Fellow of the Department of Critical Care at the University of Melbourne, Stefan Dieleman, Staff Specialist, Head of Research in the Department of Anaesthesia at Westmead Hospital and Associate Professor, Academic Lead for Anaesthesia at Western Sydney University, and a Clinical Associate Professor at The University of Sydney.

Sustainability in healthcare | #ASM24BRIS May 05, 2024

"TopMedTalk Down Under" continues our 'as live' coverage of the 2024 Australian and New Zealand College of Anaesthetists (ANZCA) and Faculty of Pain Medicine's Annual Scientific Meeting.

The importance of sustainability in medicine is a topic that continues to heat up; here we look at where progress has been made and where we can all go a little further.

Presented by Andy Cumpstey, Clinical lecturer, University Hospital Southampton NHS Foundation Trust and the University of Southampton, England, and Kate Leslie, Professor, Specialist Anaesthetist and Head of Research at the Royal Melbourne Hospital and the University of Melbourne with their guests Eugenie Kayak, consultant anaesthetist at Austin and Alfred Health, Enterprise Professor in Sustainable Healthcare in the Department of Critical Care, Melbourne Medical School and Forbes McGain, Anaesthetist and Intensive care Physician, Western Health, Melbourne, Australia, Associate Professor, University of Sydney, and the University of Melbourne, Associate Dean Healthcare Sustainability in the Faculty of Medicine, Dentistry and Health Sciences at The University of Melbourne.

Pain medicine, cannabis, ketamine and psilocybin in focus | #ASM24BRIS May 04, 2024

"TopMedTalk Down Under" continues our 'as live' coverage of the 2024 Australian and New Zealand College of Anaesthetists (ANZCA) and Faculty of Pain Medicine's Annual Scientific Meeting.

A frank conversation about the consequences surrounding relatively new legislation surrounding cannabis; how does recreational use interfere with anaesthesia? Further, how should ketamine be used in safe doses and can some of its effects be problematic? Also we discuss the momentum behind the currently unproductive drive to use psilocybin as a pain medicine. The discussion then moves to the significance of mental and psychological preparation for patients anticipating surgical events.

Presented by Andy Cumpstey, Clinical lecturer, University Hospital Southampton NHS Foundation Trust and the University of Southampton, England, and Kate Leslie, Professor, Specialist Anaesthetist and Head of Research at the Royal Melbourne Hospital and the University of Melbourne with their guests Vivanne Tawfik, Associate Professor, Stanford University, California and Hance Clarke Staff Anesthesiologist, Toronto General and Associate Professor, University of Toronto.

TopMedTalk Down Under talks to... Chris Cokis and Kieran Davis | #ASM24BRIS May 04, 2024

"TopMedTalk Down Under" is proud to present our 'as live' coverage of the 2024 Australian and New Zealand College of Anaesthetists (ANZCA) and Faculty of Pain Medicine's Annual Scientific Meeting.

This piece gets to the heart of the meeting with a conversation about how the ANZCA do what they do and what it's like to help lead the organisation.

Presented by Andy Cumpstey, Clinical lecturer, University Hospital Southampton NHS Foundation Trust and the University of Southampton, England, and Kate Leslie, Professor, Specialist Anaesthetist and Head of Research at the Royal Melbourne Hospital and the University of Melbourne with their guests Chris Cokis, President of the ANZCA, and Kieran Davis, Dean of the Faculty of Pain Medicine.

Conversation with The President and Vice President | SOAP 2024 May 04, 2024

Our ‘as live’ coverage of the Society for Obstetric Anesthesia and Perinatology (SOAP) continues with a conversation about what SOAP does and why it’s so important.

Presented by Desiree Chappell, TopMedTalk co-editor in Chief and Monty Mythen, TopMedTalk’s founder, with May Pian-Smith, President of The Society for Obstetric Anesthesia and Perinatology (SOAP) and Heather Nixon, Vice President of SOAP.

More about SOAP here: https://www.soap.org/

TopMedTalks to... Barbara Orlando | SOAP 2024 May 04, 2024

Our ‘as live’ coverage of the Society for Obstetric Anesthesia and Perinatology (SOAP) conference continues. What is the importance of data and outcomes in advocating for change?

Presented by Desiree Chappell, TopMedTalk co-editor in Chief and Monty Mythen, TopMedTalk’s founder, with Barbara Orlando, Associate Professor, Division Chief of Obstetric Anesthesiology at UT Health, Houston.

More about SOAP here: https://www.soap.org/

TopMedTalk Down Under - exclusive coverage of the ANZCA meeting | #ASM24BRIS May 03, 2024

"TopMedTalk Down Under" is proud to present our 'as live' coverage of the 2024 Australian and New Zealand College of Anaesthetists (ANZCA) and Faculty of Pain Medicine's Annual Scientific Meeting.

This piece will put you in the picture and gives you an idea of what we have to look forward to at this exciting and important scientific gathering. Ensure you subscribe to TopMedTalk, to ensure you hear it all, and share this piece with your colleagues around the world.

Presented by Andy Cumpstey, Clinical lecturer, University Hospital Southampton NHS Foundation Trust and the University of Southampton, England, and Kate Leslie, Professor, Specialist Anaesthetist and Head of Research at the Royal Melbourne Hospital and the University of Melbourne.

You can find out more about ANZCA here: https://www.anzca.edu.au/

Listeners may remember Andy from our coverage of the European Society of Anaesthesiology and Intensive Care last year: https://topmedtalk.libsyn.com/welcome-to-the-european-society-of-anaesthesiology-and-intensive-care-esaic-2023

Just as you may recall Kate Leslie's many contributions to TopMedTalk including this excellent most recent piece: https://topmedtalk.libsyn.com/women-in-anaesthesia-kate-leslie-and-anoushka-afonso-wca-2024

Trauma informed care in obstetrics | SOAP 2024 May 03, 2024

Our ‘as live’ coverage of the Society for Obstetric Anesthesia and Perinatology (SOAP) conference gets off to a compelling start with a conversation about “trauma informed birth”. Is it time to address some of the unusual and potentially traumatizing aspects of this area of healthcare?

Presented by Desiree Chappell, TopMedTalk co-editor in Chief and Monty Mythen, TopMedTalk’s founder, with Cheryl Parker, Program Director, Nurse Anesthesia, University of Louisville.

More about SOAP here: https://www.soap.org/

Controversies and Standardisation in Prehabilitation | World Congress of Prehabilitation Apr 29, 2024

A panel discussion chaired by Denny Levett, Professor in Perioperative Medicine and Critical Care at the University of Southampton and a Consultant in Perioperative Medicine at Southampton University Hospital NHS Foundation trust (UHS) and featuring; Andrew Davies, Consultant in upper gastro-intestinal surgery at Guy’s and St Thomas’ NHS Hospital Trust, Heather Gill, a vascular surgeon at McGill University and Research Chair for the Canadian Society of vascular surgery, Gerry Danjoux, consultant in Anaesthesia and Sleep Medicine at South Tees Hospitals NHS Trust, Chelsia Gillis, Assistant Professor in the School of Human Nutrition in the Faculty of Agricultural and Environmental Sciences at McGill University and Liam Humphreys, Senior Research Fellow and lead of the Living Well with Chronic Disease research theme at the Advanced Wellbeing Research Centre.

Liam’s presentation is here: https://topmedtalk.libsyn.com/behavioural-change-vs-psychological-interventions-which-is-key-in-prehabilitation-prehabilitation-world-congress

Chelsia’s presentation is here: https://topmedtalk.libsyn.com/prehab-initiative-standardisation-of-screening-assessment-interventions-and-outcomes-prehabilitation-world-congress

Andrew’s presentation is here: https://topmedtalk.libsyn.com/should-we-delay-surgery-for-prehabilitation-prehabilitation-world-congress

Exercise Screening and assessment tools for prehab | World Congress of Prehabilitation Apr 22, 2024

This talk “Exercise Screening and assessment tools for prehab” was originally given at the World Congress of Prehabilitation Medicine in London. For more information about some of this year’s conferences please go to http://www.ebpom.org

Presented by Lee Ingle, Professor in Sport Health and Exercise Science at the University of Hull.

It is the third in a series of three talks which precede a panel discussion on the wider subject of screening and assessment for prehabilitation.

The first talk was released here: https://topmedtalk.libsyn.com/psychological-screening-and-assessment-tools-for-prehab-world-congress-of-prehabilitation

The second talk is here: https://topmedtalk.libsyn.com/nutritional-screening-and-assessment-tools-for-prehab-world-congress-of-prehabilitation

The panel discussion will be released soon on TopMedTalk.

Nutritional screening and assessment tools for prehab | World Congress of Prehabilitation Apr 15, 2024

This talk “Nutritional screening and assessment tools for prehab” was originally given at the World Congress of Prehabilitation Medicine in London. For more information about some of this year’s conferences please go to www.ebpom.org

Presented by Chelsia Gillis, Assistant Professor in the School of Human Nutrition in the Faculty of Agricultural and Environmental Sciences at McGill University.

It is the second in a series of three talks which precede a panel discussion on the wider subject of screening and assessment for prehabilitation.

The first talk was released here: https://topmedtalk.libsyn.com/psychological-screening-and-assessment-tools-for-prehab-world-congress-of-prehabilitation

The panel discussion and final talk which preceded it will be released soon on TopMedTalk.

The importance of independent investigators with Medtronic | TopMedTalk Apr 11, 2024

Medtronic’s External Research Program is open to all investigators who are interested in applying for support of their independently developed research. This podcast explains more.

To submit an External Research Program yourself please go here: http://erp.medtronic.com

Presented by Desiree Chappell with her guest Katherine Liu, Program Manager, Global Clinical Research, Medtronic.

Psychological screening and assessment tools for prehab | World Congress of Prehabilitation Apr 08, 2024

Taken from The World Congress of Prehabilitation this talk goes through some psychological screening and assessment tools for prehabilitation. It is the first in a series of three talks (soon to be released here on TopMedTalk) which precede a panel discussion on the wider subject of screening and assessment for prehabilitation.

Presented by Carol Keen, Consultant AHP, Physiotherapist, Sheffield Teaching Hospitals NHS Foundation Trust.

The International Prehabilitation Trial | Prehabilitation World Congress Apr 01, 2024

This piece was originally the John Snow Plenary Lecture given at the World Congress of Prehabilitation in London.

It is introduced by Franco Carli, Professor of Anesthesia at McGill University and Associate Professor in the School of Dietetics and Human Nutrition at McGill University; our speaker is Gerrit Slooter, MD, PhD, Surgical Oncologist, Maxima Medical Centre, The Netherlands.

If you would like to learn more about the conferences available this year checkout www.ebpom.org

Prehabilitation, where are we now? (PART 2) | The World Congress of Prehabilitation Mar 25, 2024

This is the second part of a question and answer session which was originally presented at The World Congress of Prehabilitation.

Featuring Mike Grocott, TopMedTalk’s co-editor in Chief and the Professor of Anaesthesia and Critical Care Medicine at the University of Southampton as well as an NIHR Senior Investigator, Denny Levett, Professor in Perioperative Medicine and Critical Care at the University of Southampton and a Consultant in Perioperative Medicine at Southampton University Hospital NHS Foundation trust (UHS), Franco Carli, Professor of Anesthesia at McGill University and Associate Professor in the School of Dietetics and Human Nutrition at McGill University, Gerrit Slooter, Surgical Oncologist, Maxima Medical Centre, The Netherlands and Linda Denehy, Head of the Melbourne School of Health Sciences and Professor of Physiotherapy at The University of Melbourne, Australia.

If you’d like to hear part one please go here: https://topmedtalk.libsyn.com/prehabilitation-where-are-we-now-part-1-the-world-congress-of-prehabilitation

If you’d like to hear the excellent talk which prompted this discussion please go here: https://topmedtalk.libsyn.com/what-is-prehabilitation-the-world-congress-of-prehabilitation

TopMedTalk is the broadcasting arm of Evidence Based Perioperative Medicine (EBPOM), if you’d like to attend one of our forthcoming conferences go now to http://www.ebpom.org

Anesthesiology in Ukraine | WCA 2024 Mar 19, 2024

Our coverage of the 18th World Congress of Anaesthesiologists (WCA 2024) continues. A truly global congress for anaesthesiology and critical care we were fortunate to meet and speak with two practitioners from Ukraine.

In our conversation with them we cover, anesthesia practices in Ukraine, staffing shortages in a war-torn nation’s hospitals, medical training and practice in war conditions.

Desiree Chappell speaks with her guests, Yelyzaveta Plechystaya, Chief of the anesthesia department at Dobrobut medical network and Dmytro Dziuba, Professor at Shupyk National Medical Academy of Postgraduate Education, Head of anesthesiology, intensive care and extracorporal detoxication department, Kiyv Regional Hospital.

Our guests mention a foundation in the clinic for people who want to donate: https://dobrobut.foundation/en/home_en/

The Global Scholars Program | WCA 2024 Mar 19, 2024

TopMedTalk brings you more exclusive coverage, direct from the 18th WFSA World Congress of Anaesthesiologists in Singapore.

Now its tenth year, the Global Scholars Program provides support for young leaders in the specialty from low- and middle-lower income countries, more detail here: https://www.asahq.org/charity/programs/globalscholars

Here Desiree Chappell has a conversation with two global scholars, Kpehe Maimie, West African College of Surgeons and Faculty, SAFE obstetrics & Neonatal Rescucitation at Mercy Ships UK and Naima Zakaria, Medical Director, Tanga Regional Referral Hospital, Tanzania

Dr Kpehe Maimie is featured in this fascinating article here: https://wfsahq.org/news/latest-news/my-story-training-to-be-liberias-first-home-grown-anaesthesiologist/

Prehabilitation, where are we now? (PART 1) | The World Congress of Prehabilitation Mar 18, 2024

This question and answer session was originally presented at The World Congress of Prehabilitation. It features Mike Grocott, TopMedTalk’s co-editor in Chief and the Professor of Anaesthesia and Critical Care Medicine at the University of Southampton as well as an NIHR Senior Investigator, Denny Levett, Professor in Perioperative Medicine and Critical Care at the University of Southampton and a Consultant in Perioperative Medicine at Southampton University Hospital NHS Foundation trust (UHS), Franco Carli, Professor of Anesthesia at McGill University and Associate Professor in the School of Dietetics and Human Nutrition at McGill University, Gerrit Slooter, Surgical Oncologist, Maxima Medical Centre, The Netherlands and Linda Denehy, Head of the Melbourne School of Health Sciences and Professor of Physiotherapy at The University of Melbourne, Australia.

Although this piece works as a standalone listen, if you’d like to hear the excellent talk which prompted it please go here: https://topmedtalk.libsyn.com/what-is-prehabilitation-the-world-congress-of-prehabilitation

Part two of this piece will follow soon, make sure you are subscribed to TopMedTalk to ensure you don’t miss out.

TopMedTalk is the broadcasting arm of Evidence Based Perioperative Medicine (EBPOM), if you’d like to attend one of our forthcoming conferences go now to http://www.ebpom.org

The Perioperative Quality Initiative | WCA 2024 Mar 15, 2024

Desiree Chappell speaks about about the Perioperative Quality Initiative (POQI) with Mike Grocott, TopMedTalk’s co-editor in Chief, Professor of Anaesthesia and critical care at the University of Southampton and Guy Ludbrook, Professor of Anaesthesia at the University of Adelaide and Royal Adelaide Hospital.

The Perioperative Quality Initiative is here: https://thepoqi.org/

And there’s more information about the Global Summit here: https://www.anzca.edu.au/fellowship/anaesthesia-continuing-education-(1)/perioperative-medicine-special-interest-group

For more of our exclusive coverage of the 18th World Congress of Anaesthesiologists (WCA 2024) check out TopMedTalk on our YouTube channel: https://www.youtube.com/@topmedtalk/videos

The Network for the Advancement of Patient Blood Management | WCA 2024 Mar 15, 2024

More from our coverage of the 18th World Congress of Anaesthesiologists (WCA 2024)

The Network for the Advancement of Patient Blood Management, Haemostasis and Thrombosis (NATA) is a global independent medical association dedicated to advancement and promotion of best clinical practise in the management of anaemia and iron deficiency, critical bleeding, and thrombosis.

Desiree Chappell and Monty Mythen speak to Jens Meier, Professor, Head of the Department of Anaesthesia and Intensive Care, Kepler University Hospital as well as Chair Professor of Anaesthesiology and Intensive Care at the Johannes Kepler University in Linz, Austria.

For more go here: https://nataonline.com/

TopMedTalks to ... BobbieJean Sweitzer, and Denny Levett | WCA 2024 Mar 11, 2024

More from our exclusive coverage of the 18th World Congress of Anaesthesiologists (WCA 2024) as Desiree Chappell speaks with her guests Denny Levett, Professor in Perioperative Medicine and Critical Care at the University of Southampton and a Consultant in Perioperative Medicine at Southampton University Hospital NHS Foundation trust (UHS) and BobbieJean Sweitzer, Systems Director of Perioperative Practices at Inova Health, Falls Church, Virginia.

How has the term malnutrition evolved? Should we consider frailty in our younger patients more than we do? What are the particular challenges when caring for high risk patients with multiple co-morbidities? Where does nutrition education begin and should it ever end? And finally, what are the small simple changes we can make which will provide a meaningful impact upon patient care?

What is prehabilitation? | The World Congress of Prehabilitation Mar 11, 2024

“What is prehabilitation?” is presented by Mike Grocott, TopMedTalk’s co-editor in Chief and Professor of Anaesthesia and Critical Care Medicine at the University of Southampton, as well as an NIHR Senior Investigator.

Originally presented at The World Congress of Prehabilitation, this challenging and exciting talk sets the tone for those of us who advocate for Prehabilitation; how do we define it and where is the evidence that it works? The intention here is to start a stimulating conversation with the audience and the prestigious panel who are assembled for the question and answer session that follows.

That discussion is scheduled to be released here on TopMedTalk in the near future, make sure you are subscribed to us through whichever channel you found us on to ensure you hear it.

TopMedTalk is the broadcasting arm of Evidence Based Perioperative Medicine (EBPOM), if you’d like to attend one of our forthcoming conferences go now to www.ebpom.org

TopMedTalks to ... Jannicke Mellin-Olsen | WCA 2024 Mar 08, 2024

In this essential piece we discuss, anesthesiology and its global impact with experts, empathy with patients, emotional expression in medicine, improving anesthesia care globally and standardisation in anaesthesiology.

Direct from the 18th WFSA World Congress of Anaesthesiologists in Singapore, Desiree Chappell and Monty Mythen speak with their guest Jannicke Mellin-Olsen, Knight 1st Class of the Order of St.Olav (for services to medicine), past president of the World Federation of Societies of Anaesthesiologists, a member of the Board of Directors of the Patient Safety Movement Foundation, she practices at Baerum Hospital, Oslo, Norway.

TopMedTalks to ... Andy Shaw, Cleveland Clinic, Ohio | WCA 2024 Mar 08, 2024

Direct from the 18th WFSA World Congress of Anaesthesiologists in Singapore Desiree Chappell and Monty Mythen catch up with Andy Shaw, Chairman, Department of Intensive Care and Resuscitation at The Cleveland Clinic, Cleveland, Ohio.

This discussion touches on the topics of; cardiac anesthesia and care, temporary circulatory support in cardiac surgery, professional development and 'task shifting' in healthcare. We also focus upon The Perioperative Quality Initiative (POQI) and health economics, global access to cardiac surgery technology and global anesthesia and perioperative care.

The Perioperative Quality Initiative (POQI) - a wealth of free resources - is here: https://thepoqi.org/

We last heard from Andy Shaw here: https://topmedtalk.libsyn.com/the-perioperative-quality-initiative-ebpom-2023

And our YouTube audio channel is here: https://www.youtube.com/watch?v=VH0zX19sScE

Assisted fluid management and predicting hypotension | WCA 2024 Mar 08, 2024

Our coverage of the 18th World Congress of Anaesthesiologists (WCA 2024) continues.

In this piece we cover assisted fluid management in anesthesia. Using AI in anesthesia and its potential impact on anesthesiologists. The validity of the hypotension prediction index in academic debate. Reducing hypertension in surgical patients using HPI.

Desiree Chappell and Monty Mythen speak with Thomas Scheeren, Senior Director Medical Affairs, Edwards Lifesciences and Paul Van Beest, Anaesthesiologist, Medical Center Leeuwarden, University Medical Center Groningen.

TopMedTalks to ... Tim Cook of The National Audit Project | WCA 2024 Mar 08, 2024

Our coverage of the 18th World Congress of Anaesthesiologists (WCA 2024) continues. This conversation focuses upon The National Audit Projects, https://www.rcoa.ac.uk/research/research-projects/national-audit-projects-naps Patient safety and event reporting in healthcare. Anesthesia trends and patient outcomes in the UK. Cardiac arrest causes and preparedness in medical departments. Cardiac arrest outcomes and quality of care. Anesthesia patient safety and risk management.

Presented by Desiree Chappell and Mike Grocott with their guest, Tim Cook, Consultant in Anaesthesia and Intensive Care Medicine, Royal United Hospital, Bath, Honorary Professor of Anaesthesia University of Bristol and Director of National Audit Projects.

Making the world healthier through the power of conversation | WCA 2024 Mar 07, 2024

Mike Grocott, Desiree Chappell and Monty Mythen catch up at the end of “Day 2” of our coverage of the 18th WFSA World Congress of Anaesthesiologists in Singapore.

With much to look forward to and plenty to look back on the team discuss; medical technology, industry collaboration, anesthesia risk management, patient safety and the global healthcare quality initiatives associated with that.

Kevin Fong, broadcaster and medical practitioner | WCA 2024 Mar 06, 2024

Listen now as we speak about space exploration, a media career which extends to both television, radio and podcasting. We get into AI, medical safety, the oft made comparison with aviation and the ultimate role of humans and machines in complex systems.

This piece was recorded and sent to you directly from The 18th WFSA World Congress of Anaesthesiologists in Singapore. Here we have Desiree Chappell and Monty Mythen speaking with Kevin Fong, OBE MRCP FRCA, a well known British doctor and broadcaster; a consultant anaesthetist and anaesthetic lead for Major Incident Planning at University College London Hospitals and a professor (also at UCL) where he organises and runs an undergraduate course Extreme Environment Physiology.

As mentioned here is a link to the excellent new BBC radio series: https://www.bbc.co.uk/programmes/m001wjf8

You can find our guest’s insightful Twitter feed here: Dr Kevin Fong (@kevin_fong) / X (twitter.com)

Women in Anaesthesia - Kate Leslie and Anoushka Afonso | WCA 2024 Mar 04, 2024

Promoting diversity in medical publishing, preparation among women in anesthesia, leadership styles, gender differences in communication, a growth mindset and women in healthcare leadership; are all topics which come up in this conversation.

This piece was recorded and sent to you directly from The 18th WFSA World Congress of Anaesthesiologists in Singapore.

Presented by Desiree Chappell with her two guests, Kate Leslie, Professor, specialist anaesthetist and head of research in the Department of Anaesthesia and Pain Management, Royal Melbourne Hospital, and honorary professorial fellow at the University of Melbourne and Monash University in Australia and Anoushka Afonso, Associate Professor of Clinical Anesthesiology at Memorial Sloan Kettering Cancer Center (MSK), where she is the Director of Enhanced Recovery Program.

Routine Videolaryngoscopy - A Model for Success | WCA 2024 Mar 04, 2024

This discussion includes a look at some of the benefits and adoption of video laryngoscopy in medical practice, improving first pass success rate in endoscopy using virtual reality and video laryngoscope techniques for difficult airways.

This piece was recorded and sent to you directly from The 18th WFSA World Congress of Anaesthesiologists in Singapore. It's the first of our pieces from this year's conference, expect more to follow.

Desiree Chappell interviews Patrick Schoettker, Professor and Head of the department of Anesthesiology at the CHUV University Hospital (Lausanne, Switzerland), Ellen O’Sullivan, Consultant Anaesthesiologist at St James’s Hospital Dublin, Ireland affiliated to Trinity College Dublin, Director of the Fellowship in Advanced Airway Management and Simulation and Ross Hofmeyr, Associate Professor of Anaesthesiology at University of Cape Town.

Looking forward to the World Congress of Anaesthesiologists | TopMedTalk Feb 29, 2024

This piece reflects the fact we are currently getting ready for the 18th World Congress of Anaesthesiologists (WCA 2024) - we’re going to be bringing you all the coverage of the meeting that we can, live from Singapore.

The podcast primes you for the topics we’re expecting to encounter and gives you a taste of where the discussions are at the moment.

Featured in this piece are:

Carolyn Johnston, consultant Anaesthetist in St Georges hospital in London and Improvement lead for the National Emergency Laparotomy Network:

TopMedTalk: EBPOM Highlight 1.27 | Obstetric anaesthesia (libsyn.com)

Dr Attila Kett, anaesthesiologist and Chairman at St Peter’s University Hospital at New Jersey:

TopMedTalk: Enhanced Recovery for obstetrics | Perioperative Coach (libsyn.com)

Alexander J Butwick, Obstetric Anesthesiologist and Researcher in maternal hemorrhage, pain relief in labor, and obstetric epidemiology at Stanford University

TopMedTalk: TopMedTalk | Why is maternal mortality so high in the USA? (libsyn.com)

Adriane Chapman, Professor at University of Southampton, Head of Digital Health Research Group, Director for the Centre for Health Technologies

TopMedTalk: The Potential of Artificial Intelligence in Perioperative Care Q&A | EBPOM World Congress (libsyn.com)

Sandy (Alexander) Jackson, specialty trainee in anaesthetics and intensive care medicine and an NIHR Doctoral Fellow at the University of Southampton

TopMedTalk: Artificial Intelligence in Perioperative Care - Part 2 | EBPOM 2023 (libsyn.com)

Guy Ludbrook Professor of Anaesthesia at the University of Adelaide and Royal Adelaide Hospital

TopMedTalk: The hidden pandemic of post operative complications | EBPOM London 2020 (libsyn.com)

Denny Levett, Professor in Perioperative Medicine and Critical Care at the University of Southampton and a Consultant in Perioperative Medicine at Southampton University Hospital NHS Foundation trust

TopMedTalk: Morpheus Plenary Lecture: Exercise is a Perioperative medicine | EBPOM World Congress 2022 (libsyn.com)

Kate Leslie, Honorary Professor, Monash University, Melbourne, Australia, Specialist Anaesthetist, The Royal Melbourne Hospital & North Western Mental Health and Non-Executive Director, Australian Medical Council

TopMedTalk: Diversity and gender balance in research | TopMedTalk (libsyn.com)

Prehab Initiative: Standardisation of Screening, Assessment, Interventions and Outcomes | Prehabilitation World Congress Feb 26, 2024

This piece presents two short talks both of which sit under the headline, “Standardisation of Screening, Assessment, Interventions and Outcomes” and they were given at the recent Prehabilitation World Congress, held in London.

The first talk “Standardising prehabilitation outcomes” was presented on behalf of John Moore, a consultant in anaesthetics and critical care medicine from Manchester by Liam Humphries, Senior Research Fellow and lead of the Living Well with Chronic Disease research theme at the Advanced Wellbeing Research Centre.

The second talk “Standardising prehabilitation Intervention reporting” is presented by Chelsia Gillis, Assistant Professor in the School of Human Nutrition in the Faculty of Agricultural and Environmental Sciences at McGill University.

Behavioural change vs Psychological interventions: which is key in prehabilitation? | Prehabilitation World Congress Feb 19, 2024

This talk “Behavioural change vs Psychological interventions: which is key in prehabilitation?” was given at the Prehabilitation World Congress as part of a series of presentations under the heading; “Controversies and Standardisation in Prehabilitation”.

It was preceded by “Should we delay surgery for prehabilitation?” which is available for you to listen to here:

https://topmedtalk.libsyn.com/should-we-delay-surgery-for-prehabilitation-prehabilitation-world-congress

Presented by Liam Humphries, Senior Research Fellow and lead of the Living Well with Chronic Disease research theme at the Advanced Wellbeing Research Centre.

The Potential of Artificial Intelligence in Perioperative Care Q&A | EBPOM World Congress Feb 12, 2024

This piece is a discussion which followed three presentations at the Evidence Based Perioperaive Medicine (EBPOM) World Congress in London on artificial intelligence in perioperative medicine. Although, for an informed listener, it will work as a standalone piece the presentations which it is in part a response to are here:

Part one is here: https://topmedtalk.libsyn.com/ai-in-perioperative-care-part-1-ebpom-london-2023

Part two is here: https://topmedtalk.libsyn.com/artificial-intelligence-in-perioperative-care-part-2-ebpom-2023

Part three is here: https://topmedtalk.libsyn.com/ai-predictive-monitoring-to-prevent-hemodynamic-instability-and-deterioration-in-perioperative-and-acute-care-patients-ebpom-world-congress

On the panel are; Feras Hatib, Vice President of the R&D Algorithms and Signal Processing organization for Critical Care and Vascular at Edwards Lifesciences in Irvine California, Adriane Chapman, Professor at University of Southampton, Head of Digital Health Research Group, Director for the Centre for Health Technologies and Sandy (Alexander) Jackson, specialty trainee in anaesthetics and intensive care medicine and a National Institute for Health and Care Research (NIHR) Doctoral Fellow at the University of Southampton.

This piece is chaired by TopMedTalk’s co-editor in Chief Mike Grocott, Professor of Anaesthesia and Critical Care Medicine at the University of Southampton.

AI Predictive Monitoring to prevent Hemodynamic Instability and Deterioration in Perioperative and Acute Care Patients | EBPOM World Congress Feb 05, 2024

“AI Predictive Monitoring to prevent Hemodynamic Instability and Deterioration in Perioperative and Acute Care Patients” was a talk given at the Evidence Based Perioperative Medicine (EBPOM) World Congress. For more on their conferences check out www.ebpom.org

Presented by Feras Hatib, Vice President of the R&D Algorithms and Signal Processing organization for Critical Care and Vascular at Edwards Lifesciences in Irvine California.

This piece works as a standalone talk but it is part 3 of a 4 part series.

Part one is here: https://topmedtalk.libsyn.com/ai-in-perioperative-care-part-1-ebpom-london-2023

Part two is here: https://topmedtalk.libsyn.com/artificial-intelligence-in-perioperative-care-part-2-ebpom-2023

And, still to come, a fascinating panel discussion. Make sure you like and subscribe to TopMedTalk so you hear it first.

Should we delay surgery for prehabilitation? | Prehabilitation World Congress Jan 29, 2024

Should we delay surgery for prehabilitation? A short dissection of a perennial topic for anyone interested in perioparative medicine and enhanced recovery after surgery. This piece was originally part of the Prehabilitation World Congress in London. For more on this year’s conferences, organised by Evidence Based Perioperative Medicine (EBPOM), check out www.ebpom.org

Presented by Andrew Davies, consultant in upper gastro-intestinal surgery at Guy’s and St Thomas’ NHS Hospital Trust.

The business of anesthesia | AANA 2023 Jan 22, 2024

This conversation comes from the American Association of Nurse Anesthesiology conference 2023. It gets right to the business end of our profession and discusses industry trends and challenges in anesthesia; payment cuts, healthcare pricing, reimbursement, staffing and leadership.

Presented by Desiree Chappell, TopMedTalk Co-Editor in Chief, Vice President of Clinical Quality at NorthStar Anesthesia, with her guests Adam Spiegel, CEO, NorthStar Anesthesia and Randy Moore, Chief Anesthetists Officer of NorthStar Anesthesia.

Artificial Intelligence in Perioperative Care - Part 2 | EBPOM 2023 Jan 15, 2024

“It's evolution, not revolution, we've got a long way to go. But I'm certainly really excited to be on this journey. And I hope some of you will want to come on that journey with us.”

This piece looks at artificial intelligence (AI) in perioperative care. How and why can this new technology help?

Presented by Sandy (Alexander) Jackson, specialty trainee in anaesthetics and intensive care medicine and an NIHR Doctoral Fellow at the University of Southampton.

AI in Perioperative Care - Part 1 | EBPOM LONDON Jan 11, 2024

“Every single one of you can and should go build an AI model. It's actually pretty simple these days. But then think about; what actually is the problem here? And where could the system go wrong?”

This podcast opens up the first in a four part series here on TopMedTalk about a topic which has defined the last few years; what does the development of artificial intelligence (AI) systems mean for perioperative medicine, what will the benefits be and where do we already see potential challenges? This first part “An Introduction to AI” gets the conversation going.

With a short introduction from Mike Grocott this piece is presented by Adriane Chapman, Professor at University of Southampton, Head of Digital Health Research Group, Director for the Centre for Health Technologies.

This piece is taken from a four part presentation, three talks and a discussion, first given at Evidence Based Perioperative Medicine (EBPOM) 2023.

Anesthesiology 2023 Digest Part 2 | TopMedTalk Jan 01, 2024

Anesthesiology 2023, a huge event in the perioperative calendar for us here at TopMedTalk; the annual general meeting of the American Society of Anesthesiologists (ASA).

Part one of this podcast is here: https://topmedtalk.libsyn.com/anesthesiology-2023-digest-part-1-topmedtalk

The pieces linked to in this podcast are here:

Opportunities in Anesthesiology | #ANES23

https://topmedtalk.libsyn.com/opportunities-in-anesthesiology-anes23

The GAP study: Gabapentin and perioperative pain, results and analysis | #ANES23

https://topmedtalk.libsyn.com/the-gap-study-gabapentin-and-perioperative-pain-results-and-analysis-anes23

Artificial Intelligence in your practice | #ANES23

https://topmedtalk.libsyn.com/artificial-intelligence-in-your-practice-anes23

TopMedTalks to… the Chief Executive Officer and Chief Quality Officer of NorthStar Anesthesia | #ANES23

https://topmedtalk.libsyn.com/topmedtalks-to-the-chief-executive-officer-and-chief-quality-officer-of-northstar-anesthesia-anes23

Patient Safety in Anesthesiology | #ANES23

https://topmedtalk.libsyn.com/patient-safety-in-anesthesiology-anes23

Anesthesia Patient Safety Foundation; Intraoperative Hypotension and Hemodynamic Stability | #ANES23

https://topmedtalk.libsyn.com/anesthesia-patient-safety-foundation-intraoperative-hypotension-and-hemodynamic-stability-anes23

Alternative study designs for the future | #ANES23

https://topmedtalk.libsyn.com/alternative-study-designs-for-the-future-anes23

TopMedTalks to ... BobbieJean Sweitzer | #ANES23

https://topmedtalk.libsyn.com/topmedtalks-to-bobbiejean-sweitzer-anes23

Anesthesiology 2023 Digest Part 1 | TopMedTalk Dec 25, 2023

Anesthesiology 2023, a huge event in the perioperative calendar for us here at TopMedTalk; the annual general meeting of the American Society of Anesthesiologists (ASA).

This piece includes clips from the following podcasts:

Mani Vindhya, Chief Medical Officer at Provation iProcedures | #ANES23

https://topmedtalk.libsyn.com/mani-vindhya-chief-medical-officer-at-provation-iprocedures-anes23

O.R. Sustainability & End-tidal Control | #ANES23

https://topmedtalk.libsyn.com/or-sustainability-end-tidal-control-anes23

Anesthesiology as a career in the 2020's | #ANES23

https://topmedtalk.libsyn.com/anesthesiology-as-a-career-in-the-2020s-anes23

Physician payments and Medicare | #ANES23

https://topmedtalk.libsyn.com/physician-payments-and-medicare-anes23

Updates on Neuromuscular Transmission (NMT) monitoring | #ANES23

https://topmedtalk.libsyn.com/updates-on-neuromuscular-transmission-nmt-monitoring-anes23

TopMedTalks to Michael W. Champeau and Ronald L. Harter | #ANES23

https://topmedtalk.libsyn.com/topmedtalks-to-michael-w-champeau-and-ronald-l-harter-anes23

TopMedTalks to Dru Riddle | AANA 2023 Dec 18, 2023

This wide ranging conversation gets into the thorny subject of reimbursement; how and why can practitioners advocate for a fairer rates? Also, what is the role of the American Association of Nurse Anesthesiology in this debate? Further, what are some of the realities of the ‘no surprises’ billing act?

Presented by Desiree Chappell and Randy Moore, Chief Anesthetists Officer of NorthStar Anesthesia with their guest Dru Riddle, PhD, DNP, CRNA, FAAN,American Association of Nurse Anesthesiology President, Anesthesia Patient Safety Foundation (APSF) board member.

Limitless: From Dingle to Cape Horn, finding my true north in the earth’s vastest oceans | Dingle 2023 Dec 11, 2023

“We do need to give ourselves credit for the sacrifices we made along the way…”

This entertaining piece is a conversation about blood pressure, swimming, extreme physiology and the joy of exercise. You will hear Desiree Chappell and Monty Mythen chatting with Nuala Moore, an Irish swimmer known for open water swimming and ice swimming. She was the 2011 winner of the Margaret Smith Award of the Irish Long Distance Swimming Association, given for increasing the profile of open water swimming; in 2006, she was one of six swimmers to swim around the coast of Ireland in a relay, the first-ever swim of over 1300 km around the coast. Then in 2008 she did a double relay crossing of the English Channel.

Her book “Limitless: From Dingle to Cape Horn, finding my true north in the earth’s vastest oceans” is available to buy in Dingle, or on Amazon: https://amzn.eu/d/bTEBKNS

AANA Presidents past and present | TopMedTalk Dec 04, 2023

The American Association of Nurse Anesthesiology (AANA) annual conference, here we speak with the outgoing and incoming Presidents of the organization. What can we expect in the year to come and what have been the highlights of the year past?

Desiree Chappell and her co-host Randy Moore, CRNA and Chief Anesthetist Officer of Northstar Anesthesia, Irving, Texas, speak with outgoing AANA president Angie Mund, DNP, CRNA, Department Chair, Clinical Sciences MUSC College of Health Professions Charleston, South Carolina and the AANA President- Elect, Janet Setnor, MSN, CRNA, Col. (Ret), USAFR, NC and practicing Certified Registered Nurse Anesthesiologist, Springfield, Virginia.

Intraoperative hypotension; killing them softly | TopMedTalk at The AANA Nov 27, 2023

Intraoperative hypotension is now firmly associated with harm and poor outcomes, this conversation should get you thinking about what this means to you as a practitioner.

Here Desiree Chappell speaks with Amy Yerdon, Assistant Professor of Nursing, Nursing Acute, Chronic & Continuing Care, University of Alabama, Birmingham and Bradley Steg, CRNA is a Nurse Anesthetist in Jackson, Tennessee.

Advancing Perioperative Medicine | EBPOM 2023 Nov 20, 2023

This talk “Advancing POM in New Zealand and Australia” was originally the EBPOM Visiting Professor Plenary Lecture given at the Evidence Based Perioperative Medicine (EBPOM) 2023 World Congress.

Our visiting Professor is Vanessa Beavis, the Immediate Past President of The Australian and New Zealand College of Anaesthetists (ANZCA), having just completed her 2 year term, she is a specialist anaesthetist at Auckland City Hospital, New Zealand and also an Honorary Senior Lecturer at the Department of Anaesthesiology, Auckland University.

She is introduced by Monty Mythen, Senior Vice President Medical Affairs, Edwards Lifesciences, Critical Care and Emeritus Professor of Anaesthesia and Critical Care, University College London.

Find out more about the ANZCA Diploma of Perioperative Medicine here: https://www.anzca.edu.au/education-training/perioperative-medicine-qualification/dip-pom

Women in anaesthesia in 2023 | EBPOM Ireland 2023 Nov 13, 2023

This valuable conversation took place at the annual Evidence Based Perioperative Medicine (EBPOM) Ireland conference. One of our most loved conference settings we’d love you, a TopMedTalk listener, to join us next year. Go now ot www.ebpom.org to find out more.

Hear Desiree Chappell in conversation with Anoushka Alfonso, Associate Professor of Clinical Anesthesiology at Memorial Sloan Kettering Cancer Center (MSK), where she is the Director of Enhanced Recovery Program, BobbieJean Sweitzer, Systems Director of Perioperative Practices at Inova Health, Falls Church, Virginia and Kate Leslie, specialist anaesthetist and head of research in the Department of Anaesthesia and Pain Management, Royal Melbourne Hospital and honorary professorial fellow at the University of Melbourne and Monash University in Australia.

Shared decision making and prehabilitation | Prehabilitation World Congress 2023 Nov 06, 2023

This week’s podcast is another “from the TopMedTalk table” at the recent World Prehabilitation Society annual conference held this year in London. We’ve been getting a feel for the issues people were discussing by listening to some of the people who took time to pop over and say hello.

This week sees us speaking to Imogen Fecher-Jones, lead nurse and project manager for the Perioperative Medicine Service and Preassessment at University Hospital Southampton and Nicholas Tetlow, exercise physiologist at UCLH and an honorary research fellow at UCL.

TopMedTalks to ... BobbieJean Sweitzer | #ANES23 Oct 30, 2023

This discussion covers many topics including; preoperative medicine and its evolution, frailty in various age groups, brain health and anesthesia in older adults, cognitive decline and executive function testing.

It is presented by Desiree Chappell and Guy Ludbrook with their guest, BobbieJean Sweitzer, Systems Director, Preoperative Medicine, Inova Health, Falls Church, Virginia, and Professor of Medical Education, University of Virginia and the author and editor of 'Preoperative Assessment and Management' (currently 3rd edition).

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Originally streamed live as part of our coverage of Anesthesiology 2023; the annual meeting of the American Society of Anesthesiologists, the largest and most important gathering of anesthesiologists in the world. We're your free front row seat.

For more on the ASA go here: https://www.asahq.org/

Check out our YouTube page for a record of the live stream video of this podcast: https://www.youtube.com/@topmedtalk7687/streams

TopMedTalks to Bernd Saugel at Anesthesiology 2022 | Editor's Highlight Oct 30, 2023

Looking this week at one of the highlights of Anesthesiology 2022 for us here on TopMedTalk; Desiree Chappell and Monty Mythen in conversation with the always interesting Bernd Saugel, Professor and Vice Chair of the Department of Anesthesiology, Center of Anesthesiology and Intensive Care Medicine at the University Medical Center Hamburg-Eppendorf, Germany.

The study is here: https://pubmed.ncbi.nlm.nih.gov/37265355/

Bernd is a popular figure here on TopMedTalk, we featured him recently during our coverage of The Euroanesthesia 2023 conference: https://topmedtalk.libsyn.com/topmedtalks-to-bernd-saugel-and-thomas-scheeren-esaic-2023

We also reference an earlier appearance in the conversation here: https://topmedtalk.libsyn.com/bernd-saugel-at-euroanesthesia-2022-topmedtalk

The original unedited conversation is here:https://topmedtalk.libsyn.com/the-detect-study-anesthesiology-2022

TopMedTalks to Michael W. Champeau and Ronald L. Harter | ASA 2023 Oct 27, 2023

This informative conversation takes a broad look at the field of anesthesiology, the staffing crisis and opportunities arising from that, leadership in medicine, as well as the recent past and long term future of the American Society of Anesthsiologists (ASA).

Presented by Desiree Chappell and Monty Mythen with their guests Michael W. Champeau, outgoing President of The American Society of Anesthesiologists, President of the Associated Anesthesiologists Medical Group and Ronald L. Harter, incoming President of The American Society of Anesthesiologists, Professor of anesthesiology, Department of Anesthesiology at The Ohio State University Wexner Medical Center in Columbus.

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Originally streamed live as part of our coverage of Anesthesiology 2023; the annual meeting of the American Society of Anesthesiologists, the largest and most important gathering of anesthesiologists in the world. We're your free front row seat.

For more on the ASA go here: https://www.asahq.org/

Check out our YouTube page for a record of the live stream video of this podcast: https://www.youtube.com/@topmedtalk7687/streams

How much Anesthesia? Brain monitoring to optimize neurohealth | #ANES23 Oct 27, 2023

"How do you know how much anesthesia your patient needs? Brain monitoring to optimize neurohealth."

This piece dives into the details with an important subject for anyone working in surgery at the moment.

Desiree Chappell and Guy Ludbrook talk to Jiapeng Huang, Tenured Professor and Vice Chairman of the Department of Anesthesiology and Perioperative Medicine at the University of Louisville, ASA Board of Directors.

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Originally streamed live as part of our coverage of Anesthesiology 2023; the annual meeting of the American Society of Anesthesiologists (ASA), the largest and most important gathering of anesthesiologists in the world. We're your free front row seat.

For more on the ASA go here: https://www.asahq.org/

Check out our YouTube page for a record of the live stream video of this podcast: https://www.youtube.com/@topmedtalk7687/streams

Alternative study designs for the future | ASA 2023 Oct 25, 2023

This engaging conversation gets into how and why trials and research are moving forward. Find out more about the conference we discuss here: https://euroanaesthesia.org

Presented by Desiree Chappell and Monty Mythen with their guests Wolfgang Buhre, Professor and Chair, Department of Anesthesiology, Division of Vital Functions, University Medical Center, Utrecht, The Netherlands and Thomas Scheeren, Senior Director Medical Affairs CC EMEACLA, Edwards Lifesciences.

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Originally streamed live as part of our coverage of Anesthesiology 2023; the annual meeting of the American Society of Anesthesiologists (ASA), the largest and most important gathering of anesthesiologists in the world. We're your free front row seat.

For more on the ASA go here: https://www.asahq.org/

Check out our YouTube page for a record of the live stream video of this podcast: https://www.youtube.com/@topmedtalk7687/streams

The World Congress of Anesthesiologists - 2024 - essential update | #ANES23 Oct 25, 2023

This piece focuses upon The World Congress of Anesthesiologists 2024: https://www.wca2024.org/

Presented by Desiree Chappell and Mike Grocott with their guests Wayne Morriss, President, WFSA (World Federation of Societies of Anaesthesiologists), Clinical Associate Professor, University of Otago, Specialist Anaesthetist, Canterbury District Health Board, New Zealand, Adrian Gelb, Immediate Past President at WFSA (World Federation of Societies of Anaesthesiologists), Anesthesiologist, University of California and Tony Gin, WFSA, Scientific Programme Committee Co-Chair.

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Originally streamed live as part of our coverage of Anesthesiology 2023; the annual meeting of the American Society of Anesthesiologists (ASA), the largest and most important gathering of anesthesiologists in the world. We're your free front row seat.

For more on the ASA go here: https://www.asahq.org/

Check out our YouTube page for a record of the live stream video of this podcast: https://www.youtube.com/@topmedtalk7687/streams

Anesthesia Patient Safety Foundation; Intraoperative Hypotension and Hemodynamic Stability | #ANES23 Oct 24, 2023

This important piece covers the recent Anestheia Patient Safety Foundation (APSF) conference on perioperative hemodynamic instability, and the recent recommendations that they have just launched.

The Anestheia Patient Safety Foundation is here: https://www.apsf.org/

Presented by Desiree Chappell and Mike Grocott with their guests, Daniel Cole MD, APSF President, Louise Y. Sun MD, SM, FRCPC , FAHA Professor of Anesthesiology at Stanford University, Michael Scott MB, ChB, FRCP, FRCA, FFICM Professor of Anesthesiology at the University of Pennsylvania.

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Originally streamed live as part of our coverage of Anesthesiology 2023; the annual meeting of the American Society of Anesthesiologists (ASA), the largest and most important gathering of anesthesiologists in the world. We're your free front row seat.

For more on the ASA go here: https://www.asahq.org/

Check out our YouTube page for a record of the live stream video of this podcast: https://www.youtube.com/@topmedtalk7687/streams

Training in Anesthesia | AANA 2023 Oct 23, 2023

The American Association of Nurse Anesthesiology (AANA) welcomes TopMedTalk to its annual conference with an array of great guests and healthy conversation. Recorded at the conference this series takes you right to the stories that mattered.

This piece sees Desiree Chappell speaking with Tim Jones, NorthStar Anesthesia’s Vice President of Academic Affairs and Lois Stewart, co director of the South College, Nurse Anesthesia program, Knoxville, Tennessee.

Patient Safety in Anesthesiology | #ANES23 Oct 22, 2023

TopMedTalk continues to bring you our coverage of Anesthesiology 2023; the annual meeting of the American Society of Anesthesiologists (ASA), the largest and most important gathering of anesthesiologists in the world. We're your free front row seat.

For more on the ASA go here: https://www.asahq.org/

Check out our YouTube page for a record of the live stream video of this podcast: https://www.youtube.com/@topmedtalk7687/streams

This essential conversation contains a look at anesthesia leadership and quality management, medication safety and a look forward to conferences to come.

We mention the Anesthesia Patient Safety Foundation, an organisation we have profiled in the past. If you'd like more information about them go here: https://www.apsf.org/

Presented by Desiree Chappell, Mike Grocott and Monty Mythen with their guest Elizabeth Rebello, Executive Director, Anesthesiology, Critical Care, and Pain Medicine, Cancer Network; Professor, Department of Anesthesiology and Perioperative Medicine, MD Anderson Cancer Center.

TopMedTalks to… the Chief Executive Officer and Chief Quality Officer of NorthStar Anesthesia | #ANES23 Oct 20, 2023

Welcome to our coverage of Anesthesiology 2023; the annual meeting of the American Society of Anesthesiologists (ASA); it's the largest and most important gathering of anesthesiologists in the world and we're your free front row seat.

For more on the ASA go here: https://www.asahq.org/

Check out our YouTube page for a record of the live stream video of this podcast: https://www.youtube.com/@topmedtalk7687/streams

This piece looks at the management of anesthesiology in the US, what are the challenges and solutions, the realities of 'provider squeeze', broader market trends and the opportunities for long term growth?

Presented by Desiree Chappell and Mike Grocott with their guests Adam Spiegel, CEO, NorthStar Anesthesia and Josh Lumbley, Chief Quality Officer, NorthStar Anesthesia.

Updates on Neuromuscular Transmission (NMT) monitoring | #ANES23 Oct 20, 2023

Welcome to our coverage of Anesthesiology 2023; the annual meeting of the American Society of Anesthesiologists (ASA); it's the largest and most important gathering of anesthesiologists in the world and we're your free front row seat.

For more on the ASA go here: https://www.asahq.org/

Check out our YouTube page for a record of the live stream video of this podcast: https://www.youtube.com/@topmedtalk7687/streams

Presented by Desiree Chappell, Mike Grocott and Guy Ludbrook with their guest Rick Dutton, Chief Quality Officer US Anesthesia Partners, Anesthesiologist, Baylor University Medical Center, Dallas, and is an adjunct professor in the Department of Anesthesiology at Texas A&M School of Medicine.

Rick has appeared on TopMedTalk multiple times, here are some of his most listened to podcast appearances:

Rick Dutton Chief Quality Officer US Anesthesia Partners | TopMedTalk at the ASA: https://topmedtalk.libsyn.com/rick-dutton-chief-quality-officer-us-anesthesia-partners-topmedtalk-at-the-asa

Interoperative hypotension study group; USAP and NorthStar Anesthesia | TopMedTalk: https://topmedtalk.libsyn.com/interoperative-hypotension-study-group-usap-and-northstar-anesthesia-topmedtalk

Desiree's Roundtable | Rick Dutton Q&A Session: https://topmedtalk.libsyn.com/desirees-roundtable-rick-dutton-qa-session

Artificial Intelligence in your practice | #ANES23 Oct 19, 2023

Our coverage of Anesthesiology 2023, continues. It's the annual meeting of the American Society of Anesthesiologists (ASA); it's the largest and most important gathering of anesthesiologists in the world and we're your free front row seat.

For more on the ASA go here: https://www.asahq.org/

Check out our YouTube page for a record of the live stream video of this podcast: https://www.youtube.com/@topmedtalk7687/streams

This year's conference was buzzing with discussion about artificial intelligence (AI) and in this conversation we get into the nuts and bolts of it. How will AI change our practice in the next 5 years? Who will AI replace, or will it instead become a tool which all healthcare providers welcome? Where are we in now the "hype cycle" of this new technology?

Featuring Desiree Chappell and Mike Grocott with their guests; Ronald G. Pearl, ASA committee on Innovation, Professor and Chair, Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine and Peter V. Killoran, ASA Committee on Informatics and Information Technologies, Associate Professor of Anesthesiology, Assistant Professor, Biomedical Informatics at The University of Texas Health Science Center, Houston.

The GAP study: Gabapentin and perioperative pain, results and analysis | #ANES23 Oct 19, 2023

Our coverage of Anesthesiology 2023, continues. It's the annual meeting of the American Society of Anesthesiologists (ASA); it's the largest and most important gathering of anesthesiologists in the world and we're your free front row seat.

For more on the ASA go here: https://www.asahq.org/

Check out our YouTube page for a record of the live stream video of this podcast: https://www.youtube.com/@topmedtalk7687/streams

For more on the Gabapentin and perioperative pain (GAP) study go here: https://bristoltrialscentre.blogs.bristol.ac.uk/details-of-studies/gap/

We get into an important conversation about The Opioid Crisis, there's a powerful conversation about it in our archive here: https://topmedtalk.libsyn.com/topmedtalk-tackling-the-pain-of-the-opioid-crisis-0

Presented by Desiree Chappell, Mike Grocott and Guy Ludbrook with their guest Ben Gibbison Consultant Anaesthetist at University Hospitals Bristol NHS Foundation Trust.

Anesthesiology 2023 - still to come and highlights so far | #ANES23 Oct 19, 2023

This piece works as a summary of our coverage of Anesthesiology 2023, so far. It's the annual meeting of the American Society of Anesthesiologists (ASA); it's the largest and most important gathering of anesthesiologists in the world and we're your free front row seat.

For more on the ASA go here: https://www.asahq.org/

Check out our YouTube page for a record of the live stream video of this podcast: https://www.youtube.com/@topmedtalk7687/streams

Presented by Desiree Chappell, our lead US presenter, a Certified Registered Nurse Anesthetist (CRNA) and Vice President of Clinical Quality for NorthStar Anesthesia, Mike Grocott, Professor of Anaesthesia and Critical Care Medicine at the University of Southampton and an NIHR Senior Investigator, and Guy Ludbrook, Professor of Anaesthesia at the University of Adelaide and Royal Adelaide Hospital.

The team take a minute to review some of this year's coverage of Anesthesiology 2023 and look forward to some of the conversations still to come here on TopMedTalk's podcast feed.

Some of the highlights mentioned in this piece include:

Anesthesiology as a career, "the future of the profession"; https://topmedtalk.libsyn.com/anesthesiology-as-a-career-in-the-2020s-anes23

The piece on Howard University; https://topmedtalk.libsyn.com/opportunities-in-anesthesiology-anes23

The discussion about pricing; https://topmedtalk.libsyn.com/physician-payments-and-medicare-anes23

The conversation about sustainability; https://topmedtalk.libsyn.com/or-sustainability-end-tidal-control-anes23

Opportunities in Anesthesiology | #ANES23 Oct 18, 2023

Our coverage of Anesthesiology 2023, continues. It's the annual meeting of the American Society of Anesthesiologists (ASA); it's the largest and most important gathering of anesthesiologists in the world and we're your free front row seat.

For more on the ASA go here: https://www.asahq.org/

Check out our YouTube page for a record of the live stream video of this podcast: https://www.youtube.com/@topmedtalk7687/streams

This piece looks into equal opportunities in anesthesiology.

Presented by Desiree Chappell, and Guy Ludbrook with Elijah McMillan, MD Candidate at Howard University College of Medicine and Majesty Greer, MD Candidate at Howard University College of Medicine.

Physician payments and Medicare | #ANES23 Oct 18, 2023

Our coverage of Anesthesiology 2023, continues. It's the annual meeting of the American Society of Anesthesiologists (ASA); it's the largest and most important gathering of anesthesiologists in the world and we're your free front row seat.

For more on the ASA go here: https://www.asahq.org/

Check out our YouTube page for a record of the live stream video of this podcast: https://www.youtube.com/@topmedtalk7687/streams

This piece focuses in on physician payments and Medicare.

Presented by Desiree Chappell and Mike Grocott with their guests Lois Connolly, ASA Vice President for Professional Affairs, Professor, Department of Anesthesiology, Medical College of Wisconsin and Jonathan Gal, Chair of ASA Committee on Economics, Professor, Anesthesiology, Ichan School of Medicine, Medical Director for Offsite Ambulatory Surgery Centers Anesthesia, Director of Governmental and Reimbursment Affairs.

Anesthesiology as a career in the 2020's | #ANES23 Oct 17, 2023

"What is anestheiology going to look like in the next ten years?"

This is a no holds barred conversation about the future of our profession, as a career, particularly for those who are looking at how and why they should embrace some of the seismic changes we currently face.

Presented by Desiree Chappell, Mike Grocott, and Guy Ludbrook, Professor of Anaesthesia at the University of Adelaide and Royal Adelaide Hospital with their guest George W. Williams II, Chair of the ASA Comittee on Critical Care Medicine, and Professor of Anesthesiology at The University of Texas Health Science in Houston.

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Our coverage of Anesthesiology 2023, continues. It's the annual meeting of the American Society of Anesthesiologists (ASA); it's the largest and most important gathering of anesthesiologists in the world and we're your free front row seat.

For more on the ASA go here: https://www.asahq.org/

Check out our YouTube page for the live stream video of this podcast: https://www.youtube.com/@topmedtalk7687/streams

O.R. Sustainability & End-tidal Control | #ANES23 Oct 16, 2023

Our coverage of Anesthesiology 2023, continues. It's the annual meeting of the American Society of Anesthesiologists (ASA); it's the largest and most important gathering of anesthesiologists in the world and we're your free front row seat.

For more on the ASA go here: https://www.asahq.org/

Check out our YouTube page for the live stream video of this podcast: https://www.youtube.com/@topmedtalk7687/streams

Presented by Desiree Chappell, Mike Grocott, and Guy Ludbrook, Professor of Anaesthesia at the University of Adelaide and Royal Adelaide Hospital with their guest, David Hovord GE Healthcare Consultant, Clinical Assistant Professor, Michigan Medicine.

Cost savings through continuous vital sign monitoring | #ANES23 Oct 16, 2023

Our coverage of Anesthesiology 2023, continues. It's the annual meeting of the American Society of Anesthesiologists (ASA); it's the largest and most important gathering of anesthesiologists in the world and we're your free front row seat.

For more on the ASA go here: https://www.asahq.org/

Check out our YouTube page for the live stream video of this podcast: https://www.youtube.com/@topmedtalk7687/streams

This piece is presented by Desiree Chappell, our lead US presenter, a Certified Registered Nurse Anesthetist (CRNA) and Vice President of Clinical Quality for NorthStar Anesthesia, Mike Grocott, our Editor in Chief, Professor of Anaesthesia and Critical Care Medicine at the University of Southampton and an NIHR Senior Investigator, and Guy Ludbrook, Professor of Anaesthesia at the University of Adelaide and Royal Adelaide Hospital with their guest John W Beard, Chief Medical Officer at GE Healthcare - Patient Care Solutions.

We mention 'The Portrait Mobile product launch, live from the ESAIC' piece, which you can find here: https://topmedtalk.libsyn.com/the-portrait-mobile-product-launch-at-the-esaic-topmedtalk

The paper referenced in this piece, "Cost savings through continuous vital sign monitoring in the medical-surgical unit" is here: https://www.tandfonline.com/doi/full/10.1080/13696998.2023.2219156

An overview of Anesthesiology 2023 | #ANES23 Oct 15, 2023

The annual meeting of the American Society of Anesthesiologists; Anesthesiology 2023, it's the largest and most important gathering of anesthesiologists in the world and we're your free front row seat.

For more on the ASA go here: https://www.asahq.org/

Make sure you subscribe to TopMedTalk and follow along as all our conversations from the conference make their way to you.

In this piece we're getting a feel for the conference on our second day there, featuring Desiree Chappell, our lead US presenter, a Certified Registered Nurse Anesthetist (CRNA) and Vice President of Clinical Quality for NorthStar Anesthesia, Mike Grocott, Professor of Anaesthesia and Critical Care Medicine at the University of Southampton and an NIHR Senior Investigator, Monty Mythen, Senior Vice President Medical Affairs, Edwards Lifesciences, Critical Care, Emeritus Professor of Anaesthesia and Critical Care, University College London, and Guy Ludbrook, Professor of Anaesthesia at the University of Adelaide and Royal Adelaide Hospital.

Mani Vindhya, Chief Medical Officer at Provation iProcedures | #ANES23 Oct 15, 2023

Our coverage of the annual meeting of the American Society of Anesthesiologists; Anesthesiology 2023, continues. The largest and most important gathering of anesthesiologists in the world and we're your free front row seat.

For more on the ASA go here: https://www.asahq.org/

Presented by Desiree Chappell, Guy Ludbrook and Monty Mythen with Mani Vindhya, Chief Medical Officer at Provation® iProcedures, Assistant Professor of Anesthesiology, Nova Southeastern University and Attending Anesthesiologist at St Josephs Hospital.

NB// If you would like to watch these podcasts LIVE go here: https://www.youtube.com/watch?v=JPpwNqaVXP8

The ASA Committee on Governmental Affairs, Michael M Beck | #ANES23 Oct 15, 2023

Our coverage of the annual meeting of the American Society of Anesthesiologists; Anesthesiology 2023, continues. The largest and most important gathering of anesthesiologists in the world and we're your free front row seat. Hear how and why both local and state level advocacy has recently helped move our discipline forward.

For more on the ASA go here: https://www.asahq.org/

Presented by Mike Grocott, TopMedTalk's Editor in Chief and Guy Ludbrook, Professor of Anaesthesia at the University of Adelaide and Royal Adelaide Hospital with their guest Michael M. Beck, ASA Committee on Governmental Affairs, Chair, ASA Committee on Governmental Affairs Task Force on State Advocacy, Managing Board Member, Mountain West Anesthesia, Intermountain Healthcare – Riverton Hospital, The Orthopedic Specialty Hospital, Salt Lake City, Utah.

Huge TopMedTalk announcement live from Anesthesia 2023 | #ANES23 Oct 15, 2023

What is the future of TopMedTalk, where will we find our new Editor in Chief? This podcast has all the answers.

Make sure you are subscribed to this podcast so you don't miss a minute of our coverage of the annual meeting of the American Society of Anesthesiologists; Anesthesiology 2023. It's the largest and most important gathering of anesthesiologists in the world and we're your free front row seat.

For more on the ASA go here: https://www.asahq.org/

Also, check out our LIVE FREE VIDEO STREAM here: https://www.youtube.com/watch?v=JPpwNqaVXP8

This podcast features Desiree Chappell, our lead US presenter, a Certified Registered Nurse Anesthetist (CRNA) and Vice President of Clinical Quality for NorthStar Anesthesia, Monty Mythen, Senior Vice President Medical Affairs, Edwards Lifesciences, Critical Care, Emeritus Professor of Anaesthesia and Critical Care, University College London, Mike Grocott, Professor of Anaesthesia and Critical Care Medicine at the University of Southampton and an NIHR Senior Investigator and Guy Ludbrook, Professor of Anaesthesia at the University of Adelaide and Royal Adelaide Hospital.

WELCOME TO ANESTHESIOLOGY 2023 | #ANES23 Oct 14, 2023

This is a huge moment in the calendar for us here at TopMedTalk, the annual meeting of the American Society of Anesthesiologists; Anesthesiology 2023. TopMedTalk will be bringing you the best of our coverage on this podcast stream.

We also invite you to join us on our free live video stream, here: https://www.youtube.com/watch?v=c0-b3WagONQ

This piece features Desiree Chappell, our lead US presenter, a Certified Registered Nurse Anesthetist (CRNA) and Vice President of Clinical Quality for NorthStar Anesthesia, Mike Grocott, Professor of Anaesthesia and Critical Care Medicine at the University of Southampton and an NIHR Senior Investigator and Guy Ludbrook, Professor of Anaesthesia at the University of Adelaide and Royal Adelaide Hospital.

Is the pursuit of DREAMing (DRinking, EAting and Mobilising) the ultimate goal of ERAS? | TopMedTalk Oct 12, 2023

This piece is a guide to the importance behind drinking, eating and mobilising as part of an enhanced recovery after surgery programme (ERAS). It comprises clips from previous conversations, linked to below, along with a as yet to be released piece on the topic featuring Vicki Morton, Director of Clinical and Quality Outcomes at Providence Anesthesiology Associates in Charlotte, NC.

Henrik Kehlet, gastrointestinal surgeon and former professor of surgery, Copenhagen University, and now professor of perioperative therapy and Head of Section of Surgical Pathophysiology, Rigshospitalet, Copenhagen University, spoke to us in more detail here: https://topmedtalk.libsyn.com/asa-henrik-kehlet-recovery-is-all-about-inflammation

We speak with Ramani Moonesinghe, OBE, Professor of Perioperative Medicine at University College London and Honorary Consultant in Anaesthesia and Perioperative Medicine at University College London Hospital here: https://topmedtalk.libsyn.com/perioperative-quality-improvement-and-the-dreaming-question-ebpom-2023

We mention this paper “Is the pursuit of DREAMing (drinking, eating and mobilising) the ultimate goal of anaesthesia?” here: https://pubmed.ncbi.nlm.nih.gov/27079158/

Portrait Mobile, monitoring the unmonitored | Euroanesthesia 2023 Oct 09, 2023

Desiree Chappell, Monty Mythen and Andrew Cumpstey sit down with Cory Stahl, Global Marketing Manager at GE Healthcare to talk about “Portrait Mobile”.

This piece was recorded while TopMedTalk were at this year’s annual conference of The European Society of Anaesthesiology and Intensive Care (ESAIC); Euroanesthesia 2023. We had a presence there at the GE Healthcare stand.

ESAIC is the leading European Organisation for Anaesthesia, Intensive Care, Pain and Perioperative Medicine. TopMedTalk is proud to continue to bring you coverage of their annual conference.

For more information on the work ESAIC do check out their website here: https://www.esaic.org/event/euroanaesthesia-2023/

TopMedTalks to Chris Lawman and Peter van Heezik | Euroanesthesia 2023 Oct 02, 2023

TopMedTalk were at this year’s annual conference of The European Society of Anaesthesiology and Intensive Care (ESAIC); Euroanesthesia 2023.

ESAIC is the leading European Organisation for Anaesthesia, Intensive Care, Pain and Perioperative Medicine. TopMedTalk is proud to continue to bring you coverage of their annual conference.

For more information on the work ESIAC do check out their website here https://euroanaesthesia.org/

We previously featured the GE Healthcare portrait mobile launch, as mentioned in this piece, you can hear that here: https://topmedtalk.libsyn.com/the-portrait-mobile-product-launch-at-the-esaic-topmedtalk

Here Desiree Chappell and Monty Mythen pick up a conversation with Chris Lawman Senior Modality Leader for GE Healthcare and Peter van Heezik Anesthesia Digital Leader for GE Healthcare.

The Perioperative Quality Initiative (POQI) 12 | EBPOM Ireland 2023 Sep 29, 2023

TopMedTalk continues tracking the incredibly important work done by Perioperative Quality Initiative (POQI), check out their website here: http://thepoqi.org/

This piece acts as an introduction to this year’s POQI - 12.

Recorded at the Evidence Based Perioperative Medicine (EBPOM) Ireland conference this piece features an exclusive conversation between Desiree Chappell and Mike Grocott speaking with Guy Ludbrook, Professor of Anaesthesia at the University of Adelaide and Royal Adelaide Hospital and Andrew Shaw, Chairman, Department of Intensive Care and Resuscitation at The Cleveland Clinic, Cleveland, Ohio.

The Perioperative Quality Initiative | EBPOM 2023 Sep 25, 2023

The Perioperative Quality Initiative (POQI) is an international, multidisciplinary non-profit organization that organizes consensus conferences on topics of interest related to perioperative medicine with the aim of improving patient care.

This piece is an exclusive chance to hear how and why The POQI strives towards a broader perspective and the value of not existing within an echo chamber. It was originally part of The Evidence Based Perioperative Medicine (EBPOM 2023) World Congress in London.

With questions from the audience Desiree Chappell hosts a conversation with the chairs Mike Grocott, Professor of Anaesthesia and Critical Care Medicine at the University of Southampton and Andy Shaw, Chairman, Department of Intensive Care and Resuscitation at The Cleveland Clinic, Cleveland, Ohio.

Find out more about The POQI and to read their publications go here: http://thepoqi.org/

Publications: http://thepoqi.org/Publications

Prehabilitation as a practitioner and a patient | Prehabilitation / EBPOM 2023 Sep 18, 2023

Here John Koncelik, Regional Medical Director HCA Healthcare Physician Services Group, West Florida comes to the TopMedTalk table to share his thoughts on the need for prehabilitaiton and the way in which it relates to the wider question of “population health management”.

He also chooses to share his recent experiences as a patient in the healthcare system, how that has changed his view and why he’s so proud to work in the industry.

If you enjoyed this piece it may interest you to know that John will be sharing more of his personal story with us at the forthcoming Evidence Based Perioperative Medicine (EBPOM) Dingle Conference, tickets are available now: https://ebpom.org/product/ebpom-ireland-2023/

Advanced AI–guided hemodynamic management within cardiac enhanced recovery after surgery pathways | TopMedTalk Sep 16, 2023

Desiree Chappell and Monty Mythen in conversation with Seenu Reddy, Cardiothoracic Surgeon at HCA‘s TriStar Cardiovascular Surgery in Nashville, National Physician Director, HCA Healthcare's CV Service line.

We start with discussion about the ERAS Cardiac society, more about them here: https://www.erascardiac.org/

The paper discussed in this piece (10 minutes in) “Advanced artificial intelligence–guided hemodynamic management within cardiac enhanced recovery after surgery pathways: A multi-institution review” is available here: https://doi.org/10.1016/j.xjon.2023.06.023

TopMedTalk is the broadcasting arm of Evidence Based Perioperative Medicine (EBPOM). For more information on EBPOM Ireland go here: https://ebpom.org/

As mentioned in the piece we’ve enjoyed conversations with Seenu Reddy previously: https://topmedtalk.libsyn.com/the-eras-cardiac-society-conference-day-2-topmedtalk-0

https://topmedtalk.libsyn.com/eras-cardiac-2019-seenu-reddy

And we mention a forthcoming “mini-doc” on the subject of Drinking Eating and Mobilising which will include part of our essential interview with Henrik Kehlet, that you can hear here: https://topmedtalk.libsyn.com/asa-henrik-kehlet-recovery-is-all-about-inflammation

TopMedTalks to Sean Bennett | TopMedTalk at ESAIC Sep 13, 2023

This wide ranging conversation starts with a focus on the importance of Near Infra-Red Spectroscopy (NIRS) and echocardiograms, how do we move forward in patient safety while keeping in line with what works in practice? How do we go from thinking we do not need, or even consider, a piece of kit to being ready to postpone surgery without it? What does that journey look like?

Here Desiree Chappell, Monty Mythen and Andy Cumpstey speak with their guest Sean Bennet, cardiac anesthetist and intensivist at University Hospital Southampton NHS Foundation Trust.

TopMedTalk were at this year’s annual conference of The European Society of Anaesthesiology and Intensive Care (ESAIC); Euroanesthesia 2023. This piece was recorded there at the GE Healthcare stand.

ESAIC is the leading European Organisation for Anaesthesia, Intensive Care, Pain and Perioperative Medicine. TopMedTalk is proud to continue to bring you coverage of their annual conference.

For more information on the work ESIAC do check out their website here: https://www.esaic.org/event/euroanaesthesia-2023/

The use of cardiac biomarkers in perioperative risk evaluation | ESAIC 2023 Sep 11, 2023

Here Desiree Chappell and Andy Cumpstey speak with Michelle Chew, Academic Chair and Professor in Anaesthesiology, Intensive Care and Acute Care at Linköping University Hospital, Sweden and Giovanna Luratibuse, consultant and anesthesiology Professor at the University Hospital Düsseldorf, Germany.

For more on this topic - and the check out the guidelines - go to: https://journals.lww.com/ejanaesthesiology/pages/default.aspx

Or straight to the guidelines here: https://journals.lww.com/ejanaesthesiology/Fulltext/9900/ESAIC_focused_guideline_for_the_use_of_cardiac.98.aspx?WT.mc_id=HPxADx20100319xMP

This piece was recorded while TopMedTalk were at this year’s annual conference of The European Society of Anaesthesiology and Intensive Care (ESAIC); Euroanesthesia 2023. We had a presence there at the GE Healthcare stand.

ESAIC is the leading European Organisation for Anaesthesia, Intensive Care, Pain and Perioperative Medicine. TopMedTalk is proud to continue to bring you coverage of their annual conference.

For more information on the work ESIAC do check out their website here: https://www.esaic.org/event/euroanaesthesia-2023/

TopMedTalks to Manfred Blobner | Euroanesthesia 2023 Sep 07, 2023

Desiree Chappell and Andy Cumpstey talk to Manfred Blobner, Professor, Anesthesiology and the Coordinator of the Residency Program at Technische Universität München.

TopMedTalk were at this year’s annual conference of The European Society of Anaesthesiology and Intensive Care (ESAIC); Euroanesthesia 2023. This piece was recorded there at the GE Healthcare stand.

ESAIC is the leading European Organisation for Anaesthesia, Intensive Care, Pain and Perioperative Medicine. TopMedTalk is proud to continue to bring you coverage of their annual conference.

For more information on the work ESAIC do check out their website here: https://www.esaic.org/event/euroanaesthesia-2023/

TopMedTalks to Vera von Dossow | ESAIC 2023 Sep 04, 2023

TopMedTalk recorded this piece at the European Society of Anaesthesiology and Intensive Care (ESAIC) conference, Euroanaesthesia 2023 in Glasgow.

It features Desiree Chappell, Monty Mythen and Andy Cumpstey in conversation with Vera von Dossow, Director of the Institute for Anesthesiology and Pain Therapy at the HDZ NRW, Bad Oeynhausen.

With thanks to Edwards Lifesciences for their generous support in bringing free open access medical education to you.

The ERAS Cardiac society | EBPOM World Congress 2023 Aug 28, 2023

Enhanced Recovery After Surgery (ERAS) is a foundational aspect of perioperative medicine. This piece covers ERAS® Cardiac, a non-profit organization with the mission to develop evidence-based expert consensus statements promoting best practice recovery practices: https://www.erascardiac.org/about/our-team

We discuss The Perioperative Quality Initiative: https://www.thepoqi.org/

We also discuss the value proposition for perioperatvie care, the need for open access medical information and collaboration in cardiac surgery.

We discuss this paper in detail: Adult Cardiac Surgery-Associated Acute Kidney Injury: Joint Consensus Report: https://www.jcvaonline.com/article/S1053-0770(23)00340-3/fulltext

Presented by Desiree Chappell and Monty Mythen with their guest Vicki Morton, Director of Clinical and Quality Outcomes at Providence Anesthesiology Associates in Charlotte, NC.

The importance of podcasting in anesthesia and perioperative medicine | ASA Highlight Aug 21, 2023

This piece is presented by Desiree Chappell and Sol Aronson with their guest Jed Wolpaw, Anesthesiologist, intensivist, founder and host of http://accrac.com podcast, Program Director, Johns Hopkins Anesthesiology.

TopMedTalk is very proud to be partnered with the American Society of Anesthesiologists® ANESTHESIOLOGY® 2022, bringing you our most comprehensive and extensive coverage of the largest gathering of anesthesiologists in the world!

TopMedTalk is provided to you for free; if you want to help support our work and help give these conversations a wider audience please like and subscribe (if and where possible) before sharing it on your social media.

We are on Twitter here: https://twitter.com/topmedtalk

We are on LinkedIn here: https://www.linkedin.com/company/topmedtalk

We are on Facebook here: https://www.facebook.com/TopMedTalk1/

Prehabilitation - evidence over hype | Prehabilitation / EBPOM 2023 Aug 14, 2023

The World Congress of Prehabilitation Medicine preceded this year’s Evidence Based Perioperative Medicine (EBPOM). TopMedTalk had an open table and this podcast contains two of the conversations we recorded in between presentations and live streaming.

We mention two trials: https://bmjopen.bmj.com/content/13/1/e065992

And: https://clinicaltrials.gov/study/NCT05756283

We hear from, Heather Gill, a vascular surgeon at McGill University and Research Chair for the Canadian Society of vascular surgery, President elect about the wide applicability of prehabilitation balanced against the evidence and Professor Enoch Akowuah, Chair of cardiac surgery at Newcastle University and a consultant cardiac surgeon and at South Tees Hospitals NHS Foundation Trust in the UK.

ANESTHESIOLOGY® | Editor's Highlight ASA 2022 Aug 07, 2023

TopMedTalk is very proud to be partnered with the American Society of Anesthesiologists® (ASA), providing comprehensive and extensive coverage of the largest gathering of anesthesiologists in the world. Here we reflect on the conference, plans for its future and the wider picture of the discipline.

This piece is presented by Desiree Chappell, Sol Aronson and Monty Mythen with their guest Sheela Pai Cole, Clinical Professor, Anesthesiology, Perioperative and Pain Medicine at Stanford Health Center.

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TopMedTalk can be found on YouTube here: https://www.youtube.com/channel/UC-HYQmeIwcFCYO1hoQ8jShQ

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Perioperative Quality Improvement and 'The Dreaming Question' | EBPOM 2023 Jul 31, 2023

“It's kind of easy to say it; ‘drinking, eating, mobilizing’ and yet actually what does it mean? Drinking, how much? Eating, what? And mobilizing, in what way? And so we refined the definitions so that everyone was measuring the same thing…”

The Perioperative Quality Improvement Programme (PQIP): https://www.rcoa.ac.uk/research/research-projects/perioperative-quality-improvement-programme-pqip

Presented by Desiree Chappell and Monty Mythen with their guest Ramani Moonesinghe, OBE, Professor of Perioperative Medicine at University College London and Honorary Consultant in Anaesthesia and Perioperative Medicine at University College London Hospital.

Sustainability in medicine | EBPOM World Congress 2023 Jul 24, 2023

Is sustainability now one of the key performance indicators by which we are judged? How has the medical industry responded to this and where are the pressures coming from for an environmentally conscious future?

Desiree Chappell, Monty Mythen and Sol Aronson with their guest Liam Hynes, Operations Leader for Respiratory Interventions at Medtronic.

This piece was recorded at the Evidence Based Perioperative Medicine (EBPOM) World Congress held in London in 2023. If you would like more information about the incredible work EBPOM do please go here: www.ebpom.org

TopMedTalk is not possible without the support of our generous industry partners and supporters; we would like to thank Medtronic for their assistance in bringing you free open access medical education.

Talks to... Elizabeth Drum | Editor's Highlight Jul 17, 2023

This piece is presented by Desiree Chappell and Sol Aronson with their guest Elizabeth Drum, Associate Professor of Clinical Anesthesiology and Critical Care Medicine at the Perelman School of Medicine, University of Pennsylvania, Philadelphia.

Our conversation about Lifebox is here: https://topmedtalk.libsyn.com/asa-2019-lifebox

For more information about the American Society of Anesthesiologist's global humanitarian outreach go here: https://www.asahq.org/charity

Part one of TopMedTalk’s conversation with the global scholars is here: https://topmedtalk.libsyn.com/the-asa-global-scholars-program-part-1-anesthesiology-2022

And part two is here: https://topmedtalk.libsyn.com/the-asa-global-scholars-program-part-2-anesthesiology-2022

This piece was originally put out “as live” from Anesthesiology 2022 the American Society of Anesthesiologists annual conference.

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TopMedTalk is provided to you for free; if you want to help support our work and help give these conversations a wider audience please like and subscribe (if and where possible) before sharing it on your social media.

TopMedTalk can be found on YouTube here: https://www.youtube.com/channel/UC-HYQmeIwcFCYO1hoQ8jShQ

We are on Twitter here: https://twitter.com/topmedtalk

We are on LinkedIn here: https://www.linkedin.com/company/topmedtalk

We are on Facebook here: https://www.facebook.com/TopMedTalk1/

The Anesthesia Patient Safety Foundation | ASA Highlight Jul 10, 2023

Here we look back upon The Anesthesia Patient Safety Foundation (APSF) at last year’s Anesthesiology conference.

This piece is presented by Desiree Chappell and Monty Mythen with their guests JW Beard, Chief Medical Officer of GE Patient Care solutions, GE Healthcare, APSF Board of Directors and Jeffery Feldman, Attending Anesthesiologist, Children’s Hospital of Philadelphia (CHOP) and Professor of Clinical Anesthesiology at the Perelman School of Medicine, University of Pennsylvania, APSF Board of Directors.

The educational resources mentioned in this piece are here:

https://www.apsf.org/apsf-technology-education-initiative/

The APSF website is here: http://www.apsf.org

We spoke previously to The Anesthesia Patient Safety Foundation in 2019 here:

https://www.topmedtalk.com/asa-2019-anesthesia-patient-safety-foundation-mark-warner/

We also consulted them during our coverage of the COVID-19 crisis: https://www.topmedtalk.com/the-anesthesia-patient-safety-foundation-covid-19/

TopMedTalk; proud to be partnered with the American Society of Anesthesiologists® at ANESTHESIOLOGY® 2022.

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TopMedTalk is provided to you for free; if you want to help support our work and help give these conversations a wider audience please like and subscribe (if and where possible) before sharing it on your social media.

TopMedTalk can be found on YouTube here: https://www.youtube.com/channel/UC-HYQmeIwcFCYO1hoQ8jShQ

We are on Twitter here: https://twitter.com/topmedtalk

We are on LinkedIn here: https://www.linkedin.com/company/topmedtalk

We are on Facebook here: https://www.facebook.com/TopMedTalk1/

OPTIMISE 2 results…BREAKING NEWS | EBPOM 2023 Jul 08, 2023

The big talking point at The World Congress of Evidence Based Perioperative Medicine (EBPOM) 2023 was the results of the ‘OPtimisation of Peri-operaTive CardIovascular Management to Improve Surgical outcomE II (OPTIMISE II)’ trial.

The OPTIMISE II trial is an international, multi-centre, pragmatic, randomised controlled trial with an open study group allocation, to determine whether cardiac output-guided fluid therapy, with a low dose inotrope infusion is clinically effective when compared to usual care in patients undergoing major gastrointestinal surgery.

This podcast captures the moment the world has been waiting for as this global trial (with over 30 participating centres in Australia, Canada, Germany, Jordan, Poland, Romania, Spain, Switzerland, US and the UK) which launched in January 2017, reports its results.

Presented by Desiree Chappell, Monty Mythen and Mark Edwards, Consultant in Anaesthesia and Perioperative Medicine, University Hospital Southampton, Honorary Senior Clinical Lecturer, University of Southampton.

We speak to Rupert Pearse here:https://topmedtalk.libsyn.com/topmedtalks-to-rupert-pearse-esaic-2023

This story is one of the first TopMedTalk ever covered! Our second podcast (back in 2017) covers it here: https://topmedtalk.libsyn.com/monty-boston-pod-two

This podcast was recorded “as live” at EBPOM 2023 in London. Expect to find more excellent free content from that meeting soon on TopMedTalk. However, if you can’t wait, why not try going deeper by joining up or getting a ticket to one of our forthcoming conferences: www.ebpom.org

The official website for the trial is here: https://optimiseii.org/

EBPOM 2023 IS THIS WEEK - GO TO EBPOM.ORG NOW! Jul 03, 2023

This week we are drawing attention to an excellent talk from our archive and warming up for the biggest moment in the perioperative calendar; Evidence Based Perioperative Medicine (EBPOM) and the World Congress of Prehabilitation Medicine 2023.

Go now to www.ebpom.org to book your virtual tickets, if you can’t make it in person.

In this podcast we look at some of the upcoming sessions and reflect on the contributions made previously to TopMedTalk by some of the panelists and speakers.

We discuss this episode of TopMedTalk featuring Gerrit Slooter & Mike Grocott - https://topmedtalk.libsyn.com/the-international-prehabilitation-and-perioperative-exercise-testing-society-ipoetts-ebpom-world-conference

We mention the fact that Franco Carli makes important contributions during to this panel discussion:

Exercise and the cancer patient during the COVID-19 crisis: https://topmedtalk.libsyn.com/exercise-and-the-cancer-patient-during-the-covid-19-crisis-ebpom-2021

Feras Hatib features in the 2019 Prehabilitation World Congress here:

Prehab Periop World Congress: Feras Hatib, Simon Davies https://topmedtalk.libsyn.com/prehab-periop-world-congress-feras-hatib-simon-davies

And "Nutrition and surgery a dieticians perspective" with Chelsia Gillis is here: https://topmedtalk.libsyn.com/ebpom-2019-nutrition-and-surgery-a-dieticians-perspective-0

Meanwhile the talk in this week's podcast, from 2018, Sir Bruce Keogh features here in it's original form: https://topmedtalk.libsyn.com/the-topmedtalk-top-ten-sir-bruce-keogh-the-nhs-at-70

Autonomous systems in a perioperative setting | TopMedTalk Jun 26, 2023

What is the future of AI and autonomous systems in perioperative medicine? This piece revisits a conversation we had at 'Anesthesiology'; the Annual General Meeting of the American Society of Anesthesiologists (ASA).

Presented by Desiree Chappell and Monty Mythen with their guest Alexandre Joosten, Anesthetist at Hospital Erasme.

This conversation references our earlier chat with our guest which you can listen to here: https://topmedtalk.libsyn.com/topmedtalk-a-step-between-a-simple-monitor-and-a-fully-automated-system

Monitoring the unmonitored | TopMedTalk Jun 19, 2023

How far can we go with patient monitoring, how do we push forward with patient safety? What sort of monitoring is appropriate and when? How should we continue through the night time period? Where are the 'gaps and opportunities' for new technology?

This conversation, originally part of our coverage of 'Anesthesiology' the Annual General Meeting of the American Society of Anesthesiologists (ASA), features Sol Aronson with his guests Sadia Khan, Consultant Physician, Clinical Director and Service Director for Cardiology at Chelsea and Westminster Hospital and Frank Overdyk, Professor of Anaesthesiology, Charleston, South Carolina.

Sadia has featured on TopMedTalk previously here: https://www.topmedtalk.com/topmedtalks-to-sadia-khan-ebpom-2022/

We spoke with Frank here on the subject of pain monitoring: https://www.topmedtalk.com/11813-2/

What is TeleICU and how can it help put patient safety first? | TopMedTalk Jun 12, 2023

You may have heard of Telemedicine but have you heard of TeleICU? How does it work? What's it like to work in one? How do you avoid alarm fatigue? To what scale can this tecnhology be safely extended?

Our guest Mike Scott, Professor of Anesthesiology at the University of Pennsylvania in conversation with Desiree Chappell, Monty Mythen and Sol Aronson.

The paper mentioned towards the end of the piece is here: https://www.sciencedirect.com/science/article/abs/pii/S0952818022002914

This piece was originally released here: https://topmedtalk.libsyn.com/creating-high-reliability-using-tele-icu-anesthesiology-2022

Videolaryngoscopy: Is the evidence there? | ESIAC 2023 Jun 05, 2023

TopMedTalk were at this year’s annual conference of The European Society of Anaesthesiology and Intensive Care (ESAIC); Euroanesthesia 2023.

For more information on the work ESIAC do check out their website here https://euroanaesthesia.org/

This piece is presented by Monty Mythen with Ellen O’Sullivan, Consultant Anaesthesiologist at St James’s Hospital Dublin, Ross Hofmeyr, Associate Professor of Anaesthesiology at the University of Cape Town and Alistair McNarry, Consultant Anaesthetist Western General and St John's Hospitals Edinburgh.

Technology in Anesthesiology | TopMedTalk Jun 05, 2023

The TopMedTalk team have a look at some of the products which were on display during Anesthesiology 2022. Specifically, RFID and infusion pumps.

Sol Aronson speaks with his guest Robert Canfield, Director of Marketing, Fresenius Kabi and Desiree Chappell talks with her guest, Gwen Volpe, Senior Director Medication Technology and Analytics, Fresenius Kabi.

TopMedTalks to Rupert Pearse | ESAIC 2023 Jun 04, 2023

Our coverage of Euroanesthesia 2023 continues; The European Society of Anaesthesiology and Intensive Care (ESAIC) is the leading European Organisation for Anaesthesia, Intensive Care, Pain and Perioperative Medicine. TopMedTalk is proud to bring you 'as live' coverage of their annual conference. For more information on the work ESIAC do check out their website here https://euroanaesthesia.org/

Desiree Chappell, Monty Mythen and Andy Cumpstey, join Rupert Pearse, Professor of Intensive Care Medicine at Queen Mary, University of London.

Last year's conversation with our guest gets mentioned in the piece, if you want to check it out go here: https://topmedtalk.libsyn.com/rupert-pearse-from-the-university-of-london-at-euroanesthesia-2022-topmedtalk

We also highly praise the OPtimisation of Peri-operaTive CardIovascular Management to Improve Surgical outcomE II (OPTIMISE II) trial and its website: https://optimiseii.org/

Hemodynamics and Fluid Management | ESAIC 2023 Jun 04, 2023

Our coverage of Euroanesthesia 2023 continues; The European Society of Anaesthesiology and Intensive Care (ESAIC) is the leading European Organisation for Anaesthesia, Intensive Care, Pain and Perioperative Medicine. TopMedTalk is proud to bring you 'as live' coverage of their annual conference. For more information on the work ESIAC do check out their website here https://euroanaesthesia.org/

This piece covers a conversation about hemodynamics and fluid management as Desiree Chappell, Monty Mythen and Andy Cumpstey speak with their guest Marlies Ostermann, Consultant in Critical Care and Nephrology at Guy's and St Thomas' NHS Foundation Trust.

The World Federation of Societies of Anaesthesiologists | ESAIC 2023 Jun 04, 2023

Our coverage of Euroanesthesia 2023 continues; The European Society of Anaesthesiology and Intensive Care (ESAIC) is the leading European Organisation for Anaesthesia, Intensive Care, Pain and Perioperative Medicine. TopMedTalk is proud to bring you 'as live' coverage of their annual conference. For more information on the work ESIAC do check out their website here https://euroanaesthesia.org/

Here Desiree Chappell, Monty Mythen and Andy Cumpstey speak to Adrian Gelb, Professor (emeritus) in the Department of Anesthesia & Perioperative Care, University of California San Francisco (UCSF) and Immediate Past President of The World Federation of Societies of Anaesthesiologists (WFSA) and the current president; Wayne Morriss, Clinical Associate Professor, University of Otago, Christchurch and Christian Werner, Chair of Anesthesia at Johannes Gutenberg University in Mainz and WFSA Chair of the Scientific Affairs Committee.

We covered The American Society of Anesthesiologists, Global Scholar programme here:

https://topmedtalk.libsyn.com/the-asa-global-scholars-program-part-1-anesthesiology-2022

https://topmedtalk.libsyn.com/the-asa-global-scholars-program-part-2-anesthesiology-2022

Find out more about the WFSA here: https://wfsahq.org/

Oxygen - too much of a good thing? | ESAIC 2023 Jun 04, 2023

Our coverage of Euroanesthesia 2023 continues; The European Society of Anaesthesiology and Intensive Care (ESAIC) is the leading European Organisation for Anaesthesia, Intensive Care, Pain and Perioperative Medicine. TopMedTalk is proud to bring you 'as live' coverage of their annual conference. For more information on the work ESIAC do check out their website here https://euroanaesthesia.org/

This piece is a discussion about oxygen; can you have too much of a good thing?

Join Desiree Chappell, Monty Mythen and Andy Cumpstey, NIHR Clinical Lecturer in Anaesthetics & Intensive Care Medicine, Southampton.

We mention this paper here:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9438193/

And we discuss www.exovent.org

The Future of Intensive Care with Jean-Louis Vincent | ESAIC 2023 Jun 04, 2023

Our coverage of Euroanesthesia 2023 continues; The European Society of Anaesthesiology and Intensive Care (ESAIC) is the leading European Organisation for Anaesthesia, Intensive Care, Pain and Perioperative Medicine. TopMedTalk is proud to bring you 'as live' coverage of their annual conference. For more information on the work ESIAC do check out their website here https://euroanaesthesia.org/

This piece features Desiree Chappell, Monty Mythen and Andy Cumpstey in conversation with Jean-Louis Vincent, Professor of intensive care at University of Brussels.

TopMedTalks to Bernd Saugel and Thomas Scheeren | ESAIC 2023 Jun 04, 2023

Our coverage of Euroanesthesia 2023 continues; The European Society of Anaesthesiology and Intensive Care (ESAIC) is the leading European Organisation for Anaesthesia, Intensive Care, Pain and Perioperative Medicine. TopMedTalk is proud to bring you 'as live' coverage of their annual conference. For more information on the work ESIAC do check out their website here https://euroanaesthesia.org/

Monty Mythen and Desiree Chappell speak with Thomas Scheeren, Senior Director of Medical Affairs Critial Care and Vascular, Europe, Edwards Lifesciences and Bernd Saugel, Professor and Vice Chair of the Department of Anesthesiology, Center of Anesthesiology and Intensive Care Medicine at the University Medical Center Hamburg-Eppendorf, Germany about two important pieces of work:

"Intraoperative hypotension when using hypotension prediction index software during major noncardiac surgery: a European multicentre prospective observational registry (EU HYPROTECT)"

https://www.bjaopen.org/article/S2772-6096(23)00019-9/fulltext

--

"Continuous finger-cuff versus intermittent oscillometric arterial pressure monitoring and hypotension during induction of anesthesia and non-cardiac surgery: The DETECT randomized trial"

https://pubmed.ncbi.nlm.nih.gov/37265355/

--

Like this, want more? Try these:

https://www.topmedtalk.com/euroanaes2019-thomas-scheeren/

https://topmedtalk.libsyn.com/bernd-saugel-at-euroanesthesia-2022-topmedtalk

TopMedTalks to Joyce Yeung | ESAIC 2023 Jun 03, 2023

The European Society of Anaesthesiology and Intensive Care (ESAIC) is the leading European Organisation for Anaesthesia, Intensive Care, Pain and Perioperative Medicine. TopMedTalk is proud to bring you 'as live' coverage of their annual conference. For more information on the work ESIAC do check out their website here: www.esaic.org

This piece features Desiree Chappell, Monty Mythen and Joyce Yeung, Associate Clinical Professor of Anesthesia and critical care, University of Warwick.

Our guest kindly shares her Twitter address: @yeung_joyce

The UK Perioperative Medicine Clinical Trials Network is here: https://pomctn.org.uk/

The Volatile vs Total intravenous Anaesthesia for major non-cardiac surgery: A pragmatic randomised (VITAL) trial is here: https://www.pomctn.org.uk/VITAL

Platform trials for anaesthesia and perioperative medicine: a narrative review is here: https://www.bjanaesthesia.org/article/S0007-0912(22)00601-8/fulltext

The opening ceremony | ESAIC 2023 Jun 03, 2023

Monty Mythen, Desiree Chappell and Andy Cumpstey talk you through the opening ceremony of Euroanaesthesia 2023. Should we be advocating "supported" rather than "shared" decision making? What does the future hold for anesthesiology? What is the role of trials in intensive care medicine? And, what instrument do you expect to be playing at the start of this piece from Glasgow, Scotland?

The European Society of Anaesthesiology and Intensive Care (ESAIC) is the leading European Organisation for Anaesthesia, Intensive Care, Pain and Perioperative Medicine. TopMedTalk is proud to bring you 'as live' coverage of their annual conference. For more information on the work ESIAC do check out their website here: www.esaic.org

Welcome to the European Society of Anaesthesiology and Intensive Care | ESAIC 2023 Jun 03, 2023

TopMedTalk is live from the European Society of Anaesthesiology and Intensive Care. We will be bringing you interviews from the conference as well as live streaming, check our Twitter for the live feed!

Desiree Chappell and Monty Mythen introduce us to a new team member; Andy Cumpstey, NIHR Clinical Lecturer in Anaesthetics & Intensive Care Medicine University of Southampton.

Beat burnout with patient centered, provider focused, care | TopMedTalk May 29, 2023

Time to focus on “burnout”; this piece looks back at the coverage TopMedTalk did during the American Society of Anesthesiologists (ASA). We’re proud to be associated with the ASA, for more on them go here: www.asahq.org

In this piece you will hear Desiree Chappell, Monty Mythen and Sol Aronson with their guests Amy Vinson, Pediatrician and Anesthesiologist at Boston Children's Hospital and Mark Pinosky, Regional Chief Medical Officer for NorthStar Anesthesia.

The podcasts which form the bulk of this piece are here:

https://topmedtalk.libsyn.com/provider-burnout-and-well-being-anesthesiology-2022

https://topmedtalk.libsyn.com/burnout-a-systemic-problem-in-need-of-systemic-organizational-policy-level-solutions-anesthesiology-2022

Further support on the subject of “burnout” can be found here:

https://topmedtalk.libsyn.com/sunday-special-burn-out-0

https://topmedtalk.libsyn.com/topmedtalk-gezz-van-zwanenberg-matt-wiles-and-marcus-peck-0

https://topmedtalk.libsyn.com/topmedtalk-emotional-intelligence-and-occupational-stress-0

https://topmedtalk.libsyn.com/sca-burn-out-a-frank-discussion

Talks to... Lee Fleisher | TopMedTalk May 22, 2023

What is the wider view when it comes to perioperative medicine and anesthesiology? How and why should we become leaders, what opportunities for change are there?

Presented by Desiree Chappell, Monty Mythen and Sol Aronson, in conversation with; Lee Fleisher, Professor Emeritus of Anesthesiology and Critical Care, University of Pennsylvania.

ORIGINAL UNEDITED CONVERSATION HERE: https://topmedtalk.libsyn.com/topmedtalks-to-lee-fleisher-anesthesiology-2022

Anesthesiology and the bigger picture | TopMedTalk May 15, 2023

This week we revisit one of the most popular moments from our coverage of Anesthesiology 2022; a conversation about the big picture theme of TopMedTalk, Perioperative Medicine.

This piece begins with Desiree Chappell, Monty Mythen and Sol Aronson introducing their guests; BobbieJean Sweitzer, Systems Director of Perioperative Practices at Inova Health, Falls Church, Virginia and Angela Edwards, Vice Chair Professional Affairs, Atrium Health WFB Anesthesiology, Winston-Salem, North Carolina.

The original unedited conversation is here: https://topmedtalk.libsyn.com/perioperative-medicine-anesthesiology-2022

Talks to trainee representative Cameron Dunn | TopMedTalk May 09, 2023

This piece focuses upon trainee led research as Monty Mythen and Desiree Chappell speak with this year's trainee representative Cameron Dunn, Consultant Anaesthetist at Prince of Wales Hospital and Community Health Services, Sydney.

This year TopMedTalk is proud to be providing exclusive coverage of the annual ANZCA conference, the professional body responsible for the specialties of anaesthesia and pain medicine in Australia and New Zealand.

For more on ANZCA go here: https://www.anzca.edu.au/

And join in the conversation by checking out their socials here:

instagram.com/the_anzca/ https://facebook.com/ANZCA1992 https://youtube.com/AnzcaEduAu

The International Prehabilitation and Perioperative Exercise Testing Society - IPOETTS | EBPOM World Conference May 08, 2023

This podcast is part of the historic meeting which officially announed the merging of the Perioperative Exercise Testing and Training Society (POETTS) and International Prehabilitation Society (IPS) to promote the professional practice of prehabilitatation and exercise testing.

Hear how and why the society is moving forward with an international focus and an unmatched passion for prehabilitation.

IPOETTS is here: https://ipoetts.org/

This piece is chaired by Denny Levett, Professor in Perioperative Medicine and Critical Care at the University of Southampton and a Consultant in Perioperative Medicine at Southampton University Hospital NHS Foundation trust (UHS), Gerrit Slooter, Surgical Oncologist, Maxima Medical Centre, The Netherlands and Gerard Danjoux, consultant in Anaesthesia and Sleep Medicine at South Tees Hospitals NHS Trust, Mike Grocott, Professor of Anaesthesia and critical care at the University of Southampton, with questions and comments from the audience.

--

Denny is a popular name here on TopMedTalk, if you liked this piece why not delve into our extensive free archive - with more presentations here:

POETTS – Nutrition and patient living with and beyond cancer – the Macmillan Trust | EBPOM 2021

https://www.topmedtalk.com/poetts-nutrition-and-patient-living-with-and-beyond-cancer-the-macmillan-trust-ebpom-2021/

EBPOM 2020 London | Fit for surgery with Denny Levett

https://www.topmedtalk.com/ebpom-2020-london-fit-for-surgery-with-denny-levett-2/

Welfare and Advocacy | TopMedTalk May 08, 2023

Welfare and advocacy, a wide topic which intersects a little with the subject of burnout. How do we put our patients first while still listening to our own needs?

Monty Mythen speaks with Tracey Tay, Chief Medical Advisor, Calvary Health Care, NSW and Jo Sinclair, Interim Clinical Lead for Employee Wellbeing, Te Whatu Ora Health NZ.

--

This year TopMedTalk is proud to be providing exclusive coverage of the annual ANZCA conference, the professional body responsible for the specialties of anaesthesia and pain medicine in Australia and New Zealand.

For more on ANZCA go here: https://www.anzca.edu.au/

And join in the conversation by checking out their socials here:

instagram.com/the_anzca/ https://facebook.com/ANZCA1992 https://youtube.com/AnzcaEduAu

Disability and patient centered outcomes | TopMedTalk May 08, 2023

This piece focuses upon disability and patient centered outcomes. Hear Monty Mythen and Desiree Chappell speaking with 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 and Paul Myles, Director, Anaesthesiology and Perioperative Medicine, Alfred Hospital and Monash University.

-- This year TopMedTalk is proud to be providing exclusive coverage of the annual ANZCA conference, the professional body responsible for the specialties of anaesthesia and pain medicine in Australia and New Zealand.

For more on ANZCA go here: https://www.anzca.edu.au/

And join in the conversation by checking out their socials here:

instagram.com/the_anzca/ https://facebook.com/ANZCA1992 https://youtube.com/AnzcaEduAu

Opioids; clinician versus patient expectations | TopMedTalk May 07, 2023

Opiods and clinician versus patient expectations. This conversation covers all the key areas; how to reduce opioid use, where ketamine might fit into the picture, the importance of the haemodynamic response and how to lead an opioid reduced response.

Here Monty Mythen speaks with Michael Vagg, Immediate past Dean of the Faculty of pain medicine for the Australian and New Zealand College of Anaesthetists (ANZCA), Chair of the Procedures and Payments Committee, Director of Professional Affairs and a Pain Medicine Specialist in Geelong and Malcolm Hogg, staff specialist, anaesthesia and pain management at Melbourne Health.

-- This year TopMedTalk is proud to be providing exclusive coverage of the annual ANZCA conference, the professional body responsible for the specialties of anaesthesia and pain medicine in Australia and New Zealand.

For more on ANZCA go here: https://www.anzca.edu.au/

And join in the conversation by checking out their socials here:

instagram.com/the_anzca/ https://facebook.com/ANZCA1992 https://youtube.com/AnzcaEduAu

Environmental sustainability; first, do no harm | TopMedTalk May 07, 2023

Dr Jess Davies is a staff anaesthetist at Austin Health who has a proven track record of being passionate about implementing environmentally sustainable practices into healthcare while still delivering a high standard of patient care.

While a trainee she started a sustainability research network called TRA2SH that has over 370 members in Australia, NZ and UK. Find out more about them here: https://www.tra2sh.org/

She is an honorary clinical fellow in the University of Melbourne’s Department of Critical Care, an active member of their sustainability and planetary health network and is embarking on a PhD exploring how implementation science can improve the uptake of sustainable practices in perioperative settings.

Here she speaks with our Editor in Chief, Monty Mythen about environmental sustainability.

--

This year TopMedTalk is proud to be providing exclusive coverage of the annual Australian and New Zealand College of Anaesthetists (ANZCA) conference, the professional body responsible for the specialties of anaesthesia and pain medicine in Australia and New Zealand.

For more on ANZCA go here: https://www.anzca.edu.au/

And join in the conversation by checking out their socials here:

instagram.com/the_anzca/ https://facebook.com/ANZCA1992 https://youtube.com/AnzcaEduAu

Clinical Trials Network in Europe and Australasia | TopMedTalk May 07, 2023

What is a 'clinical trials network' and why is it important? This piece explores one of ANZCA’s Annual Scientific Meeting’s big talking points with two of the key opinion leaders in the field.

Desiree Chappell and Monty Mythen speak with Stefan Dieleman, Cardiac Anaesthetist at Westmead Hospital, Clinical Associate Professor at the University of Sydney and Andrew Davidson, Senior Staff Anaesthetist at the Royal Children's Hospital, head of Anaesthesia Research at the Murdoch Childrens Research Institute and Professor in the Department of Paediatrics, University of Melbourne.

Perioperative Care in Australia and New Zealand | TopMedTalk May 07, 2023

This piece is a conversation with two fascinating guests who are in attendance at the Australian and New Zealand College of Anaesthetists Annual Scientific Meeting (ANZCA).

Desiree Chappell and Monty Mythen speak with Jill Van Acker, Specialist Anaesthetist, Canberra Hospitals, Chair Perioperative Medicine SIG, ACE, ANZCA, ASA, NZSA and Louise Speedy, Anesthetist and Intensive Care Specialist at Te Matau a Maui Hawkes Bay Hospital, New Zealand and Medical Officer for the New Zealand Army, Reserve Force Major with the Deployable Health Organisation.

--

This year TopMedTalk is proud to be providing exclusive coverage of the annual Australian and New Zealand College of Anaesthetists (ANZCA) conference, the professional body responsible for the specialties of anaesthesia and pain medicine in Australia and New Zealand.

For more on ANZCA go here: https://www.anzca.edu.au/

And join in the conversation by checking out their socials here:

instagram.com/the_anzca/ https://facebook.com/ANZCA1992 https://youtube.com/AnzcaEduAu

ANZCA Day 2 Live Coverage | TopMedTalk May 07, 2023

Desiree and Monty break down the schedule for TopMedTalk over the year. Where we’ll be and what we’ll be doing. How to get involved and where to find us.

Don’t forget, for more on Evidence Based Perioperative Medicine (EBPOM) go here: www.EBPOM.org

This year TopMedTalk is proud to be providing exclusive coverage of the annual Australian and New Zealand College of Anaesthetists (ANZCA) conference, the professional body responsible for the specialties of anaesthesia and pain medicine in Australia and New Zealand.

For more on ANZCA go here: https://www.anzca.edu.au/

And join in the conversation by checking out their socials here:

instagram.com/the_anzca/ https://facebook.com/ANZCA1992 https://youtube.com/AnzcaEduAu

What do you know about REMAP-CAP? | TopMedTalk May 06, 2023

This piece focuses upon the “REMAP-CAP” trial; A Randomised, Embedded, Multi-factorial, Adaptive Platform Trial for Community-Acquired Pneumonia. It’s a wide ranging discussion which looks behind the headlines of this fascinating piece of research.

Their website is here: https://www.remapcap.org/

In the podcast you will hear Monty Mythen speaking with Steve Webb, Professor of Critical Care Research at Monash University, Director of Research for St John of God Healthcare, and a ICU consultant at St John of God Subiaco and the Mount Hospital and Doug Campbell, Anaesthetic specialist at Auckland City Hospital.

Neurocognition after surgery | TopMedTalk May 06, 2023

The subject of this piece is; neurocognition, after surgery and major anesthesia. We reference previous episodes of TopMedTalk, linked to in the footnotes.

Monty Mythen in conversation with Lis Evered, Associate Professor of Neuroscience and Anesthesiology Weill Cornell Medicine in New York and Robert Sanders, Nuffield Chair of Anaesthetics at the University of Sydney and Royal Prince Alfred Hospital and Executive Board member of the Institute of Academic Surgery, Royal Prince Alfred Hospital.

--

Lis Evered’s previous piece:

https://topmedtalk.libsyn.com/prato-2019-lis-evered

--

This year TopMedTalk is proud to be providing exclusive coverage of the annual Australian and New Zealand College of Anaesthetists (ANZCA) conference, the professional body responsible for the specialties of anaesthesia and pain medicine in Australia and New Zealand.

For more on ANZCA go here: https://www.anzca.edu.au/

And join in the conversation by checking out their socials here:

instagram.com/the_anzca/ https://facebook.com/ANZCA1992 https://youtube.com/AnzcaEduAu

Diversity and gender balance in research | TopMedTalk May 06, 2023

Diversity and gender balance is an important part of the bigger picture in medicine. This piece looks at the facts.

Monty Mythen and Desiree Chappell have an important conversation with Kate Leslie, Honorary Professor, Monash University, Melbourne, Australia, Specialist Anaesthetist, The Royal Melbourne Hospital & North Western Mental Health and Non-Executive Director, Australian Medical Council and Claire Stewart, Anaesthetist, Westmead Hospital.

This year TopMedTalk is proud to be providing exclusive coverage of the annual Australian and New Zealand College of Anaesthetists (ANZCA) conference, the professional body responsible for the specialties of anaesthesia and pain medicine in Australia and New Zealand.

For more on ANZCA go here: https://www.anzca.edu.au/

And join in the conversation by checking out their socials here:

instagram.com/the_anzca/ https://facebook.com/ANZCA1992 https://youtube.com/AnzcaEduAu

The ANZCA Diploma in Perioperative Medicine | TopMedTalk May 06, 2023

“This week sees the launch of our diploma in perioperative medicine”

Hear Desiree Chappell and Monty Mythen speaking with Vanessa Beavis, Immediate Past President, Australian and New Zealand College of Anaesthetists (ANZCA) about how they are moving on and moving forward.

Go now to their website and find out more: https://www.anzca.edu.au/

TopMedTalk is proud to be offering 'as live' coverage of ANZCA’s annual meeting.

As mentioned, Vanessa, has impressed our listeners previously here: https://topmedtalk.libsyn.com/pocapalooza-sydney-education-education-education

Australian and New Zealand College of Anaesthetists, conference begins | TopMedTalk May 05, 2023

The Australian and New Zealand College of Anaesthetists (ANZCA) is the professional body responsible for the specialties of anaesthesia and pain medicine in Australia and New Zealand; their annual general conference is this year being covered by TopMedTalk.

Monty Mythen is there live with Desiree Chappell joining him remotely.

For more on ANZCA go here: https://www.anzca.edu.au/

And check out their socials:

instagram.com/the_anzca/ https://facebook.com/ANZCA1992 https://youtube.com/AnzcaEduAu

Perfusion - not just pressure! Predict, diagnose and treat underlying cause. Don’t just ‘squeeze’! | TopMedTalk Highlight May 03, 2023

This essential TopMedTalk Highlight represents the culmination of a number of important threads we’ve been examining over the last few years around interoperative hypotension (IOH). Now though we’re hearing from practitioners who are looking at the consequences of new methods and technology to deal with this threat at scale. Could we see an end to the era of dangerous interoerative hypotension?

Selected and edited for your convenience this was originally released as a long form conversation; part of our exclusive coverage of the annual International Anesthesia Research Society, (IARS) meeting organised with the Association of University Anesthesiologists (AUA) and The Society of Critical Care Anesthesiologists (SOCCA).

Check out their website here: https://iars.org/

It features Monty Mythen, Desiree Chappell and Mike Grocott in conversation with Wael Saasouh, Regional Director of Research at NorthStar Anesthesia.

If you have comments or questions about the research and would like to take it further email: contact@topmedtalk.com

NOTES:

FEDORA trial: https://www.bjanaesthesia.org/article/S0007-0912(17)54207-5/fulltext

TOPMEDTALK PREVIOUSLY: https://topmedtalk.libsyn.com/journal-club-the-fedora-trial

The RELIEF (Restrictive versus liberal fluid therapy in major abdominal surgery) trial: https://www.nejm.org/doi/full/10.1056/NEJMoa1801601

TOPMEDTALK PREVIOUSLY: https://topmedtalk.libsyn.com/the-relief-trial-results

The Society of Cardiovascular Anesthesiologists | TopMedTalk May 01, 2023

This piece is a reflection of the fact that The Society of Cardiovascular Anesthesiologists Annual General Meeting is coming up this weekend, we hope to hear from people who attend. What are the big debates this year? Email contact@topmedtalk.com

TopMedTalk’s proud association with the SCA continues as we look back on our ‘as live’ coverage in the past and look forward to future updates in the future.

The clips used in this piece have been taken from:

https://topmedtalk.libsyn.com/emily-methangkool-at-the-sca-topmedtalk

https://topmedtalk.libsyn.com/julius-balogh-at-the-sca-topmedtalk

https://topmedtalk.libsyn.com/brad-cardonell-at-the-sca-topmedtalk

https://topmedtalk.libsyn.com/monty-and-desiree-at-sca-topmedtalk

https://topmedtalk.libsyn.com/andy-shaw-at-the-sca-topmedtalk

Where are you with perioperative care? Part 2 | EBPOM World Congress Apr 24, 2023

This piece is a question and answer session, it's divided into two parts, this is part two.

Following on from our previous podcasts, https://topmedtalk.libsyn.com/a-patients-perioperative-perspective-ebpom-world-congress / https://topmedtalk.libsyn.com/essential-update-the-center-for-perioperative-care-ebpom-world-congress / https://topmedtalk.libsyn.com/whats-new-in-education-and-training-in-perioperative-care-ebpom-world-congress this discussion is an invaluable and at points frank examination of perioperative care. What does it look like when ‘the rubber meets the road’?

Hosted by Dave Selwyn, Deputy Medical Director at Nottingham University Hospitals NHS Trust and Director of The Centre for Perioperative Care (CPOC) and Mike Grocott, Professor of Anaesthesia and critical care at the University of Southampton.

We join them as questions from the online audience are answered by the panel, which includes; Patient Advocate - Lawrence Mudford, enjoyed a 38-year healthcare career working as a dentist and dental educator within both primary and secondary care, Steven Evans, Center for Perioperative Care (CPOC) Fellow and anaesthetic trainee (ST7), Sophie Randall, Director of the Patient Information Forum and Scarlett McNally, Deputy Director for CPOC and honoree, Clinical Professor at Brighton and Sussex medical school and consultant orthopedic surgeon in East Sussex.

Talks to... Jiapeng Huang | TopMedTalk Apr 19, 2023

Our coverage of annual International Anesthesia Research Society, (IARS) meeting organised with the Association of University Anesthesiologists (AUA) and The Society of Critical Care Anesthesiologists (SOCCA) continues.

Here Mike Grocott and Desiree Chappell speak with Jiapeng Huang, Tenured Professor and Vice Chairman of the Department of Anesthesiology and Perioperative Medicine at the University of Louisville, ASA Board of Directors.

Interoperative hypotension study group; USAP and NorthStar Anesthesia | TopMedTalk Apr 19, 2023

This conversation is one of the key reasons we wanted to attend the annual general meeting of the International Anesthesia Research Society, in association with the Society of Critical Care Anesthesiologists and the Association of University Anesthesiologists.

Bringing together various strands which we have covered previously here on TopMedTalk around the subject of Interoperative Hypotension (IOH) this in depth, long form conversation, brings you up to date with the latest research.

Hear Monty Mythen and Desiree Chappell discuss interoperative hypotension with their guests, Rick Dutton, Chief Quality Officer for US Anesthesia Partners (USAP) and Josh Lumley, Chief Quality Officer from NorthStar Anesthesia before welcoming Wael Saasouh, Regional Director of Research at NorthStar Anesthesia, to the discussion along with Anna Christensen, Director of health research strategy and analytics, Mathematica.

--

We spoke previously with Rick Dutton at the ASA here:https://topmedtalk.libsyn.com/rick-dutton-chief-quality-officer-us-anesthesia-partners-topmedtalk-at-the-asa

We spoke in more depth to Wael Saasouh here: https://topmedtalk.libsyn.com/topmedtalks-to-wael-saasouh-topmedtalk

Where are you with perioperative care? Part 1 | EBPOM World Congress Apr 17, 2023

Following on from our previous podcasts, https://topmedtalk.libsyn.com/a-patients-perioperative-perspective-ebpom-world-congress / https://topmedtalk.libsyn.com/essential-update-the-center-for-perioperative-care-ebpom-world-congress / https://topmedtalk.libsyn.com/whats-new-in-education-and-training-in-perioperative-care-ebpom-world-congress this discussion is an invaluable and at points frank examination of perioperative care. What does it look like when ‘the rubber meets the road’?

Hosted by Dave Selwyn, Deputy Medical Director at Nottingham University Hospitals NHS Trust and Director of The Centre for Perioperative Care (CPOC) and Mike Grocott, Professor of Anaesthesia and critical care at the University of Southampton.

We join them as questions from the online audience are answered by the panel, which includes; Patient Advocate - Lawrence Mudford, enjoyed a 38-year healthcare career working as a dentist and dental educator within both primary and secondary care, Steven Evans, Center for Perioperative Care (CPOC) Fellow and anaesthetic trainee (ST7), Sophie Randall, Director of the Patient Information Forum and Scarlett McNally, Deputy Director for CPOC and honoree, Clinical Professor at Brighton and Sussex medical school and consultant orthopedic surgeon in East Sussex.

Live from IARS AUA SOCCA on Day 2 | TopMedTalk Apr 15, 2023

This piece released ‘as live’ from the annual International Anesthesia Research Society, (IARS) meeting organised with the Association of University Anesthesiologists (AUA) and The Society of Critical Care Anesthesiologists (SOCCA).

Day 2 and the team reflect upon the conference so far. Including thoughts on the interaction between quantum physicas and anethesia.

Check out the IARS website here: https://iars.org/

Desiree Chappell, Mike Grocott and Monty Mythen give us a sense of what's happening and what's coming up.

Talks to.. Wael Saasouh, NorthStar Anesthesia | TopMedTalk Apr 15, 2023

TopMedTalk’s exclusive coverage of #IARS2023 continues; the annual International Anesthesia Research Society, (IARS) meeting organised with the Association of University Anesthesiologists (AUA) and The Society of Critical Care Anesthesiologists (SOCCA).

Expect to hear more reports from the conference as they happen as well as longer pieces over the next few months with key opinion leaders and thinkers.

Check out their website here: https://iars.org/

This piece features Monty Mythen, Desiree Chappell and Mike Grocott in conversation with Wael Saasouh, Regional Director of Research at NorthStar Anesthesia.

Live from IARS AUA SOCCA | TopMedTalk Apr 14, 2023

This piece released ‘as live’ from the annual International Anesthesia Research Society, (IARS) meeting organised with the Association of University Anesthesiologists (AUA) and The Society of Critical Care Anesthesiologists (SOCCA).

Expect to hear more reports from the conference as they happen as well as longer pieces over the next few months with key opinion leaders and thinkers.

Check out their website here: https://iars.org/

Desiree Chappell and Mike Grocott begin proceedings.

What’s new in education and training in perioperative care? | EBPOM World Congress Apr 10, 2023

Steven Evans, Center for Perioperative Care (CPOC) Fellow and anaesthetic trainee (ST7) provides a full update on what’s new in education and training. Originally broadcast to the attendees (both online and in person) of the Evidence Based Perioperative Medicine (EBPOM) World Congress.

What are the new innovations, attitudes and standards which are emerging as perioperative practice is pushed forward?

If you enjoy this talk, please ensure you are subscribed to TopMedTalk; also ensure you are part of our EBPOM mailing list and go now to the www.ebpom.org site to check out incredible low prices for some of our forthcoming events and conferences.

ESSENTIAL UPDATE: The Center for Perioperative Care | EBPOM World Congress Apr 03, 2023

“The Center for Perioperative Care (CPOC) was set up as a cross organisational collaboration with the patients at the heart of it; focusing on improving care ‘from the moment of contemplation of surgery, through the perioperative period, to recovery’ and really hoping to change the emphasis from patients being ‘surgical patients’ to patients 'being in the perioperative pathway’.”

This piece was originally presented as a talk at the Evidence Based Perioperative Medicine (EBPOM) World Congress; “What work has The Center for Perioperative Care (CPOC) been doing?”.

It is a full update, on behalf of CPOC, from Jugdeep Dhesi, Consultant Geriatrician, Guys and St Thomas' NHS Trust, Clinical Lead for "Proactive care for Older People undergoing Surgery" (POPS) and a Deputy Director of CPOC.

For more on POPS go here: https://www.topmedtalk.com/sunday-special-the-pops-clinic-at-guys-st-thomass-2/

This exclusive update is provided to you for free by TopMedTalk, the broadcasting arm of EBPOM. If you would like to see or attend the EBPOM World Congress - go now to www.ebpom.org

A Patient's perioperative perspective | EBPOM World Congress Mar 27, 2023

Laurence Mudford (see full bio below) provides the patient perspective and here begins a discussion about perioperative care; what is it, what do people think it is, what should we make it?

Taken from the Centre for Perioperative Care’s (CPOC) outstanding contribution to the Evidence Based Perioperative Medicine’s (EBPOM) World Congress; this piece is the first in a series which originally streamed on the EBPOM.org platform. Ensure you check out their site now as we offer incredible prices on this year’s “World Congress”. See these podcasts live, before anyone else and interact with the panel via our easy to use interaction platforms and social media.

The piece also features co-chairs Dave Selwyn, Deputy Medical Director at Nottingham University Hospitals NHS Trust and Director of The Centre for Perioperative Care (CPOC) and Mike Grocott, Professor of Anaesthesia and critical care at the University of Southampton.

Lawrence Mudford has enjoyed a 38-year healthcare career working as a dentist and dental educator within both primary and secondary care. This has included serving on the Board of the Faculty of General Dental Practice (UK) and as a member of the General Dental Council.

Following diagnosis and successful treatment for cancer in 2016, Lawrence has realigned his focus and combines his healthcare background with his passion to champion the “patient voice” In this capacity, he sits on the Board of the CPOC.

More information about CPOC go here: https://cpoc.org.uk/

Does increased volume improve cancer outcomes? Part 3 | EBPOM World Congress Mar 20, 2023

This is part three of a three part piece. Although it works as a stand alone podcast we suggest you find time to loop back on episodes one ( here: https://topmedtalk.libsyn.com/does-increased-volume-improve-cancer-outcomes-ebpom-world-congress ) and two ( here: https://topmedtalk.libsyn.com/does-increased-volume-improve-cancer-outcomes-part-2-ebpom-world-congress ) if you've not yet had time. The topic up for discussion is; “Does increased volume improve cancer outcomes?”.

On the panel: Shaman Jhanj, Head of Anaesthesia and Intensive Care Research at the Royal Marsden Hospital, Blanche Symons, patient representative, an ex patient of University Collage London Hospital, Daniel Martin, Consultant in anaesthesia and intensive care medicine, working on the intensive care unit at Derriford hospital.

The piece is co-chaired by Denny Levett, Professor in Perioperative Medicine and Critical Care at the University of Southampton and a Consultant in Perioperative Medicine at Southampton University Hospital NHS Foundation trust (UHS) with Tim Wigmore, consultant, anesthetist and intensivist at the Royal Marsden Hospital.

It was taken from the www.ebpom.org World Congress. Check out their site now and learn how you can attend a discussion like this.

Also, as mentioned in the piece, here are some links to other moments we have on TopMedTalk where Vicki Morton provides more characteristically honest, incisive and occasionally challenging input:

https://www.topmedtalk.com/covid-19-usa-south-carolina-vicki-morton-joins-desiree-and-monty/

https://www.topmedtalk.com/enhanced-recovery-after-cardiac-surgery-eras-is-it-really-that-different-dingle-2022/

https://www.topmedtalk.com/cardiac-eras-covid-and-beyond-ebpom/

https://www.topmedtalk.com/novel-therapies-for-perioperative-care-ebpom-dingle/

Does increased volume improve cancer outcomes? Part 2 | EBPOM World Congress Mar 13, 2023

This is part two of a three part piece. Part one ( here: https://topmedtalk.libsyn.com/does-increased-volume-improve-cancer-outcomes-ebpom-world-congress ) presents a short introduction to the subject of “volume and cancer outcomes”. It's presented by Shaman Jhanj, Head of Anaesthesia and Intensive Care Research at the Royal Marsden Hospital.

In this part we are joined by the rest of the panel; Blanche Symons, patient representative, ex patient of University Collage London Hospital, Daniel Martin, Consultant in anaesthesia and intensive care medicine, Derriford Hospital. The discussion, which includes audience questions, is co-chaired by Denny Levett, Professor in Perioperative Medicine and Critical Care at the University of Southampton and a Consultant in Perioperative Medicine at Southampton University Hospital NHS Foundation trust (UHS) and Tim Wigmore, consultant, anesthetist and intensivist at the Royal Marsden Hospital.

To attend an event like this go now to www.ebpom.org and ensure you subscribe to our newsletter.

Does increased volume improve cancer outcomes? | EBPOM World Congress Mar 06, 2023

This piece is a short introduction to the subject of “volume and cancer outcomes” which is presented by Shaman Jhanj, Head of Anaesthesia and Intensive Care Research at the Royal Marsden Hospital.

The fascinating debate and panel discussion which followed will be released soon here on TopMedTalk but supporters of Evidence Based Perioperative Medicine (EBPOM) may recognise this piece as one of the big moments of the world congress. As mentioned in the piece, it was jointly chaired with The Onco Anesthesia Collaboration. If you’d like more information about EBPOM or to attend one of our conferences please direct yourself to www.ebpom.org

Perioperative Anaemia Part 3 - Roundtable | EBPOM London Feb 27, 2023

Part three continues our investigation into perioperative anemia, following on from our exclusive reaction and analysis to the Centre For Perioperative Care (CPOC) publication “Guideline for the Management of Anaemia in the Perioperative Pathway” from Scarlett McNally, Deputy Director for CPOC and honoree, Clinical Professor at Brighton and Sussex medical school and consultant orthopedic surgeon in East Sussex this piece covers the first part of the panel discussion which followed.

PART 1 https://traffic.libsyn.com/topmedtalk/PERIOPERATIVE_ANEMIA.mp3

PART 2 https://traffic.libsyn.com/topmedtalk/ANEM_2.mp3

Taken from the EBPOM London session on the subject of perioperative anemia, chaired by Mike Grocott, Professor of Anaesthesia and critical care at the University of Southampton, and Rachel Barlow, National Lead, Enhanced Recovery, Prehabilitation and Optimisation, at Cardiff and Vale health board, Wales.

The Center for Perioperative Care (CPOC) is ‘a cross-specialty collaboration dedicated to the promotion, advancement and development of perioperative care for the benefit of patients at all stages of their surgical journey’.

The Prevent Study is here: https://preventdementia.co.uk/

At the time of this presentation the CPOC guidelines had just been published, now you can find them online here: https://www.cpoc.org.uk/sites/cpoc/files/documents/2022-09/1. CPOC_GuidelinefortheManagementofAnaemia_September2022.pdf

This piece was made in collaboration with both Evidence Based Perioperative Medicine (EBPOM) http://www.ebpom.org and The Enhanced Recovery After Surgery Society (ERAS UK): https://www.erasuk.net/

Perioperative Anaemia Part 2 - Roundtable | EBPOM London Feb 20, 2023

The Center for Perioperative Care (CPOC) is ‘a cross-specialty collaboration dedicated to the promotion, advancement and development of perioperative care for the benefit of patients at all stages of their surgical journey’.

Following on from our exclusive reaction and analysis to the CPOC publication “Guideline for the Management of Anaemia in the Perioperative Pathway” from Scarlett McNally, Deputy Director for CPOC and honoree, Clinical Professor at Brighton and Sussex medical school and consultant orthopedic surgeon in East Sussex ( https://directory.libsyn.com/episode/index/id/25808664 ) this piece covers the first part of the panel discussion which followed.

Taken from the EBPOM London session on the subject of perioperative anemia, chaired by Mike Grocott, Professor of Anaesthesia and critical care at the University of Southampton, and Rachel Barlow, National Lead, Enhanced Recovery, Prehabilitation and Optimisation, at Cardiff and Vale health board, Wales.

The Prevent Study is here: https://preventdementia.co.uk/

At the time of this presentation the CPOC guidelines had just been published, now you can find them online here: https://www.cpoc.org.uk/sites/cpoc/files/documents/2022-09/1. CPOC_GuidelinefortheManagementofAnaemia_September2022.pdf

This piece was made in collaboration with both Evidence Based Perioperative Medicine (EBPOM) http://www.ebpom.org and The Enhanced Recovery After Surgery Society (ERAS UK): https://www.erasuk.net/

Perioperative Anaemia with Scarlett McNally | EBPOM London Feb 13, 2023

The Center for Perioperative Care (CPOC) is ‘a cross-specialty collaboration dedicated to the promotion, advancement and development of perioperative care for the benefit of patients at all stages of their surgical journey’.

Here we have exclusive reaction and analysis to their publication “Guideline for the Management of Anaemia in the Perioperative Pathway” from Scarlett McNally, Deputy Director for CPOC and honoree, Clinical Professor at Brighton and Sussex medical school and consultant orthopedic surgeon in East Sussex.

This is the first piece of an EBPOM London session on the subject of perioperative anemia which was chaired by Mike Grocott, Professor of Anaesthesia and critical care at the University of Southampton, and Rachel Barlow, National Lead, Enhanced Recovery, Prehabilitation and Optimisation, at Cardiff and Vale health board, Wales.

At the time of this presentation the guidelines had just been published, now you can find them online here: https://www.cpoc.org.uk/sites/cpoc/files/documents/2022-09/1. CPOC_GuidelinefortheManagementofAnaemia_September2022.pdf

This piece was made in collaboration with both Evidence Based Perioperative Medicine (EBPOM) www.ebpom.org and The Enhanced Recovery After Surgery Society (ERAS UK): https://www.erasuk.net/

Tom Crean: Antarctic Explorer | EBPOM Ireland 2022 Feb 06, 2023

A stand out moment from Dingle’s Evidence Based Perioperative Medicine (EBPOM) conference; the inaugural Tom Crean Plenary Lecture, presented by Mike Grocott, Professor of Anaesthesia and critical care at the University of Southampton.

To find out more about EBPOM’s fantastic line up of future events go now to www.ebpom.org

Mike Grocott is a popular contributor to TopMedTalk, if you enjoyed this why not check out some of his previous appearances:

Prehabilitation with Mike Grocott - https://topmedtalk.libsyn.com/anes19-prehabilitation-with-mike-grocott

Efficient Trial Design; ‘evidence’ in the era of ‘Big Data’ - https://topmedtalk.libsyn.com/efficient-trial-design-evidence-in-the-era-of-big-data-dingle-2022

Prehabilitation, the word of the year - https://topmedtalk.libsyn.com/asa-prehabilitation-the-word-of-the-year

Do you need non-physician anaesthesia providers? | EBPOM Dingle Jan 30, 2023

The Royal Collage of Anesthetists (RCoA) are re-evaluating in the face of a global crisis; where do you stand in the forthcoming debate?

This piece, chaired by Monty Mythen and Mike Grocott, originally closed EBPOM Dingle. It’s a much needed full and frank discussion regarding the realities of non-physician anaesthesia providers; could they be a realistic solution to the global staffing crisis we have heard about in recent years? It’s a perfect storm which combines ‘mass retirement’, COVID-19 measures and the related delay in elective surgery. When the RCoA grapple publicly with a debate like this there’s a responsibility for anaesthesia practitioners to consider it as well.

As always TopMedTalk is interested to hear what you think, email us on contact@topedtalk.com - your comments might be shared with our audience in the future.

The discussion is inspired by and uses a clip from “The future of the anaesthetic workforce in the UK - a personal view” which is available for free, in full, here:

https://www.topmedtalk.com/the-future-of-the-anaesthetic-workforce-in-the-uk-a-personal-view-william-harrop-griffiths-ebpom-2022/

TopMedTalk has also made the Question and Answer session which followed that presentation available here:

https://www.topmedtalk.com/the-future-of-the-anaesthetic-workforce-in-the-uk-part-2-qa-session-ebpom-2022/

Evidence Based Perioperative Medicine (EBPOM) conferences are also available in video form! Check out www.ebpom.org now to find out more and to discover how you can attend a conference either in person or virtually.

Morpheus Plenary Lecture: Exercise is a Perioperative medicine | EBPOM World Congress 2022 Jan 23, 2023

“I personally think this is a worse pandemic than the one we’ve just had and it’s impact - if we don’t do something about it - is going to be even more far reaching than COVID has been; this is about the global inactivity pandemic”

This talk is a timely reminder of the importance of the value of exercise. It is presented by Denny Levett, Professor in Perioperative Medicine and Critical Care at the University of Southampton and a Consultant in Perioperative Medicine at Southampton University Hospital NHS Foundation trust (UHS).

The Morpheus Plenary Lecture was originally part of Evidence Based Perioperative Medicine’s EBPOM London conference of 2022. To find out more about EBPOM go now to www.ebpom.org

Denny is a popular name here on TopMedTalk, if you liked this piece why not delve into our extensive free archive - with more presentations here:

POETTS – Nutrition and patient living with and beyond cancer – the Macmillan Trust | EBPOM 2021

https://www.topmedtalk.com/poetts-nutrition-and-patient-living-with-and-beyond-cancer-the-macmillan-trust-ebpom-2021/

EBPOM 2020 London | Fit for surgery with Denny Levett

https://www.topmedtalk.com/ebpom-2020-london-fit-for-surgery-with-denny-levett-2/

Michael Champeau - President of The American Society of Anesthesiologists | Anesthesiology 2022 Jan 19, 2023

Celebrating 5 years of TopMedTalk at 'Anesthesiology'; the Annual General Meeting of the American Society of Anesthesiologists (ASA). Please share this interview to you social media channels to help us reach a wider audience.

TopMedTalk is presented by Desiree Chappell, Monty Mythen and Sol Aronson with their guest; Michael Champeau, President-Elect of The American Society of Anesthesiologists.

It covers ‘the vision for the year ahead’ as the ASA's incoming president explains how the organisation intends to deal with the implementation of the ‘No Surprises Act’.

We took a look into our archive recently and dug out interviews with ASA Presidents over the years, have a listen here: https://directory.libsyn.com/episode/index/id/24676698

TopMedTalk is very proud to be partnered with the American Society of Anesthesiologists® at ANESTHESIOLOGY® 2022. Now in our fifth year TopMedTalk is bringing you our most comprehensive and extensive coverage of the largest gathering of anesthesiologists in the world!

TopMedTalk is provided to you for free; if you want to help support our work and help give these conversations a wider audience please like and subscribe (if and where possible) before sharing it on your social media.

TopMedTalk can be found on YouTube here: https://www.youtube.com/channel/UC-HYQmeIwcFCYO1hoQ8jShQ

We are on Twitter here: https://twitter.com/topmedtalk

We are on LinkedIn here: https://www.linkedin.com/company/topmedtalk

We are on Facebook here: https://www.facebook.com/TopMedTalk1/

The National Institute for Health and Care Research | EBPOM London Jan 16, 2023

This piece looks at how The National Institute for Health and Care Research (NIHR) is taking an active role in perioperative medicine and surgery; addressing unanswered questions and ensuring research is both inclusive and extensive in the UK health industry. How have the NIHR moved medicine forward and what lessons can be learned from the recent COVID-19 crisis?

Presented by Lucy Chappell, Professor, Chief Scientific Adviser to the Department of Health and Social Care and Chief Executive of the National Institute for Health and Care Research (NIHR) with contributions and questions from the audience and panel including; Mike Grocott, Professor of Anaesthesia and Critical Care in Southampton and Director of the NIHR Biomedical Research Center in Southampton, Guy Ludbrook, Professor of Anaesthesia at the University of Adelaide and Royal Adelaide Hospital and Ramani Moonesinghe OBE, Professor of Perioperative Medicine at University College London and a Consultant in Anaesthetics and Critical Care Medicine at UCL Hospitals.

Looking back on 2022 Part 2 | TopMedTalk Jan 09, 2023

In 2022 we covered many live events and conferences both on the subject of anesthesia and perioperative medicine; we produced audio versions of some of the most interesting speakers in the field of perioperative medicine and provided you with exclusive interviews and behind the scenes access to some of the key opinion leaders and thinkers in medicine.

That's not to mention occasional exclusive news releases, hard hitting debates and the friendly charm of your favorite presenters; Desiree, Monty, Sol, Mike and the rest of the team.

Do ensure you’ve taken advantage of the current offers available now on the Evidence Based Perioperative Medicine (EBPOM) website: www.ebpom.org

In this podcast:

A preview of "The National Institute for Health and Care Research | EBPOM London"

https://topmedtalk.libsyn.com/the-national-institute-for-health-and-care-research-ebpom-london - this link will be active upon release.

We also look back at:

"I know nothing..." Hugh Montgomery

https://topmedtalk.libsyn.com/i-know-nothing-hugh-montgomery-ernest-henry-starling-plenary-lecture-ebpom-2022

The Great Fluid Debate | EBPOM 2022

https://topmedtalk.libsyn.com/the-great-fluid-debate-ebpom-2022

Novel Therapies for Perioperative Care. This from EBPOM Dingle 2022

https://www.topmedtalk.com/novel-therapies-for-perioperative-care-ebpom-dingle/

Efficient trial design, ‘evidence’ in the era of ‘Big Data’ | Dingle 2022

https://www.topmedtalk.com/efficient-trial-design-evidence-in-the-era-of-big-data-dingle-2022/

Enhanced Recovery After Cardiac Surgery (ERAS) - Is it really that different? | Dingle 2022

https://www.topmedtalk.com/enhanced-recovery-after-cardiac-surgery-eras-is-it-really-that-different-dingle-2022/

ASA Global Scholars - Part 1: https://www.topmedtalk.com/the-asa-global-scholars-program-part-1-anesthesiology-2022/

Part 2: https://www.topmedtalk.com/the-asa-global-scholars-program-part-2-anesthesiology-2022/

Looking back on 2022 | TopMedTalk Jan 02, 2023

TopMedTalk's 2022 retrospective covers some of the big topics of the year in perioperative medicine: Perioperative diabetes management; Connected Health and the COVID era; ‘is day case total knee replacement taking ERAS too far?; are perioperative nutrition clinics essential? - and a deep dive into Intraoperative Hypotension.

The links to the shows mentioned in this piece are, in order:

"Key update on Intraoperative Hypotension | EBPOM Chicago": https://www.topmedtalk.com/key-update-on-interoperative-hypotension-ebpom-chicago/

"Nutrition clinics | EBPOM Chicago" https://www.topmedtalk.com/nutrition-clinics-ebpom-chicago/

“Nutrition clinics - panel discussion” - https://www.topmedtalk.com/nutrition-clinics-panel-discussion-ebpom-chicago-ireland/

"1st Transatlantic Leadership Forum - Connected Health - COVID Hyperdrive or Hype? | EBPOM Dingle" - https://www.topmedtalk.com/1st-transatlantic-leadership-forum-connected-health-covid-hyperdrive-or-hype-ebpom-dingle/

“2nd Transatlantic Leadership Forum - Is day case total knee replacement taking ERAS too far? | EBPOM Chicago”

https://www.topmedtalk.com/2nd-transatlantic-leadership-forum-is-day-case-total-knee-replacement-taking-eras-too-far-ebpom-chicago/

”Perioperative diabetes management, nuts and bolts | EBPOM Chicago” - https://www.topmedtalk.com/perioperative-diabetes-management-nuts-and-bolts-ebpom-chicago/

"Perioperative diabetes clinic; panel discussion | EBPOM Chicago" - https://www.topmedtalk.com/perioperative-diabetes-clinic-panel-discussion-ebpom-chicago/

The Heart – An Elegant Pump | EBPOM Ireland 2022 Dec 26, 2022

This entertaining talk is a rewarding look at the heart in a linguistic and cultural context; what does the word and the heart itself actually mean to us?

Originally part of the Evidence Based Perioperative Medicine (EBPOM) Dingle conference it is presented here to you for free. If you would like to learn more about EBPOM and the fantastic forthcoming conferences we have to come please go to www.ebpom.org

Presented by Desmond Sheridan, Emeritus Professor of Cardiology, National Heart and Lung Institute, Imperial College London.

Four key concepts regarding training in Anaesthesia | Dingle 2022 Dec 19, 2022

Originally entitled “The Future of Training” this talk evaluates four key concepts in anaesthesia training. It was originally presented as part of the hugely successful Evidence Based Perioperative Medicine (EBPOM) Dingle conference. If you would like to know more about when and where their next conference is please go now to the EBPOM website: www.ebpom.org

Presented by George Shorten, Professor of Anaesthesia and Intensive Care Medicine and Foundation Director of the ASSERT Centre at University College Cork, Ireland

Protecting the brain in the vulnerable patient | Dingle 2022 Dec 12, 2022

As patients live longer their needs are becoming more acute during surgery; this piece asks how we can adapt practice to meet the new challenges this brings. These talks take a long view across the perioperative continuum with a focus upon cognitive impairment and other vulnerable brain patients.

Presented by Laura MacDarby, Consultant Anaesthetist in The Royal London Hospital, a referral centre for Major Trauma and Stroke in the Whitechapel area of London and Roisin Coary, SpR in Geriatric and General Internal Medicine, with a specialist interest in Peri-operative Medicine, currently based in Dublin, Ireland.

Enhanced Recovery After Cardiac Surgery (ERAS) - Is it really that different? | Dingle 2022 Dec 05, 2022

This vital conversation comes in the wake of the COVID-19 crisis; how different is enhanced recovery after surgery (ERAS) and does it really get the results we want?

Recorded at the Dingle Evidence Based Perioperative Medicine (EBPOM) conference in 2022. If you’d like to attend an EBPOM conference check out www.ebpom.org now.

Chaired by Monty Mythen with contributions from Aoife Lavelle, Consultant St James’s Hospital, Dublin, Aisling Kinsella, Consultant Cardiothoracic and Transplant Surgeon at Mater Misericordiae University Hospital and Vicki Morton, Director of Clinical and Quality Outcomes, Providence Anesthesiology Associates.

The future of the anaesthetic workforce in the UK (Part 2 - Q&A session) | EBPOM 2022 Nov 28, 2022

This week we have the Evidence Based Perioperative Medicine (EBPOM) Visiting Professor Plenary Lecture question and answer session for; "The future of the anaesthetic workforce in the UK - a personal view".

The full talk - if you’ve not yet heard it - is here: https://www.topmedtalk.com/the-future-of-the-anaesthetic-workforce-in-the-uk-a-personal-view-william-harrop-griffiths-ebpom-2022/

Presented by William Harrop-Griffiths, Vice-President Royal Collage of Anesthetists (September 2020-22) and introduced by Mike Grocott, Professor of Anaesthesia and critical care at the University of Southampton.

The Perioperative Quality Improvement | TopMedTalk Nov 22, 2022

“This is not a book about the current evidence, this is a book about how you keep making things better in perioperative care”.

TopMedTalk speaks with the co-editors of the new book; “Perioperative Quality Improvement”. Following on from our extensive coverage of Anesthesiology 2022, this piece was originally intended to be part of that but - for reasons explained within - it was delayed.

To buy it now go to: https://www.amazon.co.uk/Perioperative-Quality-Improvement-Carol-Peden/dp/0323833993

Presented by Desiree Chappell and Monty Mythen with their guests, Carol Peden, Adjunct Profesor in Anesthesiology at both the Keck School of Medicine of USC in Los Angeles, California and the Perelman School of Medicine at the University of Pennsylvania in Philadelphia, Pennsylvania, Michael Engelsbe is the Cyrenus G. Darling Sr., MD and Cyrenus G. Darling Jr., MD Professor of Surgery within the Section of Transplantation Surgery at Michigan Medicine, University of Michigan, Ann Arbor, MI, USA and Lee Fleisher, Professor Emeritus, Perelman School of Medicine, University of Pennsylvania.

Efficient Trial Design; ‘evidence’ in the era of ‘Big Data’ | Dingle 2022 Nov 21, 2022

This fundamental conversation is given a fresh perspective during one of the stand out moments of the recent Evidence Based Perioperative Medicine (EBPOM) Dingle conference. How do we define evidence in the era of big data? Can we further improve the speed at which we do trials and yet still gather reliable data? In the wake of COVID-19 what new innovations can be made to how we trial and test vital medical help?

Chaired by Ramani Moonesinghe, OBE, Professor of Perioperative Medicine at University College London, Consultant in Anaesthetics and Critical Care Medicine at UCL Hospitals, this piece features; Mark Edwards, Consultant in Anaesthesia & Perioperative Medicine, University Hospital Southampton, Honorary Senior Clinical Lecturer, University of Southampton, Mike Grocott, Professor of Anaesthesia and Critical Care Medicine, University of Southampton and Matt Wilson, Anesthetist, UCL Hospitals and University College London and a PhD candidate.

Essential Update: Perioperative Quality Initiative POQI Part 3 | EBPOM 2022 Nov 14, 2022

This is the concluding Q&A session regarding the Perioperative Quality Initiative (POQI).

Please listen to parts 1 and 2 here:

Part 1: https://directory.libsyn.com/episode/index/id/24529878?_ga=2.112287174.319377695.1666031811-966310048.1569589661

Part 2: https://directory.libsyn.com/episode/index/id/24714003?_ga=2.112287174.319377695.1666031811-966310048.1569589661

And don't forget to use the resources and website here: www.poqi.org

Hosted by Mike Grocott, Professor of Anaesthesia and critical care at the University of Southampton with a panel including; Monty Mythen, Professor of Anaesthesia and Critical Care, University College London, Andy Shaw, Department of Intensive Care and Resuscitation at The Cleveland Clinic, Cleveland, Ohio, Tong Joo (TJ) Gan, Professor and Chairman at Stoney Brook in New York, Tim Miller, Associate Professor of Anesthesiology from Duke University Medical Center, Desiree Chappell, Certified Registered Nurse Anesthetist (CRNA) and Vice President of Clinical Quality for NorthStar Anesthesia, 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 and Cheryl Crisafi, Cardiac Surgery Care Coordinator Nurse at Baystate Medical Center in Springfield, MA

Essential Update: Perioperative Quality Initiative POQI Part 2 | EBPOM 2022 Nov 07, 2022

What is the Perioperative Quality Initiative (POQI) and why is this episode always a popular download - each year - for TopMedTalk listeners? How can POQI help practitioners make informed choices?

Where's the POQI website and the resources? It's here: http://thepoqi.org/

This is the second of a three part series which covers the entire POQI session from the Evidence Based Perioperative Medicine (EBPOM) conference 2022.

Hosted by Mike Grocott, Professor of Anaesthesia and critical care at the University of Southampton; it continues with Monty Mythen, Professor of Anaesthesia and Critical Care, University College London, giving a presentation about "POQI II"; moving onto a "POQI III" presentation from Andy Shaw, Department of Intensive Care and Resuscitation at The Cleveland Clinic, Cleveland, Ohio.

If you've not heard Part 1 please follow this link here: https://directory.libsyn.com/episode/index/id/24529878

Essential Update: Perioperative Quality Initiative POQI Part 1 | EBPOM 2022 Oct 31, 2022

What is the Perioperative Quality Initiative (POQI) and why is this episode always a popular download - each year - for TopMedTalk listeners? How can POQI help practitioners make informed choices?

Where's the POQI website and the resources? It's here: http://thepoqi.org/

This is the first of a three part series which will cover the entire POQI session from the Evidence Based Perioperative Medicine (EBPOM) conference 2022.

Hosted by Mike Grocott, Professor of Anaesthesia and critical care at the University of Southampton; it begins with a short introductory presentation from Tong Joo (TJ) Gan, Professor and Chairman at Stoney Brook in New York; moving onto Tim Miller, Associate Professor of Anesthesiology from Duke University Medical Centre, on the subject of "POQI I".

The importance of pre-operative optimisation | Anesthesiology 2022 Oct 25, 2022

Celebrating 5 years of TopMedTalk at 'Anesthesiology'; the Annual General Meeting of the American Society of Anesthesiologists (ASA).

This piece is presented by Desiree Chappell and Monty Mythen with their guest; Jeff Simmons, Medical Director for UAB’s Preoperative Assessment, Consultation, and Treatment Clinics and all Paranesthesia Care Units.

Jeff has featured on TopMedTalk previously:

Here: https://www.topmedtalk.com/anes19-jeff-simmons/

And here: https://www.topmedtalk.com/asa-2019-we-advocate-good-public-health-within-the-crucible-of-surgery/

The article mentioned in the piece is here: https://www.researchgate.net/publication/358651570_Preoperative_Risk_Stratification_Identifying_Modifiable_Risks_for_Optimization

TopMedTalk is very proud to be partnered with the American Society of Anesthesiologists® at ANESTHESIOLOGY® 2022. Now in our fifth year TopMedTalk is bringing you our most comprehensive and extensive coverage of the largest gathering of anesthesiologists in the world!

This audio is presented to you "as live" - if you'd like to see our coverage as it happens go now to: https://live.topmedtalk.com/

TopMedTalk is provided to you for free; if you want to help support our work and help give these conversations a wider audience please like and subscribe (if and where possible) before sharing it on your social media.

TopMedTalk can be found on YouTube here: https://www.youtube.com/channel/UC-HYQmeIwcFCYO1hoQ8jShQ

We are on Twitter here: https://twitter.com/topmedtalk

We are on LinkedIn here: https://www.linkedin.com/company/topmedtalk

We are on Facebook here: https://www.facebook.com/TopMedTalk1/

Perioperative Medicine | Anesthesiology 2022 Oct 25, 2022

Celebrating 5 years of TopMedTalk at 'Anesthesiology'; the Annual General Meeting of the American Society of Anesthesiologists (ASA).

This piece is presented by Desiree Chappell, Monty Mythen and Sol Aronson with their guest; BobbieJean Sweitzer, Systems Director of Perioperative Practices at Inova Health, Falls Church, Virginia and Angela Edwards, Vice Chair Professional Affairs, Atrium Health WFB Anesthesiology, Winston-Salem, North Carolina.

Both of our guests have impressed TopMedTalk listeners in the past; here’s a couple of pieces featuring them:

Angela Edwards: https://www.topmedtalk.com/asa-2018-san-francisco-improving-outcomes-for-the-perioperative-patient/

BobbieJean Sweitzer: https://www.topmedtalk.com/asa-frailty-and-the-perioperative-patient-enhancing-recovery/

TopMedTalk is very proud to be partnered with the American Society of Anesthesiologists® at ANESTHESIOLOGY® 2022. Now in our fifth year TopMedTalk is bringing you our most comprehensive and extensive coverage of the largest gathering of anesthesiologists in the world!

This audio is presented to you "as live" - if you'd like to see our coverage as it happens go now to: https://live.topmedtalk.com/

TopMedTalk is provided to you for free; if you want to help support our work and help give these conversations a wider audience please like and subscribe (if and where possible) before sharing it on your social media.

TopMedTalk can be found on YouTube here: https://www.youtube.com/channel/UC-HYQmeIwcFCYO1hoQ8jShQ

We are on Twitter here: https://twitter.com/topmedtalk

We are on LinkedIn here: https://www.linkedin.com/company/topmedtalk

We are on Facebook here: https://www.facebook.com/TopMedTalk1/

Randall M. Clark, a year in review, as ASA President | Anesthesiology 2022 Oct 25, 2022

Celebrating 5 years of TopMedTalk at 'Anesthesiology'; the Annual General Meeting of the American Society of Anesthesiologists (ASA).

This piece is presented by Desiree Chappell, Monty Mythen and Sol Aronson with their guest; Randall M. Clark, M.D., FASA, outgoing President of the ASA 2022.

The Anesthesia Quality Institute (AQI) is here: https://www.aqihq.org/

We took a look into our archive recently and dug out interviews with past ASA Presidents over the years, have a listen here: https://directory.libsyn.com/episode/index/id/24676698

TopMedTalk is very proud to be partnered with the American Society of Anesthesiologists® at ANESTHESIOLOGY® 2022. Now in our fifth year TopMedTalk is bringing you our most comprehensive and extensive coverage of the largest gathering of anesthesiologists in the world!

This audio is presented to you "as live" - if you'd like to see our coverage as it happens go now to: https://live.topmedtalk.com/

TopMedTalk is provided to you for free; if you want to help support our work and help give these conversations a wider audience please like and subscribe (if and where possible) before sharing it on your social media.

TopMedTalk can be found on YouTube here: https://www.youtube.com/channel/UC-HYQmeIwcFCYO1hoQ8jShQ

We are on Twitter here: https://twitter.com/topmedtalk

We are on LinkedIn here: https://www.linkedin.com/company/topmedtalk

We are on Facebook here: https://www.facebook.com/TopMedTalk1/

The ASA Global Scholars Program Part 2 | Anesthesiology 2022 Oct 25, 2022

Celebrating 5 years of TopMedTalk at 'Anesthesiology'; the Annual General Meeting of the American Society of Anesthesiologists.

This piece is presented by Desiree Chappell with her guests; representatives of the ASA Global Scholars Program; supporting young leaders in the specialty from low- and middle-lower income countries.

Part One of this piece is here: https://directory.libsyn.com/episode/index/id/24794133

This conversation was triggered by our meeting with Elizabeth Drum which you can also listen to here: https://www.topmedtalk.com/global-humanitarian-outreach-with-elizabeth-drum-anesthesiology-2022/

TopMedTalk is very proud to be partnered with the American Society of Anesthesiologists® at ANESTHESIOLOGY® 2022. Now in our fifth year TopMedTalk is bringing you our most comprehensive and extensive coverage of the largest gathering of anesthesiologists in the world!

This audio is presented to you "as live" - if you'd like to see our coverage as it happens go now to: https://live.topmedtalk.com/

TopMedTalk is provided to you for free; if you want to help support our work and help give these conversations a wider audience please like and subscribe (if and where possible) before sharing it on your social media.

TopMedTalk can be found on YouTube here: https://www.youtube.com/channel/UC-HYQmeIwcFCYO1hoQ8jShQ

We are on Twitter here: https://twitter.com/topmedtalk

We are on LinkedIn here: https://www.linkedin.com/company/topmedtalk

We are on Facebook here: https://www.facebook.com/TopMedTalk1/

The ASA Global Scholars Program Part 1 | Anesthesiology 2022 Oct 25, 2022

Celebrating 5 years of TopMedTalk at 'Anesthesiology'; the Annual General Meeting of the American Society of Anesthesiologists.

This piece is presented by Desiree Chappell with her guests, representatives of the ASA Global Scholars Program; supporting young leaders in the specialty from low- and middle-lower income countries.

This conversation was triggered by our meeting with Elizabeth Drum which you can also listen to here: https://www.topmedtalk.com/global-humanitarian-outreach-with-elizabeth-drum-anesthesiology-2022/

TopMedTalk is very proud to be partnered with the American Society of Anesthesiologists® at ANESTHESIOLOGY® 2022. Now in our fifth year TopMedTalk is bringing you our most comprehensive and extensive coverage of the largest gathering of anesthesiologists in the world!

This audio is presented to you "as live" - if you'd like to see our coverage as it happens go now to: https://live.topmedtalk.com/

TopMedTalk is provided to you for free; if you want to help support our work and help give these conversations a wider audience please like and subscribe (if and where possible) before sharing it on your social media.

TopMedTalk can be found on YouTube here: https://www.youtube.com/channel/UC-HYQmeIwcFCYO1hoQ8jShQ

We are on Twitter here: https://twitter.com/topmedtalk

We are on LinkedIn here: https://www.linkedin.com/company/topmedtalk

We are on Facebook here: https://www.facebook.com/TopMedTalk1/

Creating high reliability using Tele ICU | Anesthesiology 2022 Oct 25, 2022

Celebrating 5 years of TopMedTalk at 'Anesthesiology'; the Annual General Meeting of the American Society of Anesthesiologists.

This piece is presented by Desiree Chappell and Monty Mythen with their guest Mike Scott, Professor of Anesthesiology at the University of Pennsylvania.

TopMedTalk is very proud to be partnered with the American Society of Anesthesiologists® at ANESTHESIOLOGY® 2022. Now in our fifth year TopMedTalk is bringing you our most comprehensive and extensive coverage of the largest gathering of anesthesiologists in the world!

This audio is presented to you "as live" - if you'd like to see our coverage as it happens go now to: https://live.topmedtalk.com/

TopMedTalk is provided to you for free; if you want to help support our work and help give these conversations a wider audience please like and subscribe (if and where possible) before sharing it on your social media.

TopMedTalk can be found on YouTube here: https://www.youtube.com/channel/UC-HYQmeIwcFCYO1hoQ8jShQ

We are on Twitter here: https://twitter.com/topmedtalk

We are on LinkedIn here: https://www.linkedin.com/company/topmedtalk

We are on Facebook here: https://www.facebook.com/TopMedTalk1/

Burnout; a systemic problem in need of systemic, organizational, policy-level solutions | Anesthesiology 2022 Oct 24, 2022

Celebrating 5 years of TopMedTalk at 'Anesthesiology'; the Annual General Meeting of the American Society of Anesthesiologists.

This piece is presented by Desiree Chappell and Sol Aronson with her guest Amy Vinson, Pediatrician and Anesthesiologist at Boston Children's Hospital.

TopMedTalk is very proud to be partnered with the American Society of Anesthesiologists® at ANESTHESIOLOGY® 2022. Now in our fifth year TopMedTalk is bringing you our most comprehensive and extensive coverage of the largest gathering of anesthesiologists in the world!

This audio is presented to you "as live" - if you'd like to see our coverage as it happens go now to: https://live.topmedtalk.com/

TopMedTalk is provided to you for free; if you want to help support our work and help give these conversations a wider audience please like and subscribe (if and where possible) before sharing it on your social media.

TopMedTalk can be found on YouTube here: https://www.youtube.com/channel/UC-HYQmeIwcFCYO1hoQ8jShQ

We are on Twitter here: https://twitter.com/topmedtalk

We are on LinkedIn here: https://www.linkedin.com/company/topmedtalk

We are on Facebook here: https://www.facebook.com/TopMedTalk1/

The vision for the future of ANESTHESIOLOGY® | Anesthesiology 2022 Oct 24, 2022

Celebrating 5 years of TopMedTalk at 'Anesthesiology'; the Annual General Meeting of the American Society of Anesthesiologists.

This piece is presented by Desiree Chappell, Sol Aronson and Monty Mythen with their guest Sheela Pai Cole, Clinical Professor, Anesthesiology, Perioperative and Pain Medicine at Stanford Health Center.

TopMedTalk is very proud to be partnered with the American Society of Anesthesiologists® at ANESTHESIOLOGY® 2022. Now in our fifth year TopMedTalk is bringing you our most comprehensive and extensive coverage of the largest gathering of anesthesiologists in the world!

This audio is presented to you "as live" - if you'd like to see our coverage as it happens go now to: https://live.topmedtalk.com/

TopMedTalk is provided to you for free; if you want to help support our work and help give these conversations a wider audience please like and subscribe (if and where possible) before sharing it on your social media.

TopMedTalk can be found on YouTube here: https://www.youtube.com/channel/UC-HYQmeIwcFCYO1hoQ8jShQ

We are on Twitter here: https://twitter.com/topmedtalk

We are on LinkedIn here: https://www.linkedin.com/company/topmedtalk

We are on Facebook here: https://www.facebook.com/TopMedTalk1/

The DETECT study | Anesthesiology 2022 Oct 24, 2022

Celebrating 5 years of TopMedTalk at 'Anesthesiology'; the Annual General Meeting of the American Society of Anesthesiologists.

This piece is presented by Desiree Chappell and Monty Mythen with their guest Bernd Saugel, Professor and Vice Chair of the Department of Anesthesiology, Center of Anesthesiology and Intensive Care Medicine at the University Medical Center Hamburg-Eppendorf, Germany.

Bernd has previously appeared on TopMedTalk here: https://www.topmedtalk.com/bernd-saugel-at-euroanesthesia-2022-topmedtalk/

TopMedTalk is very proud to be partnered with the American Society of Anesthesiologists® at ANESTHESIOLOGY® 2022. Now in our fifth year TopMedTalk is bringing you our most comprehensive and extensive coverage of the largest gathering of anesthesiologists in the world!

This audio is presented to you "as live" - if you'd like to see our coverage as it happens go now to: https://live.topmedtalk.com/

TopMedTalk is provided to you for free; if you want to help support our work and help give these conversations a wider audience please like and subscribe (if and where possible) before sharing it on your social media.

TopMedTalk can be found on YouTube here: https://www.youtube.com/channel/UC-HYQmeIwcFCYO1hoQ8jShQ

We are on Twitter here: https://twitter.com/topmedtalk

We are on LinkedIn here: https://www.linkedin.com/company/topmedtalk

We are on Facebook here: https://www.facebook.com/TopMedTalk1/

Anesthesiology Journal | Anesthesiology 2022 Oct 24, 2022

Celebrating 5 years of TopMedTalk at 'Anesthesiology'; the Annual General Meeting of the American Society of Anesthesiologists (ASA).

This piece is presented by Desiree Chappell and Sol Aronson with their guest Evan Kharasch, Professor and Vice Chair for Innovation in the Department of Anesthesiology at Duke University, Director of Academic Entrepreneurship in Duke University School of Medicine and editor-in-chief of 'Anesthesiology' the official medical journal of ASA.

Find out more about the journal here: https://pubs.asahq.org/anesthesiology

TopMedTalk is very proud to be partnered with the American Society of Anesthesiologists® at ANESTHESIOLOGY® 2022. Now in our fifth year TopMedTalk is bringing you our most comprehensive and extensive coverage of the largest gathering of anesthesiologists in the world!

This audio is presented to you "as live" - if you'd like to see our coverage as it happens go now to: https://live.topmedtalk.com/

TopMedTalk is provided to you for free; if you want to help support our work and help give these conversations a wider audience please like and subscribe (if and where possible) before sharing it on your social media.

TopMedTalk can be found on YouTube here: https://www.youtube.com/channel/UC-HYQmeIwcFCYO1hoQ8jShQ

We are on Twitter here: https://twitter.com/topmedtalk

We are on LinkedIn here: https://www.linkedin.com/company/topmedtalk

We are on Facebook here: https://www.facebook.com/TopMedTalk1/

Monitoring the Unmonitored | Anesthesiology 2022 Oct 24, 2022

Celebrating 5 years of TopMedTalk at 'Anesthesiology'; the Annual General Meeting of the American Society of Anesthesiologists.

This piece is presented by Sol Aronson and with his guests Sadia Khan, Consultant Physician, Clinical Director and Service Director for Cardiology at Chelsea and Westminster Hospital and Frank Overdyk, Professor of Anaesthesiology, Charleston, South Carolina.

Sadia has featured on TopMedTalk previously here: https://www.topmedtalk.com/topmedtalks-to-sadia-khan-ebpom-2022/

We spoke with Frank here on the subject of pain monitoring: https://www.topmedtalk.com/11813-2/

TopMedTalk is very proud to be partnered with the American Society of Anesthesiologists® at ANESTHESIOLOGY® 2022. Now in our fifth year TopMedTalk is bringing you our most comprehensive and extensive coverage of the largest gathering of anesthesiologists in the world!

This audio is presented to you "as live" - if you'd like to see our coverage as it happens go now to: https://live.topmedtalk.com/

TopMedTalk is provided to you for free; if you want to help support our work and help give these conversations a wider audience please like and subscribe (if and where possible) before sharing it on your social media.

TopMedTalk can be found on YouTube here: https://www.youtube.com/channel/UC-HYQmeIwcFCYO1hoQ8jShQ

We are on Twitter here: https://twitter.com/topmedtalk

We are on LinkedIn here: https://www.linkedin.com/company/topmedtalk

We are on Facebook here: https://www.facebook.com/TopMedTalk1/

Game-changing Tech: Infusion Pump Usability with Anesthesia in Mind | Anesthesiology 2022 Oct 24, 2022

Celebrating 5 years of TopMedTalk at 'Anesthesiology'; the Annual General Meeting of the American Society of Anesthesiologists.

This piece is presented by Sol Aronson with his guest Robert Canfield, Director of Marketing, Fresenius Kabi.

TopMedTalk is very proud to be partnered with the American Society of Anesthesiologists® at ANESTHESIOLOGY® 2022. Now in our fifth year TopMedTalk is bringing you our most comprehensive and extensive coverage of the largest gathering of anesthesiologists in the world!

This audio is presented to you "as live" - if you'd like to see our coverage as it happens go now to: https://live.topmedtalk.com/

TopMedTalk is provided to you for free; if you want to help support our work and help give these conversations a wider audience please like and subscribe (if and where possible) before sharing it on your social media.

TopMedTalk can be found on YouTube here: https://www.youtube.com/channel/UC-HYQmeIwcFCYO1hoQ8jShQ

We are on Twitter here: https://twitter.com/topmedtalk

We are on LinkedIn here: https://www.linkedin.com/company/topmedtalk

We are on Facebook here: https://www.facebook.com/TopMedTalk1/

Provider burnout and wellbeing | Anesthesiology 2022 Oct 24, 2022

Celebrating 5 years of TopMedTalk at 'Anesthesiology'; the Annual General Meeting of the American Society of Anesthesiologists (ASA).

This piece is presented by Desiree Chappell, Monty Mythen and Sol Aronson with their guest Mark Pinosky, Regional Chief Medical Officer for NorthStar Anesthesia.

We consider 'burn out' to be a very important subject and have covered it extensively elsewhere, if you need to hear more on this subject try you can go here: https://www.topmedtalk.com/sca-burn-out-a-frank-discussion/

And here: https://www.topmedtalk.com/aana-emotional-intelligence-and-occupational-stress-2/

TopMedTalk is very proud to be partnered with the American Society of Anesthesiologists® at ANESTHESIOLOGY® 2022. Now in our fifth year TopMedTalk is bringing you our most comprehensive and extensive coverage of the largest gathering of anesthesiologists in the world!

This audio is presented to you "as live" - if you'd like to see our coverage as it happens go now to: https://live.topmedtalk.com/

TopMedTalk is provided to you for free; if you want to help support our work and help give these conversations a wider audience please like and subscribe (if and where possible) before sharing it on your social media.

We are on Twitter here: https://twitter.com/topmedtalk

We are on LinkedIn here: https://www.linkedin.com/company/topmedtalk

We are on Facebook here: https://www.facebook.com/TopMedTalk1/

The Anesthesia Patient Safety Foundation | Anesthesiology 2022 Oct 24, 2022

Celebrating 5 years of TopMedTalk at 'Anesthesiology'; the Annual General Meeting of the American Society of Anesthesiologists (ASA).

Here we focus upon The Anesthesia Patient Safety Foundation (APSF).

This piece is presented by Desiree Chappell and Monty Mythen with their guests JW Beard, Chief Medical Officer of GE Patient Care solutions, GE Healthcare, APSF Board of Directors and Jeffery Feldman, Attending Anesthesiologist, Children’s Hospital of Philadelphia (CHOP) and Professor of Clinical Anesthesiology at the Perelman School of Medicine, University of Pennsylvania, APSF Board of Directors.

The educational resources mentioned in this piece are here:

https://www.apsf.org/apsf-technology-education-initiative/

The APSF website is here: www.apsf.org

We spoke previously to The Anesthesia Patient Safety Foundation in 2019 here:

https://www.topmedtalk.com/asa-2019-anesthesia-patient-safety-foundation-mark-warner/

We also consulted them during our coverage of the COVID-19 crisis: https://www.topmedtalk.com/the-anesthesia-patient-safety-foundation-covid-19/

TopMedTalk is very proud to be partnered with the American Society of Anesthesiologists® at ANESTHESIOLOGY® 2022. Now in our fifth year TopMedTalk is bringing you our most comprehensive and extensive coverage of the largest gathering of anesthesiologists in the world!

This audio is presented to you "as live" - if you'd like to see our coverage as it happens go now to: https://live.topmedtalk.com/

TopMedTalk is provided to you for free; if you want to help support our work and help give these conversations a wider audience please like and subscribe (if and where possible) before sharing it on your social media.

TopMedTalk can be found on YouTube here: https://www.youtube.com/channel/UC-HYQmeIwcFCYO1hoQ8jShQ

We are on Twitter here: https://twitter.com/topmedtalk

We are on LinkedIn here: https://www.linkedin.com/company/topmedtalk

We are on Facebook here: https://www.facebook.com/TopMedTalk1/

Podcasting in anesthesiology and medicine | Anesthesiology 2022 Oct 24, 2022

Celebrating 5 years of TopMedTalk at 'Anesthesiology'; the Annual General Meeting of the American Society of Anesthesiologists (ASA).

This piece is presented by Desiree Chappell and Sol Aronson with their guest Jed Wolpaw, Anesthesiologist, intensivist, founder and host of http://accrac.com podcast, Program Director, Johns Hopkins Anesthesiology.

TopMedTalk is very proud to be partnered with the American Society of Anesthesiologists® at ANESTHESIOLOGY® 2022. Now in our fifth year TopMedTalk is bringing you our most comprehensive and extensive coverage of the largest gathering of anesthesiologists in the world!

This audio is presented to you "as live" - if you'd like to see our coverage as it happens go now to: https://live.topmedtalk.com/

TopMedTalk is provided to you for free; if you want to help support our work and help give these conversations a wider audience please like and subscribe (if and where possible) before sharing it on your social media.

We are on Twitter here: https://twitter.com/topmedtalk

We are on LinkedIn here: https://www.linkedin.com/company/topmedtalk

We are on Facebook here: https://www.facebook.com/TopMedTalk1/

TopMedTalks to Lee Fleisher | Anesthesiology 2022 Oct 24, 2022

Celebrating 5 years of TopMedTalk at 'Anesthesiology'; the Annual General Meeting of the American Society of Anesthesiologists.

This piece is presented by Desiree Chappell, Monty Mythen and Sol Aronson and features their guest Lee Fleisher, Professor Emeritus of Anesthesiology and Critical Care, University of Pennsylvania.

Lee is a firm TopMedTalk favorite, find out why by listening to some of his previous appearances:

Lee Fleisher at The ASA:

https://www.topmedtalk.com/talks-to-lee-fleisher-topmedtalk-at-the-asa/

Postoperative Critical Care - How Do We Help?

https://www.topmedtalk.com/postoperative-critical-care-how-do-we-help-ebpom-2020-2/

And this particularly popular piece here:

https://www.topmedtalk.com/ebpom-usa-part-3-a-perioperative-practicum-with-dr-lee-a-fleisher/

TopMedTalk is very proud to be partnered with the American Society of Anesthesiologists® at ANESTHESIOLOGY® 2022. Now in our fifth year TopMedTalk is bringing you our most comprehensive and extensive coverage of the largest gathering of anesthesiologists in the world!

This audio is presented to you "as live" - if you'd like to see our coverage as it happens go now to: https://live.topmedtalk.com/

TopMedTalk is provided to you for free; if you want to help support our work and help give these conversations a wider audience please like and subscribe (if and where possible) before sharing it on your social media.

TopMedTalk can be found on YouTube here: https://www.youtube.com/channel/UC-HYQmeIwcFCYO1hoQ8jShQ

We are on Twitter here: https://twitter.com/topmedtalk

We are on LinkedIn here: https://www.linkedin.com/company/topmedtalk

We are on Facebook here: https://www.facebook.com/TopMedTalk1/

The future of the anaesthetic workforce in the UK - a personal view William Harrop-Griffiths | EBPOM 2022 Oct 24, 2022

This week's podcast is the Evidence Based Perioperative Medicine (EBPOM) Visiting Professor Plenary Lecture; "The future of the anaesthetic workforce in the UK - a personal view".

The question and answer session mentioned in this piece will be available on TopMedTalk in the near future.

Presented by William Harrop-Griffiths, Vice-President Royal Collage of Anesthetists (September 2020-22) and introduced by Mike Grocott, Professor of Anaesthesia and critical care at the University of Southampton.

Perioperative applications for R.F.I.D. | Anesthesiology 2022 Oct 24, 2022

Celebrating 5 years of TopMedTalk at 'Anesthesiology'; the Annual General Meeting of the American Society of Anesthesiologists (ASA).

This piece is presented by Desiree Chappell with her guest, Gwen Volpe, Senior Director Medication Technology and Analytics, Fresenius Kabi.

TopMedTalk is very proud to be partnered with the American Society of Anesthesiologists® at ANESTHESIOLOGY® 2022. Now in our fifth year TopMedTalk is bringing you our most comprehensive and extensive coverage of the largest gathering of anesthesiologists in the world!

This audio is presented to you "as live" - if you'd like to see our coverage as it happens go now to: https://live.topmedtalk.com/

TopMedTalk is provided to you for free; if you want to help support our work and help give these conversations a wider audience please like and subscribe (if and where possible) before sharing it on your social media.

We are on Twitter here: https://twitter.com/topmedtalk

We are on LinkedIn here: https://www.linkedin.com/company/topmedtalk

We are on Facebook here: https://www.facebook.com/TopMedTalk1/

Advances in Low Flow Anesthesia | Anesthesiology 2022 Oct 24, 2022

Celebrating 5 years of TopMedTalk at 'Anesthesiology'; the Annual General Meeting of the American Society of Anesthesiologists (ASA).

This piece is presented by Desiree Chappell and Monty Mythen with their guests JW Beard, Chief Medical Officer of GE Patient Care solutions, GE Healthcare, Eric Ruedinger, General Manager for Anesthesia and Respiratory Care, Patient Care Solutions, GE Healthcare and Guy Dear, Pediatric Anesthesiologist at Duke University Hospital.

TopMedTalk is very proud to be partnered with the American Society of Anesthesiologists® at ANESTHESIOLOGY® 2022. Now in our fifth year TopMedTalk is bringing you our most comprehensive and extensive coverage of the largest gathering of anesthesiologists in the world!

This audio is presented to you "as live" - if you'd like to see our coverage as it happens go now to: https://live.topmedtalk.com/

TopMedTalk is provided to you for free; if you want to help support our work and help give these conversations a wider audience please like and subscribe (if and where possible) before sharing it on your social media.

TopMedTalk can be found on YouTube here: https://www.youtube.com/channel/UC-HYQmeIwcFCYO1hoQ8jShQ

We are on Twitter here: https://twitter.com/topmedtalk

We are on LinkedIn here: https://www.linkedin.com/company/topmedtalk

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Et Control in the USA is approved for patients 18 years of age and older

AI and Autonomous Systems in the Perioperative Setting | Anesthesiology 2022 Oct 24, 2022

"The system is not going to work by itself but just under the control of the clinicians; so it's always ... human and machine together."

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Celebrating 5 years of TopMedTalk at 'Anesthesiology'; the Annual General Meeting of the American Society of Anesthesiologists (ASA).

This piece is presented by Desiree Chappell and Monty Mythen with their guest Alexandre Joosten, Anesthetist at Hospital Erasme.

Our guest featured previously on TopMedTalk here: https://www.topmedtalk.com/euroanaes2019-alexandre-joosten/

TopMedTalk is very proud to be partnered with the American Society of Anesthesiologists® at ANESTHESIOLOGY® 2022. Now in our fifth year TopMedTalk is bringing you our most comprehensive and extensive coverage of the largest gathering of anesthesiologists in the world!

This audio is presented to you "as live" - if you'd like to see our coverage as it happens go now to: https://live.topmedtalk.com/

TopMedTalk is provided to you for free; if you want to help support our work and help give these conversations a wider audience please like and subscribe (if and where possible) before sharing it on your social media.

TopMedTalk can be found on YouTube here: https://www.youtube.com/channel/UC-HYQmeIwcFCYO1hoQ8jShQ

We are on Twitter here: https://twitter.com/topmedtalk

We are on LinkedIn here: https://www.linkedin.com/company/topmedtalk

We are on Facebook here: https://www.facebook.com/TopMedTalk1/

Periop evaluation of HPI in Orthotopic Liver Transplant | Anesthesiology 2022 Oct 23, 2022

Celebrating 5 years of TopMedTalk at 'Anesthesiology'; the Annual General Meeting of the American Society of Anesthesiologists (ASA).

This piece is presented by Desiree Chappell, Sol Aronson and Monty Mythen and Sol Aronson with their guest Kamal Maheshwari, Director, Center for Perioperative Intelligence, Cleveland Clinic.

As mentioned Kamal has featured on TopMedTalk previously here: https://www.topmedtalk.com/kamal-maheshwari-director-center-for-perioperative-intelligence-topmedtalk/

TopMedTalk is very proud to be partnered with the American Society of Anesthesiologists® at ANESTHESIOLOGY® 2022. Now in our fifth year TopMedTalk is bringing you our most comprehensive and extensive coverage of the largest gathering of anesthesiologists in the world!

This audio is presented to you "as live" - if you'd like to see our coverage as it happens go now to: https://live.topmedtalk.com/

TopMedTalk is provided to you for free; if you want to help support our work and help give these conversations a wider audience please like and subscribe (if and where possible) before sharing it on your social media.

TopMedTalk can be found on YouTube here: https://www.youtube.com/channel/UC-HYQmeIwcFCYO1hoQ8jShQ

We are on Twitter here: https://twitter.com/topmedtalk

We are on LinkedIn here: https://www.linkedin.com/company/topmedtalk

We are on Facebook here: https://www.facebook.com/TopMedTalk1/

The ASA’s Intraoperative Hypotension Measure | Anesthesiology 2022 Oct 23, 2022

Celebrating 5 years of TopMedTalk at 'Anesthesiology'; the Annual General Meeting of the American Society of Anesthesiologists (ASA).

This piece is presented by Desiree Chappell and Monty Mythen with their guests Rick Dutton, Chief Quality Officer at United States Anesthesia Partners Baltimore, Maryland Area, Josh Lumbley, Chief Quality Officer of NorthStar Anesthesia and Wael Saasouh, Regional Director for Research at NorthStar Anesthesia.

Rick Dutton is a popular contributor to TopMedTalk; you can hear more from him in our extensive podcast archive here: https://www.topmedtalk.com/rick-dutton-chief-quality-officer-us-anesthesia-partners-topmedtalk-at-the-asa/

And here: https://www.topmedtalk.com/topmedtalks-to-rick-dutton-2/

And here: https://www.topmedtalk.com/desirees-roundtable-rick-dutton-qa-session-2/

TopMedTalk is very proud to be partnered with the American Society of Anesthesiologists® at ANESTHESIOLOGY® 2022. Now in our fifth year TopMedTalk is bringing you our most comprehensive and extensive coverage of the largest gathering of anesthesiologists in the world!

This audio is presented to you "as live" - if you'd like to see our coverage as it happens go now to: https://live.topmedtalk.com/

TopMedTalk is provided to you for free; if you want to help support our work and help give these conversations a wider audience please like and subscribe (if and where possible) before sharing it on your social media.

TopMedTalk can be found on YouTube here: https://www.youtube.com/channel/UC-HYQmeIwcFCYO1hoQ8jShQ

We are on Twitter here: https://twitter.com/topmedtalk

We are on LinkedIn here: https://www.linkedin.com/company/topmedtalk

We are on Facebook here: https://www.facebook.com/TopMedTalk1/

Point-of-Care Ultrasound; Concept to Application | Anesthesiology 2022 Oct 23, 2022

Celebrating 5 years of TopMedTalk at 'Anesthesiology'; the Annual General Meeting of the Amercan Society of Anesthesiologists.

This piece is presented by Desiree Chappell, Monty Mythen and Sol Aronson with their guest Davinder Ramsingh, Vice President of Clinical Research and Development at Butterfly Network and Professor of Anesthesiology at Loma Linda Medical Center.

For more information go to: https://www.butterflynetwork.com/

A popular contributor to TopMedTalk you can hear more from Davinder in our extensive podcast archive here: https://www.topmedtalk.com/live-from-boston-asa-2017-enhanced-recovery-and-protocolised-care-in-cardiac-surgery/

Here: https://www.topmedtalk.com/asa-2018-san-francisco-point-of-care-ultrasound-pocus/

And here: https://www.topmedtalk.com/sca-davinder-ramisingh/

TopMedTalk is very proud to be partnered with the American Society of Anesthesiologists® at ANESTHESIOLOGY® 2022. Now in our fifth year TopMedTalk is bringing you our most comprehensive and extensive coverage of the largest gathering of anesthesiologists in the world!

This audio is presented to you "as live" - if you'd like to see our coverage as it happens go now to: https://live.topmedtalk.com/

TopMedTalk is provided to you for free; if you want to help support our work and help give these conversations a wider audience please like and subscribe (if and where possible) before sharing it on your social media.

TopMedTalk can be found on YouTube here: https://www.youtube.com/channel/UC-HYQmeIwcFCYO1hoQ8jShQ

We are on Twitter here: https://twitter.com/topmedtalk

We are on LinkedIn here: https://www.linkedin.com/company/topmedtalk

We are on Facebook here: https://www.facebook.com/TopMedTalk1/

Global Humanitarian Outreach with Elizabeth Drum | Anesthesiology 2022 Oct 23, 2022

Celebrating 5 years of TopMedTalk at 'Anesthesiology'; the Annual General Meeting of the American Society of Anesthesiologists.

This piece is presented by Desiree Chappell and Sol Aronson with their guest Elizabeth Drum, Associate Professor of Clinical Anesthesiology and Critical Care Medicine at the Perelman School of Medicine, University of Pennsylvania, Philadelphia.

For more information about the American Society of Anesthesiologist's global humanitarian outreach go here: https://www.asahq.org/charity

TopMedTalk is very proud to be partnered with the American Society of Anesthesiologists® at ANESTHESIOLOGY® 2022. Now in our fifth year TopMedTalk is bringing you our most comprehensive and extensive coverage of the largest gathering of anesthesiologists in the world!

This audio is presented to you "as live" - if you'd like to see our coverage as it happens go now to: https://live.topmedtalk.com/

TopMedTalk is provided to you for free; if you want to help support our work and help give these conversations a wider audience please like and subscribe (if and where possible) before sharing it on your social media.

TopMedTalk can be found on YouTube here: https://www.youtube.com/channel/UC-HYQmeIwcFCYO1hoQ8jShQ

We are on Twitter here: https://twitter.com/topmedtalk

We are on LinkedIn here: https://www.linkedin.com/company/topmedtalk

We are on Facebook here: https://www.facebook.com/TopMedTalk1/

Day 1 Introduction | Anesthesiology 2022 Oct 23, 2022

Celebrating 5 years of TopMedTalk at 'Anesthesiology'; the Annual General Meeting of the American Society of Anesthesiologists. This piece is an introduction to our coverage with your hosts this year; Desiree Chappell, Monty Mythen and Sol Aronson.

TopMedTalk is very proud to be partnered with the American Society of Anesthesiologists® at ANESTHESIOLOGY® 2022. Now in our fifth year TopMedTalk is bringing you our most comprehensive and extensive coverage of the largest gathering of anesthesiologists in the world!

This audio is presented to you "as live" - if you'd like to see our coverage as it happens go now to: https://live.topmedtalk.com/

TopMedTalk is provided to you for free; if you want to help support our work and help give these conversations a wider audience please like and subscribe (if and where possible) before sharing it on your social media.

TopMedTalk can be found on YouTube here: https://www.youtube.com/channel/UC-HYQmeIwcFCYO1hoQ8jShQ

We are on Twitter here: https://twitter.com/topmedtalk

We are on LinkedIn here: https://www.linkedin.com/company/topmedtalk

We are on Facebook here: https://www.facebook.com/TopMedTalk1/

Pain and P.O.N.V. in the Perioperative Setting | Anesthesiology 2022 Oct 23, 2022

Celebrating 5 years of TopMedTalk at 'Anesthesiology'; the Annual General Meeting of the American Society of Anesthesiologists.

This piece is presented by Desiree Chappell and Sol Aronson with their guests Michael Matthews, Senior Vice President of Acute Care for Heron Therapeutics and Randy Robbins, Managing Partner at Valliant Anesthesia Associates.

For more information check out these links:

Zynrelef: https://zynrelef.com/

Heron Therapeutics: https://www.herontx.com/

TopMedTalk is very proud to be partnered with the American Society of Anesthesiologists® at ANESTHESIOLOGY® 2022. Now in our fifth year TopMedTalk is bringing you our most comprehensive and extensive coverage of the largest gathering of anesthesiologists in the world!

This audio is presented to you "as live" - if you'd like to see our coverage as it happens go now to: https://live.topmedtalk.com/

TopMedTalk is provided to you for free; if you want to help support our work and help give these conversations a wider audience please like and subscribe (if and where possible) before sharing it on your social media.

TopMedTalk can be found on YouTube here: https://www.youtube.com/channel/UC-HYQmeIwcFCYO1hoQ8jShQ

We are on Twitter here: https://twitter.com/topmedtalk

We are on LinkedIn here: https://www.linkedin.com/company/topmedtalk

We are on Facebook here: https://www.facebook.com/TopMedTalk1/

TopMedTalk is now live streaming | Anesthesiology 2022 Oct 22, 2022

Celebrating 5 years of TopMedTalk at 'Anesthesiology'; the Annual General Meeting of the American Society of Anesthesiologists.

This piece is presented by your hosts Desiree Chappell and Sol Aronson and features a run down of what you can expect if you go now to checkout our live stream and what to expect here on the TopMedTalk podcast channel.

TopMedTalk is very proud to be partnered with the American Society of Anesthesiologists® at ANESTHESIOLOGY® 2022. Now in our fifth year TopMedTalk is bringing you our most comprehensive and extensive coverage of the largest gathering of anesthesiologists in the world!

This audio is presented to you "as live" - if you'd like to see our coverage as it happens go now to: https://live.topmedtalk.com/

TopMedTalk is provided to you for free; if you want to help support our work and help give these conversations a wider audience please like and subscribe (if and where possible) before sharing it on your social media.

Anesthesiology - a retrospective | TopMedTalk at the ASA Part 2 Oct 20, 2022

If you missed part one of this series it can be found in full here: https://topmedtalk.libsyn.com/anesthesiology-a-retrospective-topmedtalk-at-the-asa

TopMedTalk’s proud association with the American Society of Anesthesiologists (ASA) continues to be celebrated in this specially made podcast where we reflect on some of the big conversations we’ve enjoyed at their annual conference, Anesthesiology.

For more on Anesthesiology 2022, please go to www.asahq.org

These clips come from some of the most popular podcasts we’ve done about the conference. For the fuller conversations and podcasts please go here:

Post operative nausea and vomiting | TopMedTalk at the ASA

https://www.topmedtalk.com/post-operative-nausea-and-vomiting-topmedtalk-at-the-asa/

The ASA's Immediate Past President | TopMedTalk at the ASA

https://www.topmedtalk.com/the-asas-immediate-past-president-topmedtalk-at-the-asa/

ASA 2019 | Perioperative Quality Initiative P.O.Q.I. news

https://www.topmedtalk.com/asa-2019-perioperative-quality-initiative-p-o-q-i-news/

ASA 2019 | Depth of anaesthesia:

https://www.topmedtalk.com/asa-2019-depth-of-anaesthesia/

Ashish Khanna on intraoperative hypotension and beyond | TopMedTalk at the ASA:

https://www.topmedtalk.com/ashish-khanna-on-intraoperative-hypotension-and-beyond-topmedtalk-at-the-asa/

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Go now to https://live.topmedtalk.com/ to find out more about your chance to experience TopMedTalk at The ASA.

The value proposition of industry partnerships | EBPOM USA Oct 17, 2022

What is the value proposition when approaching industry partnerships; is there such a thing as information overload; where on the perioperative continuum should the focus be?

With thanks to our generous sponsor, Edwards Lifesciences.

Presented by Desiree Chappell and Sol Aronson with their guests, Patrick Farrer, Director, Professional Education at Edwards Lifesciences, Doug Marshall, Senior Director, Outcomes Managing Group, Eastern Half of the USA, Sotiris Rompas, Global Health Economics and Reimbursement, Edwards Lifesciences

Anesthesiology - a retrospective | ASA Oct 13, 2022

TopMedTalk’s long and proud association with the American Society of Anesthesiologists (ASA) means we’ve had the chance to interview many of the Presidents of the organization over the years.

Here we present some selected highlights from some of those conversations featuring; Linda Mason, MD, FASA, (2019 President of the American Society of Anesthesiologists), Mary Dale Peterson, M.D., MHA, FACHE, FASA, (2020 President of he ASA) Beverly K. Philip, MD, FACA, FASA (2021 President of the ASA) and Randall M. Clark, M.D., FASA (current President of the ASA 2022).

– Go now to https://live.ebpom.org to find out more about your chance to experience TopMedTalk at The ASA.

Other conversations with past ASA Presidents are available here:

Mark Warner (2011): https://directory.libsyn.com/episode/index/id/11741321?_ga=2.5532915.1520077474.1664448308-966310048.1569589661 Jim Grant (2018): https://directory.libsyn.com/episode/index/id/18347285?_ga=2.85944409.1520077474.1664448308-966310048.1569589661 Alexander Hannenberg: https://directory.libsyn.com/episode/index/id/11717234?_ga=2.85944409.1520077474.1664448308-966310048.1569589661

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For the fuller conversations and podcasts please go here:

Linda Mason is here: https://directory.libsyn.com/episode/index/id/10007243?_ga=2.34504801.1520077474.1664448308-966310048.1569589661

Mary Dale Peterson is here: https://directory.libsyn.com/episode/index/id/20798921?_ga=2.96963039.1520077474.1664448308-966310048.1569589661

Beverly K Philip and Randall M Clark are here: https://directory.libsyn.com/episode/index/id/20798759

Defining a best case scenario for post operative value | EBPOM USA Oct 10, 2022

"Good surgeons are good communicators"

How do we define a best case scenario for post operative value? What are the post operative realities and behaviors which interact with cost pressures, reimbursement, payer dynamics and go on to influence the site of service choices that confront us today?

Presented by Desiree Chappell and Sol Aronson with their guests, Sam Ajizian, Chief Medical Officer of the Patient Monitoring Operating Unit in Medtronic, Alan Kirk, Surgeon in Chief for The Duke University Health System, Melissa Cohen, Vice President for Medicare at Aurrera Health Group.

Optimizing intraoperative management | EBPOM USA Oct 03, 2022

This wide ranging discussion from Evidence Based Perioperative Medicine (EBPOM) USA asks how we should best try to manage the intraoperative period, where is the evidence telling us to focus? Do we get the impression that Enhanced Recovery After Surgery (ERAS) delivers the value proposition? Are reduced complications always a good thing, even from a business perspective? What are the economic barriers to adopting enhanced recovery? Is Enhanced Recovery more spoken about than actually practiced?

Presented by Monty Mythen and Desiree Chappell with their guests, Mark Koch, President and CEO of Somnia Anesthesia, Josh Lumbley, Chief Quality Officer of NorthStar Anesthesia, Sotiris Rompas, Global Health Economics and Reimbursement, Edwards Lifesciences - with additional questions from the audience.

Talks to ... Adam Spiegel, CEO, NorthStar Anesthesia | AANA 2022 Sep 29, 2022

"A very different philosophy of going about the business of anesthesia..."

Where are CRNA's placed in the current market. What are going to be the pitfalls and the plus points as we move on from a challenging time?

With thanks to NorthStar Anesthesia for their help in helping TopMedTalk to cover the American American Association of Nurse Anesthesiology's annual conference 2022.

Presented by Desiree Chappell with her co-host Randall Moore, CRNA, Chief Anesthetist Officer at NorthStar Anesthesia and Adam Spiegel, CEO, NorthStar Anesthesia.

Women in Anesthesia | AANA 2022 Sep 29, 2022

TopMedTalk's coverage of the American Association of Nurse Anesthesiology's 2022 conference continues with another installment of "Women in Anesthesia". If you enjoy this piece why not listen to some of our earlier episodes in the popular series; they are found here: https://www.topmedtalk.com/?s=women+in+anaesthesia

Presented by Desiree Chappell, Co Editor in Chief, VP of Clinical Quality, with Jennifer Squibbs, Vice President of CRNA Services, NorthStar Anesthesia, Chris Hendren, Vice President of CRNA Services NorthStar Anesthesia, Jennifer Harpe-Bates, CRNA and Director of Quality, Louisville, KY, NorthStar Anesthesia.

The Great Fluid Debate | EBPOM 2022 Sep 26, 2022

"And the good news is that we may or may not have an answer to this fluid debate that's been running now for 25 years..."

The Great Fluid Debate is a popular fixture at Evidence Based Perioperative Medicine (EBPOM) and this year that was once again the case. Are we genuinely starting to see evidence based practice emerging and finally knocking "eminence based" notions off the shelf?

Presented by Monty Mythen and starting with a short presentation from Professor John A Myburgh, Intensive Care Medicine, University of New South Wales; Director of the Division of Critical Care and Trauma at the George Institute for Global Health and Senior Intensive Care Physician at the St George Hospital, Sydney. He holds honorary Professorial appointments at the University of Sydney and Monash University School of Public Health and Preventive Medicine.

This piece is then complimented by a debate and discussion featuring Desiree Chappell, Certified Registered Nurse Anesthetist (CRNA) and Vice President of Clinical Quality for NorthStar Anesthesia and Andy Shaw, Chairman, Department of Intensive Care and Resuscitation at The Cleveland Clinic, Cleveland, Ohio. With further questions from the audience.

Are Certified Registered Nurse Anesthetists set to become more valuable? | AANA 2022 Sep 22, 2022

"It's not just about us [Anesthesia]. It's about all the stakeholders that are invested"

How can the American Association of Nurse Anesthesiology (AANA) help to maximize the value of Certified Registered Nurse Anesthetists?

This vital conversation tackles that question head on. What are the big opportunities for the profession and how do we make the most of them?

TopMedTalk brings you access to exclusive coverage of the AANA 2022 meeting. For more on the AANA go here: https://www.aana.com/

Presented by TopMedTalk's lead presenter Desiree Chappell with her guest Joseph A. Rodriguez, DNAP, CRNA, AANA Board of Directors and Managing Partner at Arizona Anesthesia Solutions.

This podcast is brought to you with thanks for the support of NorthStar Anesthesia.

Exclusive conversation with the President | AANA 2022 Sep 22, 2022

"Certified Registered Nurse Anesthetists (CRNA's) handle meeting with you ahead of time; alleviating your fears of surgery; getting an extensive health history so that we can really tailor your anesthetic to your needs. We work as a member of a team with surgeons and with nurses - in the operating room. And then afterwards; we want to make sure that you're comfortable and make sure that you're in a good spot to go home."

What is the role of the CRNA? Where might it expand to and what principles lie at the core of the job? This exclusive conversation with the new President of the American Association of Nurse Anesthetists takes on the challenges and embraces the opportunities.

Presented by Desiree Chappell with her guests, Angela R. Mund, DNP, CRNA, Chair, Dept of Clinical Sciences, Charleston, South Carolina, and The President of the AANA alongside, Dru Riddle, PhD,DNP, CRNA, FAANA President-Elect, AANA, CRNA, Northstar Anesthesia and Associate Professor, Texas Christian University TCU.

This podcast is brought to you with thanks for the support of NorthStar Anesthesia.

Perioperative Medicine, the value proposition | EBPOM USA Sep 19, 2022

EBPOM USA gets off to an incredible start; the value proposition which drives the push towards perioperative medicine on both sides of the Atlantic. How far do we go when explaining to both practitioners and patients the importance of perioperative medicine, prehabilitation and preoperative assessment? Can a focus upon the value we add motivate people to follow the evidence and provide true enhanced recovery after surgery (ERAS)?

Presented by Desiree Chappell and Sol Aronson with their guests BobbieJean Sweitzer, Editor of Preoperative Assessment and Management (currently 3rd edition) and the Systems Director of Perioperative Practices at Inova Health, Falls Church, Virginia and Chris Steel, Chief Medical Officer at White River Health System, medical director for the Perioperative Surgical Home Learning Collaborative 2020 and Chief Medical Consultant for Community Business Resources.

The value of information | EBPOM USA Sep 12, 2022

What is the value proposition when it comes to data, when does data become information and how do we mitigate between useful monitoring and an irrelevant miasma? This timely conversation takes place at a key moment in medicine as the limits on what we can know pull back thanks to increasing technological innovation.

This piece presented to you with thanks to our sponsor Medtronic. It is with such partnerships that we are able to bring you TopMedTalk entirely for free each week.

Co-Chaired by Monty Mythen and Sol Aronson with their guests, led by Sam Ajizian, Chief Medical Officer of the Patient Monitoring Operating Unit in Medtronic and Karen Philips, Chief Medical Officer for the respiratory interventions business at Medtronic.

Cardiac ERAS COVID and Beyond | EBPOM USA - Chicago 2021 Sep 05, 2022

Where is Enhanced Recovery After Surgery (ERAS) for cardiac, now we find ourselves towards the start of the "post-COVID19" era? Where is the data taking us? How do we turn our principles into everyday practice?

This piece originally contained the "Cardiac enhanced recovery - essential update | EBPOM Chicago" presentation from our panelist Mike Grant. Listeners are advised to follow this link if they've not yet heard that essential talk: https://topmedtalk.libsyn.com/cardiac-enhanced-recovery-essential-update-ebpom-chicago

Presented and Chaired by Vicki Morton, Director of Clinical and Quality Outcomes, Providence Anesthesiology Associates, with panelists; Mike Grant, Medical Co-Director, Cardiovascular Surgical ICU, The Johns Hopkins University School of Medicine, Amanda Rea, Lead of Advanced Practice For Cardiac Surgery, University of Maryland, Rakesh Arora, Medical Director, Cardiac Surgery and Intensive Care Cardiac Sciences, St Boniface General Hospital and Marjan Jahangiri, Professor of Cardiac Surgery, St George's University Hospital.

"I know nothing..." Hugh Montgomery - Ernest Henry Starling Plenary Lecture | EBPOM 2022 Aug 29, 2022

"We need to stop accepting the tenants we've all been given throughout our careers and accept that maybe we've been misinformed and maybe we've misinformed ourselves and have a bit of humility and start again"

The Ernest Henry Starling Plenary Lecture; a stand out moment from EBPOM 2022, London.

Our speaker calls for medicine to significantly reevaluate itself and focus upon the caring aspect of 'intensive care'.

Presented by Hugh Montgomery OBE; Hugh obtained a first class degree in cardiorespiratory physiology and neuropharmacology, before graduating from the Middlesex Hospital Medical School in 1987. He has since accredited in general medicine, cardiology and intensive care medicine, and is UCL Professor of Intensive Care.

He directs the UCL Institute for Human Health and Performance, and was science lead for Caudwell Xtreme Everest in 2007. He has published over 180 scientific articles, and has a specific interest in hypoxiac adaptation.

Hugh has previously presented a piece here on TopMedTalk on the subject of Nasogastric Feeding: https://www.topmedtalk.com/intensive-care-society-nasogastric-feeding/

TopMedTalks to Sadia Khan | EBPOM 2022 Aug 27, 2022

This piece focuses upon continuous ward monitoring. It provides real world experience as our guest explains how technology is moving forward. How do we avoid information overload? Do staff shortages mean this technology is rapidly going from "optional" to "essential"? How does more monitoring mean more value and better patient care?

This piece presented to you with Portrait Mobile and kindly sponsored by GE Healthcare.

Presented by Desiree Chappell and Monty Mythen with Sadia Khan, Consultant Cardiologist at West Middlesex University Hospital; with questions from the audience, both online and in attendance.

Important News: The truth about pulse oximetry and darker skin pigmentation | EBPOM USA Aug 22, 2022

Due to the importance of this topic the TopMedTalk team would appreciate it if you could help to share and boost this podcast amongst your social media networks.

Pulse Oximetry has been in the news recently, the COVID crisis has revealed discrepancies in its efficacy with patients who have darker skin tones. This conversation cuts to the realities of the situation; are pulse oximeters "racist" or is this a potentially dangerous click bait fallacy?

Presented by Desiree Chappell and Monty Mythen with their guest Sam Ajizian, Chief Medical Officer of the Patient Monitoring Operating Unit in Medtronic

TopMedTalks to Alistair McNarry | EBPOM World Congress 2022 Aug 15, 2022

Laryngosopy latest; what can we see? This piece is a full and frank update regarding where we're at from a charismatic - self described - "laryngoscopy geek".

Videolaryngoscopy versus direct laryngoscopy for adults undergoing tracheal intubation - discussed in this piece under the name "The Cochrane Review" - is here: https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD011136.pub3/full

Our guest kindly shares his Twitter handle: https://twitter.com/altgm

Presented by Desiree Chappell and Monty Mythen with their guest Alistair McNarry Consultant Anaesthetist Western General and St John’s Hospitals Edinburgh and UK National Airway Lead (Joint position between Royal College of Anaesthetists and Difficult Airway Society).

Cardiac ERAS and hypotension in focus | EBPOM World Congress 2022 Aug 08, 2022

TopMedTalk presented here as live during Evidence Based Perioperative Medicine (EBPOM)'s 2022 annual London conference.

Two presentations (the full video of which will be available on EBPOM.org) and then a panel discussion on the subjects of Enhanced Recovery After Surgery (ERAS) Cardiac and hypotension.

If you enjoyed this conversation there is a vast archive of discussion on the topic of Acute Kidney Injury on TopMedTalk here: https://www.topmedtalk.com/?s=AKI

Presented by Desiree Chappell and Monty Mythen with their guests Nick Fletcher, Professor and Chair, Institute of Critical Care, Anaesthesia and Pain at the Cleveland Clinic London and Gabor Zilahi, Consultant at St George’s University Hospital (SGH) Cardiothoracic Intensive Care Unit (CTICU) and General Intensive Care Unit (GICU).

With gratitude to our sponsor Edwards Lifesciences.

Cognitive Prehabilitation - panel discussion | EBPOM Chicago Aug 01, 2022

This vital discussion brings to the fore the realities of cognitive prehabilitation, what is possible, how do we do it right and why does it work? Linking back to a presentation which we've heard earlier on TopMedTalk - https://topmedtalk.libsyn.com/cognitive-prehabilitation-ebpom-chicago?_ga=2.222682203.1756392790.1657624918-966310048.1569589661 - the panel add context and experience to the picture.

If you'd like to attend an Evidence Based Perioperative Medicine (EBPOM) conference please follow this link to their site here: www.ebpom.org

Chaired by Feyce M. Peralta, obstetrical anesthesiologist, Program Director for the Obstetric Anesthesiology Fellowship and Director of Faculty Development for the Department of Anesthesiology at Northwestern University Feinberg School of Medicine with guest speaker, Michelle Humeidan, Associate Professor, Neuroanesthesiology, Associate Faculty, Institute for Behavioural Medicine Research, Medical Director, Enhanced Surgical Recovery and panelists; Charles Hogue, Professor and Chair of Anesthesiology at Northwestern University in Chicago, Sol Aronson, Professor Emeritus, Duke University, Durham, North Carolina and additional contributions from Mike Grocott, Professor of Anaesthesia and critical care at the University of Southampton, Desiree Chappell VP Clinical Quality for NorthStar Anesthesia and Monty Mythen, Smiths Medical Professor of Anaesthesia and Critical Care.

Reflections on anaesthesia and perioperative medicine | EBPOM Jul 25, 2022

"I think the vast majority of our colleagues still think of anesthesia as a task that has to be completed; rather than a system, or anesthesia being part of a holistic picture or whole system. I think that is something that we need to think when we think of the future"

Ravi Mahajan, Former President of The Royal College of Anaesthetists, UK. This talk 'Reflections on Anaesthesia and Perioperative medicine; looking back / looking forward' was the Rod Armstrong Plenary Lecture of (Evidence Based Perioperative Medicine) EBPOM Ireland 2021. It is presented to you here, in full, free of charge.

If you are interested in attending forthcoming events organised by EBPOM please visit www.EBPOM.org

Chaired by George Shorten, Professor of Anaesthesia and Intensive Care Medicine at University College Cork and Mike Grocott, Professor of Anaesthesia and Critical Care Medicine at The University of Southampton.

TopMedTalk Talks To Alex Oliver | EBPOM World Congress 2022 Jul 18, 2022

"EEG is more than a number"

This piece is an early taste of the forthcoming highlights of Evidence Based Perioperative Medicine (EBPOM)'s TopMedTalk presentation.

Subtitled: "pEEG Monitoring in the OR and ICU: From The Table to The Bedside" it was kindly suported by Medtronic

Presented by Desiree Chappell and Monty Mythen with their guest Alex Oliver, Consultant Anaesthetist at The Royal Marsden NHS Foundation Trust.

Unlocking the Perioperative Perspective | EBPOM 2022 Jul 11, 2022

"It's been such an amazing.. electric atmosphere"

This bonus piece gives you a taste of the 2022 Evidence Based Perioperative Medicine (EBPOM) meeting in London this year. Look out for some of the talks from EBPOM - provided exclusively for TopMedTalk for free, with thanks to our generous sponsorships and partners.

How has Perioperative Medicine been trust to the forefront of medicine in the wake of the COVID catastrophe? Are we right to take a leadership role as the healthcare industry attempts to recover from the crisis and establish a new normal? Where are the challenges in our field? Also - prehabilitation has been a hot topic for us on TopMedTalk for a few years now, what are some of the big developments there?

Presented by Nick Margerrison, TopMedTalk's senior producer with his guest Adam Beebeejaun, Fellow of Perioperative Medicine at University College London.

A fluid discussion about fluids | EBPOM World Congress 2022 Jul 07, 2022

Recorded at EBPOM and presented here 'as live' this piece is an exclusive extra conversation held in between sessions on the subject of fluid balance; is the perennial debate of our conference over, or is there still more to be said?

Listeners are advised further reading is here:

Which goal for fluid therapy during colorectal surgery is followed by the best outcome: near-maximal stroke volume or zero fluid balance?

https://pubmed.ncbi.nlm.nih.gov/22710266/

Effects of intravenous fluid restriction on postoperative complications: comparison of two perioperative fluid regimens: a randomized assessor-blinded multicenter trial

https://pubmed.ncbi.nlm.nih.gov/14578723/

Goal-directed fluid therapy in emergency abdominal surgery: a randomised multicentre trial

https://pubmed.ncbi.nlm.nih.gov/34389168/

Presented by Monty Mythen and Desiree Chappell with their guest Birgitte Brandstrup, Consultant Surgeon, Head of the Endoscopic Unit at The Surgical Gastroenterological Department at Glostrup University Hospital.

Sedation in non anaesthetic areas | EBPOM World Congress 2022 Jul 06, 2022

A staffing crisis globally in healthcare is pushing forward the need for sedation in non anaesthetic areas. What does this mean for medical practitioners? What are the safest ways to work within this crisis? This is not a conversation about shortcuts and poor practices, it's about delivering a higher and better standard of care within a perioperative environment. Listen in to find out more.

Recorded - as live - at EBPOM 2022; go now to www.ebpom.org for more details about Evidence Based Perioperative Medicine (EBPOM).

Presented by Desiree Chappell and Monty Mythen with their guest Amit Prakash, Consultant in Anaesthesia & Perioperative medicine, Clinical lead Neuroanaesthesia at Cambridge University Hospital, Addenbrookes NHS trust, UK.

This EBPOM extra for TopMedTalk listeners was graciously supported by Medtronic. Thanks to our sponsors we are able to bring you TopMedTalk entirely for free.

Novel Therapies for Perioperative Care | EBPOM Dingle Jul 04, 2022

Hear the complete live session with questions from the online audience at one of the stand out presentations of Evidence Based Perioperative Medicine (EBPOM)'s Dingle Conference.

Don't forget if you want full access to our video presentations on demand and are interested in attending the next EBPOM conference ensure you check out www.ebpom.org

Here are the two articles referenced in this piece:

Current status of perioperative hypnotics, role of benzodiazepines, and the case for remimazolam: a narrative review

https://doi.org/10.1016/j.bja.2021.03.028

Intraoperative hypotension and the risk of postoperative adverse outcomes: a systematic review

https://doi.org/10.1016/j.bja.2018.04.036

Presented by Desiree Chappell VP Clinical Quality for NorthStar Anesthesia and Vicki Morton, Director of Clinical and Quality Outcomes at Providence Anesthesiology Associates, P.A. with their guests; Rob Sneyd, Emeritus Professor, University of Plymouth, Jeff Gadsden, Associate Professor of Anesthesiology, Duke University, USA, Dru Riddle Associate Professor of Professional Practice and Director of Clinical Education, Fort Worth Texas.

Neal Sandy and Karla Asikainen from GE Healthcare | Euroanesthesia 2022 Jun 28, 2022

"Most non clinicians.. think the most risky time when you're having surgery is when you're having surgery. That is categorically false; the most risky time is after surgery!"

This piece came shortly after GE Healthcare's Portrait Mobile product launch, live from the European Society of Anaesthesiology and Intensive Care (ESAIC).

Presented by Desiree Chappell and Sol Aronson with their guests Neal Sandy, General Manager, Monitoring Solutions at GE Healthcare and Karla Asikainen, Senior Global Product Manager, Mobile Digital Health at GE Healthcare.

-- Get all the headlines and information about the hot topics and major events of this conference exclusively from TopMedTalk, thanks to our partners in GE Healthcare.

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Find out more about The ESAIC here: https://www.esaic.org/

Find out more about GE Healthcare here: https://www.gehealthcare.com/

Tom Westrick and Brandon Henak from GE Healthcare | Euroanesthesia 2022 Jun 28, 2022

"We listen a lot to our customers and their patients"

This piece came shortly after GE Healthcare's Portrait Mobile product launch, live from the European Society of Anaesthesiology and Intensive Care (ESAIC).

Presented by Desiree Chappell and Sol Aronson with their guests Tom Westrick, President & Chief Executive Officer of Life Care Solutions at GE Healthcare and Brandon Henak, Global Marketing Director, Monitoring Solutions at GE Healthcare. --

Get all the headlines and information about the hot topics and major events of this conference exclusively from TopMedTalk, thanks to our partners in GE Healthcare.

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Find out more about The ESAIC here: https://www.esaic.org/

Find out more about GE Healthcare here: https://www.gehealthcare.com/

Pain management in the perioperative space | EBPOM Ireland Jun 27, 2022

Personalized versus protocolised perioperative pain prediction and management; what are the considerations for a modern practitioner. Where does the data take us? What are the ethics for a responsible value based care approach that seeks to reduce or perhaps even eliminate opioid use? What insights can we glean from a truly transatlantic conversation on these topics? How do we both manage and set expectations for the patient?

This discussion - in its original form - also featured a presentation which you can find here: https://topmedtalk.libsyn.com/website/category/perioperative-pain-control-a-spine-surgeons-perspective-we-have-to-do-better-ebpom-chicago

A full panel discussion chaired by Desiree Chappell, Vice President of Clinical Quality at NorthStar Anesthesia, TopMedTalk lead presenter, Monty Mythen, Smiths Medical Professor of Anaesthesia and Critical Care, TopMedTalk Editor in Chief and Sol Aronson, Emeritus Professor at Duke University, TopMedTalk USA presenter with their guests Geeta Nagpal, Associate Professor of Anesthesiology and Medical Education at Feinberg School of Medicine, David Edwards, Chief Division of Pain Medicine Vanderbilt University Medical Center and Nicholas Levy, Consultant in Anaesthesia and Acute Pain Medicine in Suffolk.

Improving outcomes of orthopaedic patients | EBPOM Ireland Jun 20, 2022

This piece is an essential contribution to the debate regarding patient centered value based care. Are you able to say you are putting your orthopaedic patients' needs and priorities at the forefront of your practice?

Some of the questions from the online audience include: Is Enhanced Recovery After Surgery (ERAS) in orthopaedics a step too far? How do patients who have significant arthropathys engage with a prehab program that makes them fitter? Those that successfully complete the program, are they not the ones who probably don't need joint replacement today and rehab might actually look at elongating that reoperative window?

This piece is presented in proud association with the South of Ireland Association of Anaesthetists (SIAA).

The Centre for Perioperative Care (CPOC) is here: https://cpoc.org.uk/

"Effect of Individualized vs Standard Blood Pressure Management Strategies on Postoperative Organ Dysfunction Among High-Risk Patients Undergoing Major Surgery" is here: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5710560/

"Intraoperative hypotension and the risk of postoperative adverse outcomes: a systematic review" is here: https://pubmed.ncbi.nlm.nih.gov/30236233/

"Intraoperative Hypotension Is Associated With Adverse Clinical Outcomes After Noncardiac Surgery" is here: https://pubmed.ncbi.nlm.nih.gov/33177322/

Presented by Brian O'Donnell, Consultant Anaesthesiologist, Cork University Hospital and Frank Loughnane, Consultant Anaesthesiologist, Cork University Hospital with their guests, Emer Aherne, Consultant Geriatrician specialising in Trauma & Orthopaedic Care at Cork University Hospital, Co-lead Irish Hip Fracture Database and John Whittle, Associate Professor, Perioperative Medicine UCL.

Perioperative Pain Control - A Spine Surgeon's Perspective: We have to do Better | EBPOM Chicago Jun 13, 2022

"Decide to be part of the solution"

This inspirational talk focuses upon how and why we need to focus on and improve attitudes toward pain control. Working as a team, being proactive and engaging with our wider culture are emphasized along with the need for education, standardisation and the ability to learn from other specialties.

Presented by Jeffrey L. Gum, MD, Adult and Pediatric Spine Surgeon, Norton Leatherman Spine Center, Associate Professor University of Louisville Department of Orthopedics.

Bernd Saugel | Euroanesthesia 2022 Jun 08, 2022

This wide ranging conversation starts with a focus upon blood pressure and moves through some of the bigger trails on what an appropriate target is for a perioperative practitioner. What is the most sensible way to manage blood pressure and where are the data driving us to? Further conversation evolves around the post-op period and transition of care. Presented by Desiree Chappell, Monty Mythen and Sol Aronson with their guest Bernd Saugel, Professor and Vice Chair of the Department of Anesthesiology, Center of Anesthesiology and Intensive Care Medicine at the University Medical Center Hamburg-Eppendorf, Germany. --

Get all the headlines and information about the hot topics and major events of this conference exclusively from TopMedTalk, thanks to our partners in GE Healthcare.

Go now to www.twitter.com/topmedtalk

Go now to https://www.youtube.com/channel/UC-HYQmeIwcFCYO1hoQ8jShQ

Go now to https://www.facebook.com/TopMedTalk1

Go now to https://www.linkedin.com/company/topmedtalk/

Find out more about The ESAIC here: https://www.esaic.org/

Find out more about GE Healthcare here: https://www.gehealthcare.com/

Cognitive Prehabilitation | EBPOM Chicago Jun 06, 2022

This piece goes over some cognitive risk factors for post op delirium alongside a look at cognitive prehabilitation and a review of the results from an aerobics trial. What are the next steps for future research?

This piece was followed by a panel discussion which will be released soon here on TopMedTalk. For more information about Evidence Based Perioperative Medicine (EBPOM) go here www.ebpom.org

Presented by Michelle Humeidan, Associate Professor, Neuroanesthesiology, Associate Faculty, Institute for Behavioural Medicine Research, Medical Director, Enhanced Surgical Recovery.

Late Breaking Blood Pressure POISE-3 study | Euroanesthesia 2022 Jun 06, 2022

This piece is highlighted because of its significance. Please check out the rest of TopMedTalk's coverage of the conference on our website - www.topmedtalk.com

Regular listeners will appreciate the importance of the PeriOperative ISchemic Evaluation-3 Trial (POISE-3). Here we highlight a conversation containing late breaking news on the subject.

The New England Journal of Medicine is here: https://www.nejm.org/doi/full/10.1056/NEJMoa2201171

Presented by Desiree Chappell and Monty Mythen with their guests Frederic Michard, MD of MiCo Consulting and Daniel Sessler, Michael Cudahy Professor and Chair at Cleveland Clinic, Director of The Outcomes Research Consortium.

Frederic Michard and Dan Sessler | Euroanesthesia 2022 Jun 06, 2022

A welcome return to TopMedTalk for two big names both of whom made a huge impact with their previous appearances, links to which are here:

Dan Sessler is here: https://topmedtalk.libsyn.com/topmedtalks-to-dan-sessler-0

Frederic Michard is here: https://topmedtalk.libsyn.com/topmedtalk-wireless-wearables-on-the-ward-the-new-www-revolution

Presented by Desiree Chappell and Monty Mythen with their guests Frederic Michard, MD of MiCo Consulting and Daniel Sessler, Michael Cudahy Professor and Chair at Cleveland Clinic, Director of The Outcomes Research Consortium.

Rupert Pearse from the University of London | Euroanesthesia 2022 Jun 05, 2022

"There's been a really noticeable shift, especially in the UK, towards big pragmatic research answering the big simple questions..."

This wide ranging conversation with a TopMedTalk favorite at the European Society of Anaesthesiology and Intensive Care (ESAIC) provides a fresh perspective on how the world is going to recover from the COVID catastrophe, how it forced us to improve our standards and priorities and how it effects trials and research in the field of perioperative medicine?

If you enjoyed our guest's take today why not go here for more? http://www.topmedtalk.com/anaesthesia-2019-rupert-pearse/

Presented by Desiree Chappell and Sol Aronson with their guest Rupert Pearse, Professor of Intensive Care Medicine at Queen Mary, University of London.

Thomas Scheeren | Euroanesthesia 2022 Jun 05, 2022

"Hypotension is always a problem..." This piece is provided 'as live' from the European Society of Anaesthesiology and Intensive Care (ESAIC).

Presented by Desiree Chappell, Monty Mythen and Sol Aronson with their guest Thomas Scheeren, Professor of Anesthesiology, Department of Anesthesiology, University Medical Center Groningen, Groningen, the Netherlands.

Our guest has featured on TopMedTalk before, worth checking it out here: http://www.topmedtalk.com/euroanaes2019-thomas-scheeren/

--

Get all the headlines and information about the hot topics and major events of this conference exclusively from TopMedTalk, thanks to our partners in GE Healthcare.

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Find out more about The ESAIC here: https://www.esaic.org/

Find out more about GE Healthcare here: https://www.gehealthcare.com/

The Portrait Mobile product launch at The ESAIC | Euroanaesthesia 2022 Jun 04, 2022

"Moving from being reactive to being proactive"

The Portrait Mobile product launch, live from the ESAIC.

Presented by Monty Mythen, Smiths Medical Professor UCL and TopMedTalk's Editor in Chief, with his guest Frederic Clement, Chief Marketing Officer at GE Healthcare.

-- Get all the headlines and information about the hot topics and major events of this conference exclusively from TopMedTalk, thanks to our partners in GE Healthcare.

Go now to www.twitter.com/topmedtalk

Go now to https://www.youtube.com/channel/UC-HYQmeIwcFCYO1hoQ8jShQ

Go now to https://www.facebook.com/TopMedTalk1

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Find out more about The ESAIC here: https://www.esaic.org/

Find out more about GE Healthcare here: https://www.gehealthcare.com/

Live from the European Society of Anaesthesiology and Intensive Care (ESAIC) | Euroanaesthesia 2022 Jun 04, 2022

The TopMedTalk team are live at the European Society of Anaesthesiology and Intensive Care (ESAIC).

Join Desiree Chappell and Monty Mythen with the team, TopMedTalk's Henry Howe and Jenny Gomez, both of whom are junior doctors.

Get all the headlines and information about the hot topics and major events of this conference exclusively from TopMedTalk, thanks to our partners in GE Healthcare.

Go now to www.twitter.com/topmedtalk

Go now to https://www.youtube.com/channel/UC-HYQmeIwcFCYO1hoQ8jShQ

Go now to https://www.facebook.com/TopMedTalk1

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Find out more about The ESAIC here: https://www.esaic.org/

Find out more about GE Healthcare here: https://www.gehealthcare.com/

Perioperative smoking cessation clinics - panel | EBPOM Chicago May 30, 2022

"We just thought you guys would just tell us facts about how smoking is bad for us but you're actually giving us tools and helping us practice them and implement them and it is by far nothing I have ever experienced"

Smoking cessation clinics, as an essential part of a truly perioperative practice, is discussed in detail here. How do you reach the level of patient satisfaction outlined in the above quote in an efficient way which also reflects the principles of value based care, enhanced recovery after surgery and effective long term outcomes?

Like this, want more? This piece directly relates to a presentation we recently enjoyed here on TopMedtalk, follow this link to hear it: https://directory.libsyn.com/episode/index/id/21964205

Presented by Sol Aronson, Emeritus Professor, Duke University with assistance from Monty Mythen, Smiths Medical Professor of Anaesthesia and Critical Care, University College London and featuring panelists; Jillian Dirkes, Program Manager, Duke Smoking Cessation Program and Andrea Pratt, Tobacco Treatment Specialist, Duke Smoking Cessation Program, Toby Richards, Professor of Surgery, UWA and Sher-Lu Pai, Clinical Director, Preoperative Evaluation (POE) clinic, Mayo Clinic College of Medicine.

Perioperative smoking cessation clinics | EBPOM Chicago May 23, 2022

This piece looks at how and why you should be either setting up or running a smoking cessation clinic as part of a perioperative practice. How do you find patients for whom treatment is appropriate? How do you assess progress? How should staff be trained? What are the key indicators that treatment will be successful?

This presentation was complimented with a panel discussion which will follow soon here on TopMedTalk. Please ensure you are subscribed to us on your podcatcher. Also, check out Evidence Based Perioperative Medicine (EBPOM) now for details of our next event near you: www.ebpom.org

Presented by Jillian Dirkes, Program Manager, Duke Smoking Cessation Program and Andrea Pratt, Tobacco Treatment Specialist, Duke Smoking Cessation Program.

Nutrition clinics, panel discussion | EBPOM Chicago/Ireland May 16, 2022

"We're able to really optimize the nutrition for that specific surgery ... we're able to individualise our care plans as dieticians for these patients" This discussion follows on from a previous piece which you can find here: https://topmedtalk.libsyn.com/website/category/nutrition-clinics-ebpom-chicago

Discussion picks up, following on from the above presentation with questions from the live audience who were attending one of Evidence Based Perioperative Medicine's (EBPOM) cutting edge conferences in either Chicago or Ireland. To find out more about EBPOM's next exciting conference please go now to www.ebpom.org

Chaired by John Whittle, Associate Professor, Perioperative Medicine, University College London, and Vicki Morton, Director of Clinical and Quality Outcomes, Providence Anesthesiology Associates, with their guests, Oonagh Griffin, Senior Dietician - pancreatic cancer care, St Vincent's University Hospital, Leah Cox, Specialist Dietician - cancer rehabilitation, nutrition and dietetic department Kings College, London, Rebecca Ilic, Clinical Nutrition Manager, Northwestern Memorial Hospital.

Emily Methangkool at The SCA | TopMedTalk May 15, 2022

This piece is an 'as live' interview from the Society of Cardiovascular Anesthesiologists and part of TopMedTalk's exclusive coverage of the event.

Presented by Desiree Chappell and Monty Mythen with their guest Emily Methangkool, Vice Chair of Quality and Patient Safety at the UCLA Department of Anesthesiology and Perioperative Medicine.

TopMedTalks to... Andy Shaw | SCA 2022 May 15, 2022

This piece is an 'as live' interview from the Society of Cardiovascular Anesthesiologists and part of TopMedTalk's exclusive coverage of the event.

Presented by Monty Mythen and Desiree Chappell and Andy Shaw, Department of Intensive Care and Resuscitation at The Cleveland Clinic, Cleveland, Ohio, Fellow of the Royal College of Physicians and Surgeons of Canada, a Fellow of the Royal College of Anaesthetists (UK), a Fellow of the American College of Critical Care Medicine and a Fellow of the Faculty of Intensive Care Medicine (UK).

Monty and Desiree at The SCA | SCA 2022 May 14, 2022

Welcome to the Society of Cardiovascular Anesthesiology (SCA) annual conference. This piece is a quick look at what you can expect from us as we cover one of the world's most important medical gatherings.

Presented by Desiree Chappell and Monty Mythen.

Brad Cardonell at The SCA | TopMedTalk May 14, 2022

This piece is an 'as live' interview from the Society of Cardiovascular Anesthesiologists and part of TopMedTalk's exclusive coverage of the event.

Presented by Desiree Chappell and Monty Mythen with their guest Brad Cardonell, Assistant Professor of Clinical Anesthesiology at the University of Missouri School of Medicine, Director of cardiovascular anesthesiology, University Hospital in Columbia.

TopMedTalks to... Julius Balogh | SCA 2022 May 14, 2022

This piece is an 'as live' interview from the Society of Cardiovascular Anesthesiologists and part of TopMedTalk's exclusive coverage of the event.

Presented by Desiree Chappell and Monty Mythen with their guest, Julias Balogh, Anesthesiologist, Director of CVICU, Division Chief of Anesthesia Critical Care, Executive Director for the Donor ICU and Medical Director for the Cardiovascular ICU, at the University of Arkansas for Medical Science.

Our guest kindly shared their email: JBalogh@uams.edu

Perioperative diabetes clinic; panel discussion | EBPOM Chicago May 09, 2022

This piece is an essential guide to running your own perioperative pre-operative diabetes clinic as well as how to manage this condition before, during and after and operation. With questions from the online audience and reference to the TopMedTalk presentation - linked to here: https://directory.libsyn.com/episode/index/id/21961259 - this podcast will get you and your colleagues thinking about how to add value and patient centered care to those who come through your institution with this condition.

Introduced by Sol Aronson, Emeritus Professor, Duke University, Chaired by Owen O Sullivan, consultant anaesthestist, with Kathryn Evans Kreider, Associate Clinical Professor, Duke University School of Nursing, Nurse Practitioner, Division of Endocrinology, Metabolism and Nutrition; Duke University Medical Centre with questions and contributions from Niamh McAuliffe, Consultant Anaesthetist, Cork University Hospital, Tracy Setji, Medical Director, Endocrine Consultation Service, Duke University Hospital, Padraig O'Scannaill, National Coordinator for The Moped Study (Ireland), Feyce Peralta, Associate Professor, Northwester University, Feinberg School of Medicine.

Perioperative diabetes management, nuts and bolts | EBPOM USA - Chicago May 02, 2022

"This is an excellent opportunity to improve your care pathways, to help improve patient outcomes and really to optimise care throughout the continuum of the perioperative period."

This piece emphasises the importance of perioperative glucose management and describes evidence-based approaches for perioperative management throughout. What about pre-admission? During hospitalisation? What are the best practices for discharge?

This piece is complimented by "Perioperative Diabetes Clinic - How to set up and run" - which is soon to be released on TopMedTalk. Ensure you are subscribed to catch all of our exclusive free content.

For listeners who can't wait, it is worth checking out Evidence Based Perioperative Medicine (EBPOM) directly here: www.ebpom.org

Presented by Kathryn Evans Kreider, DNP, FNP-BC, BC-ADM, FAANP, Associate Clinical Professor, Duke University School of Nursing, Nurse Practitioner, Division of Endocrinology, Metabolism and Nutrition; Duke University Medical Centre.

2nd Transatlantic Leadership Forum - Is day case total knee replacement taking ERAS too far? | EBPOM Chicago Apr 25, 2022

"Now we've declared it possible, is it the right thing to do?"

This timely discussion considers the wisdom of day case total knee replacement: What do the data say? Can we do this without the use of opioids? What is reasonable to consider as part of an enhanced recovery after surgery program? How do patients make an informed decision when this kind of surgery is in their possible future?

The first TopMedTalk piece mentioned in the discussion is here: TopMedTalk | Henrik Kehlet and Nick Scott: https://www.topmedtalk.com/topmedtalk-henrik-kehlet-and-nick-scott-2/

And the second is here: https://www.topmedtalk.com/cryoneurolysis-and-pain-management-topmedtalk-2/

Chaired by Sol Aronson, Emeritus Professor, Duke University & Desiree Chappell, VP Clinical Quality Northstar Anaesthesia with David Howard, Honorary Consultant, Ear Nose and Throat / Head and Neck Surgeon, Imperial and UCLH NHS Trust Hospitals, Brian O'Donnell, consultant anaesthesiologist, Cork University Hospital, Vinod Dasa, VP for Academic Affairs, Dept of Orthopedics, LSU.

Cardiac enhanced recovery - essential update | EBPOM Chicago Apr 18, 2022

"How do we share enhanced recovery with the world? There's been a lot of work in this area..." This crucial update covers enhanced recovery in cardiac; all the latest on investigation, implementation science, integration and dissemination. Recorded at the Evidence Based Perioperative Medicine (EBPOM) Chicago Conference.

For more information on EBPOM check out www.ebpom.org

Presented by Michael C Grant, Associate Professor, Department of Anesthesiology/Critical Care Medicine, Johns Hopkins University School of Medicine.

Nutrition clinics | EBPOM Chicago Apr 11, 2022

How do you go about setting up and then running a perioperative nutrition clinic? How do you convince patients and providers that this will increase value and efficacy? Is nutrition really an essential part of enhanced recovery after surgery?

This piece is complimented by a panel discussion soon to be released here on TopMedTalk. However, if you can't wait to hear more you will want to check out the Evidence Based Perioperative Medicine (EBPOM) site here: www.ebpom.org

Presented by Elizabeth Villalta, MS, RD, LDN, Licensed Registered Dietitian.

1st Transatlantic Leadership Forum - Connected Health - COVID Hyperdrive or Hype? | EBPOM Dingle Apr 04, 2022

"It certainly has ignited some sort of telemedicine and remote monitoring revolution; I think we'll look back in 10 years and say, well, that's really when things ramped up and changed"

This piece is an engaging look at "connected health"; how are new technologies bringing world class experts straight to patients both safely, effectively and at a scale which was previously unimaginable? What are the drawbacks from both the perspective of patient and practitioner? Has the acceleration of these processes - caused by COVID19 restrictions - been a good thing or is it causing some people to be left behind?

Presented by Desiree Chappell, VP Clinical Quality for NorthStar Anaesthesia and Monty Mythen, Smiths Medical Professor of Anaesthesia and Critical Care, with John Whittle, consultant anesthetist, critical care physician and perioperative medicine physician and Honorary Associate Professor of perioperative medicine at University College London, Imogen Fecher-Jones, lead nurse for perioperative medicine and pre assessment services at University of Southampton Hospital, Betty Jo Rocchio, CRNA and Senior Vice President and Chief Nursing Officer, Mercy Health in the US, Sam Ajizian, CMO for patient monitoring, Vice President of Global clinical research and medical science for patient monitoring respiratory interventions at Medtronic and, as patient advocate, Neil Johnson, Chief Executive of the Croi, Heart and Stroke Centre, The National Institute for Prevention and Cardiovascular Health and The Global Heart Hub, Ireland.

Novel ventilation concepts P2 | TopMedTalk Mar 28, 2022

In part two the conversation moves to more detail about Transnasal Humidified Rapid-Insufflation Ventilatory Exchange (THRIVE). There are also wider questions about "the future of anaesthesia".

Ensure you are now subscribed to TopMedTalk so you never miss out.

Chaired by Mike Grocott Professor of Anaesthesia and critical care at the University of Southampton and Rodney Meeke, recently retired Anaesthesiologist and Intensivist, Cork University Hospital with contributions from David Howard, Professor of Head and Neck Oncology at Imperial College London in 2008 and remains Honorary Consultant ENT/Head and Neck Surgeon at Imperial and UCLH NHS Trust Hospitals, Korle-Bu Hospital, Accra, and KCMC Hospital, Tanzania, Jim Roberts, Consultant anaesthetist & medical innovator at University College London Hospital & Anil Patel, Professor, consultant anaesthetist at The Royal National ENT & Eastman Dental Hospitals, University College London Hospital and DAS professor of anaesthesia & airway management.

Part 6 Know AKI and say no to acute kidney injury for patients | POQI renal injury Mar 21, 2022

TopMedTalk's essential series on acute kidney injury continues, supported by the "Know AKI campaign" – a bioMérieux global campaign to raise awareness about AKI.

For part one of the series follow this link: https://topmedtalk.libsyn.com/part-1-know-aki-and-say-no-to-acute-kidney-injury-for-patients-perioperative-renal-injury

In this podcast you will discover how The Perioperative Quality Initiative (POQI) focuses upon renal injury. How do we identify patients early? How do we treat the condition? What should out approach to biomarkers be? What are we looking for when it comes to urine output?

Make sure you check out POQI's website here: https://www.thepoqi.org/

While you're online why not book tickets for the next EBPOM conference: www.ebpom.org

Presented by Andy Shaw, Chairman, Department of Intensive Care and resuscitation at The Cleveland Clinic, Fellow of the Royal College of Anaesthetists (UK), the American College of Critical Care Medicine and the Faculty of Intensive Care Medicine (UK), Mike Grocott, Professor of Anaesthesia and critical care at the University of Southampton, John Prowle, Senior clinical lecturer, intensivist nephrologist, Royal London Hospital in East London, Marlies Ostermann, Consultant in critical care and nephrology, Guy's and St Thomas's NHS Foundation Trust and Sandy Kane-Gill, Professor, Pharmacy and Theraputics, Univeristy of Pittsburgh School of Pharmacy.

Novel ventilation concepts P1 | TopMedTalk Mar 14, 2022

"New '21st Century iron lung' ventilator designed by British experts could revolutionise Covid treatment by taking patients out of intensive care wards" Daily Mail UK, 19th Jan 2021

This is part one of a two part piece.

This piece looks at the development of a new negative-pressure ventilatory support device: Exovent. Their website is here: https://exovent.org/

We also cover questions from the EBPOM Dingle audience; what is 'the next big thing' in ventilation? How do we optimise what we currently do? Should we expect to see more negative pressure devices and techniques? How do we get around the perennial problem of ventilator induced lung injury?

In part two the conversation moves to more detail about Transnasal Humidified Rapid-Insufflation Ventilatory Exchange (THRIVE). Ensure you are subscribe to TopMedTalk so you can't miss it.

Chaired by Mike Grocott Professor of Anaesthesia and critical care at the University of Southampton and Rodney Meeke, recently retired Anaesthesiologist and Intensivist, Cork University Hospital with contributions from David Howard, Professor of Head and Neck Oncology at Imperial College London in 2008 and remains Honorary Consultant ENT/Head and Neck Surgeon at Imperial and UCLH NHS Trust Hospitals, Korle-Bu Hospital, Accra, and KCMC Hospital, Tanzania, Jim Roberts, Consultant anaesthetist & medical innovator at University College London Hospital & Anil Patel, Professor, consultant anaesthetist at The Royal National ENT & Eastman Dental Hospitals, University College London Hospital and DAS professor of anaesthesia & airway management.

World Kidney Day, "To know AKI is to say no to AKI" | TopMedTalk Mar 10, 2022

This podcast is in addition to a series supported by the "Know AKI campaign", a bioMérieux global campaign to raise awareness about AKI. Go here for part one: https://www.topmedtalk.com/part-1-know-aki-and-say-no-to-acute-kidney-injury-for-patients-perioperative-renal-injury/ It includes contributions from Dan Engelman, Medical Director of the Heart, Vascular and Critical Care Units at Baystate Medical Center, Associate Professor of Surgery at The University of Massachusetts-Baystate, and an Associate Professor-Adjunct at Tufts University School of Medicine and Sandra Kane-Gill, Professor of Pharmacy and Therapeutics at the University of Pittsburgh School of Pharmacy, secondary appointments in the School of Medicine in the Clinical Translational Science Institute, Department of Critical Care Medicine and the Department of Biomedical Informatics, she also serves as Professor for the Center for Critical Care Nephrology and Center for Medical Machine Learning.

If you would like to hear the full presentation from Sandra Kane-Gill go here: https://directory.libsyn.com/episode/index/id/21482261

And the clips of Dan Engelman come from here: https://www.topmedtalk.com/daniel-engelman-qa-ebpom-chicago-2/

Part 5 Know AKI and say no to acute kidney injury for patients | Post-Operative Acute Kidney Injury Roundtable Mar 07, 2022

How should we best monitor and treat acute kidney injury (AKI)? Where is the information leading our best practitioners to? How can monitoring incidences of AKI help to reduce it?

This podcast is Part 5 in a series supported by the "Know AKI campaign", a bioMérieux global campaign to raise awareness about AKI.

For part one go here: https://topmedtalk.libsyn.com/part-1-know-aki-and-say-no-to-acute-kidney-injury-for-patients-perioperative-renal-injury

For part two go here: https://topmedtalk.libsyn.com/part-2-know-aki-and-say-no-to-acute-kidney-injury-for-patients-perioperative-aki-recomendations-and-research-priorities-from-adqi-24poqi-7

Part three is here: https://topmedtalk.libsyn.com/part-3-know-aki-and-say-no-to-acute-kidney-injury-for-patients-health-systems-perspectives-in-aki

And part four is here: https://topmedtalk.libsyn.com/part-4-know-aki-and-say-no-to-acute-kidney-injury-for-patients-andy-shaw-on-acute-kidney-injury-aki-biomarkers

You can watch a video of the lecture in the on demand section of the EBPOM Education Hub (www.live.ebpom.org).

For more on AKI go here: https://www.topmedtalk.com/?s=acute+kidney+injury

"Postoperative acute kidney injury in adult non-cardiac surgery: joint consensus report of the Acute Disease Quality Initiative and PeriOperative Quality Initiative" is here: https://www.nature.com/articles/s41581-021-00418-2

Presented by Monty Mythen with Desiree Chappell and their guests Mike Grocott, Professor of Anaesthesia and critical care at the University of Southampton and Vicki Morton, Director of Clinical and Quality Outcomes at Providence Anesthesiology Associates, P.A.

Intensive Care during COVID19 P2 | TopMedTalk Feb 28, 2022

How did your intensive care unit manage during COVID19? What are the common experiences of practitioners from the developed world who bravely faced a pandemic like no other?

This is part two of a two part piece.

The previous installment is here: https://topmedtalk.libsyn.com/intensive-care-during-covid19-p1-topmedtalk

The TV show mentioned in this piece is available here: https://www.channel4.com/programmes/help

Editor's note; parts of this conversation which suffered from technical issues have been removed from this podcast.

Chaired by Ramani Moonesinghe, OBE, Professor of Perioperative Medicine at UCL and a consultant anesthetist at UCL hospitals, Director of the Health Services Research Center of the Royal College of Anaesthetists and national Clinical Director for critical and perioperative care at NHS England with remote assistance from Catherine Motherway, consultant in Anaesthesia and Intensive Care in University Hospital Limerick and contributions from panelists; David Walker, Professor in Anaesthesia and Critical Care Medicine, University College London Hospitals, Honorary Senior Lecturer UCL, Jim Down, Intensivist and Consultant Anaesthetist, University College London Hospital. Colman O'Loughlin, consultant Anaesthesia, Critical Care Medicine, Extracorporeal Life Support at the Mater Hospital, Dublin, Enda O'Connor, physician intensivist and current ICU Lead and Education Lead in St James’s Hospital.

Part 4 Know AKI and say no to acute kidney injury for patients | Andy Shaw on Acute Kidney Injury (AKI) biomarkers Feb 21, 2022

This podcast is part 4 in a series which is supported by the "Know AKI campaign", a bioMérieux global campaign to raise awareness about AKI.

For part one go here: https://topmedtalk.libsyn.com/part-1-know-aki-and-say-no-to-acute-kidney-injury-for-patients-perioperative-renal-injury

For part two go here: https://topmedtalk.libsyn.com/part-2-know-aki-and-say-no-to-acute-kidney-injury-for-patients-perioperative-aki-recomendations-and-research-priorities-from-adqi-24poqi-7

And for part three follow this link here: https://topmedtalk.libsyn.com/part-3-know-aki-and-say-no-to-acute-kidney-injury-for-patients-health-systems-perspectives-in-aki

Acute kidney injury (AKI) is an important topic for anyone practicing value based care, here we learn how research is developing and where the debate is at as regards biomarkers; what do the data tell us, where can improvements be made and why is it so important?

This piece was originally available to attendees of EBPOM 2021 where it was this year's Siobhan Mythen Visiting Plenary lecture. You can watch a video of this lecture in the on demand section of of the EBPOM Education Hub (www.ebpom.live.org).

Presented by Andy Shaw, Department of Intensive Care and Resuscitation at The Cleveland Clinic, Cleveland, Ohio, Fellow of the Royal College of Physicians and Surgeons of Canada, a Fellow of the Royal College of Anaesthetists (UK), a Fellow of the American College of Critical Care Medicine and a Fellow of the Faculty of Intensive Care Medicine (UK).

Intensive Care during COVID19 P1 | TopMedTalk Feb 14, 2022

How did your intensive care unit manage during COVID19? What are the common experiences of practitioners from the developed world who bravely faced a pandemic like no other?

This is part one of a two part piece.

The TV show mentioned in this piece is available here: https://www.channel4.com/programmes/help

Editor's note; parts of this conversation which suffered from technical issues have been removed from this podcast.

Chaired by Ramani Moonesinghe, OBE, Professor of Perioperative Medicine at UCL and a consultant anesthetist at UCL hospitals, Director of the Health Services Research Center of the Royal College of Anaesthetists and national Clinical Director for critical and perioperative care at NHS England, with remote assistance from Catherine Motherway, consultant in Anaesthesia and Intensive Care in University Hospital Limerick and contributions from panelists; David Walker, Professor in Anaesthesia and Critical Care Medicine, University College London Hospitals, Honorary Senior Lecturer UCL, Jim Down, Intensivist and Consultant Anaesthetist, University College London Hospital. Colman O'Loughlin, consultant Anaesthesia, Critical Care Medicine, Extracorporeal Life Support at the Mater Hospital, Dublin, Enda O'Connor, physician intensivist and current ICU Lead and Education Lead in St James’s Hospital.

Part 3 Know AKI and say no to acute kidney injury for patients | Health systems perspectives in AKI Feb 07, 2022

"Kidney disease ... is clearly a public health concern"

Health systems perspectives in acute kidney injury, this podcast is part 3 in a series which is supported by the "Know AKI campaign", a bioMérieux global campaign to raise awareness about AKI.

For part one go here: https://topmedtalk.libsyn.com/part-1-know-aki-and-say-no-to-acute-kidney-injury-for-patients-perioperative-renal-injury

For part two go here: https://topmedtalk.libsyn.com/part-2-know-aki-and-say-no-to-acute-kidney-injury-for-patients-perioperative-aki-recomendations-and-research-priorities-from-adqi-24poqi-7

This piece is one of the highlights of both EBPOM London and EBPOM Dingle/Chicago where it provoked much discussion amongst the delegates. What does the data and evidence tell us about acute kidney injury (AKI) and how to respond to it? How do we detect and diagnose it as soon as possible? What else can be done? You can watch a video of the lecture in the on demand section of of the EBPOM Education Hub (www.ebpom.live.org).

This piece was recorded in advance of the the annual general meeting of the American Society of Anesthesiologists (ASA). TopMedTalk will be live streaming from the event, checkout www.ebpom.live.org for more details.

Presented by Sandra Kane-Gill, PharmD, MSc, FCCM, FCCP, is Professor of Pharmacy and Therapeutics at the University of Pittsburgh School of Pharmacy.

The value of tackling post operative nausea and vomiting | TopMedTalk Jan 31, 2022

This piece is the first of a four part series, supported in part through an unrestricted educational grant from Acacia Pharma, Inc, tackling the subject of post operative nausea and vomiting. How do practitioners who have an emphasis upon value based care incorporate dealing with one of the less pleasant realities of surgery for a patient?

For the fuller conversations quoted in this piece please checkout the following:

New treatments for Post Operative Nausea and Vomiting | TopMedTalk

https://www.topmedtalk.com/new-treatments-for-post-operative-nausea-and-vomiting-topmedtalk/

Why do we need a new rescue antiemetic | Novel Rescue PONV therapy

https://editors-top-picks.libsyn.com/why-do-we-need-a-new-rescue-antiemetic-novel-rescue-ponv-therapy

Quality measures in Anesthesia | Novel Rescue PONV Therapy

https://editors-top-picks.libsyn.com/quality-measures-in-anesthesia-novel-rescue-ponv-therapy

Stop your patients feeling sick | Novel Rescue PONV Therapy

https://editors-top-picks.libsyn.com/stop-your-patients-feeling-sick-novel-rescue-ponv-therapy

Part 2 Know AKI and say no to acute kidney injury for patients | Perioperative AKI: Recomendations and Research Priorities from ADQI-24/POQI-7 Jan 24, 2022

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 is also available in video format via www.ebpom.org

Presented by John Prowle, Senior Clinical Lecturer in Intensive Care Medicine within the Critical Care and Perioperative Medicine Research Group at Barts and the London School of Medicine and Dentistry, Queen Mary University of London and is an Honorary Consultant Physician in Intensive Care Medicine and Nephrology at the Royal London Hospital, Barts Health NHS Trust, London, UK.

Quality measures in Anesthesia | Novel Rescue PONV Therapy Jan 17, 2022

"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 grant from Acacia Pharma, Inc.

To hear more from our guest go here: https://www.topmedtalk.com/topmedtalks-to-rick-dutton/

Presented by Desiree Chappell and Monty Mythen with Rick Dutton, Chief Quality Officer for US Anesthesia Partners (USAP), Texas.

Key update on Intraoperative Hypotension | EBPOM Chicago Jan 11, 2022

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 Anesthsiology, Wake Forest School of Medicine.

Part 1 Know AKI and say no to acute kidney injury for patients | Perioperative Renal Injury Jan 10, 2022

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-michelle-chew/

Andy Shaw's clip comes from here: SCA | Improving your practice http://www.topmedtalk.com/sca-improving-your-practice/

John Kellum is here:

Perioperative Nephrology Fluids and the Kidney http://www.topmedtalk.com/periop-coach-4-06-perioperative-nephrology-fluids-and-the-kidney/

Renal Injury Biomarkers http://www.topmedtalk.com/renal-injury-biomarkers/

Urine Output http://www.topmedtalk.com/urine-output/

Vincent D’Intini's contribution originally appeared here: Periop SIG18 | Goal directed therapy to prevent acute kidney injury http://www.topmedtalk.com/periop-sig18-goal-directed-therapy-to-prevent-acute-kidney-injury/

Paul Myles's contributions feature also in this pertinent piece alongside Rupert Pearse: EBPOM London 2018 – any answers | Part 3 The Big Trials http://www.topmedtalk.com/ebpom-london-2018-any-answers-part-3-the-big-trials/

Tim Miller is worth listening to in more detail here: Live from Boston ASA 2017 – Intraoperative Goal Directed Fluid Therapy http://www.topmedtalk.com/live-from-boston-asa-2017-intraoperative-goal-directed-fluid-therapy/

Dan Sessler is here: Live from Boston ASA 2017 – The Elephant In The Room – intraoperative hypotension http://www.topmedtalk.com/live-from-boston-asa-2017-the-elephant-in-the-room-intraoperative-hypotension/

David Kauffman and Greg Martin feature here: Fluid Matters 3/6 | Fluid Responsiveness and venous capacitance http://www.topmedtalk.com/fluid-matters-3-6-fluid-responsiveness-and-venous-capacitance/

Dan Engelman features here: Daniel Engelman Q&A | EBPOM Chicago http://www.topmedtalk.com/daniel-engelman-qa-ebpom-chicago-2/

EBPOM Highlight | Enhanced Recovery After Cardiac Surgery http://www.topmedtalk.com/ebpom-highlight-enhanced-recovery-after-cardiac-surgery/

For more from (Trainees in Perioperative Medicine) TRIPOM and Mike Grant go here: TRIPOM 1.02 | EBPOM USA 2019 http://www.topmedtalk.com/tripom-1-02-ebpom-usa-2019/

TopMedTalk is proud to act as the broadcasting arm of Evidence Based Perioperative Medicine (EBPOM) for more information please go now to www.ebpom.org

The role of the sedationist | TopMedTalk Jan 03, 2022

"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, checkout www.ebpom.live.org for more details.

Presented by Monty Mythen and Desiree Chappell with their guest Rob Sneyd, Emeritus Professor at University of Plymouth, Faculty of Medicine and Dentistry.

Why do we need a new rescue antiemetic | TopMedTalk Dec 27, 2021

"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_the_management_of.16.aspx

Supported in part through an unrestricted educational grant from Acacia Pharma, Inc.

Presented by Desiree Chappell and Monty Mythen with their guest Tricia Meyers, PharmD, adjunct Professor, Texas A&M, College of Medicine.

Perioperative anemia clinics, panel discussion | EBPOM Chicago Dec 20, 2021

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 our popular podcast "Iron Man vs Anemia" which also features Toby Richards: https://www.topmedtalk.com/topmedtalk-iron-man-vs-anemia-2/

Chaired by Feyce M. Peralta, obstetrical anesthesiologist, Program Director for the Obstetric Anesthesiology Fellowship and Director of Faculty Development for the Department of Anesthesiology at Northwestern University Feinberg School of Medicine with guest speaker, Professor Bobbi Jean Sweitzer, The Associate Chair for Clinical Perioperative Practice, Northwestern University in Chicago, Illinois and panel members Toby Richards, Professor, Anaesthesia Teaching & Research Faculty of Medicine, Nursing and Health Sciences Central Clinical School, Monash University, Obianuju Okocha medical director of the preoperative clinic at Northwestern Memorial Hospital, Chicago & Frank Loughnane, Consultant Anaesthesiologist Cork University Hospital, Clinical lead for orthopaedic elective and trauma anaesthesia, Joint Clinical lead for pre-operative assessment, Clinical lecturer University College Cork.

Pathophysiology of blood pressure auto regulation P2 | TopMedTalk Dec 17, 2021

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 and can be found here: https://topmedtalk.libsyn.com/pathophysiology-of-blood-pressure-auto-regulation-p1-topmedtalk

Presented by Dan Martin, with Monty Mythen, Sol Aronson and panelists Damian Bailey, Professor of Physiology at the University of South Wales, Maryam Khosravi, clinical nephrology, University College London, Andrew Shaw, Chairman, Department of Anesthesiology and Pain Medicine at The University of Alberta, Edmonton, Alberta and Zone Clinical Department Head for Anesthesia, Alberta Health Services Edmonton Zone and Fellow of the Royal College of Anaesthetists (UK), the American College of Critical Care Medicine and the Faculty of Intensive Care Medicine (UK), Erik Swenson, Director of Pulmonary Diagnostics Service at VA Puget Sound Health Care System, Seattle, WA, Kim Dora, Professor of Microvascular Pharmacology, Oxford University, Chris Garland, Professor of Vascular Pharmacology, Oxford University.

Pathophysiology of blood pressure auto regulation P1 | TopMedTalk Dec 17, 2021

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 Monitoring | EBPOM Chicago" - https://www.topmedtalk.com/redefining-hypotension-based-on-real-time-cerebral-autoregulation-monitoring-ebpom-chicago/

Presented by Monty Mythen with Dan Martin, OBE, Professor of Perioperative and Intensive Care Medicine, University of Plymouth and the Royal Free Hospital, London and Sol Aronson, tenured Professor, Duke University, Durham, North Carolina with their guest Charles Hogue, Professor and Chair of Anesthesiology at Northwestern University in Chicago.

How to set up and run a Perioperative Anemia Clinic | EBPOM Chicago Dec 13, 2021

"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 check out our piece here, which also features Bobbie Jean Sweitzer: "Promote your anemia clinics in the pandemic era?" https://www.topmedtalk.com/covid-19-promote-your-anemia-clinics-in-the-pandemic-era/

Presented by Professor Bobbi Jean Sweitzer, The Associate Chair for Clinical Perioperative Practice, Northwestern University in Chicago, Illinois.

Near infrared spectroscopy (NIRS) Round Table | EBPOM Chicago Dec 06, 2021

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 muscle oxygenation as well'.

Learn how this technique could enhance your practice, what its potential for advancement is and where its limits lie. This piece is likely to be of critical interest to most cardiac surgeons and those who work alongside them.

This piece was generously supported and brought to you by Medtronic.

Presented by Desiree Chappell and Monty Mythen with their guests Robert Thiele, Cardiac Anesthesiologist and Intensivist at the University of Virginia, Carol Ann Rosenberg Associate Director of Perfusion and ECMO, Kenan Yount, Cardiac Surgeon and Director of the Valve center and Director of the Aortic Center at the University of Virginia.

Perioperative Pulmonary Complications | EBPOM 2021 Nov 29, 2021

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 & Critical Care Medicine at St. George’s Hospital and Medical School, clinical lead for the Perioperative Assessment & Planning Unit at St. George’s Hospital, clinical director for critical care at St. George’s Hospital, alongside, Linda Denehy, Head of the Melbourne School of Health Sciences and Professor of Physiotherapy at The University of Melbourne, Australia, Rinaoldo Bellomo, Professor of Intensive Care Medicine, University of Melbourne, Honorary Professor, Faculty of Medicine, Monash University, Honorary Professorial Fellow, Faculty of Medicine, The University of Sydney, Honorary Professorial Fellow, The George Institute, Honorary Fellow, Florey Institute of Physiology, Honorary Professor, Faculty of Medicine, Nanjing University, Visiting Professor, Università Vita-Salute San Raffaele, he was awarded an Officer of the Order of Australia for distinguished service and Rupert Pearse, Professor of Intensive Care Medicine at Queen Mary, University of London.

Ernest Henry Starling Plenary Lecture - David Story | EBPOM World Congress 2021 Nov 25, 2021

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 Anaesthesia at the University of Melbourne; Head of the University Department of Critical Care and a member of Council of the Australian and New Zealand College of Anesthetists (ANZCA) and the Chair of the ANZCA Safety and Quality Committee.

Like this, want more? Check out www.ebpom.org now, great prices on conferences are available including access to high quality video presentations on demand.

Respiratory care and management during COVID-19 | EBPOM 2021 Dingle/Chicago Nov 22, 2021

"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 EBPOM and for access to a huge library of resources, that goes beyond even TopMedTalk's extensive archive, go now to www.ebpom.org

Presented by Desiree Chappell and Monty Mythen with their guest Karen A. Phillips, Chief Medical Officer, Respiratory Interventions, Consultant Anesthesiologist and Intensivist.

Stop your patients feeling sick | EBPOM Dingle Nov 15, 2021

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 guest Dru Riddle, Associate Professor of Professional Practice in the School of Nurse Anesthesia at Texas Christian University, Associate Professor of Medical Education, TCU School of Medicine, and Director of the Center for Translational Research: A JBI Center of Excellence and Cochrane US TCU Center.

Nociception monitoring and pain management in 2021 | EBPOM Dingle/Chicago Nov 08, 2021

"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 Anaesthesiology, Charleston, South Carolina: https://www.topmedtalk.com/11813-2/

TopMedTalks to … | Dan Longrois on nociception: https://www.topmedtalk.com/topmedtalks-to-dan-longrois-on-nociception/

Presented by Desiree Chappell and Monty Mythen with their guest Anil Hormis, Professor, Consultant in anesthesia and Critical Care Medicine, Rotherham NHS Foundation Trust.

The HPI Monitor - avoiding hypotensive events | TopMedTalk Nov 01, 2021

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-asa-2017-the-elephant-in-the-room-intraoperative-hypotension/

Intraoperative Hypotension: https://www.topmedtalk.com/intraoperative-hypotension/

ASA 2019 | Perioperative Quality Initiative P.O.Q.I. news https://www.topmedtalk.com/asa-2019-perioperative-quality-initiative-p-o-q-i-news/

ASA 2019 | Hypotension Index: Data drives change https://www.topmedtalk.com/the-hypotension-prediction-index-hpi/

The Roundtable | The Hypotension Prediction Index (HPI) https://www.topmedtalk.com/the-roundtable-the-hypotension-probability-index-hpi/

EBPOM 2018 | Hypotension probability in practice https://www.topmedtalk.com/ebpom-2018-hypotension-probability-in-practice/

Prehab Periop World Congress: Feras Hatib, Simon Davies https://www.topmedtalk.com/prehab-periop-world-congress-feras-hatib-simon-davies/

The Hypotension Prediction Index (HPI) https://www.topmedtalk.com/the-hypotension-prediction-index-hpi/

The picture features TopMedTalk in conversation with Thomas Scheeren, Chair Cardiovascular Dynamics Section at European Society of Intensive Care Medicine (ESICM).

TopMedTalk is proud to act as the broadcasting arm of Evidence Based Perioperative Medicine (EBPOM) - our world famous conferences continue to grow in size and scope as the COVID recovery gets underway -, find out more here: www.ebpom.org

Perioperative obstetric care | EBPOM World Congress 2021 Oct 25, 2021

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 Foundation Trust and 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 their guests; Anita Sugavaganam, Consultant Anaesthetist and Lead for adult general anaesthesia and patient blood management at University Hospitals Sussex, Honorary Senior Clinical lecturer at the University of Sussex, Pervez Sultan, Associate Professor of Obstetric Anesthesiology, Stanford University School of Medicine, California, Honorary Faculty position as Associate Professor at University College London and Charlotte Holm, Obstetrics and Gynecology, resident at the Department of Obstetrics and Gynecology, Hvidovre Hospital, Denmark.

Tracheostomies and COVID 19 | EBPOM 2021 Chicago/Dingle Oct 18, 2021

"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.

We would like to thank Medtronic, for their generous support which enabled us to bring this piece to you for free.

Presented by Desiree Chappell and Monty Mythen with their guest Babak Sarani, Professor of surgery and emergency medicine and Director for the Center for Trauma and Critical Care at George Washington.

The ASA's Immediate Past President | TopMedTalk at the ASA Oct 13, 2021

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.

Post operative nausea and vomiting | TopMedTalk at the ASA Oct 13, 2021

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: https://editors-top-picks.libsyn.com/the-value-of-tackling-post-operative-nausea-and-vomiting-topmedtalk

Koalaa and The Alex Lewis Trust | TopMedTalk at the ASA Oct 13, 2021

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/

Rick Dutton Chief Quality Officer US Anesthesia Partners | TopMedTalk at the ASA Oct 13, 2021

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.

Both The President and The President-Elect of the ASA | TopMedTalk Oct 13, 2021

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.

Stephanie Byerly, Chair of the ASA Committee on Women Anesthesiologists | TopMedTalk Oct 13, 2021

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 University Hospital, Dallas.

Evan Kharasch, Chair of the ASA Committee on excellence in research | TopMedTalk at the ASA Oct 13, 2021

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.

Talks to Lee Fleisher | TopMedTalk at the ASA Oct 13, 2021

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.

Adam Striker, Chair, ASA Committee on Communications | TopMedTalk at the ASA Oct 13, 2021

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.

Perioperative Surgical Home (PSH) | TopMedTalk at the ASA Oct 13, 2021

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

REVIVEme - opioid overdose and naloxone | TopMedTalk at the ASA Oct 13, 2021

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

Ashish Khanna on intraoperative hypotension and beyond | TopMedTalk at the ASA Oct 13, 2021

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 Ashish Khanna, Associate Professor, Section Head for Research, Department of Anesthesiology, Section on Critical Care Medicine, Wake Forest School of Medicine.

Cancer and anaesthetic drugs | EBPOM World Congress 2021 Oct 11, 2021

Cancer and anesthetic drugs, informed by the basic science the pre-clinical work and observational studies suggest the way that we provide anesthesia could have an impact on cancer outcomes. This piece explores the evidence, with reference to trials both resolved and ongoing.

Presented by Monty Mythen with Tom Wall, consultant anesthesiology in the Mater Hospital he also has an academic affiliation with University College Dublin, Joyce Yeung, associate clinical professor of anesthesia and critical care, University of Warwick and Director of the UK perioperative medicine clinical trials network, Bernhard Riedel, Professor, Director of the Department of Anesthesia, Perioperative and Pain Medicine at the Peter MacCallum Cancer Centre, with an honorary academic appointment at the University of Melbourne and Vijaya Gottumukkala, Professor of Anesthesia and Deputy Chair at MD Anderson.

Jonathan Gal Vice Chair, ASA Committee on economics | TopMedTalk Oct 10, 2021

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 as they talk to their guests, Jonathan Gal, Associate Professor, System Medical Director- Facility Revenue Integrity & Optimization; System Medical Director- Offsite ASC Anesthesia; Associate Professor of Anesthesiology, Director Governmental & Reimbursement Affairs, Mount Sinai Hospital.

Dru Riddle and Tricia Meyer | TopMedTalk Oct 10, 2021

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 as they talk to their guests, Tricia Meyer, PharmD, adjunct Professor, Texas A&M, College of Medicine and Dru Riddle, Associate Professor of Professional Practice in the School of Nurse Anesthesia at Texas Christian University, Associate Professor of Medical Education, TCU School of Medicine, and Director of the Center for Translational Research: A JBI Center of Excellence and Cochrane US TCU Center.

Amy Wilkinson Director of Clinical Marketing Butterfly Network | TopMedTalk Oct 10, 2021

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, as they talk to their guest Amy Wilkinson, Director of Clinical Marketing Butterfly Network.

Kamal Maheshwari Director, Center for Perioperative Intelligence | TopMedTalk Oct 10, 2021

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, as they talk to their guest Kamal Maheshwari, Director, Center for Perioperative Intelligence, Cleveland Clinic.

Kraig de Lanzac, Assistant Secretary of the ASA | TopMedTalk Oct 10, 2021

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, as they talk with their guest Kraig S. de Lanzac, Assistant Secretary of the ASA.

For more on the ASA go here: https://www.asahq.org/

Welcome to the ASA | TopMedTalk Oct 10, 2021

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, as they talk about the hot topics, major issues and where the data is leading us.

For more on the ASA go here: https://www.asahq.org/

Exercise and the cancer patient during the COVID-19 crisis | EBPOM World Congress 2021 Oct 04, 2021

This piece focuses upon multimodal prehabilitation through the lived experience of clinicians from the different healthcare systems of Europe, the United States and the UK; both prior to and during the pandemic. We hear about the implementation of rehabilitation programs and research studies, which have managed to adapt, in the COVID era.

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 her guests Franco Carli, Professor of Anesthesia at McGill University and Associate Professor in the School of Dietetics and Human Nutrition at McGill University, Staff anesthesiologist at the McGill University Health Centre, Gerard Danjoux, consultant in Anaesthesia and Sleep Medicine at South Tees Hospitals NHS Trust, Professor Sandy Jack, PhD, Consultant Clinician Scientist in The Anaesthesia and Critical Care Research Unit at University Hospital Southampton NHS Foundation Trust, Honorary Senior Lecturer at the University of Liverpool, University of Southampton and University College London, Dan Engelman, President of the Enhanced Recovery after Cardiac surgery society, Baystate Health in Massachusetts, Medical Director, Heart, Vascular & Critical Care Services, Baystate Medical Center and Associate Professor of Surgery University of Massachusetts Medical School-Baystate.

Like this, want more? Try this piece now: https://www.topmedtalk.com/models-of-prehabilitation-ebpom-2020-2/

And remember, Evidence Based Perioperative Medicine (EBPOM) offers high quality video presentations as well as a chance to attend our next live conference here: www.ebpom.org

POETTS - Nutrition and patient living with and beyond cancer - the Macmillan Trust | EBPOM World Congress 2021 Sep 27, 2021

The Perioperative Exercise Testing and Training Society (POETTS) presents "Nutrition and patient living with and beyond cancer" in partnership with the Macmillan Trust. A real stand out moment from this year's Evidence Based Perioperative Medicine (EBPOM) London. This discussion is essential listening for anyone interested in pre-optimisation, muscle mass, nutrition, malnourishment - how to spot it and what to do about it, surgery and the importance of protein.

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, Gerrit Slooter, Surgical Oncologist, Maxima Medical Centre, The Netherlands, Steven Olde Damink, Consultant HBP Surgeon, University of Maastricht, Dileep Lobo, Professor of Gastrointestinal Surgery, Faculty of Medicine & Health Sciences, University of Nottingham and Consultant Hepatopancreaticobiliary Surgeon at Queen's Medical Centre, Chelsia Gillis, Registered Dietician, McGill University, Ca.

Perioperative care of the diabetic patient | EBPOM World Congress 2021 Sep 20, 2021

This piece looks at diabetes from a perioperative perspective, as a patient goes toward surgery how realistic and how important is it for us to treat and manage their condition? What can be done? How can our patients help? How has the evidence moved on these issues?

Also, for more on diabetes check out this Journal Club; https://www.topmedtalk.com/journal-club-1-12-various-articles-from-bmj-open-journal-of-bone-joint-surgery-american-volume-diabetes-care-annals-of-surgery/ or this Perioperative Coach; https://www.topmedtalk.com/periop-coach-3-04-perioperative-fluid-management-to-enhance-recovery-after-surgery/

And, for more on The Centre For Perioperative Care (CPOC) go here: https://www.topmedtalk.com/anaesthesia-2019-uk-centre-for-perioperative-care/

Presented by Mike Grocott, Professor of Anaesthesia and critical care at the University of Southampton, and Dave Selwyn, Deputy Medical Director at Nottingham University Hospitals NHS Trust and Director of The Centre for Perioperative Care (CPOC), Dennie Levett, Professor in Perioperative Medicine and Critical Care at Southampton University Hospital NHS Foundation trust and Honorary Associate Professor at the University of Southampton, Emma Page, Transformation Lead East Suffolk and North Essex NHS Foundation Trust, Goher Ayman, Diabetes UK, patient representative from the guideline group, Scarlett McNally, Deputy Director of The Centre for Perioperative Care (CPOC) consultant Orthopaedic Surgeon, Eastbourne DGH, UK, Gerry Rayman, Consultant physician, Ipswich Hospitals NHS Foundation Trust.

The Morpheus Consortium Plenary Lecture | EBPOM World Congress 2021 Sep 13, 2021

Introduced by Monty Mythen, TopMedTalk's Editor in Chief and Padma Gulur, Professor of Anesthesiology and Population Health and Executive Vice Chair for Performance and Operations Director, Pain Management Strategy and Opioid Surveillance at Duke University Health Systems.

Presented by Ramani Moonesinghe, OBE, Professor of Perioperative Medicine at UCL and a consultant anesthetist at UCL hospitals, Director of the Health Services Research Center of the Royal College of Anaesthetists and national Clinical Director for critical and perioperative care at NHS England.

Our speaker provided clinical leadership for the UK's national critical care response to COVID-19 and is now supporting the recovery of elective care as we emerge from the pandemic; her talk today focuses upon experiences and learnings from the past 18 months. Could it be that perioperative medicine is now the discipline which will help us build a road to recovery?

For more information about The Morpheus Consortium, the branding of three universities, Duke University, University College London and University of Southampton, with one shared goal – to be the leaders in perioperative medicine and enhanced recovery after surgery, ultimately improving the patients’ journey from the moment their surgery is contemplated to full recovery, go here: http://morpheusconsortium.org/

For more talks like this take time to discover Evidence Based Perioperative Medicine; www.ebpom.org

HPI - The Cardiac Perspective | TopMedTalk Sep 06, 2021

"Once you work with it, you really do learn to trust it. And it's very accurate."

This piece gives us an insight into practice from a cardiac perspective. What are "the TIGER protocols"? How is the HPI monitor being used? How has it impacted upon cardiac surgery?

Presented by Desiree Chappell and Monty Mythen with their guest Brad Cardonell, Assistant Professor of clinical anesthesiology at the University of Missouri School of Medicine, Director of cardiovascular anesthesiology, University Hospital in Columbia.

This piece was made available with generous support from Edwards Lifesciences.

Perioperative Care for people living with frailty | EBPOM World Congress 2021 Aug 30, 2021

Featuring a wide range of questions from the attending audience at EBPOM 2021 this piece gets into frailty: How do we assess it? How does it affect shared decision making? How can we raise awareness around it? How do we articulate what it means to patients and their loved ones? What does post operative frailty mean?

Introduced by Mike Grocott, Professor of Anaesthesia and Critical Care at the University of Southampton, Chaired by Jugdeep Dhesi, Clinical Lead for "Proactive care for Older People undergoing Surgery" (POPS) and Consultant Geriatrician, Guys and St Thomas' NHS Trust, with their guests Jude Partridge, consultant geriatrician POPS, honorary senior lecturer, King's College London, Chairs the British Geriatrics Society POPS SIG, Lawrence Mudford, 38-years as a dentist and dental educator within both primary and secondary care, including serving on the Board of the Faculty of General Dental Practice (UK) and a member of the General Dental Council, Board member of the Centre for Perioperative Care, Jessie Lupino Colquhoun, General Practitioner, Trainee, Lewisham UK, Elizabeth Huddlestone, Consultant Anesthetist, Wirral University Teaching Hospital.

If you enjoyed this piece make sure you check out www.ebpom.org for great ways you can attend our next conference.

The Editors in Chief Forum | EBPOM 2021 Aug 23, 2021

An exclusive chance to hear from the editors in chief of the major journals in our field discussing the big issues of 2021; 'The Journal of Perioperative Medicine', 'Anesthesiology', 'The British Journal of Anaesthesia', 'Anesthesia & Analgesia' and 'Anaesthesia'.

This piece was initially presented at Evidence Based Perioperative Medicine (EBPOM)'s 2021 online conference as part of the POCAPALOOZA. Make sure you check out www.ebpom.org now for more details on our other conferences this year.

Presented by Mike Grocott, Professor of Anaesthesia and critical care at the University of Southampton and co-editor in Chief of the Journal of Perioperative Medicine with his guests, Evan Kharasch, 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, Editor in Chief of 'Anesthesiology', Hugh Hemmings, Senior Associate Dean for Research, Professor and Chair of Anesthesiology at Weill Cornell Medicine and the Editor in Chief of the 'British Journal of Anaesthesia', Jean-Francois Pittet, Professor, University of Alabama, Department of Anesthesiology, Editor in Chief of 'Anesthesia & Analgesia', Andy Klein, Cardiothoracic Anaesthetist at Royal Papworth Hospital in Cambridge and Editor in Chief of 'Anaesthesia' and Lee Fleisher, Emeritus Professor of Anesthesiology and Critical Care, University of Pennsylvania, co-editor in Chief of the Journal of Perioperative Medicine.

Perioperative implementation science | EBPOM World Congress 2021 Aug 16, 2021

"Implementation science is really focused on bridging the evidence to practice gap"

One of the highlights of the 2021 Evidence Based Perioperative Medicine (EBPOM) conference. This talk is provided to you in the hope you can help us to spread its content as far and wide as possible. It is introduced by Mike Grocott, Professor of Anaesthesia and critical care at the University of Southampton.

Presented by Meghan Fall-Lane, Assistant Professor of Anesthesiology and Critical Care at the Perelman School of Medicine; Co-Director of the Penn Center for Perioperative Outcomes Research and Transformation; and Senior Fellow at the Leonard Davis Institute of Health Economics, University of Pennsylvania.

Also - make sure you check out www.EBPOM.org for more information about the next conference in the perioperative medicine calendar.

Total intravenous anaesthesia (TIVA) EBPOM 2021 | EBPOM World Congress 2021 Aug 09, 2021

This essential discussion covers total intravenous anaesthesia (TIVA) versus inhalation anesthesia, the pros, the cons, and the benefits of the process such as monitoring.

Included in this extended podcast are the two presentations (2:40mins in and 20:55mins in) and the question and answer session which followed (starts at 33:05mins in).

The Safe Brain Initiative is here: http://safebraininitiative.com/

Chaired by Desiree Chappell with her guests, Peter Kikegaard, Senior consultant and Medical Staff specialist at the Department of Anaesthesia and Intensive Care, Nykoebing Falster Hospital, University of Southern Denmark (SDU) and Anoushka Afonso, Assistant Professor of Anesthesia and critical care at Memorial Sloan Kettering Cancer Center, New York.

Provation® SurgicalValet™ Platform: Simplifying the Entire Surgical Encounter | TopMedTalk Aug 02, 2021

Ways to simplify the entire surgical encounter. This piece looks at the process of accepting patients into the surgical journey. Care coordination with a focus on the patient and the workflow associated with them; taking a fully integrated approach to the process from inception to preparation to completion and aftermath. More information about cloud-based Provation® SurgicalValet™ Perioperative Care Coordination can be found here: Provation® SurgicalValet™ Platform: Simplifying the Entire Surgical Encounter Presented by Desiree Chappell and Monty Mythen with their guests, Kari Beth Christie, Physician Anesthesiologist, NorthStar Anesthesia at Norton Healthcare in Louisville, KY and Tiffany Beatty, formerly the Director of Customer Success and now the Clinical Specialist Engineer at Provation.

Remotely performing clinical examinations during video calls | TopMedTalk Jul 26, 2021

Care home residents in South East London are to be the first in line to access remote examination technology.

Residents across 46 care homes in South East London are first in line to access innovative diagnostic technology from Arc Health ( www.archealth.io ), enabling doctors to remotely perform a clinical examination during a video call.

Where next for this sort of technology? Is a face to face meeting still the 'gold standard' of medical diagnosis?

Presented by Nick Margerrison with his guest Caroline Pilot, Honorary Professor of Algorithmic Medicine at DeMontfort University and Head of Clinical Product at Arc Health.

Perioperative Enhancement Teams - Part 2 | TopMedTalk Jul 19, 2021

Perioperative enhancement teams have been a theme on TopMedTalk for years. This program, part two of two, goes into more detail around what could be the crucial next steps for your institution as it distinguishes itself from the pack with excellent value based care instead of excessive volume driven disasters.

In this program we cover the importance of prehabilitation, the need for respect in a multidisciplinary team, cardiopulmonary exercise testing (CPET), a centre for geriatric surgery and palliative care and perioperative smoking cessation clinics.

Further listening:

Olle Ljungqvist, Prof. of Surgery, MD, PhD, Surgeon, Örebro University Hospital & Karolinska Institute, Sweden and Franco Carli, Prof. MD, PhD, Anesthesiologist, McGill University, Canada can be found in their original form here: https://www.topmedtalk.com/the-second-annual-prehabilitation-world-congress-part-1/

Desiree Chappell and Monty Mythen with their guest Amir Jaffer, Chief Medical Officer, New York Presbyterian/ Queens feature here: https://www.topmedtalk.com/perioperative-medicine-summit-2019-1-02-amir-jaffer/

John Whittle, assistant Professor at Duke University Medical Centre provides some essential listening on the subject of CPET here: https://www.topmedtalk.com/topmedtalk-cpet-cardio-pulmonary-exercise-testing/

Angela Bader, Vice Chair of Perioperative Medicine at Brigham and Women's Hospital can be heard in full here: https://www.topmedtalk.com/perioperative-medicine-summit-2019-1-03-angela-bader/

James Davis, MD, Duke Smoking Cessation Program, presents and excellent talk here: https://www.topmedtalk.com/part-1-of-3-smoking-kills-more-than-all-addictive-substances-combined-plus-car-accidents/

Perioperative Enhancement Teams | TopMedTalk Jul 12, 2021

This podcast is a look at some of the work done by practitioners who intend to take perioperative medicine to the next level; the "perioperative enhancement teams".

The program broadly follows a patient's surgical journey, we start with the UK's PREPWELL project, as explained by Gerard Danjoux, consultant in Anaesthesia and Sleep Medicine at South Tees Hospitals NHS Trust. For more information on that go to https://prepwell.co.uk/ - also, if you'd like to hear the original conversation you can find that here: https://www.topmedtalk.com/rcoa-03-adverse-outcomes-and-patient-optimisation/

Further discussion on the subject of psychological optimisation comes from, Chloe Grimmett, behavioural scientist and lead for Wesfit prehabilitation. If you'd like more details on the project go here: http://wesfit.org.uk/ - to hear the original presentation in full follow this link: https://www.topmedtalk.com/ebpom-2019-psychology-and-behavioural-change/

The fascinating debate which follows features Shawna Butler of the Singularity University in Exponential Medicine and Jennifer Brandon of the Hoag Orthopedic Institute in Irvine, California. That can be heard in full here: https://www.topmedtalk.com/using-new-technology-with-elderly-patients/

The essential contribution from Angela Coulter, a UK based health policy analyst and researcher, on the crucial area of "shared decision making" can be enjoyed in full here: https://www.topmedtalk.com/ebpom-2018-shared-decision-making-in-perioperative-care/

More wisdom from Steve Flanagan, Chair of Physical Medicine and Rehabilitation at NYU Langone can be found here: https://www.topmedtalk.com/rehabilitation-exercise-is-real-medicine/

Exciting news | TopMedTalk Jul 05, 2021

Post EBPOM Monty and Desiree explain how TopMedTalk is building on the incredible success of the last few years. After producing a podcast every day for 3+ years we are now going to produce a new podcast each week with more focus on specific topics with bespoke documentary style pieces which will help us to present complicated content in a more digestible form. We will also continue to present the core principles of Enhance Recovery After Surgery alongside cutting edge talks we think need a wider audience.

It will continue to be essential listening each week for perioperative practitioners, students and people interested in how and why their forthcoming operations will work as well as what to do as a patient to prepare.

We look forward to continuing the journey with you, our audience, who have helped turn TopMedTalk into the success it is today.

Presented by Desiree Chappell, Monty Mythen and Nick Margerrison.

--ARCHIVE LINKS

Bruce Keogh's excellent talk: https://topmedtalk.libsyn.com/ebpom-highlight-the-nhs-over-70

Can Medicine be cured? https://topmedtalk.libsyn.com/dingle-highlight-can-medicine-be-cured

Paul Wischmeyer is here: https://topmedtalk.libsyn.com/topmedtalks-to-dr-paul-wischmeyer-0

Introducing Caroline Geary | EBPOM Chicago 2021 Jul 04, 2021

In this piece we take a bit of time to speak with a newly graduated enhanced recovery after surgery (ERAS) enthusiast. How widely taught is ERAS in the US? Why is it such a game changing concept? How are people discovering and researching it?

Presented by Desiree Chappell and Vicki Morton and their guest Caroline Geary, critical care nurse residency, Novant Health Presbyterian Medical Center in Charlotte, North Carolina.

Panel discussion - Prediction of Opioid Induced Respiratory Depression: Does surveillance monitoring help? | EBPOM 2020 Jul 04, 2021

This piece is a listener generated question and answer session from EBPOM 2020. Although it works as a stand alone piece it relates directly to this talk here: https://www.topmedtalk.com/ebpom-2020-london-prediction-of-opioid-induced-respiratory-depression-on-the-general-care-floor-does-surveillance-monitoring-help/

Some of the questions considered include: How much do you think partial / inadequate neuromuscular blockade reversal, contributes to post pulmonary complications, perhaps in combination with opioids? Why as a group would we prefer to save money by avoiding sugammadex to reverse rocuronium to ensure complete reversal? Lack of reversal more than an issue? If you did a pre op sleep study on these patients, would you not find similar frequencies of desaturation? Is it just monitoring sleep? Should all wards have the capability for continuous monitoring?

Presented by Monty Mythen and Desiree Chappell with their guests, Ashish Khanna, Associate Professor, Section Head for Research, Department of Anesthesiology, Section on Critical Care Medicine,Wake Forest School of Medicine, Frank Overdyk, Professor of Anaesthesiology, Charleston, South Carolina, Leif Saager, Executive Vice Chair of the Department of anesthesiology in Germany at the University of Nottingham.

There's more from Frank Overdyk here: https://www.topmedtalk.com/11813-2/

EBPOM 2021 POCAPALOOZA final | TopMedTalk Jul 03, 2021

"The delivery of good medical care is to do as much nothing as possible." - Samuel Shem.

The POCAPALOOZA (POC, perioperative care; apalooza - a celebration of) wraps up in true style with a look at Australia and their current situation. Lauded for their handling of COVID19 but not yet 'through the woods' the conversation looks at how doing the right thing can be innovative and why a good rapport with your patient is invaluable.

Presented by Desiree Chappell with her guest Ross Kerridge, Senior Staff Specialist Anaesthetist Clinician at the John Hunter Hospital, Newcastle, Australia and Associate Professor at the University of Newcastle.

POCApalooza West | EBPOM London 2021 Jul 02, 2021

Presenting 2021's POCApalooza West; the annual tradition continues in the wake of last year's hugely successful international gathering of perioperative practitioners; hear how the rest of the world is handling the COVID-19 crisis, how the connectivity between patients and practitioners is improving and how one of TopMedTalk's favourite contributors is now taking perioperative medicine to the heart of healthcare in the USA.

Featuring Desiree Chappell, Monty Mythen and their guests, Lee Fleisher, Emeritus Professor of Anesthesiology and Critical Care, University of Pennsylvania, Sol Aronson, Professor Emeritus, Duke University, Durham, North Carolina and Carol Peden, adjunct Professor at USC and Pennsylvania and current Chair of The American Society of Anesthesiology's Brain Health Initiative.

POCApalooza East | EBPOM 2021 Jul 01, 2021

Presenting 2021's POCApalooza East. The now annual tradition continues in the wake of last year's hugely successful international gathering of perioperative practitioners; hear how the rest of the world is handling the COVID-19 crisis, how the vaccines are getting on and why perioperative medicine is primed to help in the near and necessary journey to be taken out of this current situation.

Featuring Desiree Chappell, Monty Mythen and their guests, Bruce Biccard, consultant anaesthetist at the University of Kwazulu-Natal, Director, Perioperative Research Unit, Department of Anaesthetics, Nelson R Mandela School of Medicine, Paul Myles, Director, Anaesthesiology and Perioperative Medicine, Alfred Hospital and Monash University and Mike Irwin, Professor, Head and Chief of Service, Anaesthesiology Hong Kong University, Gleneagles Hospital.

Models of perioperative care "the science of value" Part 2 | EBPOM USA - Chicago 2020 Jun 30, 2021

"Perioperative medicine ... I always think of a Venn diagram where there's truly an intersection between surgery anesthesia and medicine, and perhaps even a subset of medicine called geriatrics, that really create this convergence of what we're now creating as a novel science ... Perioperative medicine, I would say is a new clinical science that really incorporates all that"

This piece is a fascinating debate, it follows on from Part 1 of the same name; the panel discuss ways forward for perioperative medicine and the new opportunities being presented by a recent focus on both population health and the wider needs of a national healthcare system.

Presented by Desiree Chappell and Sol Aronson with panelists; Angela Bader, Harvard Medical School and Vice Chair of Perioperative Medicine at Mass General Brigham, BobbieJean Sweitzer, Professor of Anesthesiology and Director of Perioperative Medicine at Northwestern University in Chicago, Illinois, Rob Shakar, Medical Director of a 32-physician group in Wilmington, NC he oversees the Perioperative Surgical Home Project for New Hanover Regional Medical Center, Thomas Vetter, Director of Perioperative Care and Director of Comprehensive Pain Management and Professor of Surgery and Perioperative Care and Professor of Population Health, at the Dell Medical School at The University of Texas, Austin.

Total ERAS is essential to clear the backlog | TopMedTalk Jun 29, 2021

"Data is key and having champions is key"

This piece provides a truly transatlantic in-depth perspective on an area of opportunity highlighted by our needs in the wake of COVID 19; now more than ever true enhanced recovery after surgery (ERAS) is essential. Optimising value, reducing the need for return visits, decreased length of stay, there is almost no aspect of perioperative medicine and enhanced recovery that is not going to be crucial for our institutions in the near and present future. A data driven approach makes it clear, there is no other way forward.

Also in this podcast a fascinating dive into one of our favorite topics, goal directed fluid management. How have the terms "restricted" and "liberal" evolved over the years? What should we make of the new evidence that ha come in over the last few years?

Hear how these challenges are being met in this exclusive conversation, generously supported by Deltex Medical.

Presented by Desiree Chappell and Monty Mythen with their guest Michael Scott, M.B., Ch.B. Professor of Anesthesiology at the University of Pennsylvania

What is Connected Care? | EBPOM 2021 London Jun 28, 2021

"Connected care is a combination of the right tech, to monitor the patient, that's human factor friendly and easy to use"

This piece is an in-depth look at how remote patient monitoring is evolving to suit a need that's growing as patients require more from their healthcare. The COVID-19 crisis has pushed these issues to the forefront, how can your institution modernize and evolve in this direction?

Presented by Desiree Chappell with Monty Mythen and their guest Sam Ajizian CMO Patient monitoring at Medtronic.

Cryoneurolysis and pain management | TopMedTalk Jun 28, 2021

"We've been doing cryoneurolysis for total knees now for three years... people gravitate to practices that that practice this technology"

This piece focuses upon two 'early adopter' orthopedic surgeons changing up the way we treat joint pain for surgical patients.

We mention Iovera, a provider at the forefront of this technology: https://www.iovera.com/

The Doc Social website is here: www.doc.social/

The Evidence Based Perioperative Medicine (EBPOM) website is here: www.ebpom.org

This piece also features important news for TopMedTalk fans as, towards the end, we explain how your favorite perioperative podcast is asking listeners for feedback and thoughts. Email contact@topmedtalk.com

Presented by Desiree Chappell and Monty Mythen with their guests Vinod Dasa, Vice Chairman of Academic Affairs, Irv Cahen Chair of Orthopaedic Surgery and Research, Co-Director LSU Musculoskeletal Research Consortium and Josh Urban, board-certified orthopedic surgeon, OrthoNebraska, Omaha, Nebraska.

Perioperative Medicine - where we were, where we are now and where want to be P2 | EBPOM Ireland 2020 Jun 27, 2021

This piece is a worthwhile deep dive into this perioperative medicine and how we go forward with it. Hear the panel speak about what it is they want for the future and what it is they are doing now. With questions submitted from the online audience the panel get into the detail. Essential listening for any student of perioperative medicine.

It includes a mention for the Welsh Perioperative Medicine Society, their website is here: https://www.welshpoms.com/

This is part two of a two part piece of the same name.

Presented by David Walker, Professor in Anaesthesia and Critical Care Medicine, University College London Hospitals, Honorary Senior Lecturer UCL, Kim Caulfield, Perioperative Medicine Fellow, University College London Hospitals NHS Foundation Trust, Mike Grocott Professor of Anaesthesia and critical care at the University of Southampton, Aislinn Sherwin, a Fellow in Perioperative Medicine and Onco-Anaesthesia at the Peter MacCallum Cancer Centre, Melbourne, Roisin Coary, final year SpR in Geriatric and General Internal Medicine, with a specialist interest in Peri-operative Medicine, Dublin Ireland and Isra Hassan, a post-CCT Perioperative Medicine Fellow at the University College of London Hospital she co-founded the Welsh Perioperative Medicine Society in 2018 which now has over 100 members, and to date has delivered two national conferences, Andrea Haren, perioperative medicine fellow at UCLH she worked with Guys and St Thomas' working with the POPS Clinic she is currently a locum consultant anaesthetist at St. Vincent's Hospital in Dublin and Pádraig Ó Scanaill, Locum Consultant Anaesthetist at the Mater Misericordiae University Hospital, Dublin.

The hidden pandemic of post operative complications | EBPOM World Congress 2020 Jun 26, 2021

This is a story that starts with some of the challenges faced in our world outside the operating theatre and it's about how we might address some of these problems systematically. Healthcare organizations have to deliver high quality, competitive and sustainable results and costs. Good quality perioperative surgery is absolutely critical to maintain the health and well being of our population going forwards; this talk is a step in that direction.

Presented by Guy Ludbrook Professor of Anaesthesia at the University of Adelaide and Royal Adelaide Hospital.

Perioperative Medicine - where we were, where we are now and where want to be P1 | EBPOM Ireland 2020 Jun 25, 2021

This piece is a worthwhile deep dive into this perioperative medicine and how we go forward with it. Hear the panel speak about what it is they want for the future and what it is they are doing now. With questions submitted from the online audience the panel get into the detail. Essential listening for any student of perioperative medicine.

When should we pre-assess patients? Should all anaesthetists be doing pre-operative sessions? What is it about the role of the anaesthestist that makes it uniquely suited to the discipline of perioperative medicine?

This is part one of a two part piece of the same name.

Presented by David Walker, Professor in Anaesthesia and Critical Care Medicine, University College London Hospitals, Honorary Senior Lecturer UCL, Kim Caulfield, Perioperative Medicine Fellow, University College London Hospitals NHS Foundation Trust, Mike Grocott Professor of Anaesthesia and critical care at the University of Southampton, Aislinn Sherwin, a Fellow in Perioperative Medicine and Onco-Anaesthesia at the Peter MacCallum Cancer Centre, Melbourne, Roisin Coary, final year SpR in Geriatric and General Internal Medicine, with a specialist interest in Peri-operative Medicine, Dublin Ireland and Isra Hassan, a post-CCT Perioperative Medicine Fellow at the University College of London Hospital she co-founded the Welsh Perioperative Medicine Society in 2018 which now has over 100 members, and to date has delivered two national conferences, Andrea Haren, perioperative medicine fellow at UCLH she worked with Guys and St Thomas' working with the POPS Clinic she is currently a locum consultant anaesthetist at St. Vincent's Hospital in Dublin and Pádraig Ó Scanaill, Locum Consultant Anaesthetist at the Mater Misericordiae University Hospital, Dublin.

Depth of anaesthesia and long term outcomes | EBPOM Ireland 2020 Jun 24, 2021

"More than 300 million patients have surgery annually worldwide and an increasing proportion of them are elderly and at risk of perioperative adverse events. There's very few proven primary or secondary prevention measures, and the resources for monitoring and trading complications are inadequate. So - more action is required".

This piece looks at the evidence as regards perioperative outcomes for the elderly, depth of anesthesia and mortality. Also, what's the latest on depth of anesthesia and delirium?

Presented by Kate Leslie, Honorary Professor, Monash University, Melbourne, VIC, Australia, Specialist Anaesthetist, The Royal Melbourne Hospital & North Western Mental Health and Non-Executive Director, Australian Medical Council.

Haemodynamic optimisation: the song remains the same | EBPOM Ireland 2020 Jun 23, 2021

"The song remains the same"

The story picks up toward the end of the 1970's; "interesting stuff was going on ... Professor William Shoemaker, a surgeon and intensive care doctor one of the founding members of the American critical care society ... fiddling around with pulmonary artery catheters in his high risk surgical patients in South Los Angeles, and identified that those patients that were surviving tended to have higher cardiac indexes higher option deliveries than the non survivors".

This piece was Dingle 2020's Inaugural Siobhan Mythen Visiting Lecturer. For more content from that meeting check TopMedTalk's archive or go to www.ebpom.org for video presentations.

Presented by Jonathan Wilson, retired Consultant Anaesthetist, York Hospital, York.

'Hip Attack' with PJ Devereaux | EBPOM World Congress 2020 Jun 22, 2021

"Accelerated surgery for hip fracture is safe and feasable, with troponin elevation before randomization, there was a mortality advantage with accelerated surgery. The logistics and resources required for accelerated surgery need to be balanced with the demonstrated benefits and patient's desires for accelerated surgery"

This exciting piece from EBPOM 2020 provides a data download that further illucidates the perennial debate surrounding hip fractures and their management and treatment. What is the correct perioperative approach to this nasty injury?

For more on the Hip Attack Trial go here: https://clinicaltrials.gov/ct2/show/NCT02027896

Presented by P.J. Devereaux, cardiologist, clinical epidemiologist, and perioperative care physician, Professor in the Departments of Health Research Methods, Evidence, and Impact (HEI) and Medicine, Director of the Division of Perioperative Care, McMaster University, Associate Deputy Director of the Population Health Research Institute, President of the Society of Perioperative Research and Care.

Perioperative anticoagulation and anti platelet management; a user friendly approach - audience questions | EBPOM USA - Chicago Jun 21, 2021

This piece is divided into two parts, the first being discussion between the panelists and the second, part 2, being questions from the online audience: What is your opinion about spinals and hip fractures for patients on clopidogrel? Do you use any near patient tests to confirm residual anticoagulation? Where are the best guidelines to be found?

We suggest you listen to this piece alongside part 1.

Presented by Sol Aronson, tenured Professor at Duke University, with his guests; Angela Bader, Harvard Medical School and Vice Chair of Perioperative Medicine at Mass General Brigham, BobbieJean Sweitzer, Professor of Anesthesiology and Director of Perioperative Medicine at Northwestern University in Chicago, Illinois and Jeanna Blitz, Associate Professor of Anesthesiology, Director of the Preoperative Anesthesia and Surgery Screening Clinic, Director of Perioperative Medicine Fellowship at Duke University School of Medicine, Durham, North Carolina.

Perioperative anticoagulation and anti platelet management; a user friendly approach (REPEAT) | EBPOM USA - Chicago Jun 20, 2021

The conversation begins with "a day in the life" with respect to managing the anti coagulation questions that come up commonly. The contributors swap stories from their time in practice. The conversation moves to protocols, guidelines and also, when where and how to begin bridging.

This piece is divided into two parts, the first being discussion between the panelists and the second, part 2, being questions from the online audience.

Presented by Sol Aronson, tenured Professor at Duke University, with his guests; Angela Bader, Harvard Medical School and Vice Chair of Perioperative Medicine at Mass General Brigham, BobbieJean Sweitzer, Professor of Anesthesiology and Director of Perioperative Medicine at Northwestern University in Chicago, Illinois and Jeanna Blitz, Associate Professor of Anesthesiology, Director of the Preoperative Anesthesia and Surgery Screening Clinic, Director of Perioperative Medicine Fellowship at Duke University School of Medicine, Durham, North Carolina.

Daniel Engelman updates in cardiac | EBPOM USA - Chicago 2020 Jun 19, 2021

How can enhanced recovery after surgery (ERAS) be applied to cardiac and what exciting opportunities are there for those who have made this their mission? This detail driven address contains more information on The Society for Enhanced Recovery After Cardiac Surgery (ERAS® Cardiac), more information can be found on their website: https://www.erascardiac.org/

Since this address was given at Evidence Based Perioperative Medicine (EBPOM) Chicago's 2020 meeting TopMedTalk has been proud to bring you coverage of ERAS® Cardiac's online meeting. For more on that start here: https://www.topmedtalk.com/the-eras-cardiac-society-conference-topmedtalk/

Presented by Daniel Engleman, the Medical Director of the Heart, Vascular and Critical Care Units at Baystate Medical Center. He is an Associate Professor of Surgery at The University of Massachusetts-Baystate. He started the ERAS® Cardiac Collaborative to internationally standardize best practices.

The value proposition in perioperative medicine (REPEAT) | EBPOM USA - Las Vegas 2021 Jun 18, 2021

"Look at it from where is the patient, and what's best for the patient; I think that the other answers follow and yes, it is higher quality, yes, there can be some opportunities for cost savings; even if it 'breaks even' if the patients are happier, isn't that worth moving into the concept and proving that it does make a difference?"

The value proposition is an essential element of advocating perioperative care; we know it provides safer, better quality outcomes but how do we translate that into a language that both patients, fee payers and providers can all understand?

This piece follows on from "The size and scope of the problem with Jim Grant & Mike Englesbe | EBPOM 2021" Las Vegas, if you'd like to hear that go here: https://topmedtalk.libsyn.com/the-size-and-scope-of-the-problem-with-jim-grant-mike-englesbe-ebpom-2021-las-vegas

Presented by Desiree Chappell, introducing her panellists Linda Groah, CEO, Executive Director of the Association of periOperative Registered Nurses (AORN) and Amy Stout, Operating Partner at Cranemere and Interim President Clinical Services at NorthStar; alongside contributions from additional contributors from the previous session, Jim Grant, Senior Vice President and Chief Medical Officer at Blue Cross Blue Shield of Michigan and Mike Englesbe Darling Sr. & Cyrenus G. Darling Jr. Professor of Surgery, Michigan.

The size and scope of the problem with Jim Grant & Mike Englesbe (REPEAT) | EBPOM USA - Las Vegas 2021 Jun 17, 2021

"When I heard Sol Aronson, speak about perioperative medicine as 'population health', for me, it was like a eureka moment because our platform within Michigan is really an unmatched place to kind of realize that vision."

This piece asks the question; "why do we need perioperative medicine"? The answer is illustrated with a real success story where practitioners realise the value proposition it unlocks for their patients every day. Hear how it is achieved and why it is so important.

Presented by Desiree Chappell with her guests Jim Grant, Senior Vice President and Chief Medical Officer at Blue Cross Blue Shield of Michigan and Mike Englesbe, Darling Sr. & Cyrenus G. Darling Jr. Professor of Surgery, Michigan.

If you enjoyed this piece you'll love TopMedTalk's exclusive and ground breaking series POET: Perioperative Enhancement Team "Perioperative medicine is population health": https://topmedtalk.libsyn.com/poet-601-perioperative-medicine-is-population-health

Models of perioperative care "the science of value" (REPEAT) | EBPOM USA - Chicago 2020 Jun 16, 2021

This piece is part one of a two part piece. It's a short didactic presentation on the tough realities the U.S. healthcare system faces as the fee for payment system creaks against concerns about rising costs and the need for population health management.

Can we move forward with "the science of value" which true perioperative medicine offers us?

It's a talk which is designed to spark debate and that follows in part two of this piece.

Presented by Sol Aronson, tenured Professor, Duke University, Durham, North Carolina.

Daniel Engelman Q&A | EBPOM USA - Chicago Jun 15, 2021

"So in all these ERAS programs, you need a physician champion, a nurse champion, a coordinator; then we brought our pharmacist in - I will not start rounds without a pharmacist. I refuse. I won't start because the pharmacist is integral ... it's just you need that multidisciplinary team"

This piece is a question and answer session prompted by the address our guest gave during EBPOM Chicago. Both the online audience and the team challenge our speaker to explain more. If you missed the address TopMedTalk has it for you here: https://topmedtalk.libsyn.com/daniel-engelman-updates-in-cardiac-ebpom-chicago

Presented by Desiree Chappell and Monty Mythen with Daniel Engelman, Cardiac Surgeon, Medical Director of the Heart, Vascular and Critical Care Units at Baystate Medical Center, Associate Professor of Surgery at The University of Massachusetts - Baystate, Associate Professor-Adjunct at Tufts University School of Medicine. He president and co-founder of the ERAS® Cardiac Society.

Postoperative critical care: How do we help? | EBPOM World Congress 2020 Jun 14, 2021

This piece is a question and answer session with questions from the online audience.

What do we think is the clinical care difference that having an elevated level of monitoring and more people around of all all sorts? Why is it good for our patients? As regards admissions to your campus care area; what criteria do you use? Do we need rapid critical care expansion in countries with very few beds? Could the enhanced care wards, in their approach, be compared with the post anaesthetic care unit? Would you cancel or postpone a cancer patient's operation, if not enhanced care or post operative critical care bed available? If you feel it is essential, if you feel the operation essential?

Presented by Mike Grocott, Professor of Anaesthesia and Critical Care at the University of Southampton and Lee Fleisher, Emeritus Professor of Anesthesiology and Critical Care, University of Pennsylvania with Ramani Moonsinghe, Professor of Perioperative Medicine at University College London (UCL), Hon Consultant in Anaesthesia, UCLH, Mike Swart, Consultant in Anaesthesia and Critical Care Medicine at Torbay Hospital and advisor to the UK Department of Health for the Enhanced Recovery Programme and Anna Batchellor, trained in anaesthesia and Intensive Care Medicine (ICM) she works in Newcastle upon Tyne; past President of the Intensive Care Society, past Dean of the Faculty of ICM, past member of Council of the Royal College of Anaesthetists. She tried to retire in June 2016 and managed to spend a year working part time before being hijacked by the Getting It Right First Time (GIRFT) programme.

Roundtable discussion: Delivering value (REPEAT) | EBPOM USA - Las Vegas 2021 Jun 13, 2021

This roundtable discussion tackles questions from the online audience and is the third part of a longer discussion. It follows on from "The value proposition in perioperative medicine | EBPOM 2021 Las Vegas", if you'd like to hear that go here: https://topmedtalk.libsyn.com/the-value-proposition-in-perioperative-medicine-ebpom-2021-las-vegas

How do we as practitioners deliver value? How does 'population health' fit into the picture? How long before and after surgery are we invested in managing? What's the key point to start a perioperative medicine program in a low income country with no incentives at all; how do you approach the hospital financial department?

Presented by Desiree Chappell, introducing her panelists Linda Groah, CEO, Executive Director of the Association of periOperative Registered Nurses (AORN) and Amy Stout, Operating Partner at Cranemere and Interim President of Clinical Services at NorthStar; alongside contributions from additional contributors from the previous session, Jim Grant, Senior Vice President and Chief Medical Officer at Blue Cross Blue Shield of Michigan and Mike Englesbe, Darling Sr. & Cyrenus G. Darling Jr. Professor of Surgery, Michigan.

Leadership with Jeff Vender: Part 2 - Q&A | EBPOM USA - Chicago Jun 12, 2021

This piece is the second part of a conversation about leadership in medicine, during times of change. It follows on from the first part where our speaker outlines his thoughts in a short talk. Now questions from the audience are considered and the conversation develops. What have we learned after the recent huge changes we've seen in our profession?

Presented by Desiree Chappell and Monty Mythen with Jeff Vender, Emeritus, Harris Family Foundation Chairman of the Department of Anesthesiology at NorthShore University Health System, Evanston, Illinois and Clinical Professor at the University Of Chicago Pritzker School Of Medicine in Chicago, Illinois.

Leading Health Systems in times of change with Jeff Vender: Part 1 | EBPOM USA - Chicago Jun 11, 2021

"I believe most people can be leaders or better leaders. You can create or participate in change and a better future. You can make a difference in your own lives, the lives of others and the life of your organization. If you believe you can."

This piece contains a powerful, inspirational and prescient talk about leadership. Part 1 contains some conversation and the talk, to be followed by questions from the audience in Part 2. Where do leaders come from, what makes them stand out and how do they learn the skills necessary to take what they do to the next level?

Presented by Desiree Chappell and Monty Mythen with Jeff Vender, Emeritus, Harris Family Foundation Chairman of the Department of Anesthesiology at NorthShore University Health System, Evanston, Illinois and Clinical Professor at the University Of Chicago Pritzker School Of Medicine in Chicago, Illinois.

Am I safe? Q & A with Lee Fleisher | EBPOM World Congress 2020 Jun 10, 2021

This question and answer session was a highlight of EBPOM London 2020, it works as a standalone piece or as a companion piece to this talk here: https://topmedtalk.libsyn.com/ebpom-2020-london-am-i-safe

The discussion follows themes outlined in the presentation as our online audience asked a series of questions.

Some of the questions included in the discussion are "How should leaders deal with anxiety both in themselves and their team? What is the evidence on perceived command gradient in residents and the fear of looking inadequate in front of peers and superiors? Bad for patients, versus bad for me? The people at the top end, the older people within an organization, are often the most resistant to culture change, yet they have the most influence over culture, any advice? What defines the people who are ready for change?"

Conversational in tone this piece was first heard on the "TopMedTalk stage" at Evidence Based Perioperative Medicine (EBPOM) for more details go now to www.ebpom.org

Presented by Monty Mythen and Desiree Chappell with Lee Fleisher, Emeritus Professor of Anesthesiology and Critical Care, University of Pennsylvania.

World Delirium Awareness Day with iDelirium | TopMedTalk Jun 09, 2021

This piece focuses on iDelirium; The International Federation of Delirium Societies on world delirium day. As well as considering this difficult condition the conversation asks what the latest research shows us and how things could improve both for patients and practitioners. For more detail check out their website here: http://www.idelirium.org/

Presented by Desiree Chappell and Monty Mythen with their guests Heidi L. Lindroth, Senior Associate Consultant Nurse Scientist, Nursing Research Division Critical Care Nurse, Gideon Caplan, Director, Geriatric Medicine, Prince of Wales Hospital, Alasdair Macclullich, Professor of Geriatric Medicine, Honorary Consultant in Geriatric Medicine, Edinburgh, Delirium Research Group, Rakesh C. Arora, Co-Founder of IDelirium, Professor and Head of Cardiac Surgery and Cardiac Critical Care at Max Rady College of Medicine - University of Manitoba, Canada.

The ERAS Cardiac Society Conference Day 2 | ERAS Cardiac 2021 Jun 08, 2021

"The goal of ERAS® Cardiac is when you leave one of our meetings, you're going to be chock full of tips and tricks that you can take back and implement, if not the next day, then in the next week or next month."

TopMedTalk's coverage of The Society for Enhanced Recovery After Cardiac Surgery (ERAS® Cardiac) conference continues with a conversation that covers the nuggets and insights that a conference such as this delivers. This exclusive chat is only possible thanks to the support of the society who's excellent website is here: https://erasvirtual2021.com/

"I think that also your [TopMedTalk] platform is going to be key. We need to have more of these podcasts. We need short little vignettes, eight to 15 minutes that people can listen to in the car on the way home where they learn and thought leaders having interactive discussions and get ideas. And that's the future really of education"

Presented by Desiree Chappell with her guests, Seenu Reddy, Cardiothoracic Surgeon at HCA‘s TriStar Cardiovascular Surgery in Nashville, National Physician Director for HCA Healthcare's CV Service line and Daniel Engelman, Cardiac Surgeon, Medical Director of the Heart, Vascular and Critical Care Units at Baystate Medical Center, Associate Professor of Surgery at The University of Massachusetts - Baystate, Associate Professor-Adjunct at Tufts University School of Medicine and President of the ERAS Cardiac international Society.

The ERAS Cardiac Society Conference | ERAS Cardiac 2021 Jun 07, 2021

"You didn't have to think about it, the compliance continued, because it was so standardized. We had a well oiled machine that just kept on working through COVID".

The Society for Enhanced Recovery After Cardiac Surgery (ERAS® Cardiac)'s conference has gotten off to a great start; this exclusive chat gets into some of the stand out moments so far; nutrition, data collection, the essentials of ERAS and the importance of standardization.

For more information on the conference check out https://www.erascardiac.org/

We mention Dan Engelman in this piece, he features in this popular conversation from the TopMedTalk archives here: https://www.topmedtalk.com/sunday-special-preoperative-optimization-framing-up-the-value-proposition/

Paul Wischmeyer gets mentioned on this piece as a "fan favourite", he features frequently. If you've not yet heard him start with this podcast - one of our most popular so far - here: https://www.topmedtalk.com/topmedtalks-to-dr-paul-wischmeyer/

Presented by Desiree Chappell with her guests Gina McConnell, ERAS Coordinator for all WakeMed health systems and Cheryl Crisafi, Cardiac Surgery Care Coordinator Nurse at Baystate Medical Center in Springfield, MA.

ERAS® Cardiac Roundtable with Kevin Lobdell, Rawn Salenger, Desiree Chappell | ERAS Cardiac 2021 Jun 06, 2021

"You have to take the viewpoint that if the Nurses and the Physical Therapists and the Pharmacists are resisting the idea that you're putting forward, then there's probably something wrong with it, it doesn't work for them, for some reason, and you got to find out what that is..."

This long form conversation is a highlight for TopMedTalk's coverage of The Society for Enhanced Recovery After Cardiac Surgery (ERAS® Cardiac) conference. The conversation covers a wide range of interesting areas, including; the nature of leadership in medicine, the global nature of many of the questions we face, how the internet is changing what we do, what the phrase "better never stops" means, how to take and use feedback and why the patient has to be at the heart of what we do, the importance of "the growth mindset".

Also, discover how one of our guests has learned from his experience becoming a Lieutenant Colonel, US Army Reserves; what can a military mindset tell us about the task we face as advocates of perioperative medicine?

We wrap with a conversation about blood transfusion reduction.

This exclusive chat is only possible thanks to the support of the society, their excellent website is here: https://erasvirtual2021.com/

Presented by Desiree Chappell with her guests Kevin Lobdell, Professor and the Director of Regional Cardiovascular and Thoracic Quality, Education, and Research for Carolinas HealthCare System, Charlotte, NC, USA, as well as the Clinical Professor at the University of North Carolina-Chapel Hill, Chapel Hill, NC, USA and Rawn Salenger, Chief of Cardiac Surgery at University of Maryland St. Joseph Medical Center, Assistant Professor of Surgery at the University of Maryland School of Medicine.

TopMedTalks to Jeffrey Gum, Assistant Clinical Professor, Department of Orthopaedic Surgery, University of Louisville, Spine Surgeon, Leatherman Spine Center| TopMedTalk Jun 05, 2021

"Our real 'next barrier' in the continuum of care is, it's okay to have pain, right? It's expected to have pain. [...] but it is better for you recovery wise, complication wise; to be able to get up, move around, know what's going on, not be confused, right? A little bit of that education goes a really long way."

The opioid crisis, spine surgery, working as a team, pioneering efforts being done at the world leading Norton Leatherman Spine Center, enhanced recovery after surgery (ERAS) and some of the fascinating research our guest is conducting; all this and more as our "TopMedTalks to..." series makes a welcome return.

Presented by Desiree Chappell with Jeffrey Gum, Assistant Clinical Professor (Gratis), Department of Orthopaedic Surgery, University of Louisville, Pediatric and Adult spine surgeon at the Leatherman Spine Center in Louisville, KY.

Fitness, function or frailty? P2 | EBPOM World Congress 2020 Jun 04, 2021

This piece is a continued deep dive into the subject, of 'fitness, function, or frailty' and, perhaps, "fixing". It's essential listening for anyone interested in the latest thinking on this crucial topic and was a highlight of the London conference.

How can we integrate frailty and cognitive scores in risk assessment tools to facilitate inclusion in shared decision making? How can we improve a surgical colleague's ability to identify frailty? Most patients will have an operation sometime in their life; should surgical school be renamed and moved to being a "well being" clinic and offered to all patients? What screening tools would you recommend if only minimal time or money is available? Is pre-op screening actually 'public health' and should it really be being done for everyone? What are the differences and where is the overlap between fitness functional capacity, frailty, and sarcopenia? In mild cognitive impairment, should we tell patient that it will work and postop and not be expected to fully recover? What strategies have you found most helpful in engaging surgeons with identifying their frail patients? How are we tackling the workforce shortage among geriatricians? What has your experience been in advising achieving physical fitness in patients who present to surgery with persistent pain which is a limitation?

This is part two of a two part piece. Each of the contributors comments upon talks which they gave at EBPOM 2020, all of which are now available as part of the TopMedTalk podcast. To ensure you are among the first to hear information of this kind please investigate www.ebpom.org for more details about how you can attend our online conferences.

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Presented by Scarlett McNally, Deputy Director of The Centre for Perioperative Care (CPOC) consultant Orthopaedic Surgeon, Eastbourne DGH, UK and Monty Mythen, Smiths Medical Professor of Anaesthesia and Critical Care at University College London with questions from the online audience for their guests; 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, Daniel Conway, Consultant in Anaesthesia and Critical Care, Group Lead for Perioperative Medicine, Manchester Royal Infirmary, UK and Chair of the Manchester Perioperative Medicine Society, Jude Partridge, consultant geriatrician POPS, honorary senior lecturer, King's College London, Chairs the British Geriatrics Society POPS SIG, Vicki Morton, Director of Clinical and Quality Outcomes at Providence Anesthesiology Associates, P.A.

Fitness, function or frailty? P1 | EBPOM London 2020 Jun 03, 2021

Fitness, function and, or, frailty are important determinants of the quality of the life that we live. In the context of major surgery it's very important we recognize and work with individual patients improving and optimizing them and their ability to handle an operation. This piece is an essential deep dive into the subject, essential listening for anyone interested in the latest thinking on this crucial topic.

What are the limitations on your resources when considering a plan of preoperative evaluation?

This is part one of a two part piece. Each of the contributors comments upon talks which they gave at EBPOM 2020, all of which are now available as part of the TopMedTalk podcast. To ensure you are among the first to hear information of this kind please investigate www.ebpom.org for more details about how you can attend our online conferences.

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Presented by Scarlett McNally, Deputy Director of The Centre for Perioperative Care (CPOC) consultant Orthopaedic Surgeon, Eastbourne DGH, UK and Monty Mythen, Smiths Medical Professor of Anaesthesia and Critical Care at University College London with questions from the online audience for their guests; 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, Daniel Conway, Consultant in Anaesthesia and Critical Care, Group Lead for Perioperative Medicine, Manchester Royal Infirmary, UK and Chair of the Manchester Perioperative Medicine Society, Jude Partridge, consultant geriatrician POPS, honorary senior lecturer, King's College London, Chairs the British Geriatrics Society POPS SIG, Vicki Morton, Director of Clinical and Quality Outcomes at Providence Anesthesiology Associates, P.A.

Finding Goldilocks, more or less | EBPOM 2020 Jun 02, 2021

With questions from the online audience, this piece looks at the "not too much and not too litte" sweet spot regarding fuel, fluid and oxygen; where is it and how do we get there, according to our distinguished panel?

This podcast works well as a companion piece to the following talks which have already been released here on TopMedTalk:

Helen McKenna, "Fuel, can you have too much?" https://www.topmedtalk.com/ebpom-2020-london-fuel-can-you-have-too-much/

Tim Miller "Optimising fluid and hemodynamic management during major surgery" https://www.topmedtalk.com/ebpom-london-2020-optimizing-fluid-and-hemodynamic-management-during-major-surgery/

Dan Martin "Perioperative Oxygenation" https://www.topmedtalk.com/ebpom-london-2020-perioperative-oxygenation/

Presented by Mike Grocott and Dennie Levett with their panelists; Tim Miller, Associate Professor of Anesthesiology from Duke University Medical Centre, Helen McKenna, is in the final year of her PhD at University College London, investigating bioenergetic and redox function in critically ill patients and Dan Martin, OBE anaesthetist and intensivist at the Royal Free Hospital and Reader at University College London (UCL).

Taking the time to care | COVID19 Jun 01, 2021

"I just feel there is some intrinsic value to, you know, a human presence"

This piece tells the story of an anesthesiologist who, once vaccinated, decided to go the extra mile and work out a way to spend some quality time with his COVID-19 patients. Hear how he went through the appropriate procedures to arrange for them to be able to have as much human interaction as was safely possible.

"With vaccination with full PPE, N-95, you know, face shield, gloves, gown, all the rest of it, you are very low risk"

Read more here: https://www.statnews.com/2021/01/27/vaccinated-health-care-workers-immunity-spend-time-visiting-covid-19-patients/

Presented by TopMedTalk's Nick Margerrison with his guest Dr. Ben Moor, Anesthesiologist at Beth Israel Deaconess Hospital in Plymouth, Boston.

Enhanced Recovery After Surgery (ERAS) Part 2 | EBPOM USA - Chicago 2020 May 31, 2021

Part 2 of this conversation continues the momentum of Part 1 with a conversation about electronic medical records (EMR), how important data is to the process, the need for those who collect it to understand it and then, more broadly, the importance of putting the patient at the heart of what you do.

Presented by Desiree Chappell with Vicki Morton, Director of Clinical and Quality Outcomes at Providence Anesthesiology Associates, P.A, Cheryl Crisafi, Cardiac Surgery Care Coordinator Nurse at Baystate Medical Center in Springfield, MA and Gina McConnell, ERAS Coordinator for all WakeMed health systems.

Enhanced Recovery After Surgery (ERAS) PART 1 | EBPOM USA - Chicago 2020 May 30, 2021

This piece is a two part conversation about the essence of what many of TopMedTalk's listeners do; Enhanced Recovery. A fascinating conversation between a number of experts in the field the conversation presented here was part of the hugely popular EBPOM Chicago 2020 meeting. For more on Evidence Based Perioperative Medicine (EBPOM) go to www.ebpom.org

This first part of the conversation covers what the main elements of an Enhanced Recovery After Surgery program entail, what literature our contributors favor and what service lines include enhanced recovery at their practice.

Presented by Desiree Chappell with Vicki Morton, Director of Clinical and Quality Outcomes at Providence Anesthesiology Associates, P.A, Cheryl Crisafi, Cardiac Surgery Care Coordinator Nurse at Baystate Medical Center in Springfield, MA and Gina McConnell, ERAS Coordinator for all WakeMed health systems.

Fit for surgery with Denny Levett | EBPOM World Congress 2020 May 29, 2021

How important is it to screen patients and measure their fitness prior to surgery? What is exercise training in the preoperative period?

There is a very clear relationship between physical fitness and mortality. Importantly, when we think of prehabilitation, or exercise training, it's good to remember that you get the greatest benefit in the most unfit patients, in terms of mortality reductions. The "pandemic ... of physical inactivity worldwide" is believed to cause more than 5 million deaths annually. The advantage of fitness in terms of predicting perioperative outcomes is it is an important modifiable risk factor before major surgery; we can modify health behaviors and exercise and we can sometimes optimize comorbidities before surgery. Exercise is real medicine!

Originally part of the hugely successful EBPOM Live from London 2020 conference this piece is nicely complimented by the panel discussion which TopMedTalk has also released free of charge here: https://www.topmedtalk.com/ebpom-london-2020-prehabilitation-update/

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.

Enabling Enhanced Recovery Part 2 | EBPOM 2020 May 28, 2021

"Accelerated surgery is not a panacea"

This piece, presented in two parts, is a discussion about enabling enhanced recovery. Originally part of EBPOM London this is an 'as live' discussion with four of the main presenters from the conference.

Get more detail on nutrition, hip fractures, psychological optimisation and discover both where the difficulties are and what opportunities they provide. For more of this sort of content go now to www.ebpom.org to find out more about how you can be part of Evidence Based Perioperative Medicine.

Presented by Professor Denny Levett and Jugdeep Dhesi with their guests P.J. Devereaux, cardiologist, clinical epidemiologist, and perioperative care physician, Professor in the Departments of Health Research Methods, Evidence, and Impact (HEI) and Medicine, Director of the Division of Perioperative Care, McMaster University, Associate Deputy Director of the Population Health Research Institute, President of the Society of Perioperative Research and Care, Chloe Grimmett, National Institute of Health Research (NIHR) post-doctoral Research Fellow and Senior Research Fellow for the Macmillan Survivorship Research Group at the University of Southampton, Dr Paul Wischmeyer, Professor of Anaesthesiology and Surgery at Duke Anesthesiology.

Enabling Enhanced Recovery Part 1 | EBPOM 2020 May 27, 2021

"Accelerated surgery is not a panacea"

This piece, presented in two parts, is a discussion about enabling enhanced recovery. Originally part of EBPOM London this is an 'as live' discussion with four of the main presenters from the conference.

Get more detail on nutrition, hip fractures, psychological optimisation and discover both where the difficulties are and what opportunities they provide. For more of this sort of content go now to www.ebpom.org to find out more about how you can be part of Evidence Based Perioperative Medicine.

Presented by Professor Denny Levett and Jugdeep Dhesi with their guests P.J. Devereaux, cardiologist, clinical epidemiologist, and perioperative care physician, Professor in the Departments of Health Research Methods, Evidence, and Impact (HEI) and Medicine, Director of the Division of Perioperative Care, McMaster University, Associate Deputy Director of the Population Health Research Institute, President of the Society of Perioperative Research and Care, Chloe Grimmett, National Institute of Health Research (NIHR) post-doctoral Research Fellow and Senior Research Fellow for the Macmillan Survivorship Research Group at the University of Southampton, Dr Paul Wischmeyer, Professor of Anaesthesiology and Surgery at Duke Anesthesiology.

Models of Prehabilitation | EBPOM 2020 May 26, 2021

This piece is an informative conversation about the models of prehabilitation from a number of different angles. Questions come in from an online audience as our panelists tackle the topic from their respective areas.

What are the risks and how are they mitigated? Where does your funding come from and why? How safe is iron for cancer patients?

The link to Safe Fit self referal is here: https://www.macmillan.org.uk/cancer-information-and-support/get-help/physical-help/safefit%20#refer_yourself_to_this_service

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 and Gerard Danjoux, consultant in Anaesthesia and Sleep Medicine at South Tees Hospitals NHS Foundation Trust with their guests John Moore, Clinical Director for Intensive Care at Manchester Royal Infirmary and Medical Lead for Enhanced Recovery After Surgery, Professor Sandy Jack, PhD, Consultant Clinician Scientist in The Anaesthesia and Critical Care Research Unit at University Hospital Southampton NHS Foundation Trust, Honorary Senior Lecturer at the University of Liverpool, University of Southampton and University College London and Rachel Barlow, National Lead, Enhanced Recovery, Prehabilitation and Optimisation, at Cardiff and Vale health board, Wales.

Monitoring and management of neuromuscular blockade | EBPOM USA - Chicago May 25, 2021

"In the United States approximately 112,000 patients annually are at risk for adverse events associated with discharge from the operating room with residual neuromuscular blockade"

This talk highlights the latest thinking on both monitoring and management of neuromuscular blockade. Where does the data lead us to? How big a problem do they suggest poor efficiency in this area is? What are the realities behind postoperative pulmonary complications? How can we reduce the risk of residual block?

Presented by Glenn Murphy, Jeffery S. Vender Chair of Anesthesiology Research and Education and Director of Cardiac Anesthesia and Clinical Research at NorthShore University HealthSystem, a hospital affiliated with the University of Chicago Pritzker School of Medicine.

Introducing 'The CSCS Beat' podcast | ERAS Cardiac May 24, 2021

"As a cardiac surgeon, I feel like I'm hearing more and more about ERAS than ever before"

"The CSCS Beat - more than just matters of the heart" is a fantastic new podcast from The Canadian Society of Cardiac Surgeons (CSCS); this piece sees TopMedTalk teaming up with them to tackle their first episode on the subject of Enhanced Recovery After Surgery and perioperative medicine.

What is ERAS? How is it being implemented? Why is it so successful?

If you'd like to hear more of "The CSCS Beat" their iTunes profile is here: https://podcasts.apple.com/ca/podcast/the-cscs-beat-more-than-just-matters-of-the-heart/id1559309108?l=fr

Presented by Ansar Hassan with his guests Desiree Chappell, lead presenter for TopMedTalk, Certified Registered Nurse Anesthetist (CRNA) and Vice President of Clinical Quality for NorthStar Anesthesia and Monty Mythen, TopMedTalk's Editor in Chief, Professor of Anesthesia and Critical Care at the University College London, co-president of the International Board of Perioperative Medicine and Rakesh C. Arora, Chief of Cardiac Surgery and a Critical Care specialist at St. Boniface hospital, Winnipeg, Manitoba, co-founder of the Canadian Cardiovascular Critical Care Society, President of the Canadian Society of Cardiac Surgeons and Dan Engelman, Medical Director of the Heart, Vascular and Critical Care Units at Baystate Medical Center, Associate Professor of Surgery at The University of Massachusetts-Baystate Medical School

Prediction of Opioid Induced Respiratory Depression on the General Care Floor: Does surveillance monitoring help? | EBPOM 2020 London May 23, 2021

This piece deals with the prediction of opioid induced respiratory depression for our inpatients on hospital wards, could a change in monitoring practices help? The postoperative period seems to be critical, the thirty day period immediately after anesthesia being a key area. 7.7% of postoperative deaths are in this period, according to The Lancet here; https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(18)33139-8/fulltext

What is happening in the post operative period? How do we find out more? Are hospital general care wards the safe haven we expect them to be? What should we monitor and how do we avoid "alarm fatigue"?

More on the "PRediction of Opioid-induced Respiratory Depression In Patients Monitored by capnoGraphY (PRODIGY)" trial here:

https://clinicaltrials.gov/ct2/show/NCT02811302

The official STOP BANG score website is here: http://www.stopbang.ca/osa/screening.php

This piece was sponsored by Medtronic.

This is part 1 of a two part piece.

Presented by Monty Mythen with Desiree Chappell and Ashish Khanna, Associate Professor, Section Head for Research, Department of Anesthesiology, Section on Critical Care Medicine,Wake Forest School of Medicine.

If you loved this piece you'll also enjoy this piece here:

Desiree’s Roundtable | Can you bite your upper lip? Assessing patients to reduce post-op respiratory complications

http://www.topmedtalk.com/desirees-roundtable-can-you-bite-your-upper-lip-assessing-patients-to-reduce-post-op-respiratory-complications-2/

Point of care Ultrasound in acute medical settings | EBPOM Ireland 2020 May 22, 2021

"Maybe it's time to evolve our practice"

Many believe ultrasound is an essential bedside tool which should be as common as the archetypal Doctor's stethoscope, with training made mandatory for all acute medicine specialists. This piece is structured as a debate where this point of view is advocated and debated.

Presented by Mark Edwards, Consultant in Anaesthesia and Perioperative Medicine at The University Hospital Southampton NHS Foundation Trust with Catherine Nix, Consultant Anaesthetist Intensivist at University Hospital Limerick, with panelists; Janette Brohan, Consultant in Anaesthesia and Intensive Care Medicine in Cork University Hospital, David Walker, Professor in Anaesthesia and Critical Care Medicine, University College London Hospitals, Honorary Senior Lecturer UCL, Kevin Murphy, Professor of Endocrinology & Metabolism at University College London, Ashley Miller, Intensivist at Shrewsbury and Telford Hospitals and Monty Mythen, Smiths Medical Professor of Anaesthesia and Critical Care, University College London.

Airway education during COVID19 and beyond | EBPOM Ireland 2020 May 21, 2021

This piece starts with the challenges faced by non-consultant hospital doctors (NCHD's) in this pandemic environment and the challenges of teaching novice anesthesiologists during COVID19. What insights can be gained from this high stress high demand environment where correct and comprehensive training is essential?

The conversation is then thrown out to a panel and questions are considered; what is the future of training, what have we learned and what must we prioritize in the near and long term future?

Chaired by Janette Brohan, Consultant in Anaesthesia Intensive Care Medicine in Cork University Hospital with an initial short presentation from Niamh McAuliffe Anesthesiologist in Cork University Hospital and featuring the following panellists; Viki Mitchell, consultant anaesthetist and divisional clinical director at University College London Hospitals, Brian O'Brien, Consultant in Anaesthesia and Intensive Care Medicine, at Cork University Hospital, where he is Chairman of Department, Ray O'Conner Consultant in Anaesthesia at Cork University Hospital and Monty Mythen, Smiths Medical Professor of Anaesthesia and Critical Care, University College London.

Methadone, 'the opioid sparing opioid' | EBPOM USA - Chicago May 20, 2021

"There is some great literature out there that has been shared ... great data, especially in cardiac surgery, which is where we are using it and I would like to expand it out to other service lines as well..."

Methadone has had something of a resurgence recently, thanks in part to the work of some of our contributors in this piece. Could it be that this "opioid sparing opioid" could be a way to actually help fight the crisis we can see in US hospitals and beyond?

This piece gets into the detail, how and where and why is it used?

Presented by Sol Aronson with questions from the online audience for his panelists; Glenn Murphy, Jeffery S. Vender Chair of Anesthesiology Research and Education and Director of Cardiac Anesthesia and Clinical Research at NorthShore University HealthSystem, a hospital affiliated with the University of Chicago Pritzker School of Medicine, Evan Kharasch, 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 and Vicki Morton Director of Clinical and Quality Outcomes at Providence Anesthesiology Associates, P.A.

We suggest listening to this piece alongside this excellent talk: https://www.topmedtalk.com/ebpom-chicago-methadone-use-in-perioperative-medicine/

This piece was originally part of EBPOM Chicago and is presented for the first time here exclusively to TopMedTalk listeners. For more details on Evidence Based Perioperative Medicine go now to www.ebpom.org

Monitoring and management of neuromuscular blockade - questions | EBPOM USA - Chicago May 19, 2021

This piece, part 2 of 2, is a series of questions related to part 1; "Monitoring and management of neuromuscular blockade | EBPOM Chicago".

This piece gets into the detail regarding one of the stand out moments of EBPOM Chicago 2020; questions from the online audience facilitate the discussion.

Given the fact that our methods of monitoring residual neuromuscular blockade are often inadequate do you transport and do you recommend routine transport to patients from the operating room to the post-anesthesia care unit?

Sugammadex is a unique drug that does exactly what we want it to do; why are alternatives still used and available?

Some wearables have accelerometer hardware, are you aware of, or do you know if anyone is studying, firm software solutions, marshaling this ubiquitous hardware?

Don't forget, for more details on Evidence Based Perioperative Medicine EBPOM conferences go now to www.ebpom.org

Presented by Sol Aronson, tenured Professor at Duke University, Glenn Murphy, Jeffery S. Vender Chair of Anesthesiology Research and Education and Director of Cardiac Anesthesia and Clinical Research at NorthShore University HealthSystem, a hospital affiliated with the University of Chicago Pritzker School of Medicine.

The Perioperative Care Team | EBPOM USA - Chicago May 18, 2021

This piece is an informative conversation about "the Perioperative Care Team"; who is essential to the team and how do we make sure everyone feels included? What elements do you need to make up such a team, how do you keep people energized and excited about it over the long term? How do we ensure, in this context, that a fee for service system interlocks with the needs of both the institution and its patients? Furthermore, how does such a team increase our commitment to value based care and good quality long term outcomes?

Also, an exciting commitment is made toward a journal club, stick with TopMedTalk for more details.

Presented by Vicki Morton with panelists Dennie Levett, Professor in Perioperative Medicine and Critical Care at Southampton University Hospital NHS Foundation trust and Honorary Associate Professor at the University of Southampton, Kay Mitchell, Senior Research Manager for Critical Care Research, NIHR Biomedical Research Center, University Hospital, Southampton, UK and Gina McConnell, ERAS Coordinator for all WakeMed health systems.

Redefining Hypotension based on Real-time Cerebral Autoregulation Monitoring | EBPOM USA - Chicago May 17, 2021

"If you want to take population based data, and define hypotension, you'll be right for the majority of our average patients, but not for all patients and it appears that the amount of time we spend below the lower limit of autoregulation has meaning for patient outcomes"

Starting from the origins of blood pressure monitoring, via the father of neurosurgery endocrinology, Harvey Cushing, through to the current debate as to what exactly constitutes hypotension this piece is an important part of a longstanding discussion here on TopMedTalk. How and why does hypotension occur and what is the correct evidence based strategy now the data are mounting as regards potential patient harm and unsatisfactory outcomes?

Presented by Charles Hogue, Professor and Chair of Anesthesiology at Northwestern University in Chicago.

The Business Case for Prehabilitation | EBPOM London May 16, 2021

"It was successful early on within the National Health Service.. [because] you could eliminate the cost of some unhelpful, unnecessary tests... referrals to other "-ologists"... in our system that works, because more work is just more work. It's not more money."

Is the business case for prehabilitation a "slam dunk", as some enthusiasts claim? If so how do you measure value versus volume, is value always a subjective term and can the balance between the two be addressed? How does the NHS's "internal market" compare to the US's fee for service environment? Furthermore, where are the sensible limits of prehabilitation, how far do we take it before we move forward to an operation?

This piece has been available to EBPOM London attendees since it was first recorded in the earlier part of the year. For exclusive access to other similar pieces now and in the future please visit www.ebpom.org

Presented by Monty Mythen and Kay Mitchell, Senior Research Manager for critical care research, NIHR Biomedical Research Centre, University Hospital Southampton, UK, with their guests, David Selwyn, Deputy Medical Director at Nottingham University Hospitals NHS Trust and Director of The Centre for Perioperative Care (CPOC), Sol Aronson, tenured Professor, Duke University and Jeff Vender, Emeritus, Harris Family Foundation Chairman of the Department of Anesthesiology at NorthShore University Health System, Evanston, Illinois and Clinical Professor at the University Of Chicago Pritzker School Of Medicine in Chicago, Illinois

Screening assessment of nutritional fitness | EBPOM 2020 London May 15, 2021

What do we mean by "nutritionally fit" and why does it matter? How do we identify those most at risk in terms of screening and assessment and what's the difference between these two processes? How can we use screening and assessment to triage patients into care? Also, in the time of COVID19, are there ways we can perform some tasks related to these processes remotely?

Presented by Steve Wooton, Senior Lecturer in Human Nutrition within Medicine at the University of Southampton.

EBPOM Chicago | Anemia Management May 14, 2021

"Studies suggest that even three fourths of patients may be anemic when they present for surgery and many of these patients are previously undiagnosed"

This common problem is known to cause issues both within the perioperative period and beyond. How can we manage this condition and where does the latest data lead us?

Following a presentation there is a panel discussion featuring questions from the EBPOM Chicago audience. Check out www.ebpom.org to find out how you can attend our online conferences.

Make sure you also check out the article mentioned in this piece here: https://pubs.asahq.org/anesthesiology/article/133/1/109/109133/An-Effective-and-Efficient-Testing-Protocol-for

If you enjoyed this piece we suggest you go here next:

TopMedTalk | Iron Man vs Anemia https://www.topmedtalk.com/topmedtalk-iron-man-vs-anemia/

Presented by Monty Mythen with Bobbie Jean Sweitzer, Professor of Anesthesiology and Associate Chair for Perioperative Clinical Practice at Northwestern University and Jeanna Blitz, Associate Professor of Anesthesiology, Director of the Preoperative Anesthesia and Surgery Screening Clinic, Director of Perioperative Medicine Fellowship at Duke University School of Medicine, Durham, North Carolina.

Brain Health: Frailty, Delirium and Post-operative cognitive dysfunction Part 2 | Chicago 2020 May 13, 2021

This piece gets deep into a much needed discussion regarding frailty, delirium, post-operative cognitive dysfunction and brain health. Noted as one of the highlights of the year in our recent holiday specials and previously only available to attendees to the incredibly successful EBPOM Chicago 2020; go to www.ebpom.org now for more details on forthcoming events and special offers now. This piece is part two of two.

This piece gets a mention "End of life decision planning in the perioperative setting: the elephant in the room?" https://academic.oup.com/bja/article/115/5/648/230412?login=true

The Global Council on Brain Health is here on the American Association of Retired People's website: https://www.aarp.org/health/brain-health/global-council-on-brain-health/

This is part one of a two part piece, part two features questions from the online conference audience.

Presented by Monty Mythen with Angela Bader, Professor of Anesthesia at Harvard Medical School and Vice Chair for Perioperative Medicine in the Department of Anesthesiology, Perioperative and Pain Medicine at Brigham and Women’s Hospital, founding Director of the Weiner Center for Preoperative Evaluation, Sarah Lenz Lock, Senior Vice President for Policy and Brain Health in the American Association of Retired People's (AARP) Policy, Research and International Affairs (PRI), Executive Director of the Global Council on Brain Health, Jeanna Blitz associate professor of Anesthesiology at Duke University School of Medicine, Director of the Preoperative Anesthesia Surgical Screening (PASS) Clinic. There's also a surprise appearance from the EBPOM Chicago 2020 host, Sol Aronson, tenured Professor at Duke University.

Brain Health: Frailty, Delirium and Post-operative cognitive dysfunction Part 1 | EBPOM USA - Chicago 2020 May 12, 2021

This piece gets deep into a much needed discussion regarding frailty, delirium, post-operative cognitive dysfunction and brain health. Noted as one of the highlights of the year in our recent holiday specials and previously only available to attendees to the incredibly successful EBPOM Chicago 2020; go to www.ebpom.org now for more details on forthcoming events and special offers.

This piece gets a mention "End of life decision planning in the perioperative setting: the elephant in the room?" https://academic.oup.com/bja/article/115/5/648/230412?login=true

The Global Council on Brain Health is here on the American Association of Retired People's website: https://www.aarp.org/health/brain-health/global-council-on-brain-health/

This is part one of a two part piece, part two features questions from the online conference audience.

Presented by Monty Mythen with Angela Bader, Professor of Anesthesia at Harvard Medical School and Vice Chair for Perioperative Medicine in the Department of Anesthesiology, Perioperative and Pain Medicine at Brigham and Women’s Hospital, founding Director of the Weiner Center for Preoperative Evaluation, Sarah Lenz Lock, Senior Vice President for Policy and Brain Health in the American Association of Retired People's (AARP) Policy, Research and International Affairs (PRI), Executive Director of the Global Council on Brain Health, Jeanna Blitz associate professor of Anesthesiology at Duke University School of Medicine, Director of the Preoperative Anesthesia Surgical Screening (PASS) Clinic. There's also a surprise appearance from the EBPOM Chicago 2020 host, Sol Aronson, tenured Professor at Duke University.

Frailty, Brain Health and Perioperative Cognitive Dysfunction | EBPOM USA - Chicago May 11, 2021

"Cognitive testing has been in the news ... there are recommendations for keeping pets mentally sound by implementing nutritional modifications, regular exercise and mental stimulation, we should certainly think about providing the same support to our geriatric patients."

What does the latest research say about this vital issue? How is frailty defined? What's the clinical impact of preoperative cognitive dysfunction?

Presented by Angela Bader, MD, MPH Professor of Anesthesia at Harvard Medical School and Vice Chair for Perioperative Medicine in the Department of Anesthesiology, Perioperative and Pain Medicine at Brigham and Women’s Hospital. She is also the founding director of the Weiner Center for Preoperative Evaluation.

For more on this subject check out this piece here: https://www.topmedtalk.com/poet-3-04-is-paternalism-always-bad/

Methadone use in Perioperative Medicine | EBPOM USA - Chicago May 10, 2021

This talk examines the rationale for using methadone in our surgical patient population, reviews clinical trials that assess the effect of intraoperative methadone on post operative outcomes and discusses some unanswered questions related to the administration of this long acting opioid in the perioperative period.

Presented by Glenn Murphy, Jeffery S. Vender Chair of Anesthesiology Research and Education and Director of Cardiac Anesthesia and Clinical Research at NorthShore University HealthSystem, a hospital affiliated with the University of Chicago Pritzker School of Medicine.

For more on the "opioid sparing opioid" go here: https://www.topmedtalk.com/ebpom-2019-methadone-the-overlooked-opiate-2/

The Future of Prehabilitation "Standardisation of definitions and outcomes" | EBPOM 2020 London May 09, 2021

"The main challenge around the variability in the perioperative period is nomenclature, definitions and standardized endpoints. Well designed and well conducted randomized control trials determine effectiveness to an unbiased comparison of outcomes, events, or endpoints between intervention groups".

If data is destiny it is to this that we must look if we want to understand what the future may hold for prehabilitation. This piece takes a pragmatic approach toward the task of ensuring information and datasets are widely applicable, as free from bias as possible and ultimately standardised by consistent definitions and terminology alongside a methodology which produces clear outcomes.

Find out more about the Comet Initiative here: https://www.comet-initiative.org/

Find more about the 'Standardised Endpoints in Perioperative Medicine-Core Outcome Measures in Perioperative and Anaesthetic Care (StEP-COMPAC) Group' here: https://www.comet-initiative.org/Studies/Details/1317

Presented by Malcolm West NIHR funded Clinical Lecturer in Surgery and Honorary colorectal surgical specialist registrar at the University of Southampton.

Getting "fit for surgery" | EBPOM 2020 London May 08, 2021

"In this session, we're going to talk about the importance of fitness, frailty, function and perioperative medicine."

Fitness, frailty and function are overlapping concepts. In the UK, about quarter of patients will be over the age of 65 by 2034. As patients age they may develop comorbidities. These factors combine to present a unique opportunity for the perioperative physician; fitness increases the chances of a positive outcome, time to ensure every patient is "fit for surgery".

The Making Every Contact Count (MECC) campaign is here: https://www.makingeverycontactcount.co.uk/

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.

Functional Assesment | EBPOM London 2020 May 07, 2021

"Perhaps assessing functional performance is something that we've overlooked in medicine"

This piece is about the role of functional assessment and status in perioperative medicine.

The Duke Activity Status Index (DASI) can be found here: https://www.mdcalc.com/duke-activity-status-index-dasi

The Mini Cog assessment is here: http://mini-cog.com/wp-content/uploads/2015/12/Mini-Cog-Form-010816.pdf

The video resources mentioned in the piece are here: https://www.youtube.com/channel/UCvOamR8Sb4RXENr56fvRehA/featured

Presented by Daniel Conway, Consultant in Anaesthesia and Critical Care, Group Lead for Perioperative Medicine, Manchester Royal Infirmary, UK and Chair of the Manchester Perioperative Medicine Society.

Nutrition and metabolism before surgery - PART 2 of 2 | EBPOM London 2020 May 06, 2021

"I hope to impress upon you that this is a topic that we can and must do better at ... no malnourished patient should ever have elective surgery without having a nutrition assessment done"

This piece is presented in two parts; this is part 2.

Using perioperative nutrition to optimize our patients outcomes; data shows us that nutrition therapy or nutrition optimization is literally life saving. Anyone who uses evidence as their guide know it has to be part of their practice.

Enhanced Recovery After surgery, sometimes called "fast track surgery" is about ensuring we apply the best information we have to the process. This talk focuses on how and why this ties into a sensible attitude towards nutrition and nutritional assessment.

This talk pulls no punches and yet is powerfully optimistic in its message. We implore TopMedTalk listeners to share it with colleagues.

The entertaining audio clips used in this piece are available, with video and in full here: https://www.youtube.com/watch?v=zHEincgSm1k&t=190s

Our speaker kindly shares his email address for further correspondence and questions: paul.wischmeyer@duke.edu

Presented by Paul Wischmeyer, Professor of Anaesthesiology and Surgery at Duke Anesthesiology.

Nutrition and metabolism before surgery - PART 1 of 2 | EBPOM London 2020 May 05, 2021

"I hope to impress upon you that this is a topic that we can and must do better at ... no malnourished patient should ever have elective surgery without having a nutrition assessment done"

This piece is presented in two parts; this is part 1.

Using perioperative nutrition to optimize our patients outcomes; data shows us that nutrition therapy or nutrition optimization is literally life saving. Anyone who uses evidence as their guide know it has to be part of their practice.

Enhanced Recovery After surgery, sometimes called "fast track surgery" is about ensuring we apply the best information we have to the process. This talk focuses on how and why this ties into a sensible attitude towards nutrition and nutritional assessment.

This talk pulls no punches and yet is powerfully optimistic in its message. We implore TopMedTalk listeners to share it with colleagues.

The entertaining audio clips used in this piece are available, with video and in full here: https://www.youtube.com/watch?v=zHEincgSm1k&t=190s

Our speaker kindly shares his email address for further correspondence and questions: paul.wischmeyer@duke.edu

Presented by Paul Wischmeyer, Professor of Anaesthesiology and Surgery at Duke Anesthesiology.

Models of Prehabilitation in Greater Manchester | EBPOM 2020 London May 04, 2021

It's widely understood that high value care during, before and immediately after surgery is optimal whereas poor quality care in the perioperative period produces long term difficulties which are compounded by the acute stresses produced during and immediately after a procedure. This talk covers three main areas; surgical care for patients in Greater Manchester, "ERAS+"; prehabilitation for cancer, for the population of Greater Manchester; how Manchester has supported patients during the time of COVID19.

This piece is mentioned in the introduction and serves as a useful compliment to the talk, "Implementing a system-wide cancer prehabilitation programme: The journey of Greater Manchester's ‘Prehab4cancer’": https://www.ejso.com/article/S0748-7983(20)30438-8/fulltext

Find out more about the work in Greater Manchester here: https://gmcancer.org.uk/our-areas-of-work/prehab4cancer-2/

Also the Perioperative Quality Improvement Programme is here: https://pqip.org.uk/content/home

Presented by Dr. John Moore, Clinical Director for Intensive Care at Manchester Royal Infirmary and Medical Lead for Enhanced Recovery After Surgery.

Perioperative team: a surgeon’s view | EBPOM London 2020 May 03, 2021

This piece looks at some of the advantages to having a perioperative interdisciplinary team reducing complications, understanding and discussing risk, facilitating better shared decision making and increased patient satisfaction, even among those who - as part of this process - decide not to go ahead with an operation.

It also incorporates evidence regarding what we know about COVID-19; "The risks ... of the COVID-19 virus is that if people contract it during or after their surgery, they have a much worse result with perhaps 51% pulmonary complications or 24% mortality".

The World Health Organisation report mentioned in this piece, "Smoking greatly increases risk of complications after surgery", is here: https://www.who.int/news/item/20-01-2020-smoking-greatly-increases-risk-of-complications-after-surgery

The Montgomery ruling is covered on a previous TopMedTalk in more detail in "Sunday Special | Being on the right side of the law" here: https://www.topmedtalk.com/sunday-special-being-on-the-right-side-of-the-law-2/

The Centre for Perioperative Care website is an excellent resource, here is the section specifically for your patients: https://www.cpoc.org.uk/patients

The Royal College of Surgeons is here: https://www.rcseng.ac.uk/

Our presenter has a website dedicated to her work here: http://www.scarlettmcnally.co.uk/

And she maintains a twitter feed - focused on medical issues - here: https://twitter.com/scarlettmcnally

Presented by Scarlett McNally, Deputy Director of The Centre for Perioperative Care (CPOC) consultant Orthopaedic Surgeon, Eastbourne DGH, UK.

Introduction to the Pathophysiology of COVID 19 | EBPOM Ireland 2020 May 02, 2021

This piece is essential listening for any medical practitioner. The pathophysiology of COVID 19 is now being understood, although there are still a number of outstanding questions. This piece attempts to answer those questions; where does it come from, what do we know about it now, what would we like to know about it in the future?

Why is the disease more pronounced in men, how come obesity seems to be a factor, what's the mechanism which leaves children less at risk than adults and senior citizens?

This piece is a standout part of Evidence Based Perioperative Medicine's (EBPOM) Dingle 2020 conference. For more of the latest up to date information go now to www.ebpom.org

Presented by Hugh Montgomery, Professor of Cardiovascular Genetics and Critical Care University College London.

Depth of anaesthesia and long term outcomes | EBPOM Ireland 2020 May 01, 2021

"More than 300 million patients have surgery annually worldwide and an increasing proportion of them are elderly and at risk of perioperative adverse events. There's very few proven primary or secondary prevention measures, and the resources for monitoring and trading complications are inadequate. So - more action is required".

This piece looks at the evidence as regards perioperative outcomes for the elderly, depth of anesthesia and mortality. Also, what's the latest on depth of anesthesia and delirium?

Presented by Kate Leslie, Honorary Professor, Monash University, Melbourne, VIC, Australia, Specialist Anaesthetist, The Royal Melbourne Hospital & North Western Mental Health and Non-Executive Director, Australian Medical Council.

The Changes that Change Culture - panel discussion | EBPOM USA - Chicago Apr 30, 2021

This panel discussion covers essential ground for any institution that is trying to make real and lasting change. What do we need to know? What do our patients need to know? Who is responsible for questions of safety? How important are checklists? What about "patient advocates"?

Presented by Sol Aronson with Mike Ramsey, Chair of the department of Anesthesia and pain management at the Baylor University Medical Center in Dallas and Board Chair of the Patient Safety Movement Foundation, Lee Fleisher, CMO and director for the Center for Clinical Standards and Quality for the centers of Medicare and Medicaid, Sarah Lenz Lock, Senior Vice President for Policy Research and International Affairs for the AARP, Lili Brillstein, Director of Specialty Care Value Based Models for Horizon Blue Cross Blue Shield of New Jersey and Monty Mythen, Smiths Medical Professor of Anaesthesia and Critical Care at University College London.

Video Laryngoscopy During Covid-19 | EBPOM London 2020 Apr 29, 2021

How have we adapted in our views on the use of video laryngoscopy during the Covid-19 pandemic? Who is best suited to intubate? Are we seeing "a poorly managed first wave"? How are practitioners changing their approach in light of the possibility of infections? What lessons are being learned by practitioners in the midst of the COVID crisis?

This piece was generously supported by Medtronic.com

Presented by Desiree Chappell with Monty Mythen and her guests, Patrick Schoettker, Professor of Anesthesia and Emergency Medicine at Lausanne University Hospital, Sol Aronson, tenured Professor, Duke University, Henry Howe, Junior Doctor, NHS England and TopMedTalk team member.

Perioperative Medicine - where we were, where we are now and where want to be P2 | EBPOM Ireland 2020 Apr 28, 2021

This piece is a worthwhile deep dive into this perioperative medicine and how we go forward with it. Hear the panel speak about what it is they want for the future and what it is they are doing now. With questions submitted from the online audience the panel get into the detail. Essential listening for any student of perioperative medicine.

It includes a mention for the Welsh Perioperative Medicine Society, their website is here: https://www.welshpoms.com/

This is part two of a two part piece of the same name.

Presented by David Walker, Professor in Anaesthesia and Critical Care Medicine, University College London Hospitals, Honorary Senior Lecturer UCL, Kim Caulfield, Perioperative Medicine Fellow, University College London Hospitals NHS Foundation Trust, Mike Grocott Professor of Anaesthesia and critical care at the University of Southampton, Aislinn Sherwin, a Fellow in Perioperative Medicine and Onco-Anaesthesia at the Peter MacCallum Cancer Centre, Melbourne, Roisin Coary, final year SpR in Geriatric and General Internal Medicine, with a specialist interest in Peri-operative Medicine, Dublin Ireland and Isra Hassan, a post-CCT Perioperative Medicine Fellow at the University College of London Hospital she co-founded the Welsh Perioperative Medicine Society in 2018 which now has over 100 members, and to date has delivered two national conferences, Andrea Haren, perioperative medicine fellow at UCLH she worked with Guys and St Thomas' working with the POPS Clinic she is currently a locum consultant anaesthetist at St. Vincent's Hospital in Dublin and Pádraig Ó Scanaill, Locum Consultant Anaesthetist at the Mater Misericordiae University Hospital, Dublin.

Cryoneurolysis and pain management | TopMedTalk Apr 27, 2021

"We've been doing cryoneurolysis for total knees now for three years... people gravitate to practices that that practice this technology"

This piece focuses upon two 'early adopter' orthopedic surgeons changing up the way we treat joint pain for surgical patients.

We mention Iovera, a provider at the forefront of this technology: https://www.iovera.com/

The Doc Social website is here: www.doc.social/

The Evidence Based Perioperative Medicine (EBPOM) website is here: www.ebpom.org

This piece also features important news for TopMedTalk fans as, towards the end, we explain how your favorite perioperative podcast is asking listeners for feedback and thoughts. Email contact@topmedtalk.com

Presented by Desiree Chappell and Monty Mythen with their guests Vinod Dasa, Vice Chairman of Academic Affairs, Irv Cahen Chair of Orthopaedic Surgery and Research, Co-Director LSU Musculoskeletal Research Consortium and Josh Urban, board-certified orthopedic surgeon, OrthoNebraska, Omaha, Nebraska.

Perioperative Medicine - where we were, where we are now and where want to be P1 | EBPOM Ireland 2020 Apr 26, 2021

This piece is a worthwhile deep dive into this perioperative medicine and how we go forward with it. Hear the panel speak about what it is they want for the future and what it is they are doing now. With questions submitted from the online audience the panel get into the detail. Essential listening for any student of perioperative medicine.

When should we pre-assess patients? Should all anaesthetists be doing pre-operative sessions? What is it about the role of the anaesthestist that makes it uniquely suited to the discipline of perioperative medicine?

This is part one of a two part piece of the same name.

Presented by David Walker, Professor in Anaesthesia and Critical Care Medicine, University College London Hospitals, Honorary Senior Lecturer UCL, Kim Caulfield, Perioperative Medicine Fellow, University College London Hospitals NHS Foundation Trust, Mike Grocott Professor of Anaesthesia and critical care at the University of Southampton, Aislinn Sherwin, a Fellow in Perioperative Medicine and Onco-Anaesthesia at the Peter MacCallum Cancer Centre, Melbourne, Roisin Coary, final year SpR in Geriatric and General Internal Medicine, with a specialist interest in Peri-operative Medicine, Dublin Ireland and Isra Hassan, a post-CCT Perioperative Medicine Fellow at the University College of London Hospital she co-founded the Welsh Perioperative Medicine Society in 2018 which now has over 100 members, and to date has delivered two national conferences, Andrea Haren, perioperative medicine fellow at UCLH she worked with Guys and St Thomas' working with the POPS Clinic she is currently a locum consultant anaesthetist at St. Vincent's Hospital in Dublin and Pádraig Ó Scanaill, Locum Consultant Anaesthetist at the Mater Misericordiae University Hospital, Dublin.

Perioperative Medicine - Editor's top picks for last year | EBPOM USA - Chicago Apr 25, 2021

In this piece you can hear the co-editors of the Journal of Perioperative Medicine describing this year's "Editor's Picks"; the best manuscripts, literature and lessons learned in the last year in the space of perioperative medicine.

"Functional performance and 30-day postoperative mortality after emergency laparotomy—a retrospective, multi-center, observational cohort study of 1084 patients" is here: https://perioperativemedicinejournal.biomedcentral.com/articles/10.1186/s13741-020-00143-7

There is more information about the Eastern Cooperative Oncology Group (ECOG) here: https://ecog-acrin.org/resources/ecog-performance-status

"A randomised trial of non-invasive cardiac output monitoring to guide haemodynamic optimisation in high risk patients undergoing urgent surgical repair of proximal femoral fractures (ClearNOF trial NCT02382185)" is here: https://perioperativemedicinejournal.biomedcentral.com/articles/10.1186/s13741-019-0119-x

"The effect of virtual reality technology on preoperative anxiety in children: a Solomon four-group randomized clinical trial" is here: https://perioperativemedicinejournal.biomedcentral.com/articles/10.1186/s13741-019-0116-0

Presented by Mike Grocott, Professor of Anaesthesia and Critical Care at the University of Southampton and a Consultant in Critical Care Medicine at University Hospital Southampton NHS Foundation Trust with his guests Clifford Ko, Professor of Surgery at UCLA, Director of the Division of Research and Optimal Patient Care at the American College of Surgeons and Lee Fleisher, Professor of Anesthesiology and Critical Care, University of Pennsylvania.

Originally part of the hugely successful EBPOM 2020 Chicago this piece is introduced by Sol Aronson, tenured Professor at Duke University.

Models of perioperative care "the science of value" | EBPOM USA - Chicago 2020 Apr 24, 2021

This piece is part one of a two part piece. It's a short didactic presentation on the tough realities the U.S. healthcare system faces as the fee for payment system creaks against concerns about rising costs and the need for population health management.

Can we move forward with "the science of value" which true perioperative medicine offers us?

It's a talk which is designed to spark debate and that follows in part two of this piece.

Presented by Sol Aronson, tenured Professor, Duke University, Durham, North Carolina.

Total ERAS is essential to clear the backlog | TopMedTalk Apr 22, 2021

"Data is key and having champions is key"

This piece provides a truly transatlantic in-depth perspective on an area of opportunity highlighted by our needs in the wake of COVID 19; now more than ever true enhanced recovery after surgery (ERAS) is essential. Optimising value, reducing the need for return visits, decreased length of stay, there is almost no aspect of perioperative medicine and enhanced recovery that is not going to be crucial for our institutions in the near and present future. A data driven approach makes it clear, there is no other way forward.

Also in this podcast a fascinating dive into one of our favorite topics, goal directed fluid management. How have the terms "restricted" and "liberal" evolved over the years? What should we make of the new evidence that ha come in over the last few years?

Hear how these challenges are being met in this exclusive conversation, generously supported by Deltex Medical.

Presented by Desiree Chappell and Monty Mythen with their guest Michael Scott, M.B., Ch.B. Professor of Anesthesiology at the University of Pennsylvania

Perioperative Frailty with Jude Partridge | EBPOM 2020 London Apr 22, 2021

"If I were to develop a simple uncomplicated urinary tract infection, I may well be able to continue to go to work as I was being treated for that illness but if an older frail patient develops a similar uncomplicated urinary tract infection, that can be a very significant illness, that patient may well be unable to walk or transfer as they could"

Frailty in the perioperative period - what is it, what is it not and how do we work with and manage it before, during and after an operation so as to increase the value of care to our patients?

The opening article refered to in this piece is here: https://journals.sagepub.com/doi/full/10.1177/1756287220916614

The British Geriatrics Society "Fit for Frailty" document is here: https://www.bgs.org.uk/resources/resource-series/fit-for-frailty

More information on Perioperative medicine for older people undergoing surgery (POPS), an award winning geriatrician led service and the first of its kind in the UK, go here: https://www.guysandstthomas.nhs.uk/our-services/ageing-and-health/specialties/pops/overview.aspx

Presented by Jude Partridge, consultant geriatrician POPS, honorary senior lecturer, King's College London, Chairs the British Geriatrics Society POPS SIG.

SNAP-2 EPICCS; summary results | EBPOM London 2020 Apr 21, 2021

"It's useful to reflect on what SNAP-2 EPICCS might offer us in the brave new world that we find ourselves in with Coronavirus"

The 2nd Sprint National Anaesthesia Project: Epidemiology of Critical Care after Surgery (SNAP-2 - EPICCS) study launched in March 2017 around the UK. More than 2,200 investigators at more than 250 sites across the UK were signed up to take part. The observational study collected data on all patients undergoing inpatient surgery during a one-week period (21 March to 27 March) in UK NHS hospitals.

What is the scale of the problem; when it comes to cancellation of inpatient surgery surgery, with a specific lens on critical care capacity? What about the value of higher levels of post operative care for high risk surgical patients? What are the essential ingredients for higher intensity post operative care?

Also, learn about some of the organically developed solutions that have come around to capacity issues for high risk surgical patients in the NHS and overseas. As well as this hear how we might select patients to be admitted to higher levels of care; the methods that we might use for risk stratification of inpatient surgical patients and what we think the potential benefits of post operative high levels of care could be. Do we have any data to support the notion that critical care confers benefits on post surgical patients?

The website is here: https://www.niaa-hsrc.org.uk/SNAP-2-EpiCCS

More on SNAP-2 is here: https://www.topmedtalk.com/what-is-snap-2/

Presented by Ramani Moonesinghe, OBE, Professor of Perioperative Medicine at University College London (UCL), Hon Consultant in Anaesthesia, UCLH.

Patient Safety: How do you make the Changes that Change Culture? | EBPOM USA - Chicago 2020 Apr 20, 2021

Patient safety, as a priority, is assumed to be at the heart of medical practice. Yet still, preventable harm and death occurs in our profession, how do we change this and how do we make the changes we implement last? Can safety and avoidable harm be somehow hardwired into the culture of what we do in a way similar to that of the airline industry?

This popular and refreshing talk is presented here after it was a big hit at the Chicago 2020 conference organised by Evidence Based Perioperative Medicine (EBPOM). For more check out www.ebpom.org

Presented by Mike Ramsey, Chair of the Board of Directors of the Patient Safety Movement Foundation (PSMF), Chair of the Department of Anesthesiology at Baylor University Medical Center in Dallas, Texas.

Roundtable discussion: Delivering value | EBPOM USA - Las Vegas 2021 Apr 19, 2021

This roundtable discussion tackles questions from the online audience and is the third part of a longer discussion. It follows on from "The value proposition in perioperative medicine | EBPOM 2021 Las Vegas", if you'd like to hear that go here: https://topmedtalk.libsyn.com/the-value-proposition-in-perioperative-medicine-ebpom-2021-las-vegas

How do we as practitioners deliver value? How does 'population health' fit into the picture? How long before and after surgery are we invested in managing? What's the key point to start a perioperative medicine program in a low income country with no incentives at all; how do you approach the hospital financial department?

Presented by Desiree Chappell, introducing her panelists Linda Groah, CEO, Executive Director of the Association of periOperative Registered Nurses (AORN) and Amy Stout, Operating Partner at Cranemere and Interim President of Clinical Services at NorthStar; alongside contributions from additional contributors from the previous session, Jim Grant, Senior Vice President and Chief Medical Officer at Blue Cross Blue Shield of Michigan and Mike Englesbe, Darling Sr. & Cyrenus G. Darling Jr. Professor of Surgery, Michigan.

The value proposition in perioperative medicine | EBPOM USA - Las Vegas 2021 Apr 18, 2021

"Look at it from where is the patient, and what's best for the patient; I think that the other answers follow and yes, it is higher quality, yes, there can be some opportunities for cost savings; even if it 'breaks even' if the patients are happier, isn't that worth moving into the concept and proving that it does make a difference?"

The value proposition is an essential element of advocating perioperative care; we know it provides safer, better quality outcomes but how do we translate that into a language that both patients, fee payers and providers can all understand?

This piece follows on from "The size and scope of the problem with Jim Grant & Mike Englesbe | EBPOM 2021" Las Vegas, if you'd like to hear that go here: https://topmedtalk.libsyn.com/the-size-and-scope-of-the-problem-with-jim-grant-mike-englesbe-ebpom-2021-las-vegas

Presented by Desiree Chappell, introducing her panellists Linda Groah, CEO, Executive Director of the Association of periOperative Registered Nurses (AORN) and Amy Stout, Operating Partner at Cranemere and Interim President Clinical Services at NorthStar; alongside contributions from additional contributors from the previous session, Jim Grant, Senior Vice President and Chief Medical Officer at Blue Cross Blue Shield of Michigan and Mike Englesbe Darling Sr. & Cyrenus G. Darling Jr. Professor of Surgery, Michigan.

The size and scope of the problem with Jim Grant & Mike Englesbe | EBPOM USA - Las Vegas 2021 Apr 17, 2021

"When I heard Sol Aronson, speak about perioperative medicine as 'population health', for me, it was like a eureka moment because our platform within Michigan is really an unmatched place to kind of realize that vision."

This piece asks the question; "why do we need perioperative medicine"? The answer is illustrated with a real success story where practitioners realise the value proposition it unlocks for their patients every day. Hear how it is achieved and why it is so important.

Presented by Desiree Chappell with her guests Jim Grant, Senior Vice President and Chief Medical Officer at Blue Cross Blue Shield of Michigan and Mike Englesbe, Darling Sr. & Cyrenus G. Darling Jr. Professor of Surgery, Michigan.

If you enjoyed this piece you'll love TopMedTalk's exclusive and ground breaking series POET: Perioperative Enhancement Team "Perioperative medicine is population health": https://topmedtalk.libsyn.com/poet-601-perioperative-medicine-is-population-health

Am I safe? Q&A with Lee Fleisher | | EBPOM World Congress 2020 Apr 16, 2021

This question and answer session was a highlight of EBPOM London 2020, it works as a standalone piece or as a companion piece to this talk here: https://topmedtalk.libsyn.com/ebpom-2020-london-am-i-safe

The discussion follows themes outlined in the presentation as our online audience asked a series of questions.

Some of the questions included in the discussion are "How should leaders deal with anxiety both in themselves and their team? What is the evidence on perceived command gradient in residents and the fear of looking inadequate in front of peers and superiors? Bad for patients, versus bad for me? The people at the top end, the older people within an organization, are often the most resistant to culture change, yet they have the most influence over culture, any advice? What defines the people who are ready for change?"

Conversational in tone this piece was first heard on the "TopMedTalk stage" at Evidence Based Perioperative Medicine (EBPOM) for more details go now to www.ebpom.org

Presented by Monty Mythen and Desiree Chappell with Lee Fleisher, Emeritus Professor of Anesthesiology and Critical Care, University of Pennsylvania.

Daniel Engelman Q&A | EBPOM USA - Chicago Apr 15, 2021

"So in all these ERAS programs, you need a physician champion, a nurse champion, a coordinator; then we brought our pharmacist in - I will not start rounds without a pharmacist. I refuse. I won't start because the pharmacist is integral ... it's just you need that multidisciplinary team"

This piece is a question and answer session prompted by the address our guest gave during EBPOM Chicago. Both the online audience and the team challenge our speaker to explain more. If you missed the address TopMedTalk has it for you here: https://topmedtalk.libsyn.com/daniel-engelman-updates-in-cardiac-ebpom-chicago

Presented by Desiree Chappell and Monty Mythen with Daniel Engelman, Cardiac Surgeon, Medical Director of the Heart, Vascular and Critical Care Units at Baystate Medical Center, Associate Professor of Surgery at The University of Massachusetts - Baystate, Associate Professor-Adjunct at Tufts University School of Medicine. He president and co-founder of the ERAS® Cardiac Society.

Postoperative critical care: How do we help? | EBPOM World Congress 2020 Apr 14, 2021

This piece is a question and answer session with questions from the online audience.

What do we think is the clinical care difference that having an elevated level of monitoring and more people around of all all sorts? Why is it good for our patients? As regards admissions to your campus care area; what criteria do you use? Do we need rapid critical care expansion in countries with very few beds? Could the enhanced care wards, in their approach, be compared with the post anaesthetic care unit? Would you cancel or postpone a cancer patient's operation, if not enhanced care or post operative critical care bed available? If you feel it is essential, if you feel the operation essential?

Presented by Mike Grocott, Professor of Anaesthesia and Critical Care at the University of Southampton and Lee Fleisher, Emeritus Professor of Anesthesiology and Critical Care, University of Pennsylvania with Ramani Moonsinghe, Professor of Perioperative Medicine at University College London (UCL), Hon Consultant in Anaesthesia, UCLH, Mike Swart, Consultant in Anaesthesia and Critical Care Medicine at Torbay Hospital and advisor to the UK Department of Health for the Enhanced Recovery Programme and Anna Batchellor, trained in anaesthesia and Intensive Care Medicine (ICM) she works in Newcastle upon Tyne; past President of the Intensive Care Society, past Dean of the Faculty of ICM, past member of Council of the Royal College of Anaesthetists. She tried to retire in June 2016 and managed to spend a year working part time before being hijacked by the Getting It Right First Time (GIRFT) programme.

Perioperative team: a physician’s view | EBPOM 2020 London Apr 13, 2021

This piece considers the need to understand the patient having surgery and the complexity with which they present so we can match our skills to them. Developing these skills requires new approaches; to education and training at undergraduate and postgraduate level; to challenge the old ways of delivering perioperative care. This requires new ways of working, the breaking down of silos, a rethink of the financial support that is required and that we share good practice rather than 'reinventing the wheel'. It also means ensuring that we continue to gain evidence from the real world of clinical medicine, whether that's through original research or through employing quality improvement and implementation science.

More on Proactive care for Older People undergoing Surgery (POPS) here: https://www.guysandstthomas.nhs.uk/our-services/ageing-and-health/specialties/pops/overview.aspx

If you enjoy this piece you'll love our series here: "POPS Part 1| TopMed talk at Guy’s and St Thomas’s Hospital in Central London" - https://www.topmedtalk.com/pops-part-1-topmed-talk-at-guys-and-st-thomass-hospital-in-central-london/

Presented by Jugdeep Dhesi, Clinical Lead for "Proactive care for Older People undergoing Surgery" (POPS) and Consultant Geriatrician, Guys and St Thomas' NHS Trust.

Leadership with Jeff Vender: Part 2 - Q&A | EBPOM USA - Chicago Apr 12, 2021

This piece is the second part of a conversation about leadership in medicine, during times of change. It follows on from the first part where our speaker outlines his thoughts in a short talk. Now questions from the audience are considered and the conversation develops. What have we learned after the recent huge changes we've seen in our profession?

Presented by Desiree Chappell and Monty Mythen with Jeff Vender, Emeritus, Harris Family Foundation Chairman of the Department of Anesthesiology at NorthShore University Health System, Evanston, Illinois and Clinical Professor at the University Of Chicago Pritzker School Of Medicine in Chicago, Illinois.

Leading Health Systems in times of change with Jeff Vender: Part 1 | EBPOM USA - Chicago Apr 11, 2021

"I believe most people can be leaders or better leaders. You can create or participate in change and a better future. You can make a difference in your own lives, the lives of others and the life of your organization. If you believe you can."

This piece contains a powerful, inspirational and prescient talk about leadership. Part 1 contains some conversation and the talk, to be followed by questions from the audience in Part 2. Where do leaders come from, what makes them stand out and how do they learn the skills necessary to take what they do to the next level?

Presented by Desiree Chappell and Monty Mythen with Jeff Vender, Emeritus, Harris Family Foundation Chairman of the Department of Anesthesiology at NorthShore University Health System, Evanston, Illinois and Clinical Professor at the University Of Chicago Pritzker School Of Medicine in Chicago, Illinois.

EBPOM 2020 London | "The Business Case: UK" by Kay Mitchell Apr 10, 2021

This piece presents an invaluable wealth of first hand experience in setting up various business cases in relation to perioperative medicine in the UK. At University College London (UCL) cardiopulmonary exercise testing (CPET) was set up as a research tool "but then clinicians came, became interested in the results of the tests and started to ask for tests to be done on their patients for clinical evaluation".

An external contractor model, using a charitable organisation, enabled them to charge the NHS for these tests; as the service expanded they were able to expand to other clinical sites connected with UCL, published early data on outcomes and obtained grant funding to look at a robust evaluation model.

Hear how this model was refined and the idea has evolved during its growth within the UK's National Health Service (NHS). Also, consider what other models could apply this thought process; learn how new perioperative care pathways offer interesting opportunities in these areas.

This piece is further enhanced by the discussion we released recently on the same topic: https://www.topmedtalk.com/ebpom-london-2020-the-business-case-for-prehabilitation/

Presented by Kay Mitchell, Senior Research Manager for Critical Care Research, NIHR Biomedical Research Center, University Hospital, Southampton, UK.

EBPOM 2020 London | Extending roles: what is the future? Apr 09, 2021

"Just having more staff doesn't always equate to better care, especially when the staff do not have the skills required."

Perioperative medicine has the opportunity to lead the way in advanced practice; the extended role of the practitioner within the perioperative pathway can be done with nurses, allied health professionals or physician associates. As we evolve these roles, we must be mindful and recognise not all services will be the same.

How can you tailor your service to your specific needs? How do you construct a business case which provides a better quality of value based care within your institution? Could this help by giving the practitioner role focus and allowing you to measure their effectiveness?

For more information about Guy's and St Thomas's practice we suggest you look at their website, an excellent information resource, here: https://www.guysandstthomas.nhs.uk/our-services/ageing-and-health/specialties/pops/overview.aspx

Presented by Jason Cross, Advanced Nurse Practitioner, Department of Aging and Health, Guy's and St Thomas's, London.

Opioid-induced Respiratory Depression | EBPOM USA - Las Vegas 2021 Apr 08, 2021

"46% pretty much means every other patient who was getting IV opioids was having some sort of a respiratory depression event"

After a quick round up of COVID news in the contributor's respective areas this piece gets involved in a much needed discussion about the “PRediction of Opioid-induced Respiratory Depression In Patients Monitored by capnoGraphY (PRODIGY)” trial.

PRODIGY trial is here:

https://clinicaltrials.gov/ct2/show/NCT02811302

Presented by Desiree Chappell and Monty Mythen with Mike Grocott, and their guests Ashish Khanna, Associate Professor, Section Head for Research, Department of Anesthesiology, Section on Critical Care Medicine, Wake Forest School of Medicine and Roop Kaw, Associate Professor of Medicine at Cleveland Clinic, Founder Member of The Society of Anesthesia and Sleep Medicine.

As mentioned TopMedTalk have been eagerly following the development of this research, you might also enjoy this piece we did here: https://www.topmedtalk.com/ebpom-2020-london-prediction-of-opioid-induced-respiratory-depression-on-the-general-care-floor-does-surveillance-monitoring-help/

More discussion regarding risk factors for opioid-induced respiratory depression in surgical patients here: https://www.topmedtalk.com/topmedtalks-to-paul-grant-2/

Non-invasive evaluation of autonomic nervous system- A nociception monitor (REPEAT) | EBPOM USA - Las Vegas 2021 Apr 07, 2021

Armed with a background in biomedical engineering, doubled with an EMBA in Finance, our guest has spent the past 20 years within the medical device industry. In 2010 he was instrumental in setting up MDoloris Medical Systems, with the mission to provide technologies that allow clinicians a reliable, continuous and non-invasive evaluation of autonomic nervous system (ANS) activity. Based on 23 years of academic research, performed by a French research lab, the technology allows anaesthetists and intensivists to effectively tailor analgesia; more so for patients who are unable to communicate.

The technology is available for adults, paediatrics, neonates as well as animals (specifically horses, cats and dogs), in both standalone and more recently modular format.

Presented by Desiree Chappell and Monty Mythen with their guest Fabian Pagniez, CEO and founder of MDoloris Medical Systems.

For more details on EBPOM please visit www.ebpom.org

Also, if you enjoyed this piece we cover nociception in more detail here: https://www.topmedtalk.com/topmedtalks-to-dan-longrois-on-nociception/

Guidance on prehabilitation for cancer | EBPOM London 2020 Apr 06, 2021

This piece looks at the most recent guidance regarding prehabilitation for cancer, developed and published in 2009 by Macmillan Cancer Care. Extremely well received across the UK, and internationally, here we look at the details and some context in terms of UK national policy.

From an NHS England point of view the desire is to ensure that all patients and participants have personalized care embedded into everyday NHS services. Work around streamlining multidisciplinary team meetings for cancer include the opportunity to discuss the needs of people with cancer and the importance of preparing people in advance and during treatment. Furthermore you will hear elements of the principles of rehabilitation, as well as the importance of earlier and faster diagnosis, the importance of perioperative medicine and prehabilitation before surgery.

Further reading here "Principles and guidance for prehabilitation": https://www.macmillan.org.uk/about-us/health-professionals/resources/practical-tools-for-professionals/prehabilitation.html

Originally part of the hugely successful EBPOM Live from London 2020 conference this piece is nicely complimented by the panel discussion which TopMedTalk has also released free of charge here: https://www.topmedtalk.com/ebpom-london-2020-prehabilitation-update/

Presented by June Davis, Director of Allied Health Solutions, Allied Health Professions Advisor (part time) for Macmillan Cancer Support and a professional advisor to the Care Quality Commission.

Perioperative oxygenation | EBPOM London 2020 Apr 05, 2021

"Oxygen is the commonest drug that we give to our patients today during surgery and the general anaesthetic" but what do we really know and understand about it from a perioperative perspective?

This talk illustrates why, even with some of the evidence and background physiology that we have at our fingertips today, the following questions are still perplexing: How much is too little oxygen? How much is too much oxygen? And how much is just the right amount of oxygen?

Presented by Daniel Martin, OBE, Professor of Perioperative and Intensive Care Medicine, University of Plymouth and the Royal Free Hospital, London.

Panel discussion - Prediction of Opioid Induced Respiratory Depression: Does surveillance monitoring help? | EBPOM 2020 Apr 04, 2021

This piece is a listener generated question and answer session from EBPOM 2020. Although it works as a stand alone piece it relates directly to this talk here: https://www.topmedtalk.com/ebpom-2020-london-prediction-of-opioid-induced-respiratory-depression-on-the-general-care-floor-does-surveillance-monitoring-help/

Some of the questions considered include: How much do you think partial / inadequate neuromuscular blockade reversal, contributes to post pulmonary complications, perhaps in combination with opioids? Why as a group would we prefer to save money by avoiding sugammadex to reverse rocuronium to ensure complete reversal? Lack of reversal more than an issue? If you did a pre op sleep study on these patients, would you not find similar frequencies of desaturation? Is it just monitoring sleep? Should all wards have the capability for continuous monitoring?

Presented by Monty Mythen and Desiree Chappell with their guests, Ashish Khanna, Associate Professor, Section Head for Research, Department of Anesthesiology, Section on Critical Care Medicine,Wake Forest School of Medicine, Frank Overdyk, Professor of Anaesthesiology, Charleston, South Carolina, Leif Saager, Executive Vice Chair of the Department of anesthesiology in Germany at the University of Nottingham.

There's more from Frank Overdyk here: https://www.topmedtalk.com/11813-2/

Finding Goldilocks, more or less | EBPOM 2020 Apr 03, 2021

With questions from the online audience, this piece looks at the "not too much and not too litte" sweet spot regarding fuel, fluid and oxygen; where is it and how do we get there, according to our distinguished panel?

This podcast works well as a companion piece to the following talks which have already been released here on TopMedTalk:

Helen McKenna, "Fuel, can you have too much?" https://www.topmedtalk.com/ebpom-2020-london-fuel-can-you-have-too-much/

Tim Miller "Optimising fluid and hemodynamic management during major surgery" https://www.topmedtalk.com/ebpom-london-2020-optimizing-fluid-and-hemodynamic-management-during-major-surgery/

Dan Martin "Perioperative Oxygenation" https://www.topmedtalk.com/ebpom-london-2020-perioperative-oxygenation/

Presented by Mike Grocott and Dennie Levett with their panelists; Tim Miller, Associate Professor of Anesthesiology from Duke University Medical Centre, Helen McKenna, is in the final year of her PhD at University College London, investigating bioenergetic and redox function in critically ill patients and Dan Martin, OBE anaesthetist and intensivist at the Royal Free Hospital and Reader at University College London (UCL).

Fitness, function or frailty? P2 | EBPOM World Congress 2020 Apr 02, 2021

This piece is a continued deep dive into the subject, of 'fitness, function, or frailty' and, perhaps, "fixing". It's essential listening for anyone interested in the latest thinking on this crucial topic and was a highlight of the London conference.

How can we integrate frailty and cognitive scores in risk assessment tools to facilitate inclusion in shared decision making? How can we improve a surgical colleague's ability to identify frailty? Most patients will have an operation sometime in their life; should surgical school be renamed and moved to being a "well being" clinic and offered to all patients? What screening tools would you recommend if only minimal time or money is available? Is pre-op screening actually 'public health' and should it really be being done for everyone? What are the differences and where is the overlap between fitness functional capacity, frailty, and sarcopenia? In mild cognitive impairment, should we tell patient that it will work and postop and not be expected to fully recover? What strategies have you found most helpful in engaging surgeons with identifying their frail patients? How are we tackling the workforce shortage among geriatricians? What has your experience been in advising achieving physical fitness in patients who present to surgery with persistent pain which is a limitation?

This is part two of a two part piece. Each of the contributors comments upon talks which they gave at EBPOM 2020, all of which are now available as part of the TopMedTalk podcast. To ensure you are among the first to hear information of this kind please investigate www.ebpom.org for more details about how you can attend our online conferences.

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Presented by Scarlett McNally, Deputy Director of The Centre for Perioperative Care (CPOC) consultant Orthopaedic Surgeon, Eastbourne DGH, UK and Monty Mythen, Smiths Medical Professor of Anaesthesia and Critical Care at University College London with questions from the online audience for their guests; 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, Daniel Conway, Consultant in Anaesthesia and Critical Care, Group Lead for Perioperative Medicine, Manchester Royal Infirmary, UK and Chair of the Manchester Perioperative Medicine Society, Jude Partridge, consultant geriatrician POPS, honorary senior lecturer, King's College London, Chairs the British Geriatrics Society POPS SIG, Vicki Morton, Director of Clinical and Quality Outcomes at Providence Anesthesiology Associates, P.A.

Fitness, function or frailty? P1 | EBPOM World Congress 2020 Apr 01, 2021

Fitness, function and, or, frailty are important determinants of the quality of the life that we live. In the context of major surgery it's very important we recognize and work with individual patients improving and optimizing them and their ability to handle an operation. This piece is an essential deep dive into the subject, essential listening for anyone interested in the latest thinking on this crucial topic.

What are the limitations on your resources when considering a plan of preoperative evaluation?

This is part one of a two part piece. Each of the contributors comments upon talks which they gave at EBPOM 2020, all of which are now available as part of the TopMedTalk podcast. To ensure you are among the first to hear information of this kind please investigate www.ebpom.org for more details about how you can attend our online conferences.

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Presented by Scarlett McNally, Deputy Director of The Centre for Perioperative Care (CPOC) consultant Orthopaedic Surgeon, Eastbourne DGH, UK and Monty Mythen, Smiths Medical Professor of Anaesthesia and Critical Care at University College London with questions from the online audience for their guests; 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, Daniel Conway, Consultant in Anaesthesia and Critical Care, Group Lead for Perioperative Medicine, Manchester Royal Infirmary, UK and Chair of the Manchester Perioperative Medicine Society, Jude Partridge, consultant geriatrician POPS, honorary senior lecturer, King's College London, Chairs the British Geriatrics Society POPS SIG, Vicki Morton, Director of Clinical and Quality Outcomes at Providence Anesthesiology Associates, P.A.

"Am I safe?" | EBPOM World Congress 2020 Mar 31, 2021

"We have to create the culture of learning; the culture of having a safe space, the culture of wanting to do better and learning those conditions in which we do do better"

This powerful talk looks directly at how a clear approach to patient safety really can improve the standard of care where you work. What is the culture of quality and safety that you're trying to embed, can you actually do better? Learn why it's important to focus on psychological safety; "if people start being scared, everyone gets scared then it expands".

Learn how an evidence based approach can allow us to tackle these issues rather than shy away from them; "what factors are maintaining safety? How do we get to good outcomes? What are the things working well? How do we understand human variation?".

Presented by Lee Fleisher, Emeritus Professor of Anesthesiology and Critical Care, University of Pennsylvania.

Models of Prehabilitation, South Tees and PREP-WELL | EBPOM 2020 London Mar 30, 2021

This piece covers the PREP-WELL project which is a community based prehabilitation program in South Tees, in the North of England:

"We established the following guiding principles; we wanted to provide patient centered care under one roof with facilitated self management; we wanted to work as a cross sector collaborative, by that I mean primary care, secondary care and public health; all working together to try and improve on the fragmented service provision and sign work that we often see in our health care services; we wanted to provide a community based facility for patients; and I'll come to the reasons for this".

See the PREP-WELL team here: https://www.southtees.nhs.uk/services/prepwell-project/meet-the-prepwell-team/

The links mentioned in the talk are here:

Home exercises: https://www.southtees.nhs.uk/services/prepwell-project/home-exercises/

Nutrition: https://www.southtees.nhs.uk/services/prepwell-project/nutrition/

Pdf download: https://bmjopenquality.bmj.com/content/bmjqir/9/1/e000898.full.pdf

We've been following the groundbreaking success of the PREP-WELL project for some time now here on TopMedTalk, why not check out this piece here, the first part in our most recent "P.O.E.T - Perioperative Enhancement Teams" series; https://www.topmedtalk.com/poet-2-01-the-uks-prepwell-initiative/

This piece was originally part of EBPOM 2020 - Live from London, our groundbreaking virtual conference; find out more about Evidence Based Perioperative Medicine (EBPOM) here: www.ebpom.org

Presented by Gerard Danjoux, consultant in Anaesthesia and Sleep Medicine at South Tees Hospitals NHS Foundation Trust.

Shared decision-making: a team game? | EBPOM 2020 London Mar 29, 2021

"We have to remember that patients have a team"

How do we involve patients in the increasingly complex conversations we have in the perioperative space? This piece is a detailed case study which shows how shared decision making works in the perioperative setting. We know this improves patient experience yet in the last 10 or so years, consistently only 50 to 60% of patients say they were involved in decision making.

How can shifting towards a value based care model help? What is "moral injury" and how do we avoid it? Can a data driven analysis actually show shared decision making reduces costs?

Perioperative medicine for older people undergoing surgery (POPS) is an award winning geriatrician led service and the first of its kind in the UK - find out more here: https://www.guysandstthomas.nhs.uk/our-services/ageing-and-health/specialties/pops/overview.aspx

The Centre for Perioperative Care is here: https://cpoc.org.uk/

Presented by Ramai Santhirapala, Consultant Anaesthetist and Perioperative Medicine Lead at Guy’s and St Thomas’ NHS Foundation Trust, fellow of the Royal College of Anaesthetists, Faculty of Intensive Care Medicine and Higher Education Academy, Honorary Associate Professor at University College London, Clinical Lead for the UK arm of an international programme in shared decision making, “Choosing Wisely”, which is led by the Academy of Medical Royal Colleges, Shared Decision Making Lead at the Centre for Perioperative Care and sits on the Choosing Wisely International Roundtable.

Optimizing fluid and hemodynamic management during major surgery | EBPOM London 2020 Mar 28, 2021

This talk aims to answer four major questions: How much fluid should you give perioperatively? Does hypotension matter? Should you use advanced hemodynamic monitoring, and do colloids have any advances over crystalloids?

Using high quality studies and a data based approach in all four categories, a lot of which has come from conversations that have had happened at Evidence Based Perioperative Medicine (EBPOM) meetings, this talk draws some interesting conclusions.

The American Society of Enhanced Recovery (ASER) is here: https://www.aserhq.org/web/

The Perioperative Quality Initiative (POQI) is here: https://thepoqi.org/

Presented by Tim Miller, Associate Professor of Anesthesiology from Duke University Medical Centre.

Fuel: can you have too much? | EBPOM 2020 London Mar 27, 2021

"As Anaesthetists the ultimate goal of almost all of our interventions and monitoring is to support cell energy production to provide mitochondria with the oxygen and the fuel they need to produce enough adenosine triphosphate (ATP) to power cell function and integrity".

How human cells produce energy, how this changes in response to stress and how this may influence survival; this piece focuses what we know about how our bodies get the fuel they need to survive surgery and thrive as a result, providing a positive long term outcome. This is not a piece about nutrition, it's a provocative session exploring concepts designed to provide food for thought.

Presented by Helen McKenna, is in the final year of her PhD at University College London, investigating bioenergetic and redox function in critically ill patients.

The hidden pandemic of post operative complications | EBPOM London 2020 Mar 26, 2021

This is a story that starts with some of the challenges faced in our world outside the operating theatre and it's about how we might address some of these problems systematically. Healthcare organizations have to deliver high quality, competitive and sustainable results and costs. Good quality perioperative surgery is absolutely critical to maintain the health and well being of our population going forwards; this talk is a step in that direction.

Presented by Guy Ludbrook Professor of Anaesthesia at the University of Adelaide and Royal Adelaide Hospital.

End of year stress, insurance and 'wellness' | AANA 2020 Mar 25, 2021

"I cannot sleep. It's like, I wake up at 1am and my mind's going crazy ... if you had someone come to you and say; 'I'm really struggling right now, I'm having a lot of anxiety, with work with family, with kids with whatever'; what are some of the top things that you want to share with them?"

How can a regular yoga practice bring you into a deeper union with what you do and help improve your performance? Why is it that people in the caring profession sometimes leave self care at the bottom of their priority list? What resources can professional bodies offer you?

With special thanks to the American Association of Nurse Anesthetists (AANA) for their help with this piece, their excellent website is here: www.aana.com/covidwellness

The help number mentioned is: 1-800 654 5167

The Breathing App is here: https://eddiestern.com/the-breathing-app/

The book "Why we sleep" is here: https://www.amazon.co.uk/Why-We-Sleep-Science-Dreams/dp/0141983760

"Insight Timer" is here: https://insighttimer.com/

Presented by Desiree Chappell with her guests Bridget Petrillo, CRNA at The Mayo Clinic in Phoenix Arizona, volunteer member for the AANA Peer Assistance Advisors Committee, State Peer Advisor for the Arizona Association of Nurse Anesthetists (AZANA), member of the Wellness Committee for AZANA and Jessica Switzman, CRNA, MSN, Johns Hopkins, also served on the AANA Wellness Committee and AANA Peer Advisors Committee, State Peer Advisor for MANA and has been teaching Yoga since 2007.

Vaccine time! | AANA 2020 Mar 24, 2021

"I think you're now famous in the CRNA community for being one of the first people in Fargo to receive the the COVID vaccine"

This piece sees us catching up with Certified Registered Nurse Anesthetists (CRNA's) who have just been vaccinated for COVID-19. Their story reminds us that even now some practitioners are facing their first real wave of the pandemic in their area: "We had a kind of trickle in, so to say, of COVID patients, and then this in this fall, the middle of November was really when it hit us pretty hard".

Presented by Desiree Chappell with Jordan Rohrich CRNA, Anesthesiology, Fargo, North Dakota and Jordi Idso MS, CRNA, Sanford Health in Fargo.

Models of perioperative care "the science of value" Part 2 | EBPOM USA - Chicago 2020 Mar 23, 2021

"Perioperative medicine ... I always think of a Venn diagram where there's truly an intersection between surgery anesthesia and medicine, and perhaps even a subset of medicine called geriatrics, that really create this convergence of what we're now creating as a novel science ... Perioperative medicine, I would say is a new clinical science that really incorporates all that"

This piece is a fascinating debate, it follows on from Part 1 of the same name; the panel discuss ways forward for perioperative medicine and the new opportunities being presented by a recent focus on both population health and the wider needs of a national healthcare system.

Presented by Desiree Chappell and Sol Aronson with panelists; Angela Bader, Harvard Medical School and Vice Chair of Perioperative Medicine at Mass General Brigham, BobbieJean Sweitzer, Professor of Anesthesiology and Director of Perioperative Medicine at Northwestern University in Chicago, Illinois, Rob Shakar, Medical Director of a 32-physician group in Wilmington, NC he oversees the Perioperative Surgical Home Project for New Hanover Regional Medical Center, Thomas Vetter, Director of Perioperative Care and Director of Comprehensive Pain Management and Professor of Surgery and Perioperative Care and Professor of Population Health, at the Dell Medical School at The University of Texas, Austin.

Introduction to the Pathophysiology of COVID 19 | EBPOM Ireland 2020 Mar 22, 2021

This piece is essential listening for any medical practitioner. The pathophysiology of COVID 19 is now being understood, although there are still a number of outstanding questions. This piece attempts to answer those questions; where does it come from, what do we know about it now, what would we like to know about it in the future?

Why is the disease more pronounced in men, how come obesity seems to be a factor, what's the mechanism which leaves children less at risk than adults and senior citizens?

This piece is a standout part of Evidence Based Perioperative Medicine's (EBPOM) Dingle 2020 conference. For more of the latest up to date information go now to www.ebpom.org

Presented by Hugh Montgomery, Professor of Cardiovascular Genetics and Critical Care University College London.

Perioperative anticoagulation and anti platelet management; a user friendly approach - audience questions | EBPOM USA - Chicago Mar 21, 2021

This piece is divided into two parts, the first being discussion between the panelists and the second, part 2, being questions from the online audience: What is your opinion about spinals and hip fractures for patients on clopidogrel? Do you use any near patient tests to confirm residual anticoagulation? Where are the best guidelines to be found?

We suggest you listen to this piece alongside part 1.

Presented by Sol Aronson, tenured Professor at Duke University, with his guests; Angela Bader, Harvard Medical School and Vice Chair of Perioperative Medicine at Mass General Brigham, BobbieJean Sweitzer, Professor of Anesthesiology and Director of Perioperative Medicine at Northwestern University in Chicago, Illinois and Jeanna Blitz, Associate Professor of Anesthesiology, Director of the Preoperative Anesthesia and Surgery Screening Clinic, Director of Perioperative Medicine Fellowship at Duke University School of Medicine, Durham, North Carolina.

Perioperative anticoagulation and anti platelet management; a user friendly approach | EBPOM USA - Chicago Mar 20, 2021

The conversation begins with "a day in the life" with respect to managing the anti coagulation questions that come up commonly. The contributors swap stories from their time in practice. The conversation moves to protocols, guidelines and also, when where and how to begin bridging.

This piece is divided into two parts, the first being discussion between the panelists and the second, part 2, being questions from the online audience.

Presented by Sol Aronson, tenured Professor at Duke University, with his guests; Angela Bader, Harvard Medical School and Vice Chair of Perioperative Medicine at Mass General Brigham, BobbieJean Sweitzer, Professor of Anesthesiology and Director of Perioperative Medicine at Northwestern University in Chicago, Illinois and Jeanna Blitz, Associate Professor of Anesthesiology, Director of the Preoperative Anesthesia and Surgery Screening Clinic, Director of Perioperative Medicine Fellowship at Duke University School of Medicine, Durham, North Carolina.

Daniel Engelman updates in cardiac | EBPOM USA - Chicago 2020 Mar 19, 2021

How can enhanced recovery after surgery (ERAS) be applied to cardiac and what exciting opportunities are there for those who have made this their mission? This detail driven address contains more information on The Society for Enhanced Recovery After Cardiac Surgery (ERAS® Cardiac), more information can be found on their website: https://www.erascardiac.org/

Since this address was given at Evidence Based Perioperative Medicine (EBPOM) Chicago's 2020 meeting TopMedTalk has been proud to bring you coverage of ERAS® Cardiac's online meeting. For more on that start here: https://www.topmedtalk.com/the-eras-cardiac-society-conference-topmedtalk/

Presented by Daniel Engleman, the Medical Director of the Heart, Vascular and Critical Care Units at Baystate Medical Center. He is an Associate Professor of Surgery at The University of Massachusetts-Baystate. He started the ERAS® Cardiac Collaborative to internationally standardize best practices.

Surgery after COVID-19 diagnosis | TopMedTalk Mar 18, 2021

This piece looks at some of the latest research from a perioperative perspective regarding an essential question, when and how is surgery possible after a COVID-19 infection? How do we balance that ideal with the other pressures coming to bare on patients, practitioners and public health as a whole?

The paper "Timing of surgery following SARS‐CoV‐2 infection: an international prospective cohort study" is here: https://doi.org/10.1111/anae.15458

Presented by Desiree Chappell with Monty Mythen, Smiths Medical Professor of Anaesthesia and Critical Care at University College London, Sol Aronson, tenured Professor at Duke University and Mike Grocott, Professor of Anaesthesia and critical care at the University of Southampton.

This piece is the first of in a series of two, supported by Deltex Medical, for more information on their work please go here: www.deltexmedical.com

World Delirium Awareness Day with iDelirium | TopMedTalk Mar 17, 2021

This piece focuses on iDelirium; The International Federation of Delirium Societies on world delirium day. As well as considering this difficult condition the conversation asks what the latest research shows us and how things could improve both for patients and practitioners. For more detail check out their website here: http://www.idelirium.org/

Presented by Desiree Chappell and Monty Mythen with their guests Heidi L. Lindroth, Senior Associate Consultant Nurse Scientist, Nursing Research Division Critical Care Nurse, Gideon Caplan, Director, Geriatric Medicine, Prince of Wales Hospital, Alasdair Macclullich, Professor of Geriatric Medicine, Honorary Consultant in Geriatric Medicine, Edinburgh, Delirium Research Group, Rakesh C. Arora, Co-Founder of IDelirium, Professor and Head of Cardiac Surgery and Cardiac Critical Care at Max Rady College of Medicine - University of Manitoba, Canada.

ERAS® Cardiac Roundtable with Kevin Lobdell, Rawn Salenger, Desiree Chappell | ERAS Cardiac 2021 Mar 16, 2021

"You have to take the viewpoint that if the Nurses and the Physical Therapists and the Pharmacists are resisting the idea that you're putting forward, then there's probably something wrong with it, it doesn't work for them, for some reason, and you got to find out what that is..."

This long form conversation is a highlight for TopMedTalk's coverage of The Society for Enhanced Recovery After Cardiac Surgery (ERAS® Cardiac) conference. The conversation covers a wide range of interesting areas, including; the nature of leadership in medicine, the global nature of many of the questions we face, how the internet is changing what we do, what the phrase "better never stops" means, how to take and use feedback and why the patient has to be at the heart of what we do, the importance of "the growth mindset".

Also, discover how one of our guests has learned from his experience becoming a Lieutenant Colonel, US Army Reserves; what can a military mindset tell us about the task we face as advocates of perioperative medicine?

We wrap with a conversation about blood transfusion reduction.

This exclusive chat is only possible thanks to the support of the society, their excellent website is here: https://erasvirtual2021.com/

Presented by Desiree Chappell with her guests Kevin Lobdell, Professor and the Director of Regional Cardiovascular and Thoracic Quality, Education, and Research for Carolinas HealthCare System, Charlotte, NC, USA, as well as the Clinical Professor at the University of North Carolina-Chapel Hill, Chapel Hill, NC, USA and Rawn Salenger, Chief of Cardiac Surgery at University of Maryland St. Joseph Medical Center, Assistant Professor of Surgery at the University of Maryland School of Medicine.

New enhanced care guidelines | EBPOM 2020 London Mar 15, 2021

"Critical Care has a moment in time, a moment where we can make some big changes, a moment of opportunity"

This uncompromising and informative talk from the technical lead for critical care in the Getting It Right First Time (GIRFT) project takes us through how services can improve and work alongside perioperative care to improve standards and outcomes for patients.

Sharing best practice between trusts GIRFT identifies changes that help improve and change an institution’s procedures and cost savings, this is a vital talk and one of the highlights of the hugely successful EBPOM London 2020 virtual conference. For more details on up coming events from Evidence Based Perioperative Medicine EBPOM at www.ebpom.org

The GIRFT website is here – https://gettingitrightfirsttime.co.uk/

Further listening regarding GIRFT can be found here: https://www.topmedtalk.com/rcoa-13-the-girft-getting-it-right-first-time-project/

Presented by Anna Batchelor, MB ChB, FRCA, FFICM, Consultant Anaesthetist - Intensive Care Medicine, Newcastle upon Tyne. She is the technical lead for critical care in the 'Getting It Right First Time' (GIRFT) programme.

Access to critical care for high risk surgical patients | EBPOM London 2020 Mar 14, 2021

From a UK perspective this piece covers variation in access to critical care, behaviors and decisions regarding its use. With reference to how, over the last 20 years, efforts have been made in Torbay to improve access to critical care we look at what can be done and what works. Finally there's a summary of where we are on this issue today.

Getting it right first time (GIRFT) is here: https://www.gettingitrightfirsttime.co.uk/

Presented by Mike Swart, Consultant in Anaesthesia and Critical Care Medicine at Torbay Hospital and advisor to the UK Department of Health for the Enhanced Recovery Programme.

The Perioperative Exercise, Testing and Training Society (POETTS) | EBPOM 2020 London Mar 13, 2021

This piece provides an update on the Perioperative Exercise, Testing and Training Society (POETTS); "established back in 2017, in the context, in the United Kingdom, of cardiopulmonary exercise testing becoming much more common in the preoperative period". Now, more than half of acute hospital trusts in the United Kingdom have a cardiopulmonary exercise testing service to evaluate their patient's functional capacity prior to surgery. Furthermore exercise interventions to optimise a patient's fitness before surgery have seen a sudden and growing interest.

With just over 400 members POETTS exists to help standardize education and training in the field, develop consensus clinical guidelines, look after patients around the time of surgery and help club together acute hospital trusts across the UK, so that they can do collaborative research.

Their website is here: https://www.poetts.co.uk/

Presented by Denny Levett, Professor of Perioperative Medicine at the University of Southampton and President of the Perioperative Exercise, Testing and Training Society (POETTS).

Models of Prehabilitation, Southampton and Wesfit | EBPOM 2020 London Mar 12, 2021

This piece gives you the evidence base required to deliver an even higher standard of perioperative medicine where you work. Hear about the "Fit 4 surgery" studies; the "fit 4 surgery consortium", the ongoing e-studies, key findings, recent studies and the set up in Southampton.

Physical fitness is greatly affected by chemotherapy; poor outcomes are significantly linked to physical fitness; learn how preoperative cardio-pulmonary exercise testing and training can monitor and track this potentially dangerous spiral. Hear how multiple studies are now providing a clear evidence base for this exciting area of perioperative care.

Could more such targeted interventions, alongside shared decision making, provide a real difference to outcomes for your patients and a higher standard of value based care in your institution?

For more on this go here: http://wesfit.org.uk/

Read more about the great work being done by MacMillan Cancer Trust here: https://www.macmillan.org.uk/

The video version of this presentation, along with slides, was presented to the many thousands of people who attended the hugely successful Evidence Based Perioperative Medicine (EBPOM) virtual conference, "Live from London". For more details on this and future conferences please visit www.ebpom.org

Presented by Professor Sandy Jack, PhD, Consultant Clinician Scientist in The Anaesthesia and Critical Care Research Unit at University Hospital Southampton NHS Foundation Trust, Honorary Senior Lecturer at the University of Liverpool, University of Southampton and University College London.

The ERAS Cardiac Society Conference Day 2 | ERAS Cardiac 2021 Mar 11, 2021

"The goal of ERAS® Cardiac is when you leave one of our meetings, you're going to be chock full of tips and tricks that you can take back and implement, if not the next day, then in the next week or next month."

TopMedTalk's coverage of The Society for Enhanced Recovery After Cardiac Surgery (ERAS® Cardiac) conference continues with a conversation that covers the nuggets and insights that a conference such as this delivers. This exclusive chat is only possible thanks to the support of the society who's excellent website is here: https://erasvirtual2021.com/

"I think that also your [TopMedTalk] platform is going to be key. We need to have more of these podcasts. We need short little vignettes, eight to 15 minutes that people can listen to in the car on the way home where they learn and thought leaders having interactive discussions and get ideas. And that's the future really of education"

Presented by Desiree Chappell with her guests, Seenu Reddy, Cardiothoracic Surgeon at HCA‘s TriStar Cardiovascular Surgery in Nashville, National Physician Director for HCA Healthcare's CV Service line and Daniel Engelman, Cardiac Surgeon, Medical Director of the Heart, Vascular and Critical Care Units at Baystate Medical Center, Associate Professor of Surgery at The University of Massachusetts - Baystate, Associate Professor-Adjunct at Tufts University School of Medicine and President of the ERAS Cardiac international Society.

The ERAS Cardiac Society Conference | ERAS Cardiac 2021 Mar 10, 2021

"You didn't have to think about it, the compliance continued, because it was so standardized. We had a well oiled machine that just kept on working through COVID".

The Society for Enhanced Recovery After Cardiac Surgery (ERAS® Cardiac)'s conference has gotten off to a great start; this exclusive chat gets into some of the stand out moments so far; nutrition, data collection, the essentials of ERAS and the importance of standardization.

For more information on the conference check out https://www.erascardiac.org/

We mention Dan Engelman in this piece, he features in this popular conversation from the TopMedTalk archives here: https://www.topmedtalk.com/sunday-special-preoperative-optimization-framing-up-the-value-proposition/

Paul Wischmeyer gets mentioned on this piece as a "fan favourite", he features frequently. If you've not yet heard him start with this podcast - one of our most popular so far - here: https://www.topmedtalk.com/topmedtalks-to-dr-paul-wischmeyer/

Presented by Desiree Chappell with her guests Gina McConnell, ERAS Coordinator for all WakeMed health systems and Cheryl Crisafi, Cardiac Surgery Care Coordinator Nurse at Baystate Medical Center in Springfield, MA.

Prehabilitation Business Case? A slam dunk! | EBPOM 2020 London Mar 09, 2021

"In the elective surgical domain 20% of people who are scheduled to have surgery are not ready for surgery"

The road towards economic reality is paved with data; this talk, confidently assertive in tone, provides you with a number of useful facts and reassurances which can be transformed into reasons why you and your patients can enjoy the benefits of prehabilitation; a better value of care and a higher standard of good quality outcomes.

This piece works well in tandem with this debate here: https://www.topmedtalk.com/ebpom-london-2020-the-business-case-for-prehabilitation/

Presented by Sol Aronson, tenured Professor, Duke University, Durham, North Carolina.

Methadone, 'the opioid sparing opioid' | EBPOM USA - Chicago Mar 08, 2021

"There is some great literature out there that has been shared ... great data, especially in cardiac surgery, which is where we are using it and I would like to expand it out to other service lines as well..."

Methadone has had something of a resurgence recently, thanks in part to the work of some of our contributors in this piece. Could it be that this "opioid sparing opioid" could be a way to actually help fight the crisis we can see in US hospitals and beyond?

This piece gets into the detail, how and where and why is it used?

Presented by Sol Aronson with questions from the online audience for his panelists; Glenn Murphy, Jeffery S. Vender Chair of Anesthesiology Research and Education and Director of Cardiac Anesthesia and Clinical Research at NorthShore University HealthSystem, a hospital affiliated with the University of Chicago Pritzker School of Medicine, Evan Kharasch, 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 and Vicki Morton Director of Clinical and Quality Outcomes at Providence Anesthesiology Associates, P.A.

We suggest listening to this piece alongside this excellent talk: https://www.topmedtalk.com/ebpom-chicago-methadone-use-in-perioperative-medicine/

For more details on Evidence Based Perioperative Medicine go now to www.ebpom.org

Monitoring and management of neuromuscular blockade - questions | EBPOM USA - Chicago Mar 07, 2021

This piece, part 2 of 2, is a series of questions related to part 1; "Monitoring and management of neuromuscular blockade | EBPOM Chicago".

This piece gets into the detail regarding one of the stand out moments of EBPOM Chicago 2020; questions from the online audience facilitate the discussion.

Given the fact that our methods of monitoring residual neuromuscular blockade are often inadequate do you transport and do you recommend routine transport to patients from the operating room to the post-anesthesia care unit?

Sugammadex is a unique drug that does exactly what we want it to do; why are alternatives still used and available?

Some wearables have accelerometer hardware, are you aware of, or do you know if anyone is studying, firm software solutions, marshaling this ubiquitous hardware?

Don't forget, for more details on Evidence Based Perioperative Medicine EBPOM conferences go now to www.ebpom.org

Presented by Sol Aronson, tenured Professor at Duke University, Glenn Murphy, Jeffery S. Vender Chair of Anesthesiology Research and Education and Director of Cardiac Anesthesia and Clinical Research at NorthShore University HealthSystem, a hospital affiliated with the University of Chicago Pritzker School of Medicine.

The Perioperative Care Team | EBPOM USA - Chicago Mar 06, 2021

This piece is an informative conversation about "the Perioperative Care Team"; who is essential to the team and how do we make sure everyone feels included? What elements do you need to make up such a team, how do you keep people energized and excited about it over the long term? How do we ensure, in this context, that a fee for service system interlocks with the needs of both the institution and its patients? Furthermore, how does such a team increase our commitment to value based care and good quality long term outcomes?

Also, an exciting commitment is made toward a journal club, stick with TopMedTalk for more details.

Presented by Vicki Morton with panelists Dennie Levett, Professor in Perioperative Medicine and Critical Care at Southampton University Hospital NHS Foundation trust and Honorary Associate Professor at the University of Southampton, Kay Mitchell, Senior Research Manager for Critical Care Research, NIHR Biomedical Research Center, University Hospital, Southampton, UK and Gina McConnell, ERAS Coordinator for all WakeMed health systems.

Enhanced Recovery After Surgery (ERAS) Part 2 | EBPOM USA - Chicago 2020 Mar 05, 2021

Part 2 of this conversation continues the momentum of Part 1 with a conversation about electronic medical records (EMR), how important data is to the process, the need for those who collect it to understand it and then, more broadly, the importance of putting the patient at the heart of what you do.

Presented by Desiree Chappell with Vicki Morton, Director of Clinical and Quality Outcomes at Providence Anesthesiology Associates, P.A, Cheryl Crisafi, Cardiac Surgery Care Coordinator Nurse at Baystate Medical Center in Springfield, MA and Gina McConnell, ERAS Coordinator for all WakeMed health systems.

Enhanced Recovery After Surgery (ERAS) Part 1 | EBPOM USA - Chicago 2020 Mar 04, 2021

This piece is a two part conversation about the essence of what many of TopMedTalk's listeners do; Enhanced Recovery. A fascinating conversation between a number of experts in the field the conversation presented here was part of the hugely popular EBPOM Chicago 2020 meeting. For more on Evidence Based Perioperative Medicine (EBPOM) go to www.ebpom.org

This first part of the conversation covers what the main elements of an Enhanced Recovery After Surgery program entail, what literature our contributors favor and what service lines include enhanced recovery at their practice.

Presented by Desiree Chappell with Vicki Morton, Director of Clinical and Quality Outcomes at Providence Anesthesiology Associates, P.A, Cheryl Crisafi, Cardiac Surgery Care Coordinator Nurse at Baystate Medical Center in Springfield, MA and Gina McConnell, ERAS Coordinator for all WakeMed health systems.

"The international prehabilitation society" | EBPOM 2020 London Mar 03, 2021

What are the aims of The International Prehabilitation Society? Its vision is about "bringing together international multidisciplinary expertise, across healthcare and beyond, creating a platform of shared learning, research and education for the benefit of patients".

This piece updates you on the current board members, the roles of committee members, conferences that the society has previously supported alongside those being planned for the future. Also there's an update on some exciting new sponsorship news and a brief overview of future plans.

The society's website is here: https://prehabsociety.com/

Presented by Gerard Danjoux, consultant in Anaesthesia and Sleep Medicine at South Tees Hospitals NHS Trust.

Models of prehabilitation in Cardiff in Wales | EBPOM 2020 London Mar 02, 2021

"The people of Wales are particularly unfit", there is a high incidence of smoking, physical inactivity, and alcohol intake. Grim news from one angle but on the other hand it's a huge opportunity to make a massive difference in the prehabilitation stage of the perioperative process. Hear how cancer outcomes are being dramatically improved as a clear pathway of optimisation is rolled out.

Presented by Rachael Barlow, National Lead, Enhanced Recovery, Prehabilitation and Optimisation, at Cardiff and Vale health board, Wales.

The Anesthesia Patient Safety Foundation | COVID 19 Mar 01, 2021

This piece focuses on the great work done by The Anesthesia Patient Safety Foundation. We turn to their specific focus on COVID 19 and then look at the wider benefits of a network dedicated to patient safety in our field.

Their section on COVID 19 is here: https://www.apsf.org/news-updates/perioperative-considerations-for-the-2019-novel-coronavirus-covid-19/

Furthermore there is a remarkably prescient article by Mike Grocott and Monty Mythen on there in which we discuss, Perioperative Fluid Management: Cheers to the Dream of Moderation: https://www.apsf.org/article/perioperative-fluid-management-cheers-to-the-dream-of-moderation/

Presented by Desiree Chappell and Monty Mythen with their guest Steven Greenberg, MD, FCCP, FCCM, Editor-in-Chief, Anesthesia Patient Safety Foundation (APSF) Newsletter, Vice Chairperson, Education, Department of Anesthesiology, Director of Critical Care Services, Evanston Hospital NorthShore University HealthSystem, Clinical Professor, Department of Anesthesiology Critical Care, University of Chicago, Pritzker School of Medicine.

Enabling Enhanced Recovery Part 2 | EBPOM 2020 Feb 28, 2021

"Accelerated surgery is not a panacea"

This piece, presented in two parts, is a discussion about enabling enhanced recovery. Originally part of EBPOM London this is an 'as live' discussion with four of the main presenters from the conference.

Get more detail on nutrition, hip fractures, psychological optimisation and discover both where the difficulties are and what opportunities they provide. For more of this sort of content go now to www.ebpom.org to find out more about how you can be part of Evidence Based Perioperative Medicine.

Presented by Professor Denny Levett and Jugdeep Dhesi with their guests P.J. Devereaux, cardiologist, clinical epidemiologist, and perioperative care physician, Professor in the Departments of Health Research Methods, Evidence, and Impact (HEI) and Medicine, Director of the Division of Perioperative Care, McMaster University, Associate Deputy Director of the Population Health Research Institute, President of the Society of Perioperative Research and Care, Chloe Grimmett, National Institute of Health Research (NIHR) post-doctoral Research Fellow and Senior Research Fellow for the Macmillan Survivorship Research Group at the University of Southampton, Dr Paul Wischmeyer, Professor of Anaesthesiology and Surgery at Duke Anesthesiology.

Enabling Enhanced Recovery Part 1 | EBPOM 2020 Feb 27, 2021

"Accelerated surgery is not a panacea"

This piece, presented in two parts, is a discussion about enabling enhanced recovery. Originally part of EBPOM London this is an 'as live' discussion with four of the main presenters from the conference.

Get more detail on nutrition, hip fractures, psychological optimisation and discover both where the difficulties are and what opportunities they provide. For more of this sort of content go now to www.ebpom.org to find out more about how you can be part of Evidence Based Perioperative Medicine.

Presented by Professor Denny Levett and Jugdeep Dhesi with their guests P.J. Devereaux, cardiologist, clinical epidemiologist, and perioperative care physician, Professor in the Departments of Health Research Methods, Evidence, and Impact (HEI) and Medicine, Director of the Division of Perioperative Care, McMaster University, Associate Deputy Director of the Population Health Research Institute, President of the Society of Perioperative Research and Care, Chloe Grimmett, National Institute of Health Research (NIHR) post-doctoral Research Fellow and Senior Research Fellow for the Macmillan Survivorship Research Group at the University of Southampton, Dr Paul Wischmeyer, Professor of Anaesthesiology and Surgery at Duke Anesthesiology.

Models of Prehabilitation | EBPOM 2020 Feb 26, 2021

This piece is an informative conversation about the models of prehabilitation from a number of different angles. Questions come in from an online audience as our panelists tackle the topic from their respective areas.

What are the risks and how are they mitigated? Where does your funding come from and why? How safe is iron for cancer patients?

The link to Safe Fit self referal is here: https://www.macmillan.org.uk/cancer-information-and-support/get-help/physical-help/safefit%20#refer_yourself_to_this_service

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 and Gerard Danjoux, consultant in Anaesthesia and Sleep Medicine at South Tees Hospitals NHS Foundation Trust with their guests John Moore, Clinical Director for Intensive Care at Manchester Royal Infirmary and Medical Lead for Enhanced Recovery After Surgery, Professor Sandy Jack, PhD, Consultant Clinician Scientist in The Anaesthesia and Critical Care Research Unit at University Hospital Southampton NHS Foundation Trust, Honorary Senior Lecturer at the University of Liverpool, University of Southampton and University College London and Rachel Barlow, National Lead, Enhanced Recovery, Prehabilitation and Optimisation, at Cardiff and Vale health board, Wales.

Nutrition and metabolism before surgery - PART 2 of 2 | EBPOM London 2020 Feb 25, 2021

"I hope to impress upon you that this is a topic that we can and must do better at ... no malnourished patient should ever have elective surgery without having a nutrition assessment done"

This piece is presented in two parts; this is part 2.

Using perioperative nutrition to optimize our patients outcomes; data shows us that nutrition therapy or nutrition optimization is literally life saving. Anyone who uses evidence as their guide know it has to be part of their practice.

Enhanced Recovery After surgery, sometimes called "fast track surgery" is about ensuring we apply the best information we have to the process. This talk focuses on how and why this ties into a sensible attitude towards nutrition and nutritional assessment.

This talk pulls no punches and yet is powerfully optimistic in its message. We implore TopMedTalk listeners to share it with colleagues.

The entertaining audio clips used in this piece are available, with video and in full here: https://www.youtube.com/watch?v=zHEincgSm1k&t=190s

Our speaker kindly shares his email address for further correspondence and questions: paul.wischmeyer@duke.edu

Presented by Paul Wischmeyer, Professor of Anaesthesiology and Surgery at Duke Anesthesiology.

Nutrition and metabolism before surgery - PART 1 of 2 | EBPOM London 2020 Feb 24, 2021

"I hope to impress upon you that this is a topic that we can and must do better at ... no malnourished patient should ever have elective surgery without having a nutrition assessment done"

This piece is presented in two parts; this is part 1.

Using perioperative nutrition to optimize our patients outcomes; data shows us that nutrition therapy or nutrition optimization is literally life saving. Anyone who uses evidence as their guide know it has to be part of their practice.

Enhanced Recovery After surgery, sometimes called "fast track surgery" is about ensuring we apply the best information we have to the process. This talk focuses on how and why this ties into a sensible attitude towards nutrition and nutritional assessment.

This talk pulls no punches and yet is powerfully optimistic in its message. We implore TopMedTalk listeners to share it with colleagues.

The entertaining audio clips used in this piece are available, with video and in full here: https://www.youtube.com/watch?v=zHEincgSm1k&t=190s

Our speaker kindly shares his email address for further correspondence and questions: paul.wischmeyer@duke.edu

Presented by Paul Wischmeyer, Professor of Anaesthesiology and Surgery at Duke Anesthesiology.

Monitoring and management of neuromuscular blockade | EBPOM USA - Chicago Feb 23, 2021

"In the United States approximately 112,000 patients annually are at risk for adverse events associated with discharge from the operating room with residual neuromuscular blockade"

This talk highlights the latest thinking on both monitoring and management of neuromuscular blockade. Where does the data lead us to? How big a problem do they suggest poor efficiency in this area is? What are the realities behind postoperative pulmonary complications? How can we reduce the risk of residual block?

Presented by Glenn Murphy, Jeffery S. Vender Chair of Anesthesiology Research and Education and Director of Cardiac Anesthesia and Clinical Research at NorthShore University HealthSystem, a hospital affiliated with the University of Chicago Pritzker School of Medicine.

Redefining Hypotension based on Real-time Cerebral Autoregulation Monitoring | EBPOM USA - Chicago Feb 22, 2021

"If you want to take population based data, and define hypotension, you'll be right for the majority of our average patients, but not for all patients and it appears that the amount of time we spend below the lower limit of autoregulation has meaning for patient outcomes"

Starting from the origins of blood pressure monitoring, via the father of neurosurgery endocrinology, Harvey Cushing, through to the current debate as to what exactly constitutes hypotension this piece is an important part of a longstanding discussion here on TopMedTalk. How and why does hypotension occur and what is the correct evidence based strategy now the data are mounting as regards potential patient harm and unsatisfactory outcomes?

Presented by Charles Hogue, Professor and Chair of Anesthesiology at Northwestern University in Chicago.

EBPOM London 2020 | Functional Assesment Feb 21, 2021

"Perhaps assessing functional performance is something that we've overlooked in medicine"

This piece is about the role of functional assessment and status in perioperative medicine.

The Duke Activity Status Index (DASI) can be found here: https://www.mdcalc.com/duke-activity-status-index-dasi

The Mini Cog assessment is here: http://mini-cog.com/wp-content/uploads/2015/12/Mini-Cog-Form-010816.pdf

The video resources mentioned in the piece are here: https://www.youtube.com/channel/UCvOamR8Sb4RXENr56fvRehA/featured

Presented by Daniel Conway, Consultant in Anaesthesia and Critical Care, Group Lead for Perioperative Medicine, Manchester Royal Infirmary, UK and Chair of the Manchester Perioperative Medicine Society.

Essential COVID knowledge: Dr. Manuel Ignacio Monge García | COVID 19 Feb 20, 2021

This piece digs deep into the realities of coping with COVID 19 patients who have had their care escalated to the Intensive Care Unit (ICU); "we don't seem to be looking at our typical sepsis patients who get multiple organ failure in the classical way" and "you're surprised at how young some of the patients are...".

Our guest provides us further insight; a 'household name' in the haemodynamic monitoring space; he is treating patients in a medium sized hospital (500 beds) with mostly COVID patients in Spain. How are things going there, how does it compare to Italy? How are the patients being dealt with, what can we learn about the basics here, airway, breathing, ventilation (ABC)?

There is also a gripping discussion regarding dynamic arterial elastance. If you'd like to know more about that do check out our discussion here: https://www.topmedtalk.com/periop-coach-2-09-haemodynamic-monitoring/

The webinar mentioned in this piece can be found here: https://www.esicm.org/education/webinars/

Presented by Desiree Chappell and Monty Mythen with their guest Dr. Manuel Ignacio Monge García who works in an ICU in the South of Spain.

New treatments for Post Operative Nausea and Vomiting | TopMedTalk Feb 19, 2021

This piece gives us a look at some of the latest thinking on Post Operative Nausea and Vomiting (PONV). It includes a discussion about Amisulpride and discusses new, yet to be published, consensus guidelines for PONV.

The original guidelines are here: https://www.ncbi.nlm.nih.gov/pubmed/24356162

Also, you may like to check out the details of this paper here: Amisulpride: A New Dopamine Antagonist for Treatment of Postoperative Nausea and Vomiting https://www.ncbi.nlm.nih.gov/pubmed/31094771

Presented by Desiree Chappell and Monty Mythen with their guest Tong Joo (TJ) Gan, Professor and Chairman at Stoney Brook in New York.

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Like this, want more?

Check out TJ Gan's masterful presentation "EBPOM USA Part 5| Practical realities; How and why multimodal Analgesia matters" here: https://www.topmedtalk.com/ebpom-usa-part-5-a-perioperative-practicum-with-tj-gan/

Practical tips for preoperative risk assessment | EBPOM Ireland 2020 Feb 18, 2021

"Some practical tips you can take away and implement in your hospital..."

In the UK there is a legal imperative to minimalise and individualise risk now but it's widely understood to be helpful if you want to provide better value and patient outcomes. How can risks be identified and minimised? How can these risks then help to provide better quality shared decision making? How can plan a perioperative pathway tailored to these needs?

Presented by Ramani Moonsinghe, Professor of Perioperative Medicine at University College London (UCL).

IMPORTANT NOTE: We discuss "The Montgomery Case" in more detail here; this piece is very relevant to you and your patients, legally speaking, if you work in the UK: https://www.topmedtalk.com/sunday-special-being-on-the-right-side-of-the-law-2

Critical care for the very elderly patient | EBPOM Ireland Highlight Feb 17, 2021

"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 institution?

Presented by Dr Brian Marsh, Anaesthesia, Critical Care Medicine, Extracorporeal Life Support, The Mater Hospital, Dublin.

Brain Health: Frailty, Delirium and Post-operative cognitive dysfunction Part 2 | Chicago 2020 Feb 16, 2021

This piece gets deep into a much needed discussion regarding frailty, delirium, post-operative cognitive dysfunction and brain health. Noted as one of the highlights of the year in our recent holiday specials and previously only available to attendees to the incredibly successful EBPOM Chicago 2020; go to www.ebpom.org now for more details on forthcoming events and special offers now. This piece is part two of two.

This piece gets a mention "End of life decision planning in the perioperative setting: the elephant in the room?" https://academic.oup.com/bja/article/115/5/648/230412?login=true

The Global Council on Brain Health is here on the American Association of Retired People's website: https://www.aarp.org/health/brain-health/global-council-on-brain-health/

This is part one of a two part piece, part two features questions from the online conference audience.

Presented by Monty Mythen with Angela Bader, Professor of Anesthesia at Harvard Medical School and Vice Chair for Perioperative Medicine in the Department of Anesthesiology, Perioperative and Pain Medicine at Brigham and Women’s Hospital, founding Director of the Weiner Center for Preoperative Evaluation, Sarah Lenz Lock, Senior Vice President for Policy and Brain Health in the American Association of Retired People's (AARP) Policy, Research and International Affairs (PRI), Executive Director of the Global Council on Brain Health, Jeanna Blitz associate professor of Anesthesiology at Duke University School of Medicine, Director of the Preoperative Anesthesia Surgical Screening (PASS) Clinic. There's also a surprise appearance from the EBPOM Chicago 2020 host, Sol Aronson, tenured Professor at Duke University.

Brain Health: Frailty, Delirium and Post-operative cognitive dysfunction Part 1 | EBPOM USA - Chicago 2020 Feb 15, 2021

This piece gets deep into a much needed discussion regarding frailty, delirium, post-operative cognitive dysfunction and brain health. Noted as one of the highlights of the year in our recent holiday specials and previously only available to attendees to the incredibly successful EBPOM Chicago 2020; go to www.ebpom.org now for more details on forthcoming events and special offers.

This piece gets a mention "End of life decision planning in the perioperative setting: the elephant in the room?" https://academic.oup.com/bja/article/115/5/648/230412?login=true

The Global Council on Brain Health is here on the American Association of Retired People's website: https://www.aarp.org/health/brain-health/global-council-on-brain-health/

This is part one of a two part piece, part two features questions from the online conference audience.

Presented by Monty Mythen with Angela Bader, Professor of Anesthesia at Harvard Medical School and Vice Chair for Perioperative Medicine in the Department of Anesthesiology, Perioperative and Pain Medicine at Brigham and Women’s Hospital, founding Director of the Weiner Center for Preoperative Evaluation, Sarah Lenz Lock, Senior Vice President for Policy and Brain Health in the American Association of Retired People's (AARP) Policy, Research and International Affairs (PRI), Executive Director of the Global Council on Brain Health, Jeanna Blitz associate professor of Anesthesiology at Duke University School of Medicine, Director of the Preoperative Anesthesia Surgical Screening (PASS) Clinic. There's also a surprise appearance from the EBPOM Chicago 2020 host, Sol Aronson, tenured Professor at Duke University.

Perioperative Quality Initiative P.O.Q.I. news | ASA 2019 Feb 14, 2021

"It might just be 'boring old blood pressure ... (but) ... every fourth operation there is evidence of a modifiable risk factor".

The Perioperative Quality Initiative (POQI) is our starting point for this conversation, seven concensus conferences focusing on various topics of interest to the perioperative practitioner. Check out their extensive open source resources here: www.poqi.org

Hypotension and Mean Arterial Pressure (MAP) are discussed in detail; how are patients now being managed? How can a 'hazard index' help?

"25% of our patients experience hypotension!"; regular TopMedTalk listeners know this has been frequently highlighted as an issue for patient mortality.

Also, 26 minutes in, hear about the recent POQI and Acute Dialysis Quality Initiative (ADQI) meeting of 2019. "There is no such thing as a bit of a creatinine bump that is 'normal'".

Presented by Desiree Chappell, Monty Mythen and a surprise appearance from Sol Aronson, with their guest Andrew Shaw, Chairman, Department of Anesthesiology and Pain Medicine at The University of Alberta, Edmonton, Alberta and Zone Clinical Department Head for Anesthesia, Alberta Health Services Edmonton Zone. He is also a Fellow of the Royal College of Anaesthetists (UK), the American College of Critical Care Medicine and the Faculty of Intensive Care Medicine (UK).

Like this, want more?

Find out more about POQI here: "Desiree's Roundtable | What is the Perioperative Medicine Summit?" https://www.topmedtalk.com/desirees-roundtable-what-is-the-perioperative-medicine-summit/

For more regarding the papers published by POQI, referenced in this piece, go here: "Sunday Special | Blood Pressure" https://www.topmedtalk.com/sunday-special-blood-pressure/

We speak with Dan Sessler here: https://www.topmedtalk.com/topmedtalks-to-dan-sessler-2

Also, if you enjoyed Andrew Shaw's take on these issues go listen to this fascinating conversation: "Desiree's Roundtable | Fluids in the 2020's" https://www.topmedtalk.com/desirees-roundtable-fluids-in-the-2020s/

Finally, Professor Sol Aronson, tenured, Duke University, who features on this podcast, delivered a talk you're bound to love here: "Perioperative Medicine is population health" https://www.topmedtalk.com/poet-6-01-perioperative-medicine-is-population-health/

Somnia Anesthesia Services | TopMedTalk Feb 13, 2021

"We're so invested in outcomes and data that it really gives us an objective view on how to approach things"

This wide ranging conversation looks at how a data driven approach to change can produce better results in terms of patient outcomes. How do you highlight those opportunities with tact and clarity? How do we start to reward and recognise the best care that the evidence supports?

We also hear more about Evidence Based Perioperative Medicine (EBPOM) in 2021; for more on the opportunities mentioned in this piece please go to www.ebpom.org

Also, if you're aligned with the great nation of Wales or you love perioperative medicine, you'll be delighted to hear about the Welsh Perioperative Medicine Society:

Their Twitter is here: https://twitter.com/pomswelsh

Their Facebook page is here: https://www.facebook.com /PomsWelsh/

And their excellent website is here: https://www.welshpoms.com/

Presented by Desiree Chappell and Monty Mythen with Marc Koch, President and CEO of Somnia Anesthesia and Shelley Sharma, Acute Pain service line Director for Somni Anesthesia.

Can medicine be cured? | EBPOM Ireland Highlight Feb 12, 2021

Warning; this piece may make for uncomfortable listening. It is a fascinating look at the recent history of medicine and how our profession may in fact be sick. Contained within the story is a message of hope; evidence may contain the cure.

In our recent history we seem to have enjoyed something of a "Golden Age" of medicine which, by raising quality of life so dramatically, has transformed our understanding of concepts such as "public health" and even "standard of living". However, running alongside that is an industry and society that is primarily interested in business and profit above evidence and health. Has the industry which built up around our profession during the 'Golden Age' now become a parasite which weakens its host to the point of near exhaustion?

After a concise critique of the current culture of research this talk asks why we are wasting time on research that is not reliable, not useful and does not impact care. Could it be that market forces have strangely made us less efficient? Evidence based medicine is the way forward but can we overcome the inherent bias behind the fact that often big business funds the evidence gathering and its publication?

Some assumed the period of rapid development, which included discovering the DNA helix, successful organ transplant and vaccinations, would soon inevitably be followed by equally epoch transforming breakthroughs, others are less optimistic. Are genomics and big data more often 'science' than medicine? Is "digital health" "simply one part of what has now been called surveillance capitalism"?

This challenging but ultimately hopeful and inspirational talk was given at the EBPOM Dingle conference 2019, please share it to as wide an audience of your peers as you can to help make this important and healing conversation happen.

Presented by Seamus O'Mahony, Consultant Gastroenterologist at Cork University Hospital, associate editor for medical humanities of the Journal of the Royal College of Physicians of Edinburgh and is a regular contributor to the Dublin Review of Books.

Testing the Hypotension Prediction Index | TopMedTalk Feb 11, 2021

"We wanted to know if goal directed therpy using a (Hypotension Prediction Index) HPI monitor can prevent hypotension". This piece looks in detail at the HPI monitor in practice- what is the benefit of this piece of technology in relation to hypotensive episodes? Furthermore how else is it to be tested and when will these tests be carried out?

Presented by Desiree Chappell and Monty Mythen with their guest Marit Habicher, Specialist, Department of Anesthesia and Critical Care at UKGM Giessen.

Shared decision-making: a team game? | EBPOM 2020 London Feb 10, 2021

"We have to remember that patients have a team"

How do we involve patients in the increasingly complex conversations we have in the perioperative space? This piece is a detailed case study which shows how shared decision making works in the perioperative setting. We know this improves patient experience yet in the last 10 or so years, consistently only 50 to 60% of patients say they were involved in decision making.

How can shifting towards a value based care model help? What is "moral injury" and how do we avoid it? Can a data driven analysis actually show shared decision making reduces costs?

Perioperative medicine for older people undergoing surgery (POPS) is an award winning geriatrician led service and the first of its kind in the UK - find out more here: https://www.guysandstthomas.nhs.uk/our-services/ageing-and-health/specialties/pops/overview.aspx

The Centre for Perioperative Care is here: https://cpoc.org.uk/

Presented by Ramai Santhirapala, Consultant Anaesthetist and Perioperative Medicine Lead at Guy’s and St Thomas’ NHS Foundation Trust, fellow of the Royal College of Anaesthetists, Faculty of Intensive Care Medicine and Higher Education Academy, Honorary Associate Professor at University College London, Clinical Lead for the UK arm of an international programme in shared decision making, “Choosing Wisely”, which is led by the Academy of Medical Royal Colleges, Shared Decision Making Lead at the Centre for Perioperative Care and sits on the Choosing Wisely International Roundtable.

Getting "fit for surgery" | EBPOM 2020 London Feb 09, 2021

"In this session, we're going to talk about the importance of fitness, frailty, function and perioperative medicine."

Fitness, frailty and function are overlapping concepts. In the UK, about quarter of patients will be over the age of 65 by 2034. As patients age they may develop comorbidities. These factors combine to present a unique opportunity for the perioperative physician; fitness increases the chances of a positive outcome, time to ensure every patient is "fit for surgery".

The Making Every Contact Count (MECC) campaign is here: https://www.makingeverycontactcount.co.uk/

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.

Perioperative Frailty with Jude Partridge | EBPOM 2020 London Feb 08, 2021

"If I were to develop a simple uncomplicated urinary tract infection, I may well be able to continue to go to work as I was being treated for that illness but if an older frail patient develops a similar uncomplicated urinary tract infection, that can be a very significant illness, that patient may well be unable to walk or transfer as they could"

Frailty in the perioperative period - what is it, what is it not and how do we work with and manage it before, during and after an operation so as to increase the value of care to our patients?

The opening article refered to in this piece is here: https://journals.sagepub.com/doi/full/10.1177/1756287220916614

The British Geriatrics Society "Fit for Frailty" document is here: https://www.bgs.org.uk/resources/resource-series/fit-for-frailty

More information on Perioperative medicine for older people undergoing surgery (POPS), an award winning geriatrician led service and the first of its kind in the UK, go here: https://www.guysandstthomas.nhs.uk/our-services/ageing-and-health/specialties/pops/overview.aspx

Presented by Jude Partridge, consultant geriatrician POPS, honorary senior lecturer, King's College London, Chairs the British Geriatrics Society POPS SIG.

Healthy eating and cancer | TopMedTalk & MacMillan Cancer Special Feb 07, 2021

TopMedTalk in Collaboration with MacMillan Cancer Support in the UK developed this podcast series to support patients during their cancer journey amidst the COVID 19 crisis.

We know food gives us energy "but it also provides so much more". This podcast looks at the raw materials you'll need, when facing a cancer diagnosis, to get a better outcome; the vitamins, minerals and proteins, as well as the energy sources you're best using.

What is a balanced diet when you have cancer? "We're talking about eating well to stay well [...] we're not really looking for people to lose weight"; it's often important for people to try to maintain their weight during a cancer diagnosis, should you track your weight throughout your cancer journey?

Recorded at the height of the COVID 19 crisis this podcast also reflects upon how this information is applied in the context of a global pandemic. What foods can we store which also contain the vital building blocks of our body's natural defenses?

Presented by Nick Margerrison with his guest Clare Shaw, consultant Dietician at The Royal Marsden NHS Foundation Trust.

For more information, in the UK, phone: 0808 808 00 00 email: CancerPrehabilitation@macmillan.org.uk

Twitter: @macmillancancersupport

Get active and feel good? | TopMedTalk & MacMillan Cancer Special Feb 06, 2021

TopMedTalk in Collaboration with MacMillan Cancer Support in the UK developed this podcast series to support patients during their cancer journey amidst the COVID 19 crisis.

It's vital you remain active after a cancer diagnosis, why is this? Hear the fascinating story behind the discovery that activity not only reduces your overall levels of fatigue but also improves your chances of recuperation. "You have to pace yourself [...] listen to your body"; but any physical activity will help fight feelings of tiredness. In short, if you get active you feel good.

Also in this podcast, with direct reference to medical trials and studies, our guests give you the mechanism behind incredibly helpful changes caused by moderate exercise in cancer patients, evidence which has led medics to conclude that "exercise is real medicine".

"When we're talking about being active during cancer it's at any stage of the cancer journey: from prehabilitation through recovery". Prehabilitation is the process by which people prepare their bodies for a major obstacle such as an operation or chemotherapy. It's like rehabilitation but it takes place before the event.

Just as when you start your recovery after treatment you would expect to get your body back to full health, here you try to achieve the best possible physical health before you start. The key point is that the medicine of exercise can be useful from diagnosis right through to full recovery and beyond.

Again, with direct reference to the evidence, find out how incredible research into prehabilitation is changing the way we think about cancer and recovery.

Recorded specifically at the height of the COVID 19 crisis hear how this research is being applied in the context of a global pandemic. Group forms of exercise are not an option while social distancing restrictions are in place, can exercising with other people bring us special benefits? If so, can those benefits be matched if we use the internet to continue the social side of going to a gym or a class?

Presented by Nick Margerrison with the Professor of Clinical Exercise Science, Anna Campbell, MBE, of Edinburgh Napier University and the director of CAN Rehab and the Professor of Prehabilitation Medicine, Sandy Jack, a consultant clinician scientist from The University of Southampton and University of Southampton NHS Foundation Trust .

For more information, in the UK, phone: 0808 808 00 00 email: CancerPrehabilitation@macmillan.org.uk

Twitter: @macmillancancersupport

Mental well being for the patient | TopMedTalk & MacMillan Cancer Special Feb 05, 2021

TopMedTalk in Collaboration with MacMillan Cancer Support in the UK developed this podcast series to support patients during their cancer journey amidst the COVID 19 crisis.

"It's very normal to sit with some difficult thoughts and feelings" after a cancer diagnosis. Broadly there are two types of mindsets; anxiety, which can be helpful, an element of wanting to 'do something' and, on the other hand, low mood, a feeling of not wanting to do anything, this can be unhelpful if not addressed at a certain level. We should expect both of these mindsets the question is 'how does the latest scientific research show can we control them'? Your body and mind are not separate, one effects the other, this is why it is so important we look at mental health as part of an overall approach.

"You can do quite a lot of things [...] that put you into a better mood"; exercise, meditation, even simple breathing exercises. Spending time communicating with friends and family is another suggestion.

Recorded at the height of the COVID 19 crisis this podcast also reflects upon how this is applied in the context of a global pandemic; how important is it that people engage with online facilities and opportunities to maintain relationships? "In an odd way the relationships seem to intensify".

It's not about ignoring negative feelings though, anxiety and low mood are very common for people with a cancer diagnosis. Hear how it is important to allow yourself to reflect, part of understanding your mental health is about regaining control, we are allowed to let ourselves feel difficult thoughts as part of the process of monitoring and working with them.

This podcast also contains a reminder about the importance of goal setting in allowing people to regain control over their lives. Small, realistic and specific, short term goals are useful at this particular stage of life; "start with the thing you are most confident you are able to change [...] make a day and a time that you'll stick to".

Presented by Nick Margerrison with his guests Judit Varkonyi-Sepp psychologist, psychology lead for the Wesfit prehabilitation programme and Chloe Grimmett, behavioural scientist and lead for Wesfit prehabilitation.

For more information, in the UK, phone: 0808 808 00 00 email: CancerPrehabilitation@macmillan.org.uk

Twitter: @macmillancancersupport

'Hip Attack' with PJ Devereaux | EBPOM World Congress 2020 Feb 04, 2021

"Accelerated surgery for hip fracture is safe and feasable, with troponin elevation before randomization, there was a mortality advantage with accelerated surgery. The logistics and resources required for accelerated surgery need to be balanced with the demonstrated benefits and patient's desires for accelerated surgery"

This exciting piece from EBPOM 2020 provides a data download that further illucidates the perennial debate surrounding hip fractures and their management and treatment. What is the correct perioperative approach to this nasty injury?

For more on the Hip Attack Trial go here: https://clinicaltrials.gov/ct2/show/NCT02027896

Presented by P.J. Devereaux, cardiologist, clinical epidemiologist, and perioperative care physician, Professor in the Departments of Health Research Methods, Evidence, and Impact (HEI) and Medicine, Director of the Division of Perioperative Care, McMaster University, Associate Deputy Director of the Population Health Research Institute, President of the Society of Perioperative Research and Care.

EBPOM Highlight | Intraoperative hypotension doesn’t happen to me Feb 03, 2021

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 this here via our large selection of podcasts on the topic: https://www.topmedtalk.com/?s=hypotension

For those who are already across the data the next question is, how do we detect it and prevent it, ideally before it even occurs? Here the HPI monitor comes into play, a cutting edge piece of technology which uses artificial intelligence to analyse the data and make predictions which could save your patient from a problematic outcome.

Presented by Dr Simon Davies, Consultant Anaesthetist, York Teaching Hospitals, NHS Foundation Trust.

Obstetrics in the pandemic (REPEAT) | COVID 19 Feb 02, 2021

"Babies are still being born" Still! Revisiting this conversation from early in the pandemic, we discuss obstetrics during COVID.

This piece looks at the area of obstetrics in the midst of an unprecedented global crisis regarding the COVID 19 outbreak. How can the delicate balance between reducing infections and social distancing be interwoven with the needs of modern childbirth.

Should we be concerned that some patients may shun hospital assisted births for fear of contagion? How has the data from China, much of which focused upon cesarean section births, been useful to us in the West? Why do the data have that angle?

Are there benefits to the new ways in which we have found to communicate during this global crisis which can be moved into a new life with COVID present but in a more manageable form?

Presented by Desiree Chappell and Monty Mythen with Sam Bampoe, University College London Hospital, Consultant Anesthetist, Director, Trainees with an Interest in Perioperative Medicine (TRIPOM), Nuala Lucas, Consultant Anesthetist at Northwick Park Hospital, Executive Committee Member for the Obstetric Anesthetists’ association and Pat O'Brien, Consultant Obstetrician at University College London Hospital, Vice President of Royal College of Obstetricians and Gynecologists.

Thank you to our sponsor Edwards Lifesciences.

Edwards clinical education (ECE): https://www.edwards.com/clinicaleducation

https://www.edwards.com/clinicaleducation

Periop SIG| Improving the quality of the patient surgical journey Feb 01, 2021

What are the latest developments in quality improvement programs that help operative teams around the world take what they do to the next level? When does the surgical journey begin? How has a focus upon patients prior to surgery improved outcomes? What are "the five phases of care"? How has data collection and management helped us to continually improve a patient's surgical journey?

This piece is a talk which was given during the 8th Australian and New Zealand Symposium of Perioperative Medicine Special Interest Group: “Updates in Perioperative Medicine 360” which took place between November 7th-9th 2019

Presented by Clifford Ko, Professor of Surgery at UCLA, Director of the Division of Research and Optimal Patient Care at the American College of Surgeons.

Outstanding outcomes | The RoundTable Jan 31, 2021

This piece, originally streamed live on www.topmedtalk.com features a conversation about the implementation of enhanced recovery protocols and the results practitioners report. The discussion starts with the observation that just implementing the ERAS intraoperative protocols drove outstanding outcomes in practice. The wider discussion focuses on the importance of putting into practice a bigger plan.

Presented by Desiree Chappell with her guests Raul Castillo, Anesthesia Medical Director at the University of Missouri Hospital, Jennifer Clark, Staff Nurse Anesthetist at the University of Missouri Hospital Department of Anesthesiology, and Kay Smith, pain nurse coordinator University of Missouri Hospital.

Improving Readiness (REPEAT) | COVID 19 Jan 30, 2021

"I'm also a United States Air Force Officer and reservist and on April 4th was activated and given approximately 48hrs to deploy on a C-5 Galaxy Military Aircraft to the epicenter, New York City and I've been here for approximately, it's been almost a month now"

This piece follows on from a previous exclusive conversation regarding the US military deployment to New York; here we get more detail and spend time thinking about how Enhanced Recovery must be an essential part of any "new normal".

The fascinating Carol Peden piece is here: https://www.topmedtalk.com/covid-19-disruptive-innovation/

And Bobbie Jean Sweitzer is here: https://www.topmedtalk.com/covid-19-promote-your-anemia-clinics-in-the-pandemic-era/

The previous conversation we mention is here: https://www.topmedtalk.com/covid-19-rapid-deployment-of-us-national-reserves-ease-stress-in-new-york

Presented by Desiree Chappell with Captain Joel Sherwood United States Air Force Reserves and Medical Science Liaison, National Director, Government Affairs, Pacira Pharmaceuticals.

TopMedTalk | Automation and artifical intelligence Jan 29, 2021

This piece focuses upon the increasing development of artificial intelligence and automation within the medical profession. Can automated monitoring actually allow practitioners to live more "in the moment" while in the operating theater? How do we use algorithms to avoid information overload?

The book "Deep Medicine: How Artificial Intelligence Can Make Healthcare Human Again", your "anxiety antidote" to the AI discussion, is here: https://www.amazon.co.uk/Deep-Medicine-Artificial-Intelligence-Healthcare/dp/1541644638

This piece was originally streamed from ‘The Society of Cardiovascular Anesthesiologists’ (SCA) annual conference, 2019.

Presented by Desiree Chappell and Monty Mythen with Sol Aronson, Tenured Professor, Duke University and Executive Vice Chairman in the Department of Anesthesiology, and their guest Tjorvi Perry, Assistant Professor, Department of Anesthesiology, University Minnesota.

Resource management, COVID patient management and innovation from New Jersey, USA (REPEAT) | COVID 19 Jan 28, 2021

This piece takes a look at the frontline fight against COVID 19 at Penn Medicine Princeton Medical Center in New Jersey, USA. Details of airway, ventilation and hemodynamic management are discussed with the director of Critical care and Anesthesiology. Resource management is a clear front runner as the virus creates a public health emergency for medics to try to battle. Additional beds and treatment facilities are being prepared, what other innovations are being brought to the fore.

Presented by Desiree Chappell with Monty Mythen and their guests Michael Scott, M.B., Ch.B. Professor of Anesthesiology at the University of Pennsylvania, Asmeet Bajaj, MD, Chief of Critical Care and Bridget Ruscito, MD Chair of the Dept of Anesthesiology at the Penn Medicine Princeton Medical Center and Jesse James Kiefer, MD, Anesthesiologist Assistant Professor of Clinical Anesthesiology and Critical Care at the University of Pennsylvania.

If you found this interesting listen to more on the topic here: https://www.topmedtalk.com/covid-19-epidemiology-revisited-a-case-for-virtual-meetings/

Thank you to Edwards Lifesciences for the generous support of our series "COVID 19 From the Frontlines"

EBPOM Highlight | Obstetric anaesthesia Jan 27, 2021

"Obstetric anaesthesia" - originally streamed live from The Institute of Engineering and Technology (IET) in London during EBPOM 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: https://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 Carolyn Johnston, consultant Anaesthetist in St Georges hospital in London and Improvement lead for the National Emergency Laparotomy Network (NELA.org.uk).

Opioid-induced Respiratory Depression | EBPOM USA - Las Vegas 2021 Jan 26, 2021

"46% pretty much means every other patient who was getting IV opioids was having some sort of a respiratory depression event"

After a quick round up of COVID news in the contributor's respective areas this piece gets involved in a much needed discussion about the “PRediction of Opioid-induced Respiratory Depression In Patients Monitored by capnoGraphY (PRODIGY)” trial.

PRODIGY trial is here:

https://clinicaltrials.gov/ct2/show/NCT02811302

Presented by Desiree Chappell and Monty Mythen with Mike Grocott, and their guests Ashish Khanna, Associate Professor, Section Head for Research, Department of Anesthesiology, Section on Critical Care Medicine, Wake Forest School of Medicine and Roop Kaw, Associate Professor of Medicine at Cleveland Clinic, Founder Member of The Society of Anesthesia and Sleep Medicine.

As mentioned TopMedTalk have been eagerly following the development of this research, you might also enjoy this piece we did here: https://www.topmedtalk.com/ebpom-2020-london-prediction-of-opioid-induced-respiratory-depression-on-the-general-care-floor-does-surveillance-monitoring-help/

More discussion regarding risk factors for opioid-induced respiratory depression in surgical patients here: https://www.topmedtalk.com/topmedtalks-to-paul-grant-2/

Non-invasive evaluation of autonomic nervous system- A nociception monitor | EBPOM USA - Las Vegas 2021 Jan 25, 2021

Armed with a background in biomedical engineering, doubled with an EMBA in Finance, our guest has spent the past 20 years within the medical device industry. In 2010 he was instrumental in setting up MDoloris Medical Systems, with the mission to provide technologies that allow clinicians a reliable, continuous and non-invasive evaluation of autonomic nervous system (ANS) activity. Based on 23 years of academic research, performed by a French research lab, the technology allows anaesthetists and intensivists to effectively tailor analgesia; more so for patients who are unable to communicate.

The technology is available for adults, paediatrics, neonates as well as animals (specifically horses, cats and dogs), in both standalone and more recently modular format.

Presented by Desiree Chappell and Monty Mythen with their guest Fabian Pagniez, CEO and founder of MDoloris Medical Systems.

For more details on EBPOM Las Vegas please visit www.ebpom.org

Also, if you enjoyed this piece we cover nociception in more detail here: https://www.topmedtalk.com/topmedtalks-to-dan-longrois-on-nociception/

TopMedTalk | Blood Pressure Jan 24, 2021

This piece highlights four papers published in the May 2019 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 and Sol Aronson, tenured professor at Duke University and Executive Vice Chairman in the Department of Anesthesiology.

Angela Bader - The need for 'end of life' conversations (REPEAT) | COVID 19 Jan 23, 2021

"The peak keeps getting pushed..."

What's the difference between a strategy of rationing as compared with one where the aim is concordence?

As the crisis rumbles on, how do we decide who should have surgery, as well as the pressing question of how and where? The principles of perioperative medicine kick in here, pre-optimisation and enhanced recovery are uniquely suited within the profession to assist in the worldwide battle against this pandemic.

What about the need for end of life conversations? How does the process of informed decision making apply here, how also does it apply to providers? How can we protect our essential human resources?

Finally, the conversation wraps with an important nod from the healthcare profession to the overwhelming goodwill being expressed around the world to people in medicine who are risking their lives to defeat this virus.

Presented by Desiree Chappell and Monty Mythen with their guest Professor of Anesthesia, Angela Bader, Harvard Medical School and Vice Chair of Perioperative Medicine at Mass General Brigham.

If you loved Angela Bader's incisive take why not listen to this popular interview we previously featured here on TopMedTalk: https://www.topmedtalk.com/topmedtalks-to-angela-bader/

We also mention TopMedTalk favorite Carol Peden, why not check out her appearance here: https://www.topmedtalk.com/covid-19-disruptive-innovation/

And Bobbie Jean Sweitzer is here: https://www.topmedtalk.com/covid-19-promote-your-anemia-clinics-in-the-pandemic-era/

Thank you to our sponsor’s Edward’s Life Sciences.

Edwards clinical education (ECE): https://www.edwards.com/clinicaleducation

EBPOM Highlight | Enhanced Recovery After surgery - plus! Jan 22, 2021

This piece gives you clear practical suggestions which you might want to include in your practice and institution. How do we improve the physiological reserve of patients? Is there a way to do enhanced recovery with an extra edge? Specifically, how do we reduce pulmonary complications? What is 'surgery school'? How does 'icough' fit into this? How can practitioners and admin staff help to reduce anxiety as surgery comes closer?

Visit the I COUGH UK website here: https://mft.nhs.uk/mri/services/i-cough-uk/

Make sure you check out the surgery school on the ERAS+ website here: https://www.erasplus.co.uk/How/SurgerySchool

Presented by Dr Daniel Conway, consultant in anaesthesia and critial care at University Hospitals Manchester.

Tackling the pain of the opioid crisis | ASA 2019 Jan 21, 2021

The opioid crisis "a unique American problem". This piece uncovers the origin of some of the misinformation about opioids, the consequences of calling pain a "fifth vital sign" and the absurd practice of waking patients up in the middle of the night to ask them if they are in any pain.

As these factors combined fatalities started to spiral into the crisis we see today. Recent statistics make for grim reading, in 2017 it was estimated over 47,000 Americans died from an opioid overdose. However action is now being taken; learn how The American Association of Nurse Anesthetists (AANA) has pushed forward with a sensible, responsible, pain management strategy which tackles the crisis head on.

Opioids are a last resort, many cases do not need them at all and a 30 day prescription to a highly addictive substance is something practitioners should never take lightly. Furthermore ensure patients are well informed, not 'opioid naive' and ideally do not have a family history of opioid dependence.

If you enjoyed this piece we have more on the topic here: https://www.topmedtalk.com/periop-coach-3-06-is-pain-the-fifth-vital-sign/

Also, if you've not yet heard Paul Wishmeyer's powerful take on this topic we highly reccomend you go here: https://www.topmedtalk.com/treating-patients-properly-ebpom-usa/

The Center For Disease Control's guidelines, mentioned in this piece, are here: https://www.cdc.gov/drugoverdose/prescribing/guideline.html

The PDF our guest mentions "The PAIN MANAGEMENT BEST PRACTICES INTER-AGENCY TASK FORCE REPORT" is here: https://www.hhs.gov/sites/default/files/pain-mgmt-best-practices-draft-final-report-05062019.pdf

This piece was part of our coverage of The AANA 2019 Annual Congress in Chicago, Illinois.

Check out the AANA here: https://www.aana.com/

Presented by Monty Mythen and Desiree Chappell with their guest, Bruce Schoneboom, PhD, CRNA, FAAN, Associate Dean for Practice, Innovation and Leadership at Johns Hopkins School of Nursing.

EBPOM London 2020 | Perioperative care: A new paradigm for the next decade Jan 20, 2021

"Patients undergo surgery for important reasons, we need to improve surgical outcomes to the point where anyone can have surgery - and I believe that is do-able; we need to implement what we know, we need to avoid missed opportunities and we need to conduct more research. We should learn from the history of anesthesiology and how intraoperative care so dramatically improved outcomes"

This powerful data based talk sets a bold standard for the year, a highlight from the momentous (Evidence Based Perioperative Medicine) EBPOM 2020 - Live From London, it featured as this year's Ernest Henry Starling Plenary Lecture, entitled: "Perioperative Care: A new paradigm for the next decade".

Introduced by Mike Grocott and presented by P.J. Devereaux, MD, PhD, FRCP(C), McMaster University, cardiologist, clinical epidemiologist, and perioperative care physician. Director of the Division of Perioperative Care at McMaster University he is the Associate Deputy Director of the Population Health Research Institute. He is also the Scientific Leader of the Anesthesiology, Perioperative Medicine, and Surgical Research Group at the Population Health Research Institute. A full Professor in the Departments of Health Research Methods, Evidence, and Impact (HEI) and Medicine at McMaster University. He has published over 330 peer reviewed papers and over 80 book chapters, editorials, and commentaries. He has given over 900 lectures and research presentations in 40 countries. He is supported by the McMaster University/ Hamilton Health Sciences Chair in Perioperative Care and a Tier 1 Canadian Research Chair in Perioperative Medicine. He's also the President of the Society of Perioperative Research and Care.

Talks to ... Bob Thiele | EBPOM Ireland 2020 Jan 19, 2021

This piece is a chance to hear more about the work of our guest, who made a big impact as a guest on a recent edition of TopMedTalk: https://www.topmedtalk.com/topmedtalk-computer-gamer-to-life-saver/

The Perioperative Quality Initiative (POQI) is here: www.poqi.org

This piece covers cerebral oximetry with near-infrared spectroscopy (NIRS), often used during the perioperative period of cardiovascular operations.

Article here:

"American Society for Enhanced Recovery and Perioperative Quality Initiative Joint Consensus Statement on the Role of Neuromonitoring in Perioperative Outcomes"

https://journals.lww.com/anesthesia-analgesia/Abstract/9000/American_Society_for_Enhanced_Recovery_and.95500.aspx

We're celebrating Evidence Based Perioperative Medicine's (EBPOM) Dingle conference which holds a special place in the hearts of TopMedTalk listeners. We've covered it for the last few years in detail, making many hours of valuable educational information accessible to a global audience of thousands of medical professionals each week. If you'd like to find out more about EBPOM's groundbreaking online proposition please checkout www.ebpom.org

Presented by Desiree Chappell and Monty Mythen with their guest Robert Thiele, Associate Professor, Departments of Anesthesiology and Biomedical Engineering, Division Chief, Critical Care Anesthesiology, Board of Directors, University Physicians Group, University of Virginia School of Medicine. He has a background in engineering and has been using technology to improve education since his residency in 2008. He is co-founder of www.OpenAnesthesia.org which lead to the development of Self-Study, and also authored one of the first iBooks focused on cardiac and critical care ultrasound.

TopMedTalk | Hemodynamics - State of the Science Jan 18, 2021

This piece explores the current thinking on hemodynamics, get ready for a deep dive into the conversation and controversies. Originally streamed live from www.topmedtalk.com as part of our coverage of The EBPOM USA Dallas Master's Course 2019. This panel discussion is chaired by Desiree Chappell, CRNA from Louisville Kentucky and Board Member of ASER. It features Monty Mythen, TopMedTalk Editor In Chief, Smiths Medical Professor of Anaesthesia and Critical Care at University College London, Tim Miller, from Duke University Medical Centre and Dr Simon Davies, Consultant Anaesthetist at York Teaching Hospital NHS Foundation Trust.

Paul Grant | TopMedTalks To ... Jan 17, 2021

This piece ploughs into some of the academic papers that have provoked discussion 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 Glucose on Postoperative Mortality in Noncardiac and Cardiac Surgeries.

https://www.ncbi.nlm.nih.gov/pubmed/29440113

Frailty as a Predictor of Death or New Disability After Surgery: A Prospective Cohort Study.

https://www.ncbi.nlm.nih.gov/pubmed/30048320

Presented by Desiree Chappell and Monty Mythen with their guest Paul Grant, Hospitalist and Director of Perioperative and Consultant Medicine at the University of Michigan.

COVID 19 | Roneet Lev, San Diego Jan 16, 2021

This piece took a look at the San Diego front line of the global fight against COVID 19 on March the 30th at the start of the crisis.

What unique pressures were there; the large homeless population is a particular challenge, how do psychiatric patients further the conundrum. Also, what about the assumption that patients are likely to be carrying the virus so should all be treated as if that is the case, does that apply here?

Presented by Desiree Chappell with Roneet Lev, MD FACEP, Chief Medical Officer, White House Office of National Drug Control Policy Director of Operations, Scripps Mercy Hospital Emergency Department San Diego.

TopMedTalk | Research and development during COVID and beyond Jan 15, 2021

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 does product development actually work these days? How important have standards of proof become? Should we celebrate the fact hardware appears to be being pushed toward a similar evidence standard needed to take a new drug to market? How are research and development administered? How can we make a clinical and economic argument that makes sense to everyone?

Also, how has the Covid Crisis galvanized the medical industry and shown them that things can be achieved at speed in our profession?

The Ventilator Training App episode we reference is here: https://www.topmedtalk.com/covid-19-the-ventilator-training-alliance-app/

Presented by Desiree Chappell and Monty Mythen with their guests, Vafa Jamali, Senior Vice President and President of Respiratory, Gastrointestinal & Informatics (RGI) within Medtronic's Minimally Invasive Therapies Group (MITG) and Jennifer Doyle, Global Vice President, Medical Affairs - Respiratory, Gastrointestinal & Informatics and MITG at Medtronic.

Outcome criteria associated with residual neuromuscular blockade | AANA 2020 Jan 14, 2021

"The more I learn about this, the more my eyes are opened to how much opportunity we have to improve in this area"

This piece covers the "perennial topic" of whether paralysis is bad for breathing, here with a focus upon outcome criteria associated with residual neuromuscular blockade. It's a piece based in part upon a recent talk at the American Association of Nurse Anesthetists annual conference which was this year held virtually.

Presented by Desiree Chappell with her guest Brent Dunsworth, CRNA, DNP, Director of Advanced Practice for the Department of Anesthesiology at Vanderbilt University Medical Center.

EBPOM 2020 London | Extending roles: what is the future? Jan 13, 2021

"Just having more staff doesn't always equate to better care, especially when the staff do not have the skills required."

Perioperative medicine has the opportunity to lead the way in advanced practice; the extended role of the practitioner within the perioperative pathway can be done with nurses, allied health professionals or physician associates. As we evolve these roles, we must be mindful and recognise not all services will be the same.

How can you tailor your service to your specific needs? How do you construct a business case which provides a better quality of value based care within your institution? Could this help by giving the practitioner role focus and allowing you to measure their effectiveness?

For more information about Guy's and St Thomas's practice we suggest you look at their website, an excellent information resource, here: https://www.guysandstthomas.nhs.uk/our-services/ageing-and-health/specialties/pops/overview.aspx

Presented by Jason Cross, Advanced Nurse Practitioner, Department of Aging and Health, Guy's and St Thomas's, London.

Covid 19 - ventilation strategies | EBPOM Ireland 2020 Jan 12, 2021

This vital piece deals with a variety of issues related to COVID-19; what we know and what we know we do not know:

- Similarities and differences between COIVD-19 and Aqute Respiratory Distress Syndrome (ARDS) - The most useful information observed by practitioners at the bedside, conscious of the lack of Randomised Controlled Trials (RCTs) in this area - The controversy regrading early invasive ventilation versus non-invasive ventilation - What are the aerosolization risks? - Pragmatic patient prioritization - The role of anti-coagulation - The role of continuous positive airwave pressure (CPAP) - who benefits and why?

Presented by Professor Mervyn Singer, Intensive Care Medicine at University College London.

TopMedTalk | Henrik Kehlet and Nick Scott Jan 11, 2021

"It's all about safety and recovery, it's not about speed"; this conversation focuses on enhanced recovery, are we getting it right and where are people getting it wrong? How reliable and well understood is the data behind it? Also, what are the current thoughts on perioperative steroids? How do we refocus and move back to enhanced recovery after surgery rather than "enhanced discharge" after surgery.

Presented by Monty Mythen and Desiree Chappell with Sol Aronson, tenured Professor at Duke University, and their guests Henrik Kehlet, a gastrointestinal surgeon and former professor of surgery, Copenhagen University, and now professor of perioperative therapy and Head of Section of Surgical Pathophysiology, Rigshospitalet, Copenhagen University and Nick Scott, an early proponent of Enhanced Recovery in the UK who has spent the last six years as the Vice Chairman of Anesthesia and Perioperative Medicine at Hamad Medical Corporation in Qatar.

Enhanced Recovery with Monty and Desiree | EBPOM Ireland Highlight Jan 10, 2021

TopMedTalk has recently engaged with a large number of new listeners, we are delighted to have you join our family of perioptimists! This piece works as a primer, it explains what lies at the core of the world's favorite perioperative medicine podcast; enhanced recovery. What is it? How do you implement it? What are its core principles?

If you've never heard TopMedTalk before but you are a medical practitioner this piece is a great place to start; if you're already onboard it will be a welcome refresher regarding the ideas we all gather around daily.

How widespread is enhanced recovery after surgery and, perhaps more importantly, how widespread are its principles? Are patients living the drinking, eating and mobilising early on and so "living the (drink, eat, mobilise) dream?".

The "POWER" study "Association Between Use of Enhanced Recovery After Surgery Protocol and Postoperative Complications in Colorectal Surgery: The Postoperative Outcomes Within Enhanced Recovery After Surgery Protocol (POWER) Study" is here: https://pubmed.ncbi.nlm.nih.gov/31066889/

The App Store has our app here: https://apps.apple.com/gb/app/topmedtalk/id1438159784

Google Play has it here: https://play.google.com/store/apps/details?id=com.topmedtalk.android.medtalk&hl=en_GB

There is a recent conversation with Henrik Kehlet here: https://www.topmedtalk.com/topmedtalk-henrik-kehlet-and-nick-scott/

There's also a recent one with Angela Bader here: https://www.topmedtalk.com/covid-19-angela-bader-the-need-for-end-of-life-conversations/

Our famous Bill Clinton piece is here: https://www.topmedtalk.com/sunday-special-bill-clinton-at-the-world-patient-safety-science-technology-summit-2/

The excellent Chris Snowden piece we mention is here: https://www.topmedtalk.com/dingle-2019-the-opportunity-in-variability/

(Enhanced Recovery After Surgery) ERAS Guidelines are here "Guidelines for Perioperative Care in Cardiac SurgeryEnhanced Recovery After Surgery Society Recommendations" : https://jamanetwork.com/journals/jamasurgery/fullarticle/2732511?guestAccessKey=04f7090d-122c-4e94-a46f-22e49dab7c51

The Perioperative Quality Initiative is here: https://thepoqi.org/

Presented by Desiree Chappell and Monty Mythen.

EBPOM Live from London | Australian Perspective on shared decision making Jan 09, 2021

This piece explores perioperative shared decision making from a variety of angles. Where is the latest research? Is it something we can reasonably out source? Does it always play in the favour of the patient or do we as practitioner benefit from this process also? How do we implement it without 'bulldozing' through years of experience?

Link to video featuring patient "Doug": http://www.petermac.org/sdm

Presented by Desiree Chappell and Ross Kerridge, "The Father of Perioperative Medicine", Debra Leung, Anaesthesiologist , Peter MacCallum Cancer Centre, Melbourne, Aisling Fleury, Geriatrician at Logan Hospital, Brisbane, Jon Gani, Conjoint Professor of Surgery at the University of Newcastle and an Honorary Medical Officer at John Hunter and Belmont District Hospitals, Pragya Ajitsaria is a staff Specialist Anaesthetist at John Hunter Hospital, Conjoint Lecturer at the University of Newcastle.

EBPOM London 2020 | Prehabilitation Update Jan 08, 2021

2020 was a big year for prehabilitation, the advent of a global pandemic has only increased the importance of this exciting field of medicine.

Various questions from EBPOM 2020 attendees were tackled by the panel: Can you use "Timed Up and Go" (TUG) and The Duke Activity Status Index (DASI) to screen out unnecessary cardio-pulminary exercise testing (CPET)? What exactly is prehabilitation and what's its natural scope? How important is nutrition? Is it possible to standardise these areas more? What areas are being significantly worked on in prehabilitation medicine in the UK this year? What about - in these COVID 19 times - remote screening and assessment? Also, what about the possibilities regarding aerosolisation, particularly of COVID-19, during CPET? Can prehabilitation work to minimise time spent in hospital?

Presented by Mike Grocott, Professor of Anaesthesia and Critical Care Medicine at the University of Southampton with Karen Kerr, Consultant Anaesthetist, Departmental Lead for CPET, Sheffield Teaching Hospitals (STH) and featuring panelists; Denny Levett, Professor in Perioperative Medicine and Critical Care at the University of Southampton and a Consultant in Perioperative Medicine at Southampton University Hospital NHS Foundation trust (UHS), June Davis, Director of Allied Health Solutions, Allied Health Professions Advisor (part time) for Macmillan Cancer Support and a professional advisor to the Care Quality Commission and Steve Wootton, OBE, Associate Professor in Nutrition at the University of Southampton with an honorary appointment with University Hospital Southampton in Clinical Nutrition.

Ketamine Infusion Centers: From Inception to Infusion | AANA 2020 Jan 07, 2021

"My first thought was - why can't we do this here?"

What is ketamine, what sort of drug is it and how is it used? How was it first synthesized? Was it intentionally found or another of science's happy accidents?

This piece is a fascinating look into the history and future of ketamine with a focus on outpatient infusion centers. Could this unusual and "dirty" drug - meaning it acts on many parts of the body and is not fully understood - have incredibly useful consequences for people who face the grueling task of handling depression or a post traumatic stress disorder?

We look at the research and evidence base regarding ketamine, how it is effective for different disease processes and how the drug might be more widely used in the future. It appears to have come into something of a renaissance, "thank you for getting the word out about ketamine".

Check out the clinic here: https://www.neuromendcenter.com/

Presented by Desiree Chappell and Monty Mythen with Tracy Young, MSNA, MBA, CRNA, CEO of YPS Anesthesia, he also a two time past State President for the Louisiana State Association of Nurse Anesthetists as well as currently sitting on several other boards.

Managing OR Capacity In a Post #COVID19 World | EBPOM USA - Chicago 2020 Jan 06, 2021

How do we manage our operating room capacity and restore elective surgery in a post-COVID19 world? A world where conditions change week by week, sometimes day by day.

Managing capacity was always a challenge but now we need to think differently in order to stay resilient and agile. How has COVID19 changed the landscape now?

What are the tools that exist to handle it? What are the systems and best practice guidelines that are helping institutions cope? How do we look at supply and demand within the constraints of what's available to us?

Finally the possibility of a "second wave" is investigated, how should it be tackled should it arise?

Presented by Sanjeev Agrawal, President, LeanTaas.

EBPOM London 2020 | Perioperative oxygenation Jan 05, 2021

"Oxygen is the commonest drug that we give to our patients today during surgery and the general anaesthetic" but what do we really know and understand about it from a perioperative perspective?

This talk illustrates why, even with some of the evidence and background physiology that we have at our fingertips today, the following questions are still perplexing: How much is too little oxygen? How much is too much oxygen? And how much is just the right amount of oxygen?

Presented by Daniel Martin, OBE, Professor of Perioperative and Intensive Care Medicine, University of Plymouth and the Royal Free Hospital, London.

EBPOM London 2020 | Optimizing fluid and hemodynamic management during major surgery Jan 04, 2021

This talk aims to answer four major questions: How much fluid should you give perioperatively? Does hypotension matter? Should you use advanced hemodynamic monitoring, and do colloids have any advances over crystalloids?

Using high quality studies and a data based approach in all four categories, a lot of which has come from conversations that have had happened at Evidence Based Perioperative Medicine (EBPOM) meetings, this talk draws some interesting conclusions.

The American Society of Enhanced Recovery (ASER) is here: https://www.aserhq.org/web/

The Perioperative Quality Initiative (POQI) is here: https://thepoqi.org/

Presented by Tim Miller, Associate Professor of Anesthesiology from Duke University Medical Centre.

EBPOM 2020 London | Fuel: can you have too much? Jan 03, 2021

"As Anaesthetists the ultimate goal of almost all of our interventions and monitoring is to support cell energy production to provide mitochondria with the oxygen and the fuel they need to produce enough adenosine triphosphate (ATP) to power cell function and integrity".

How human cells produce energy, how this changes in response to stress and how this may influence survival; this piece focuses what we know about how our bodies get the fuel they need to survive surgery and thrive as a result, providing a positive long term outcome. This is not a piece about nutrition, it's a provocative session exploring concepts designed to provide food for thought.

Presented by Helen McKenna, is in the final year of her PhD at University College London, investigating bioenergetic and redox function in critically ill patients.

EBPOM 2020 London | Models of Prehabilitation, South Tees and PREP-WELL Jan 02, 2021

This piece covers the PREP-WELL project which is a community based prehabilitation program in South Tees, in the North of England:

"We established the following guiding principles; we wanted to provide patient centered care under one roof with facilitated self management; we wanted to work as a cross sector collaborative, by that I mean primary care, secondary care and public health; all working together to try and improve on the fragmented service provision and sign work that we often see in our health care services; we wanted to provide a community based facility for patients; and I'll come to the reasons for this".

See the PREP-WELL team here: https://www.southtees.nhs.uk/services/prepwell-project/meet-the-prepwell-team/

The links mentioned in the talk are here:

Home exercises: https://www.southtees.nhs.uk/services/prepwell-project/home-exercises/

Nutrition: https://www.southtees.nhs.uk/services/prepwell-project/nutrition/

Pdf download: https://bmjopenquality.bmj.com/content/bmjqir/9/1/e000898.full.pdf

We've been following the groundbreaking success of the PREP-WELL project for some time now here on TopMedTalk, why not check out this piece here, the first part in our most recent "P.O.E.T - Perioperative Enhancement Teams" series; https://www.topmedtalk.com/poet-2-01-the-uks-prepwell-initiative/

This piece was originally part of EBPOM 2020 - Live from London, our groundbreaking virtual conference; find out more about Evidence Based Perioperative Medicine (EBPOM) here: www.ebpom.org

Presented by Gerard Danjoux, consultant in Anaesthesia and Sleep Medicine at South Tees Hospitals NHS Foundation Trust.

"Am I safe?" | EBPOM World Congress 2020 Jan 01, 2021

"We have to create the culture of learning; the culture of having a safe space, the culture of wanting to do better and learning those conditions in which we do do better"

This powerful talk looks directly at how a clear approach to patient safety really can improve the standard of care where you work. What is the culture of quality and safety that you're trying to embed, can you actually do better? Learn why it's important to focus on psychological safety; "if people start being scared, everyone gets scared then it expands".

Learn how an evidence based approach can allow us to tackle these issues rather than shy away from them; "what factors are maintaining safety? How do we get to good outcomes? What are the things working well? How do we understand human variation?".

Presented by Lee Fleisher, Emeritus Professor of Anesthesiology and Critical Care, University of Pennsylvania.

Sex, race and social class disparities in pain | AANA 2020 Dec 31, 2020

Pain is a subjective experience that affects all segments of the population. However, there are inter-individual differences in pain. The biopsychosocial model proposes that the intersection of biological, psychological, and social factors create a pain experience and pain outcomes that differ by sex, race, and socioeconomic status.

"The minority stress theory ... the idea that for racial minorities, especially blacks, they are exposed to chronic stress; the stress of daily racism"

Could epigenetics hold the key to understanding how social factors compound differences between patients? How does this impact on you and your practice?

Further reading is to be found here: https://pubmed.ncbi.nlm.nih.gov/19411059/

https://pubmed.ncbi.nlm.nih.gov/32487870/

https://pubmed.ncbi.nlm.nih.gov/30863142/

Presented by Desiree Chappell and Monty Mythen with Edwin N. Aroke, Ph.D., CRNA, Assistant Professor, Associate Scientist, Minority Health and Health Disparities Research Center, Associate Scientist, Comprehensive Arthritis, Musculoskeletal, Bone, & Autoimmunity Center, The University of Alabama, Birmingham, US.

TopMedTalk | Tom Woodcock Dec 30, 2020

This piece was recorded at the start of the year, to celebrate the launch of Tom Woodcock's book Fluid Physiology, A Handbook for Anaesthesia and Critical Care Practice: https://books.google.co.uk/books?id=F-m4DwAAQBAJ&printsec=copyright&redir_esc=y#v=onepage&q&f=false

The editorial team here at TopMedTalk recently (08/12/2020) reflected upon the fact that Tom's 'big areas to watch in 2020' have proven to be remarkably prescient.

The 13 Minutes To The Moon podcast is here: https://www.bbc.co.uk/programmes/w3csz4dn

Presented by Monty Mythen with Desiree Chappell and their guest Tom Woodcock, author and independent consultant in patient safety, medical law and ethics.

EBPOM 2020 London | Perioperative team: a physician’s view Dec 29, 2020

This piece considers the need to understand the patient having surgery and the complexity with which they present so we can match our skills to them. Developing these skills requires new approaches; to education and training at undergraduate and postgraduate level; to challenge the old ways of delivering perioperative care. This requires new ways of working, the breaking down of silos, a rethink of the financial support that is required and that we share good practice rather than 'reinventing the wheel'. It also means ensuring that we continue to gain evidence from the real world of clinical medicine, whether that's through original research or through employing quality improvement and implementation science.

More on Proactive care for Older People undergoing Surgery (POPS) here: https://www.guysandstthomas.nhs.uk/our-services/ageing-and-health/specialties/pops/overview.aspx

If you enjoy this piece you'll love our series here: "POPS Part 1| TopMed talk at Guy’s and St Thomas’s Hospital in Central London" - https://www.topmedtalk.com/pops-part-1-topmed-talk-at-guys-and-st-thomass-hospital-in-central-london/

Presented by Jugdeep Dhesi, Clinical Lead for "Proactive care for Older People undergoing Surgery" (POPS) and Consultant Geriatrician, Guys and St Thomas' NHS Trust.

EBPOM London 2020 | Perioperative team: a surgeon’s view Dec 28, 2020

This piece looks at some of the advantages to having a perioperative interdisciplinary team reducing complications, understanding and discussing risk, facilitating better shared decision making and increased patient satisfaction, even among those who - as part of this process - decide not to go ahead with an operation.

It also incorporates evidence regarding what we know about COVID-19; "The risks ... of the COVID-19 virus is that if people contract it during or after their surgery, they have a much worse result with perhaps 51% pulmonary complications or 24% mortality".

The World Health Organisation report mentioned in this piece, "Smoking greatly increases risk of complications after surgery", is here: https://www.who.int/news/item/20-01-2020-smoking-greatly-increases-risk-of-complications-after-surgery

The Montgomery ruling is covered on a previous TopMedTalk in more detail in "Sunday Special | Being on the right side of the law" here: https://www.topmedtalk.com/sunday-special-being-on-the-right-side-of-the-law-2/

The Centre for Perioperative Care website is an excellent resource, here is the section specifically for your patients: https://www.cpoc.org.uk/patients

The Royal College of Surgeons is here: https://www.rcseng.ac.uk/

Our presenter has a website dedicated to her work here: http://www.scarlettmcnally.co.uk/

And she maintains a twitter feed - focused on medical issues - here: https://twitter.com/scarlettmcnally

Presented by Scarlett McNally, Deputy Director of The Centre for Perioperative Care (CPOC) consultant Orthopaedic Surgeon, Eastbourne DGH, UK.

TopMedTalk | Fluid Physiology in detail Dec 27, 2020

"We did not have a concensus view on the very basic subject of fluid physiology and I needed to write a book".

Recorded at the start of the year this piece builds on our previous look at Fluid Physiology, which you can find here: https://www.topmedtalk.com/topmedtalk-tom-woodcock/

We also make reference to the book "Fluid Physiology" which is available now, check out the website here: http://fluidphysiology.org/

Tom's always entertaining twitter feed is here: https://twitter.com/thomaswoodcock

Presented by Monty Mythen and Desiree Chappell with their guests Sol Aronson a tenured professor at Duke University and Executive Vice Chairman in the Department of Anesthesiology and Tom Woodcock author and independent consultant in patient safety, medical law and ethics.

Like this, want more? Tom Woodcock appears frequently on TopMedTalk: https://www.topmedtalk.com/?s=tom+woodcock

TopMedTalk | "Boxing Day" Holiday Special Dec 26, 2020

"We, who physically will be elsewhere in the world, for example, in London and in Southampton, are going to - within what we're allowed to do - get together in a bubble probably at work, and set aside the time to watch the meeting together, and to share some food and maybe share some diet coke and talk about what we've been looking at what we've been learning. So that's the start of the hybrid events - and we hope that by the time we get to the World Congress of Perioperative Care, which used to be known as the London meeting, we are going to have 10's if not hundreds, if not 1000's of hybrid venues around the world..."

Listen to the end to find out more about the ambitious plans for COVID conscious "hybrid meetings" in 2021. Email us if you think you can help arrange a hybrid zone breakout space: admin@ebpom.org

Recollections regarding Evidence Based Perioperative Medicine's (EBPOM) Chicago virtual meeting begin the piece, as the TopMedTalk team look back over the final part of the year.

The Toby Richards piece mentioned is here: https://www.topmedtalk.com/topmedtalk-iron-man-vs-anemia/

The entertaining discussion between Angela Bader and Gina Blitz will be available in a forthcoming episode of TopMedTalk. It has been heard already by EBPOM Chicago attendees under the title: "Brain Health: Frailty, Delirium, POCD". This talk will be available for free in full on TopMedTalk in the future.

For more details of the next EBPOM 'hybrid' meeting please visit www.ebpom.org

The music of Jeremy Sassoon - part of the EBPOM Chicago entertainment offering - is available to enjoy here: https://www.youtube.com/watch?v=D_baYCXTdY8

The Dingle lectures will also form part of TopMedTalk's programming next year, make sure you hit the subscribe button on whichever platform you receive us on.

Presented by Desiree Chappell and Monty Mythen with TopMedTalk producer Nick Margerrison.

TopMedTalk | Christmas Day Special Dec 25, 2020

The team enjoy reflecting on 2020 as we appreciate the fact that there were the green shoots of hope during the middle part of the year.

The patient facing Macmillan Cancer Care podcasts are here: https://www.topmedtalk.com/?s=topmedtalk+%26+macmillan

The POCAPALOOZA is here: https://www.topmedtalk.com/?s=pocapalooza

Find out more about the African Surgical Outcomes Study (ASOS) and the African Perioperative Research Group (APORG) here: https://www.topmedtalk.com/pocapalooza-cape-town/

Guy Ludbrook's interview and talk will be available on TopMedTalk in the new year.

Our friend and collaborator Jeremy Sassoon is here: https://www.facebook.com/watch/jeremysassoon/

The highlighted piece from the American Association of Nurse Anesthetists is here: https://www.topmedtalk.com/aana-e-cigarettes-and-their-impact-on-patients-undergoing-anesthesia-2/

Presented by Monty Mythen and Desiree Chappell with producer Nick Margerrison.

Happy Holidays and - if you celebrate it - Merry Christmas from everyone here at TopMedTalk!

TopMedTalk | Christmas Eve Special Dec 24, 2020

The annual TopMedTalk Holiday Special series this year takes a look back at COVID19 and the first year we had to live with it.

Listen to the full conversations used in this piece:

TopMedTalk | Henrik Kehlet and Nick Scott https://www.topmedtalk.com/topmedtalk-henrik-kehlet-and-nick-scott/

TopMedTalk | Silent pandemic of surgical complications https://www.topmedtalk.com/topmedtalk-silent-pandemic-of-surgical-complications/

COVID 19 | An update on patient, Professor Monty Mythen https://www.topmedtalk.com/8381-2/

COVID 19 | “You must learn the epidemiology” https://www.topmedtalk.com/covid-19-you-must-learn-the-epidemiology/

COVID 19 | Disruptive Innovation https://www.topmedtalk.com/covid-19-disruptive-innovation/

COVID 19 | Bring on the vaccine! https://www.topmedtalk.com/covid-19-bring-on-the-vaccine/

Presented by Monty Mythen and Desiree Chappell with producer Nick Margerrison.

COVID 19 | 2020 End of year stress, insurance and 'wellness' Dec 23, 2020

"I cannot sleep. It's like, I wake up at 1am and my mind's going crazy ... if you had someone come to you and say; 'I'm really struggling right now, I'm having a lot of anxiety, with work with family, with kids with whatever'; what are some of the top things that you want to share with them?"

How can a regular yoga practice bring you into a deeper union with what you do and help improve your performance? Why is it that people in the caring profession sometimes leave self care at the bottom of their priority list? What resources can professional bodies offer you?

With special thanks to the American Association of Nurse Anesthetists (AANA) for their help with this piece, their excellent website is here: www.aana.com/covidwellness

The help number mentioned is: 1-800 654 5167

The Breathing App is here: https://eddiestern.com/the-breathing-app/

The book "Why we sleep" is here: https://www.amazon.co.uk/Why-We-Sleep-Science-Dreams/dp/0141983760

"Insight Timer" is here: https://insighttimer.com/

Presented by Desiree Chappell with her guests Bridget Petrillo, CRNA at The Mayo Clinic in Phoenix Arizona, volunteer member for the AANA Peer Assistance Advisors Committee, State Peer Advisor for the Arizona Association of Nurse Anesthetists (AZANA), member of the Wellness Committee for AZANA and Jessica Switzman, CRNA, MSN, Johns Hopkins, also served on the AANA Wellness Committee and AANA Peer Advisors Committee, State Peer Advisor for MANA and has been teaching Yoga since 2007.

TopMedTalk | Silent pandemic of surgical complications Dec 22, 2020

This remarkably prescient conversation was recorded at an Australian National Summit in Adelaide regarding the 'hidden pandemic of postoperative complications'. The dangers presented by them certainly suggest this area needs to be taken more seriously. Although staged in Australia this conversation is of global concern, particularly at a time when the world is realising the benefits of proper perioperative care.

For more about the National Emergency Laparotomy Audit go here: https://www.topmedtalk.com/ebpom-2018-12-the-importance-of-cpet-and-nela/

The article mentioned in this piece is here: https://bjanaesthesia.org/article/S0007-0912(18)30654-8/abstract

There's a good piece about the summit here: http://theleadsouthaustralia.com.au/industries/health-and-medical/summit-targets-post-op-pandemic/

Presented by Monty Mythen and Mike Grocott with their guest Guy Ludbrook Professor of Anaesthesia at the University of Adelaide and Royal Adelaide Hospital.

Vaccine time! | COVID 19 Dec 21, 2020

"I think you're now famous in the CRNA community for being one of the first people in Fargo to receive the the COVID vaccine"

This piece sees us catching up with Certified Registered Nurse Anesthetists (CRNA's) who have just been vaccinated for COVID-19. Their story reminds us that even now some practitioners are facing their first real wave of the pandemic in their area: "We had a kind of trickle in, so to say, of COVID patients, and then this in this fall, the middle of November was really when it hit us pretty hard".

Presented by Desiree Chappell with Jordan Rohrich CRNA, Anesthesiology, Fargo, North Dakota and Jordi Idso MS, CRNA, Sanford Health in Fargo.

TopMedTalk | Computer gamer to life saver Dec 20, 2020

What happens when cutting edge computer game creators, fresh from working on top titles in their industry such as 'Hunger Games' and 'Mission Impossible', use their skills to simulate high stress moments from the real world of anesthesia and surgery? Using "the neuro-science of game design" to help accelerate learning within the profession:

"The motivation for starting Level Ex, what if we actually took the top game designers and developers in the industry? We're talking the executive producer of "Mortal Kombat", the creative director of "Call of Duty", the marketing director of "Words with Friends"; put them with top physicians from multiple specialties, to capture the challenges of the practice of medicine using video game mechanics".

"This doesn't recreate the mannequin, what this does replace is the five hundred live patients you need to train on in order to encounter those five to ten rare scenarios because we can recreate the rare and the difficult and then we can help you train your visualization skills, your recognition skills, your deductive reasoning skills, on those cases."

The key point here is not that motor function is being copied by a screen interactive experience but instead the aim is to "optimise cognitive load" and recreate the thought process alongside an emotional experience.

"We're not introducing you to how to do a fiber optic intubation, we're going to present dozens of rare difficult challenging once in a lifetime cases". Here computer games can currently excel in their teaching ability, "it's a cognitive skill, it's a decision making algorithm". As time ticks by in the simulation "you do get to a point where there's no return and you have like three minutes to do this successfully and so your algorithm and decision making is absolutely crucial". It's about taking in data and making decisions in a way that is not possible on a mannequin or ethical on a live patient.

"Everything that goes into the app is peer reviewed" and, with any computer game you can earn points as you go along; this game though gives you (Continuing Medical Education) CME points.

Google Play: https://play.google.com/store/apps/details?id=com.levelex.airwayex&hl=en_GB

Apple: https://apps.apple.com/us/app/airway-ex/id1154656060

Open Anesthesia is here: https://www.openanesthesia.org/

Presented by Desiree Chappell and Monty Mythen with their guests. Sam Glassenberg, CEO and Founder of Level Ex, before which he was CEO of the leading independent game publisher in Hollywood, releasing games based on popular films, including The Hunger Games and Mission: Impossible, he also led the DirectX graphics team at Microsoft, where he accepted a Technical Emmy on behalf of his team for advancing the visual realism of video games across the industry. His career began at LucasArts, creating Star Wars games for PlayStation and Xbox. Sam serves on numerous industry advisory boards and speaks internationally on video games in medicine. Robert H. Thiele, Associate Professor, Departments of Anesthesiology and Biomedical Engineering, Division Chief, Critical Care Anesthesiology, Board of Directors, University Physicians Group, University of Virginia School of Medicine. He has a background in engineering and has been using technology to improve education since his residency in 2008. He is co-founder of www.OpenAnesthesia.org which lead to the development of Self-Study, and also authored one of the first iBooks focused on cardiac and critical care ultrasound.

TopMedTalk | Iron Man vs Anemia Dec 19, 2020

"You've given us all a lot to think about" - a randomized controlled trial regarding intravenous iron does not go 'as expected'.

"I mean, look, I've built my entire career on thinking this was the best thing since sliced bread, the silver bullet, the magic wand ..."

A great scientist follows accurate data to wherever it may lead, what now? More trials, more time, more questions? How common is anemia? Are there any nuggets of hope buried within these data? What have we learned?

Evidence Based Perioperative Medicine sticks to the facts and there's nothing more important than data; make sure you listen to the end, there are interesting details that give many a sense of optimism.

Preoperative intravenous iron to treat anaemia before major abdominal surgery (PREVENTT): a randomised, double-blind, controlled trial is here: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)31539-7/fulltext

Toby is a popular contributor to TopMedTalk - check out his earlier piece here: https://www.topmedtalk.com/prato-2019-toby-richards/

Presented by Monty Mythen and Mike Grocott with their guest Toby Richards, Professor, Anaesthesia Teaching & Research Faculty of Medicine, Nursing and Health Sciences Central Clinical School, Monash University.

EBPOM Highlight | Delivering Personalised Care: aligning prehabilitation with healthcare policy Dec 18, 2020

How can we align personalised care with prehabilitation? "Personalised care is where people have more choice and control over how their health and care needs are met" where we recognise "people themselves can sometimes be the best integrators of health and care". In this context our role is to support them to "live as independently as they wish". With shared decision making and personal choice at the heart of this we allow patients to be "experts in their own lives, health and care".

The increase in life expectancy means more long term conditions and comorbidities in patients, what opportunities does this present? How do we hone in on what matters to patients and help them manage the cumulative burden of long term health difficulties? How comfortable are healthcare practitioners when talking about physical activity?

Is it possible that personalised care could eventually be business as usual?

The NHS Long Term Plan has a website which you can see here: https://www.longtermplan.nhs.uk/

The NHS website is here: www.england.nhs.uk

Presented by Anna Lowe, Programme manager, National Centre for Sport and Exercise Medicine, Lead Allied Health Physical Activity Clinical Champion at Public Health, England.

Emergence Delirium in US Veterans: Best Practice Recommendations | AANA 2020 Dec 17, 2020

After working at a Veterans Affair Medical Center, hear how our guests moved into the field of emergence delirium: "upon emergence our patients were swinging and very aggressive ... there must be some way to prevent this".

This fascinating piece enjoys an engaging discussion about an important topic for both patients and practitioners; how important is it for you to know a patient may suffer from post traumatic stress disorder? Do different anesthetics promote or avoid emergence delirium? Can emergence delirium cause further long term trauma? How do we deal with US military veterans specifically?

Patient Health Questionnaire 9 (PHQ-9) is here: https://patient.info/doctor/patient-health-questionnaire-phq-9

The State Trait Anxiety Inventory is here: https://www.advancedassessments.co.uk/resources/Mental-Health-Test.pdf

Presented by Desiree Chappell and Monty Mythen with Kristen Roman, MSN, MFA, SRNA, Ignacio Diaz, BSN, SRNA and Jena Borgonia, BSN, SRNA, student registered nurse anesthetists (SRNAs) at The University of Southern California.

EBPOM London 2020 | SNAP-2 EPICCS; summary results Dec 16, 2020

"It's useful to reflect on what SNAP-2 EPICCS might offer us in the brave new world that we find ourselves in with Coronavirus"

The 2nd Sprint National Anaesthesia Project: Epidemiology of Critical Care after Surgery (SNAP-2 - EPICCS) study launched in March 2017 around the UK. More than 2,200 investigators at more than 250 sites across the UK were signed up to take part. The observational study collected data on all patients undergoing inpatient surgery during a one-week period (21 March to 27 March) in UK NHS hospitals.

What is the scale of the problem; when it comes to cancellation of inpatient surgery surgery, with a specific lens on critical care capacity? What about the value of higher levels of post operative care for high risk surgical patients? What are the essential ingredients for higher intensity post operative care?

Also, learn about some of the organically developed solutions that have come around to capacity issues for high risk surgical patients in the NHS and overseas. As well as this hear how we might select patients to be admitted to higher levels of care; the methods that we might use for risk stratification of inpatient surgical patients and what we think the potential benefits of post operative high levels of care could be. Do we have any data to support the notion that critical care confers benefits on post surgical patients?

The website is here: https://www.niaa-hsrc.org.uk/SNAP-2-EpiCCS

More on SNAP-2 is here: https://www.topmedtalk.com/what-is-snap-2/

Presented by Ramani Moonesinghe, Professor of Perioperative Medicine at University College London (UCL), Hon Consultant in Anaesthesia, UCLH.

EBPOM 2020 London | New enhanced care guidelines Dec 15, 2020

"Critical Care has a moment in time, a moment where we can make some big changes, a moment of opportunity"

This uncompromising and informative talk from the technical lead for critical care in the Getting It Right First Time (GIRFT) project takes us through how services can improve and work alongside perioperative care to improve standards and outcomes for patients.

Sharing best practice between trusts GIRFT identifies changes that help improve and change an institution’s procedures and cost savings, this is a vital talk and one of the highlights of the hugely successful EBPOM London 2020 virtual conference. For more details on up coming events from Evidence Based Perioperative Medicine EBPOM at www.ebpom.org

The GIRFT website is here – https://gettingitrightfirsttime.co.uk/

Further listening regarding GIRFT can be found here: https://www.topmedtalk.com/rcoa-13-the-girft-getting-it-right-first-time-project/

Presented by Anna Batchelor, MB ChB, FRCA, FFICM, Consultant Anaesthetist - Intensive Care Medicine, Newcastle upon Tyne. She is the technical lead for critical care in the 'Getting It Right First Time' (GIRFT) programme.

EBPOM London 2020 | Access to critical care for high risk surgical patients. Dec 14, 2020

From a UK perspective this piece covers variation in access to critical care, behaviors and decisions regarding its use. With reference to how, over the last 20 years, efforts have been made in Torbay to improve access to critical care we look at what can be done and what works. Finally there's a summary of where we are on this issue today.

Getting it right first time (GIRFT) is here: https://www.gettingitrightfirsttime.co.uk/

Presented by Mike Swart, Consultant in Anaesthesia and Critical Care Medicine at Torbay Hospital and advisor to the UK Department of Health for the Enhanced Recovery Programme.

The Perioperative Exercise, Testing and Training Society (POETTS) | EBPOM World Congress 2020 Dec 13, 2020

This piece provides an update on the Perioperative Exercise, Testing and Training Society (POETTS); "established back in 2017, in the context, in the United Kingdom, of cardiopulmonary exercise testing becoming much more common in the preoperative period". Now, more than half of acute hospital trusts in the United Kingdom have a cardiopulmonary exercise testing service to evaluate their patient's functional capacity prior to surgery. Furthermore exercise interventions to optimise a patient's fitness before surgery have seen a sudden and growing interest.

With just over 400 members POETTS exists to help standardize education and training in the field, develop consensus clinical guidelines, look after patients around the time of surgery and help club together acute hospital trusts across the UK, so that they can do collaborative research.

Their website is here: https://www.poetts.co.uk/

Presented by Denny Levett, Professor of Perioperative Medicine at the University of Southampton and President of the Perioperative Exercise, Testing and Training Society (POETTS).

EBPOM Highlight | Obstetric anaesthesia Dec 12, 2020

"Obstetric anaesthesia" - originally streamed live from The Institute of Engineering and Technology (IET) in London during EBPOM 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: https://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 Carolyn Johnston, consultant Anaesthetist in St Georges hospital in London and Improvement lead for the National Emergency Laparotomy Network (www.NELA.org.uk).

"The Business Case: UK" by Kay Mitchell | EBPOM World Congress 2020 Dec 11, 2020

This piece presents an invaluable wealth of first hand experience in setting up various business cases in relation to perioperative medicine in the UK. At University College London (UCL) cardiopulmonary exercise testing (CPET) was set up as a research tool "but then clinicians came, became interested in the results of the tests and started to ask for tests to be done on their patients for clinical evaluation".

An external contractor model, using a charitable organisation, enabled them to charge the NHS for these tests; as the service expanded they were able to expand to other clinical sites connected with UCL, published early data on outcomes and obtained grant funding to look at a robust evaluation model.

Hear how this model was refined and the idea has evolved during its growth within the UK's National Health Service (NHS). Also, consider what other models could apply this thought process; learn how new perioperative care pathways offer interesting opportunities in these areas.

This piece is further enhanced by the discussion we released recently on the same topic: https://www.topmedtalk.com/ebpom-london-2020-the-business-case-for-prehabilitation/

Presented by Kay Mitchell, Senior Research Manager for Critical Care Research, NIHR Biomedical Research Center, University Hospital, Southampton, UK.

E-cigarettes and their impact on patients undergoing anesthesia | AANA 2020 Dec 10, 2020

The electronic cigarette market is a $14 billion industry worldwide. As of August 2019, 215 cases of severe pulmonary illness related to e-cigarette use are being investigated in the United States. The known hazards of e-cigarette use are rapidly coming to light with the sudden onset of serious bronchiolitis-related pulmonary disease in otherwise healthy people who were known to use e-cigarettes. Learn also how COVID 19 has increased these dangers.

Presented by Desiree Chappell with Monty Mythen and Bernard Gilligan, III, DNP, CRNA, APRN, Program Assistant Director, Assistant Professor, Cedar Crest College Nurse Anesthesia Program, Allentown, PA.

EBPOM 2020 London | Prehabilitation Business Case? A slam dunk! Dec 09, 2020

"In the elective surgical domain 20% of people who are scheduled to have surgery are not ready for surgery"

The road towards economic reality is paved with data; this talk, confidently assertive in tone, provides you with a number of useful facts and reassurances which can be transformed into reasons why you and your patients can enjoy the benefits of prehabilitation; a better value of care and a higher standard of good quality outcomes.

This piece works well in tandem with this debate here: https://www.topmedtalk.com/ebpom-london-2020-the-business-case-for-prehabilitation/

Presented by Sol Aronson, tenured Professor, Duke University, Durham, North Carolina.

Amir Jaffer | TopMedTalks to... Dec 08, 2020

What is a "Respect Officer"? Why is respect so important in perioperative care? How does improving 'the culture of safety' also help to improve outcomes? Should we be overly concerned about high cancellation rates for surgery? And what are the advantages of a preoperative risk assessment clinic (PRAC)?

Presented by Desiree Chappell and Monty Mythen with their guest Amir Jaffer, Chief Medical Officer, New York Presbyterian / Queens.

EBPOM 2020 London | "The international prehabilitation society" Dec 07, 2020

What are the aims of The International Prehabilitation Society? Its vision is about "bringing together international multidisciplinary expertise, across healthcare and beyond, creating a platform of shared learning, research and education for the benefit of patients".

This piece updates you on the current board members, the roles of committee members, conferences that the society has previously supported alongside those being planned for the future. Also there's an update on some exciting new sponsorship news and a brief overview of future plans.

The society's website is here: https://prehabsociety.com/

Presented by Gerard Danjoux, consultant in Anaesthesia and Sleep Medicine at South Tees Hospitals NHS Trust.

EBPOM 2020 London | Models of Prehabilitation, Southampton and Wesfit Dec 06, 2020

This piece gives you the evidence base required to deliver an even higher standard of perioperative medicine where you work. Hear about the "Fit 4 surgery" studies; the "fit 4 surgery consortium", the ongoing e-studies, key findings, recent studies and the set up in Southampton.

Physical fitness is greatly affected by chemotherapy; poor outcomes are significantly linked to physical fitness; learn how preoperative cardio-pulmonary exercise testing and training can monitor and track this potentially dangerous spiral. Hear how multiple studies are now providing a clear evidence base for this exciting area of perioperative care.

Could more such targeted interventions, alongside shared decision making, provide a real difference to outcomes for your patients and a higher standard of value based care in your institution?

For more on this go here: http://wesfit.org.uk/

Read more about the great work being done by MacMillan Cancer Trust here: https://www.macmillan.org.uk/

The video version of this presentation, along with slides, was presented to the many thousands of people who attended the hugely successful Evidence Based Perioperative Medicine (EBPOM) virtual conference, "Live from London". For more details on this and future conferences please visit www.ebpom.org

Presented by Professor Sandy Jack, PhD, Consultant Clinician Scientist in The Anaesthesia and Critical Care Research Unit at University Hospital Southampton NHS Foundation Trust, Honorary Senior Lecturer at the University of Liverpool, University of Southampton and University College London.

EBPOM 2020 London | Models of prehabilitation in Cardiff in Wales Dec 05, 2020

"The people of Wales are particularly unfit", there is a high incidence of smoking, physical inactivity, and alcohol intake. Grim news from one angle but on the other hand it's a huge opportunity to make a massive difference in the prehabilitation stage of the perioperative process. Hear how cancer outcomes are being dramatically improved as a clear pathway of optimisation is rolled out.

Presented by Rachael Barlow, National Lead, Enhanced Recovery, Prehabilitation and Optimisation, at Cardiff and Vale health board, Wales.

EBPOM London 2020 | Guidance on prehabilitation for cancer Dec 04, 2020

This piece looks at the most recent guidance regarding prehabilitation for cancer, developed and published in 2009 by Macmillan Cancer Care. Extremely well received across the UK, and internationally, here we look at the details and some context in terms of UK national policy.

From an NHS England point of view the desire is to ensure that all patients and participants have personalized care embedded into everyday NHS services. Work around streamlining multidisciplinary team meetings for cancer include the opportunity to discuss the needs of people with cancer and the importance of preparing people in advance and during treatment. Furthermore you will hear elements of the principles of rehabilitation, as well as the importance of earlier and faster diagnosis, the importance of perioperative medicine and prehabilitation before surgery.

Further reading here "Principles and guidance for prehabilitation": https://www.macmillan.org.uk/about-us/health-professionals/resources/practical-tools-for-professionals/prehabilitation.html

Originally part of the hugely successful EBPOM Live from London 2020 conference this piece is nicely complimented by the panel discussion which TopMedTalk has also released free of charge here: https://www.topmedtalk.com/ebpom-london-2020-prehabilitation-update/

Presented by June Davis, Director of Allied Health Solutions, Allied Health Professions Advisor (part time) for Macmillan Cancer Support and a professional advisor to the Care Quality Commission.

How to "ACE" pediatric emergence! | AANA 2020 Dec 03, 2020

Pediatric patients can present quite a challenge when emerging from anesthesia. Here we discuss ways to “ACE” your transition to PACU! “A”void Emergence Agitation, and discover the latest evidence about “C"riteria for “E”xtubation in this challenging population. How do the protocols and standard of care compare between the UK and US. What does the evidence tell us? Also, how is Enhanced Recovery After Surgery progressing in pediatrics?

Presented by Desiree Chappell and Monty Mythen with their guest Kristin Henderson, DNAP, CRNA, CHSE, CPT, USAR Assistant Professor, Wake Forest School of Medicine, Nurse Anesthesia Program.

EBPOM 2020 London | Models of Prehabilitation in Greater Manchester Dec 02, 2020

It's widely understood that high value care during, before and immediately after surgery is optimal whereas poor quality care in the perioperative period produces long term difficulties which are compounded by the acute stresses produced during and immediately after a procedure. This talk covers three main areas; surgical care for patients in Greater Manchester, "ERAS+"; prehabilitation for cancer, for the population of Greater Manchester; how Manchester has supported patients during the time of COVID19.

This piece is mentioned in the introduction and serves as a useful compliment to the talk, "Implementing a system-wide cancer prehabilitation programme: The journey of Greater Manchester's ‘Prehab4cancer’": https://www.ejso.com/article/S0748-7983(20)30438-8/fulltext

Find out more about the work in Greater Manchester here: https://gmcancer.org.uk/our-areas-of-work/prehab4cancer-2/

Also the Perioperative Quality Improvement Programme is here: https://pqip.org.uk/content/home

Presented by Dr. John Moore, Clinical Director for Intensive Care at Manchester Royal Infirmary and Medical Lead for Enhanced Recovery After Surgery.

EBPOM 2020 London | Screening assessment of nutritional fitness Dec 01, 2020

What do we mean by "nutritionally fit" and why does it matter? How do we identify those most at risk in terms of screening and assessment and what's the difference between these two processes? How can we use screening and assessment to triage patients into care? Also, in the time of COVID19, are there ways we can perform some tasks related to these processes remotely?

Presented by Steve Wooton, Senior Lecturer in Human Nutrition within Medicine at the University of Southampton.

EBPOM 2020 London | The Future of Prehabilitation "Standardisation of definitions and outcomes" Nov 30, 2020

"The main challenge around the variability in the perioperative period is nomenclature, definitions and standardized endpoints. Well designed and well conducted randomized control trials determine effectiveness to an unbiased comparison of outcomes, events, or endpoints between intervention groups".

If data is destiny it is to this that we must look if we want to understand what the future may hold for prehabilitation. This piece takes a pragmatic approach toward the task of ensuring information and datasets are widely applicable, as free from bias as possible and ultimately standardised by consistent definitions and terminology alongside a methodology which produces clear outcomes.

Find out more about the Comet Initiative here: https://www.comet-initiative.org/

Find more about the 'Standardised Endpoints in Perioperative Medicine-Core Outcome Measures in Perioperative and Anaesthetic Care (StEP-COMPAC) Group' here: https://www.comet-initiative.org/Studies/Details/1317

Presented by Malcolm West NIHR funded Clinical Lecturer in Surgery and Honorary colorectal surgical specialist registrar at the University of Southampton.

EBPOM 2020 London | Fit for surgery with Denny Levett Nov 29, 2020

How important is it to screen patients and measure their fitness prior to surgery? What is exercise training in the preoperative period?

There is a very clear relationship between physical fitness and mortality. Importantly, when we think of prehabilitation, or exercise training, it's good to remember that you get the greatest benefit in the most unfit patients, in terms of mortality reductions. The "pandemic ... of physical inactivity worldwide" is believed to cause more than 5 million deaths annually. The advantage of fitness in terms of predicting perioperative outcomes is it is an important modifiable risk factor before major surgery; we can modify health behaviors and exercise and we can sometimes optimize comorbidities before surgery. Exercise is real medicine!

Originally part of the hugely successful EBPOM Live from London 2020 conference this piece is nicely complimented by the panel discussion which TopMedTalk has also released free of charge here: https://www.topmedtalk.com/ebpom-london-2020-prehabilitation-update/

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.

Periop SIG | Ward Based postoperative care; where should we focus? Nov 28, 2020

This wide ranging talk asks where and how we should focus on the needs of postoperative care patients. "Brain care has an impact way beyond the acute surgical episode"; how do we minimise the risks of a poor outcome when it comes to postoperative care?

"Advanced recovery from anaesthesia and surgery" is a talk originally given at the 8th Australian and New Zealand Symposium of Perioperative Medicine Special Interest Group: “Updates in Perioperative Medicine 360” which took place between November 7th-9th 2019.

Presented by Professor Jacqueline Close, Principal Research Fellow, NeuRA Conjoint Professor, UNSW Consultant Geriatrician, Prince of Wales Hospital.

COVID 19 | Essential COVID knowledge; Dr. Manuel Ignacio Monge García. Nov 27, 2020

This piece has been released to coincide with the first virtual International Fluid Academy Day (IFAD). TopMedTalk listeners have enjoyed following the meeting annually for some time now; we're equally as excited about their online proposition. Find out more here: https://www.fluidacademy.org/

This piece digs deep into the realities of coping with COVID 19 patients who have had their care escalated to the Intensive Care Unit (ICU); "we don't seem to be looking at our typical sepsis patients who get multiple organ failure in the classical way" and "you're surprised at how young some of the patients are...".

Our guest provides us further insight; a 'household name' in the haemodynamic monitoring space; he is treating patients in a medium sized hospital (500 beds) with mostly COVID patients in Spain. How are things going there, how does it compare to Italy? How are the patients being dealt with, what can we learn about the basics here, airway, breathing, ventilation (ABC)?

There is also a gripping discussion regarding dynamic arterial elastance. If you'd like to know more about that do check out our discussion here: https://www.topmedtalk.com/periop-coach-2-09-haemodynamic-monitoring/

The webinar mentioned in this piece can be found here: https://www.esicm.org/education/webinars/

Presented by Desiree Chappell and Monty Mythen with their guest Dr. Manuel Ignacio Monge García who works in an ICU in the South of Spain.

POQI 5 - Fluid Management | POQI Nov 26, 2020

This piece has been released to coincide with the first virtual International Fluid Academy Day (IFAD). TopMedTalk listeners have enjoyed following the meeting annually for some time now; we're equally as excited about their online proposition. Find out more here: https://www.fluidacademy.org/

The Perioperative Quality Initiative (POQI) is a vital part of the process needed to more widely implement sensible practice which, using a clear evidence base, provides better value care with more positive outcomes for the patient. POQI continues to provide its work in an attempt to clarify fundamental concepts in perioperative care. The fact this one focuses upon fluid management makes it particularly appropriate.

Link to the paper: https://perioperativemedicinejournal.biomedcentral.com/articles/10.1186/s13741-020-00142-8

Presented by Desiree Chappell with Monty Mythen and their guests Tim Miller, Professor of Anesthesiology from Duke University Medical Centre and Greg Martin Professor of Medicine, Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Emory University School of Medicine

Like this, want more?

Try our popular in depth series "Fluid Matters" http://topmedtalk.libsyn.com/fluid-matters-1

TopMedTalk provides world leading information about perioperative medicine like this every day. Dr Greg Martin's deeper dive into these issues is here: http://topmedtalk.libsyn.com/fluid-matters-3

Fluid Matters | Series Highlight: Total body water and electrolytes Nov 25, 2020

This piece has been released to coincide with the first virtual International Fluid Academy Day (IFAD). TopMedTalk listeners have enjoyed following the meeting annually for some time now; we're equally as excited about their online proposition.

This piece is a chance to hear a now famous discussion which TopMedTalk recorded at the Peroperative Quality Initiative (POQI) at Washington Duke University in Durham. The discussion is predominately about total body water, electrolytes and the movement of fluid around the body; the idea of circulation of interstitial fluid; the Starling Curve and lymphatics; sodium balance and, at the end, there's a moment when the speakers agree to disagree about whether saline is "abnormal" or not.

If you would like to find out more about IFAD go here: https://www.fluidacademy.org/

Presented by Monty Mythen and Henry Howe with their guests Tom Woodcock, an independent consultant in patient safety, medical law and ethics, and Manu Malbrain, Professor at Faculty of Medicine and Pharmacology Vrije University in Brussells.

Prato | The 5th Collaborative Clinical Trials in Anaesthesia biennial conference Nov 24, 2020

This piece focuses upon the unique 'Collaborative Clinical Trials in Anaesthesia biennial conference', of which this was the fifth, organised in Prato, Italy, by Monash University.

TopMedTalk was given the chance to listen in on this cutting edge gathering of trialists, academics and practitioners as it happened. We take a deeper dive on the history behind this very special meeting, how it works and special moments from the meeting.

Learn how some of the big trials gather pace and how major studies get established.

The ANZCA Clinical Trials Network is here: http://www.anzca.edu.au/ctn

More detail on the African Surgical Outcomes Study - 2 (ASOS-2) here: https://www.asos.org.za/index.php/about-the-study

Presented by Desiree Chappell with Monty Mythen and their guest Paul Myles, Director, Anaesthesiology and Perioperative Medicine, Alfred Hospital and Monash University.

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Like this, want more?

Bruce Biccard is interviewed here: https://www.topmedtalk.com/prato-2019-bruce-biccard/

TopMedTalk | A step between a simple monitor and a fully automated system Nov 23, 2020

This piece focuses upon goal directed fluid therapy, with an automated system, for decision support; "a step between a simple monitor and a fully automated system".

The "proof of concept" paper we highlight towards the end of the podcast, "Feasibility of closed-loop titration of norepinephrine infusion in patients undergoing moderate - and high-risk surgery" has now been published and can be found here: https://bjanaesthesia.org/article/S0007-0912(19)30443-X/abstract

This paper here "Perioperative goal directed therapy using automated closed-loop fluid management: the future?" is also referenced: https://www.ncbi.nlm.nih.gov/pubmed/26578397

You may also find this piece, which our guest is also part of, here interesting: https://www.ncbi.nlm.nih.gov/pubmed/29068831

Presented by Desiree Chappell and Monty Mythen with their guest Alexandre Joosten, Anesthetist at Hospital Erasme.

Periop SIG | Updates in cardiac devices Part 2 Nov 22, 2020

"Updates in cardiac devices, Part 2" was a talk originally given at the 8th Australian and New Zealand Symposium of Perioperative Medicine Special Interest Group: “Updates in Perioperative Medicine 360” which took place between November 7th-9th 2019.

This piece is focused upon transcatheter aortic valve implantation (TAVI) devices. "A balloon valvular plasti in comparison to a TAVI is 90% of the risk, 10% of the gain" you're trading one problem with another, argues our speaker.

Find out more about ANZCA here: http://www.anzca.edu.au/

Presented by Dr Karl Poon, TAVI specialist at St Andrews War Memorial Hospital, Physician Proctor, Edwards LifeSciences, Senior Lecturer, University of Queensland Interventional cardiologist, The Prince Charles Hospital, Brisbane.

Periop SIG | Updates in cardiac devices, Part 1 Nov 21, 2020

"Updates in cardiac devices, Part 1" was a talk originally given at the 8th Australian and New Zealand Symposium of Perioperative Medicine Special Interest Group: “Updates in Perioperative Medicine 360” which took place between November 7th-9th 2019.

This piece is a look at some of the new technology which looks set to become more widely used. A leadless pacemaker is a small implantable "bullet like" device that sends electrical pulses to the heart whenever it senses that the heartbeat is too slow. Also new implantable cardioverter defibrillators are discussed as are implantable cardiac monitors. There is also discussion regarding cardiac resynchronization therapy.

The TYRX™ Absorbable Antibacterial Envelope is here: https://www.medtronic.com/us-en/healthcare-professionals/products/cardiac-rhythm/infection-control.html

The CardioMEMS™ Heart Failure System: https://www.cardiovascular.abbott/us/en/hcp/products/heart-failure/cardiomems-hf-system.html

Find out more about ANZCA here: http://www.anzca.edu.au/

Presented by Dr Stephen Pavia, Cardiologist and Cardiac Electrophysiologist at The Wesley Hopsital.

POCAPALOOZA | Hong Kong Nov 20, 2020

The POCAPALOOZA, a celebration of perioperative care that went around the world in the wake of EBPOM 2020.

"Early intervention and people taking it seriously is a big thing"

The conversation evolves as our guest speaks to the realities of moving internationally to pursue your career in medicine. Can a truly global perspective better position the medical community when it comes to international co-operation?

The World Congress of Anaesthesiologists is here: https://www.wcaprague2020.com/

Also, what's the future of medical conferencing in the world of COVID 19 and the global pandemic?

Presented by Desiree Chappell and Monty Mythen with Mike Irwin, Professor, Head and Chief of Service, Anaesthesiology Hong Kong University, Gleneagles Hospital.

Opioids: Pain, Euphoria, and a New Surgical Complication. Are Your Patients Safe? | AANA 2020 Nov 19, 2020

"4-10% of opioid naïve patients will continue to use opioids more than 90 days after surgery"

Opioids are good for pain control but there's another issue, they also numb emotional pain. How do we responsibly deal with this? It's important to remember: "When you give patients high doses, you're putting them at risk".

Long term listeners will recall TopMedTalk spent the best part of our launch year on this topic. If you're one of our many new listeners please use this huge resource of podcasts to help update your practice and cut down unnecessary risk: https://www.topmedtalk.com/?s=opioid

"We should be minimizing opioids every chance we can", if you want to cut straight to our groundbreaking talk on opioid free anesthesia please go here: https://www.topmedtalk.com/ebpom-2019-opioid-free-anaesthesia-2/

Presented by Desiree Chappell and Monty Mythen with their guest Jennifer Lanzillotta-Rangeley, CRNA, PhD, Assistant Professor, College of Nursing, University of Cincinnati, Cincinnati, Ohio.

The Business Case for Prehabilitation | EBPOM World Congress 2020 Nov 18, 2020

"It was successful early on within the National Health Service.. [because] you could eliminate the cost of some unhelpful, unnecessary tests... referrals to other "-ologists"... in our system that works, because more work is just more work. It's not more money."

Is the business case for prehabilitation a "slam dunk", as some enthusiasts claim? If so how do you measure value versus volume, is value always a subjective term and can the balance between the two be addressed? How does the NHS's "internal market" compare to the US's fee for service environment? Furthermore, where are the sensible limits of prehabilitation, how far do we take it before we move forward to an operation?

This piece has been available to EBPOM London attendees since it was first recorded in the earlier part of the year. For exclusive access to other similar pieces now and in the future please visit www.ebpom.org

Presented by Monty Mythen and Kay Mitchell, Senior Research Manager for critical care research, NIHR Biomedical Research Centre, University Hospital Southampton, UK, with their guests, David Selwyn, Deputy Medical Director at Nottingham University Hospitals NHS Trust and Director of The Centre for Perioperative Care (CPOC), Sol Aronson, tenured Professor, Duke University and Jeff Vender, Emeritus, Harris Family Foundation Chairman of the Department of Anesthesiology at NorthShore University Health System, Evanston, Illinois and Clinical Professor at the University Of Chicago Pritzker School Of Medicine in Chicago, Illinois

Maurizio Cecconi | TopMedTalks to... Nov 17, 2020

This piece focuses on intensive care, the use of data and the future of fluid therapy research and its related physiological outcomes.

The article mentioned in this podcast is here: "Perioperative haemodynamic therapy for major gastrointestinal surgery: the effect of a Bayesian approach to interpreting the findings of a randomised controlled trial" https://bmjopen.bmj.com/content/9/3/e024256

Presented by Desiree Chappell and Monty Mythen with their guest Maurizio Cecconi, Head of the Anaesthesia and Intensive Care Department at Humanitas Research Hospital; President-elect of the European Society of Intensive Care Medicine (ESICM) for 2020-2021, Chair Division of Scientific Affairs at ESICM; Director of the Master in Patient Blood Management at Humanitas University.

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Like this, want more?

Rupert Pearse, one of the co-authors of the above article, was interviewed on TopMedTalk here: https://www.topmedtalk.com/anaesthesia-2019-rupert-pearse/

Frailty, Brain Health and Perioperative Cognitive Dysfunction | EBPOM USA - Chicago 2020 Nov 16, 2020

"Cognitive testing has been in the news ... there are recommendations for keeping pets mentally sound by implementing nutritional modifications, regular exercise and mental stimulation, we should certainly think about providing the same support to our geriatric patients."

What does the latest research say about this vital issue? How is frailty defined? What's the clinical impact of preoperative cognitive dysfunction?

Presented by Angela Bader, MD, MPH Professor of Anesthesia at Harvard Medical School and Vice Chair for Perioperative Medicine in the Department of Anesthesiology, Perioperative and Pain Medicine at Brigham and Women’s Hospital. She is also the founding director of the Weiner Center for Preoperative Evaluation.

For more on this subject check out this piece here: https://www.topmedtalk.com/poet-3-04-is-paternalism-always-bad/

EBPOM Highlight | SNAP-2 - EPICCS Nov 15, 2020

The 2nd Sprint National Anaesthesia Project: Epidemiology of Critical Care after Surgery (SNAP-2 - EPICCS) study launched in March 2017 around the UK. More than 2,200 investigators at more than 250 sites across the UK were signed up to take part. The observational study collected data on all patients undergoing inpatient surgery during a one-week period (21 March to 27 March) in UK NHS hospitals.

The website is here: https://www.niaa-hsrc.org.uk/SNAP-2-EpiCCS?newsid=1710

This talk explains the study and its far reaching implications.

Another talk on SNAP-2 is available here: https://www.topmedtalk.com/what-is-snap-2/

Presented by Ramani Moonesinghe, Professor of Perioperative Medicine at University College London (UCL).

Anemia Management | EBPOM USA - Chicago 2020 Nov 14, 2020

"Studies suggest that even three fourths of patients may be anemic when they present for surgery and many of these patients are previously undiagnosed"

This common problem is known to cause issues both within the perioperative period and beyond. How can we manage this condition and where does the latest data lead us?

Following a presentation there is a panel discussion featuring questions from the EBPOM Chicago audience. Check out www.ebpom.org to find out how you can attend our online conferences.

Make sure you also check out the article mentioned in this piece here: https://pubs.asahq.org/anesthesiology/article/133/1/109/109133/An-Effective-and-Efficient-Testing-Protocol-for

If you enjoyed this piece we suggest you go here next:

TopMedTalk | Iron Man vs Anemia https://www.topmedtalk.com/topmedtalk-iron-man-vs-anemia/

Presented by Monty Mythen with Bobbie Jean Sweitzer, Professor of Anesthesiology and Associate Chair for Perioperative Clinical Practice at Northwestern University and Jeanna Blitz, Associate Professor of Anesthesiology, Director of the Preoperative Anesthesia and Surgery Screening Clinic, Director of Perioperative Medicine Fellowship at Duke University School of Medicine, Durham, North Carolina.

Methadone use in Perioperative Medicine | EBPOM USA - Chicago 2020 Nov 13, 2020

This talk examines the rationale for using methadone in our surgical patient population, reviews clinical trials that assess the effect of intraoperative methadone on post operative outcomes and discusses some unanswered questions related to the administration of this long acting opioid in the perioperative period.

Presented by Glenn Murphy, Jeffery S. Vender Chair of Anesthesiology Research and Education and Director of Cardiac Anesthesia and Clinical Research at NorthShore University HealthSystem, a hospital affiliated with the University of Chicago Pritzker School of Medicine.

For more on the "opioid sparing opioid" go here: https://www.topmedtalk.com/ebpom-2019-methadone-the-overlooked-opiate-2/

Caring for the transgender patient | AANA 2019 Nov 12, 2020

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: https://www.nhs.uk/conditions/gender-dysphoria/guidelines/

Presented by Desiree Chappell and Monty Mythen with Jose Castillo, PhD, CRNA Faculty, Texas Wesleyan University, AANA Diversity and Inclusion Committee.

Periop SIG 2019 | A physician’s perspective Nov 11, 2020

How does an experienced physician, health service changer, improver and researcher see the process of re-engineering perioperative care pathways? What are the challenges we face when we try to rework or improve the culture of an institution? How do we tackle common issues, which nowadays seem less acceptable, such as delirium?

This piece is part of a series of talks regarding "re-engineering perioperative care pathways" which were given during the 8th Australian and New Zealand Symposium of Perioperative Medicine Special Interest Group: “Updates in Perioperative Medicine 360” which took place between November 7th-9th 2019

Presented by Professor Alison Mudge, Conjoint Professor of Medicine, Royal Brisbane Clinical Unit, Faculty of Medicine.

EBPOM 2019 | Overview of perioperative smoking cessation Nov 10, 2020

Smoking is bad for you, there's little debate about that, even among users of the drug. However, further to the widely known consequences, the bottom line in the perioperative period is that smokers are 40% more likely to die after major surgery. Do patients also know this?

Tissue healing, increased risk of infection and increased possiblities of complications with the anaesthetic; with these risks in mind how do we cut through the ubiquitous, but often ignored, government health risk messaging and get patients to understand the increased risk for those undergoing surgery? How do we use smoking cessation techniques in the perioperative setting? How do we manage to start, ideally, six weeks before surgery? What is the latest thinking on the neuro psychiatric consequences of smoking cessation? How useful is the Fagerstrom test of nicotine dependence? What about "vaping", is it better than smoking from a perioperative perspective?

Presented by David Yates, Consultant in Anaesthesia and Critical Care Medicine at York Teaching Hospital, set up one of the UK’s first Perioperative Medicine Services in York, Anaesthesia, Perioperative Medicine and Pain Clinical Lead for the Yorkshire & Humber Comprehensive Research Network.

Michelle Chew | TopMedTalks to... Nov 09, 2020

"Excellent teamwork"; the key to good outcomes.

This piece features an in depth discussion of post operative acute kidney injury (AKI), are there fresh approaches we can take? Could more data help us? The conversation then moves to myocardial injury after noncardiac surgery (MINS). What should our thoughts be as regards postoperative troponin levels?

Presented by Desiree Chappell and Monty Mythen with their guest Michelle Chew, Professor, Senior Consultant, Faculty of Medicine, Linköping University; Associate Professor, Faculty of Health and Medical Sciences, UCPH; Associate Professor, Consultant, Department of Anaestheisa and Intensive Care Medicine, Hallands Sjukhus Halmstad.

Prato | Gender and racial diversity Nov 08, 2020

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 integration of evidence-based practices, interventions and policies into routine health care and public health settings.

More about Athena SWAN (Scientific Women's Academic Network) here: https://www.ecu.ac.uk/equality-charters/athena-swan/

Presented by Desiree Chappell with Monty Mythen and their guest Meghan Fall-Lane, Assistant Professor of Anesthesiology and Critical Care at the Perelman School of Medicine; Co-Director of the Penn Center for Perioperative Outcomes Research and Transformation; and Senior Fellow at the Leonard Davis Institute of Health Economics, University of Pennsylvania.

How you can protect yourself (REPEAT) | COVID 19 Nov 07, 2020

“When you start to think about how we can protect ourselves; we have some reasonably robust literature for a few interventions [..] that do seem to associate with the prevention of viral infections…”; maintain a normal vitamin D level, probiotics, vitamin C.

This piece is an edited highlight of a fascinating conversation with a TopMedTalk favorite. How can we optimise ourselves for an oncoming viral attack? How can we make sure our patients get the best possible care and are as informed as they can be? What research is being carried out into COVID 19?

Presented by Desiree Chappell with her guest Paul Wischmeyer, Professor of the Department of Anesthesiology and Critical Care, Duke University.

EBPOM 2019 | Delivery of Prehabilitation, panel discussion Nov 06, 2020

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 Medical Center, The Netherlands, lecturer at the first Health Innovation School (Ministry of Health, Welfare and Sport and Reshape innovation), Surgical resident, Department of Surgery at Maxima Medical Center (ANIOS); Gerard Danjoux, Consultant in Anaesthesia and Sleep Medicine at South Tees Hospitals NHS Foundation Trust; Ken Van Someren, Director KvS Performance Ltd.

This piece follows on from the presentation to be found here: http://www.topmedtalk.com/ebpom-2019-the-science-of-high-performance-insights-from-elite-sport-2/

Substance Use Disorder - Peer Support: An Empathetic Information Resource | AANA 2019 Nov 05, 2020

"I know how to manage pain medication [...] addiction was the absolute last thing that would happen to me".

This podcast helps tackle the difficult subject of Substance Use Disorder in healthcare practitioners. How do we, from a caring and helpful perspective, address this issue either within ourselves or others?

This piece was part of our coverage of The American Association of Nurse Anesthetists (AANA) 2019 Annual Congress in Chicago, Illinois.

Check out the AANA here: https://www.aana.com/

The Peer Assistance section of the AANA's website is here: http://peerassistance.aana.com/directory.asp?State=All

The phone number we share in the podcast is: (800) 654-5167

Furthermore there is an interesting article about Parkdale here: https://www.aana.com/docs/default-source/wellness-aana.com-web-documents-(all)/aana-parkdale-partnership-jan-2019.pdf?sfvrsn=bd8f51b1_2

Presented by Desiree Chappell and Monty Mythen with their guests, Linda Stone, DNP, CRNA Assistant Program Director at Raleigh School of Nurse Anesthesia and Rodrigo Garcia, CEO Parkdale; APN, MSN, CRNA, MBA.

POQI 5 - Fluid Management | POQI Nov 04, 2020

The Perioperative Quality Initiative (POQI) is a vital part of the process needed to more widely implement sensible practice which, using a clear evidence base, provides better value care with more positive outcomes for the patient. POQI continues to provide its work in an attempt to clarify fundamental concepts in perioperative care. The fact this one focuses upon fluid management makes it particularly appropriate in these times.

Link to the paper: https://perioperativemedicinejournal.biomedcentral.com/articles/10.1186/s13741-020-00142-8

Presented by Desiree Chappell with Monty Mythen and their guests Tim Miller, Professor of Anesthesiology from Duke University Medical Centre and Greg Martin Professor of Medicine, Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Emory University School of Medicine

Like this, want more?

Try our popular in depth series "Fluid Matters" http://topmedtalk.libsyn.com/fluid-matters-1

TopMedTalk provides world leading information about perioperative medicine like this every day. Dr Greg Martin's deeper dive into these issues is here: http://topmedtalk.libsyn.com/fluid-matters-3

Anaesthesia 2019 | The Clinical Trials Network and Optimising Shared Decision Making Nov 03, 2020

We begin with a conversation about The UK Perioperative Medicine Clinical Trials Network, their website is here: https://www.pomctn.org.uk/

This piece focuses on the Optimising Shared decision-makIng for high-RIsk major Surgery (OSIRIS) programme. Shared decision making can be very challenging when we're not sure what the risks are and older patients with chronic diseases often make very different decisions when informed. How do we make this process more evidence based? How do we better understand this group and communicate with them? Are there technological answers to these questions?

If you'd like to see the OSIRIS section there here's the link: https://www.pomctn.org.uk/OSIRIS

You can find the OSIRIS website here: https://osiris-programme.org/

Recorded at Anaesthesia 2019; where world-renowned experts presented the latest advances in perioperative medicine, critical care and pain medicine.

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.

EBPOM London 2020 | Video Laryngoscopy During Covid-19 Nov 02, 2020

How have we adapted in our views on the use of video laryngoscopy during the Covid-19 pandemic? Who is best suited to intubate? Are we seeing "a poorly managed first wave"? How are practitioners changing their approach in light of the possibility of infections? What lessons are being learned by practitioners in the midst of the COVID crisis?

This piece was generously supported by Medtronic.com

Presented by Desiree Chappell with Monty Mythen and her guests, Patrick Schoettker, Professor of Anesthesia and Emergency Medicine at Lausanne University Hospital, Sol Aronson, tenured Professor, Duke University, Henry Howe, Junior Doctor, NHS England and TopMedTalk team member.

TopMedTalk | Perioperative medicine and being a good sport Nov 01, 2020

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 in Anaesthesia and Sleep Medicine at South Tees Hospitals NHS Trust and Ken Van Someren, Director KvS Performance Ltd.

TopMedTalk | Guidelines for Perioperative Care in Cardiac Surgery Oct 31, 2020

This piece focuses in upon the important work being done by The Enhanced Recovery After Cardiac Surgery Society, specifically the new guidelines which were published in May 2019. Furthermore, how is the society going to move forward, will it continue to push for a sensible combination of both care providers and academics and what areas of focus are most impactful when it comes to improving care and helping implementation?

The article discussed in this piece "Guidelines for Perioperative Care in Cardiac Surgery, Enhanced Recovery After Surgery Society Recommendations" is here: https://jamanetwork.com/journals/jamasurgery/fullarticle/2732511?guestAccessKey=04f7090d-122c-4e94-a46f-22e49dab7c51

The Enhanced Recovery After Cardiac Surgery website is here: https://www.erascardiac.org/

Presented by Desiree Chappell with her guest Kevin Lobdell, Director of Regional CVT Quality, Education, and Research.

EBPOM 2019 | Community-based Prehabilitation Oct 30, 2020

In the UK community based prehabilitation is being spearheaded by the Prepwell Initiative, supported by a grant from Sports England. Their pioneering work is a great example of the way in which prehabilitation is gathering pace at the moment.

The “PREP: Preoperative Risk Education Package” website is here: https://www.prepwell.co.uk/

What are the economics of such a programme? Why did the project start to get referrals from initially sceptical surgeons? How did the programme impact the lives and treatment of patients?

Presented by Gerard Danjoux, Consultant in Anaesthesia and Sleep Medicine at South Tees Hospitals NHS Foundation Trust.

Outcome criteria associated with residual neuromuscular blockade | AANA 2020 Oct 29, 2020

"The more I learn about this, the more my eyes are opened to how much opportunity we have to improve in this area"

This piece covers the "perennial topic" of whether paralysis is bad for breathing, here with a focus upon outcome criteria associated with residual neuromuscular blockade. It's a piece based in part upon a recent talk at the American Association of Nurse Anesthetists annual conference which was this year held virtually.

Presented by Desiree Chappell with her guest Brent Dunsworth, CRNA, DNP, Director of Advanced Practice for the Department of Anesthesiology at Vanderbilt University Medical Center.

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You heard Desiree correctly! We have passed the million downloads mark! An incredible achievement and a reflection of the global reach and power of our message.

Thank you for your support, thanks to those listeners who have gone above and beyond the cause to promote TopMedTalk for us on their social media and in their talks and presentations, thanks also to our sponsors who have allowed us to keep this vital information free to all; wherever in the world you are Perioperative Medicine is the safest way to cut reduce unnecessary surgery, improve outcomes and reduce the time spent in hospital by our patients.

SCA | Burn out - a frank discussion Oct 28, 2020

Burn out and stress management have been an important theme on TopMedTalk recently, here we have a top medical professional sharing their story in relation to the topic. How do we describe "burn out", are certain words a barrier to discussion? How do we cut through to people who are most likely to suffer from this incredibly dangerous condition? Is the medical profession finally making progress here?

Our interview with Sasha Shillcut is here "Sunday Special | Burn out": https://www.topmedtalk.com/sunday-special-burn-out/

This piece was originally streamed live from ‘The Society of Cardiovascular Anesthesiologists’ (SCA) annual conference, 2019.

Presented by Desiree Chappell and Monty Mythen with Sol Aronson, Tenured Professor, Duke University and Executive Vice Chairman in the Department of Anesthesiology, and their guest Tjorvi Perry, Assistant Professor, Department of Anesthesiology, University Minnesota

The Changes that Change Culture - panel discussion | EBPOM USA - Chicago 2020 Oct 27, 2020

This panel discussion covers essential ground for any institution that is trying to make real and lasting change. What do we need to know? What do our patients need to know? Who is responsible for questions of safety? How important are checklists? What about "patient advocates"?

This piece was generously supported by Massimo.com it follows on from this piece here: https://www.topmedtalk.com/ebpom-chicago-patient-safety-how-do-you-make-the-changes-that-change-culture/

Presented by Sol Aronson with Mike Ramsey, Chair of the department of Anesthesia and pain management at the Baylor University Medical Center in Dallas and Board Chair of the Patient Safety Movement Foundation, Lee Fleisher, CMO and director for the Center for Clinical Standards and Quality for the centers of Medicare and Medicaid, Sarah Lenz Lock, Senior Vice President for Policy Research and International Affairs for the AARP, Lili Brillstein, Director of Specialty Care Value Based Models for Horizon Blue Cross Blue Shield of New Jersey and Monty Mythen, Smiths Medical Professor of Anaesthesia and Critical Care at University College London.

Perioperative Medicine - Editor's top picks for 2020 | EBPOM USA - Chicago 2020 Oct 26, 2020

In this piece you can hear the co-editors of the Journal of Perioperative Medicine describing this year's "Editor's Picks"; the best manuscripts, literature and lessons learned in the last year in the space of perioperative medicine.

"Functional performance and 30-day postoperative mortality after emergency laparotomy—a retrospective, multi-center, observational cohort study of 1084 patients" is here: https://perioperativemedicinejournal.biomedcentral.com/articles/10.1186/s13741-020-00143-7

There is more information about the Eastern Cooperative Oncology Group (ECOG) here: https://ecog-acrin.org/resources/ecog-performance-status

"A randomised trial of non-invasive cardiac output monitoring to guide haemodynamic optimisation in high risk patients undergoing urgent surgical repair of proximal femoral fractures (ClearNOF trial NCT02382185)" is here: https://perioperativemedicinejournal.biomedcentral.com/articles/10.1186/s13741-019-0119-x

"The effect of virtual reality technology on preoperative anxiety in children: a Solomon four-group randomized clinical trial" is here: https://perioperativemedicinejournal.biomedcentral.com/articles/10.1186/s13741-019-0116-0

Presented by Mike Grocott, Professor of Anaesthesia and Critical Care at the University of Southampton and a Consultant in Critical Care Medicine at University Hospital Southampton NHS Foundation Trust with his guests Clifford Ko, Professor of Surgery at UCLA, Director of the Division of Research and Optimal Patient Care at the American College of Surgeons and Lee Fleisher, Professor of Anesthesiology and Critical Care, University of Pennsylvania.

Originally part of the hugely successful EBPOM 2020 Chicago this piece is introduced by Sol Aronson, tenured Professor at Duke University.

TopMedTalk | Why is maternal mortality so high in the USA? Oct 25, 2020

Why does the US have the highest maternal mortality rate of any developed country? This piece tackles a very controversial issue in healthcare head on, could the problem be due to racism? The chances of a serious issue is "substantially higher if you come from a minority group, in particular if you are African-American".

We also cover the issue of postpartum hemorrhage, what are the key signs that a patient is at risk? Furthermore, how are quality care initiatives and standardization of care helping improve the field of obstetrics? Also, what is the latest thinking on home births, are they a financial decision for some?

The California Maternal Quality Care Collaborative is here: https://www.cmqcc.org/

For more info on the Society for Obstetric Anesthesia and Perinatology (SOAP) go to www.soap.org

Presented by Desiree Chappell and Monty Mythen with their guest Alexander J Butwick, Obstetric Anesthesiologist and Researcher in maternal hemorrhage, pain relief in labor, and obstetric epidemiology at Stanford University.

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Like this, want more?

On the subject of obstetrics find out more here:

EBPOM Highlight 1.27 | Obstetric anaesthesia - https://www.topmedtalk.com/ebpom-highlight-1-27-obstetric-anaesthesia/

ASA 2018 San Francisco | Smith’s Medical Symposium on Enhanced Recovery – Part 5 - https://www.topmedtalk.com/asa-2018-san-francisco-smiths-medical-symposium-on-enhanced-recovery-part-5/

Periop Coach 4.10 | Enhanced Recovery for obstetrics https://www.topmedtalk.com/periop-coach-4-10-enhanced-recovery-for-obstetrics/

EBPOM | Malnutrition and functional capacity Oct 24, 2020

This piece is taken from the free papers presentations given at EBPOM 2019. Malnutrition and functional capacity; what is the effect of multimodal prehabilitation? What can the six minute walk test really show us? Does nutritional status predict preoperative change in a six minute walk test in colorectal cancer patients following a prehabilitation programme?

Presented by Lauren Richer, Director, Nutritional Services, Keyto, Registered Dietician, Greene Family Medicine Clinic and Montreal General Hospital, Montreal, Quebec.

EBPOM 2020 London: Prediction of Opioid Induced Respiratory Depression on the General Care Floor: Does surveillance monitoring help? Oct 23, 2020

This piece deals with the prediction of opioid induced respiratory depression for our inpatients on hospital wards, could a change in monitoring practices help? The postoperative period seems to be critical, the thirty day period immediately after anesthesia being a key area. 7.7% of postoperative deaths are in this period, according to The Lancet here; https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(18)33139-8/fulltext

What is happening in the post operative period? How do we find out more? Are hospital general care wards the safe haven we expect them to be? What should we monitor and how do we avoid "alarm fatigue"?

More on the "PRediction of Opioid-induced Respiratory Depression In Patients Monitored by capnoGraphY (PRODIGY)" trial here:

https://clinicaltrials.gov/ct2/show/NCT02811302

The official STOP BANG score website is here: http://www.stopbang.ca/osa/screening.php

This piece was sponsored by Medtronic.

This is part 1 of a two part piece.

Presented by Monty Mythen with Desiree Chappell and Ashish Khanna, Associate Professor, Section Head for Research, Department of Anesthesiology, Section on Critical Care Medicine,Wake Forest School of Medicine.

If you loved this piece you'll also enjoy this piece here:

Desiree’s Roundtable | Can you bite your upper lip? Assessing patients to reduce post-op respiratory complications

http://www.topmedtalk.com/desirees-roundtable-can-you-bite-your-upper-lip-assessing-patients-to-reduce-post-op-respiratory-complications-2/

Innovators in anesthesia: Anesthesia electronic medical records | AANA 2019 Oct 22, 2020

"Data is destiny"; this piece looks at way we can unlock it for Anesthetists. The Open-Source Anesthesia Electronic Medical Record (OSAEMR) was developed specifically for Nurse Anesthetists. Its focus is on solo or small-practice nurse anesthetists operating in environments with limited or no network and computing resources other than an iPad. One patient, one nurse anesthetist, and one iPad. It can now be scaled to larger multi-provider practices outside of CRNAs. Hear how this innovation came about.

This piece was part of our coverage of The American Association of Nurse Anesthetists (AANA) 2019 Annual Congress in Chicago, Illinois.

Check out the AANA here: https://www.aana.com/

The Open-Source Anesthesia Electronic Medical Record (OSAEMR) website is here: https://www.osaemr.com/

Presented by Monty Mythen and Desiree Chappell with John T. "Jack" Hitchens, CRNA, BA, ARNP, partner in a CRNA owned and operated Anesthesia Practice, Watchful Care and Dan Simonson, CRNA, MHPA retired as Chief CRNA and managing partner of the Spokane Eye Surgery Center, adjunct faculty at the Washington State University College of Nursing’s Department of Health Policy and Administration.

Patient Safety: How do you make the Changes that Change Culture? | EBPOM USA - Chicago 2020 Oct 21, 2020

Patient safety, as a priority, is assumed to be at the heart of medical practice. Yet still, preventable harm and death occurs in our profession, how do we change this and how do we make the changes we implement last? Can safety and avoidable harm be somehow hardwired into the culture of what we do in a way similar to that of the airline industry?

This popular and refreshing talk is presented here after it was a big hit at the Chicago 2020 conference organised by Evidence Based Perioperative Medicine (EBPOM). For more check out www.ebpom.org

Presented by Mike Ramsey, Chair of the Board of Directors of the Patient Safety Movement Foundation (PSMF), Chair of the Department of Anesthesiology at Baylor University Medical Center in Dallas, Texas.

EBPOM Highlight | The Wesfit trial Oct 20, 2020

Patients with physiological and psychological resilliance have a clear advantage in surgery. The Wessex Fit-4-Cancer Surgery Trial (WesFit) is attempting to determine the effects of multi-modal physical and psychological prehabilitation. This piece gives you the detail and ends with a short informative question and answer session.

Presented by Samantha Leggett, Study Director, University Hospitals Southampton NHS Foundation Trust.

POCAPALOOZA | London: The International Board of Perioperative Medicine and the Centre for Perioperative Care Oct 19, 2020

"At the moment perioperative care in the UK doesn't really have the profile that I think it needs; now I suspect that COVID-19 has raised it up the agenda"

If you enjoyed Monty's explanation regarding the UK's perioperative journey you may find this link interesting:

Evidence submitted by the Improving Surgical Outcomes Group (ISOG) (NICE 75): https://publications.parliament.uk/pa/cm200607/cmselect/cmhealth/503/503we35.htm

"Now we're here at this Pocapalooza" - POC, standing for Perioperative Care and "apalooza" being an extravagant event. However, as one of our guests suggests, perhaps we should call this one a "CPOC-apalooza!" as a lot of our focus is on The CPOC (Centre for Perioperative Care).

The International Board of Perioperative Medicine is essential for anyone listening to this podcast: https://www.internationalboardpom.org/

Presented by Desiree Chappell with Monty Mythen, and their guests Mike Grocott - a frequent TopMedTalk anchor - and Professor of Anaesthesia and critical care at the University of Southampton and David Selwin, Medical Director at Sherwood Forest Hospitals NHS Foundation Trust.

For more information on these topics look for the next POCAPALOOZA and get the US perspective!

POCAPALOOZA | Sydney: Education, education, education. Oct 18, 2020

"It also must start and end in primary care"

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 developed countries". We hear that TopMedTalk engaging with the African Perioperative Research Group (APORG) has helped move the cause of perioperative care forward, both in Africa and elsewhere.

The conversation further evolves: Once educated how do we demonstrate the value of perioperative practice? How do we launch projects that will really make a difference? Where, from a research perspective, do the more fruitful areas of investigation present themselves? Would a minimum data set help? Moving to clinical trials we hear how research is being conducted, both the challenges and the sources of success.

"Perioperative medicine is a team sport" - how do we use the interdisciplinary aspect of what we do to enhance our educational options?

Regular listeners to TopMedTalk may recall the series we did about the Perioperative Special Interest Group (SIG) - if you want more details of http://www.anzca.edu.au/fellows/special-interest-groups/perioperative-medicine

The ANZCA Clinical Trials Network can be found at http://www.anzca.edu.au/ctn

Also, The International Board of Perioperative Medicine is here: https://www.internationalboardpom.org/

Further, make sure you check out https://www.periopmedicine.org.uk/ for more information on the perioperative medicine short course we discuss.

And Perioperative Medicine for The Junior Clinician is available here: https://www.amazon.co.uk/Perioperative-Medicine-Junior-Clinician-Symons/dp/1118779169

Presented by Desiree Chappell alongside co-host Ross Kerridge, Anaesthetist from Newcastle in Australia - sometimes called the 'Father of Perioperative Medicine'. Guests are Jill Van Acker, Staff Specialist Anaesthetist and Clinical Lead Perioperative Services, Canberra Hospital, and Chair of the ANZ Perioperative Special Interest Group; Vanessa Beavis, President, Australian & New Zealand College of Anaesthetists, & until recently Director of Perioperative Services, Auckland District Health Board; Prof. Jackie Close Orthogeriatrician at the Prince of Wales Hospital in Sydney and Clinical Director of the Falls, Balance and Injury Research Centre at Neuroscience Research Australia; Prof. Dave Story, Head of the ANZCA Clinical Trials Network, and Chair of the Anaesthesia, Perioperative and Pain Medicine Unit within the University of Melbourne Medical School. Joel Symons, Anaesthetist at the Alfred Hospital in Melbourne and Senior Lecturer at Monash University, Leader in the development of Educational Programs based at Monash University and member of International Board of Perioperative Medicine.

The Balanced Anesthesia Study |Prato 2019 Oct 17, 2020

This piece focuses on The Balanced Anesthesia Study, 'A Prospective Randomized Clinical Trial of Two Levels of Anesthetic Depth on Patient Outcome After Major Surgery'. How can delerium be measured and standardised in a multi-centre trial?

More on the study here: https://journals.lww.com/anesthesia-analgesia/FullText/2015/08000/Rationale_and_Design_of_the_Balanced_Anesthesia.14.aspx

More on the Confusion Assesment Method here: https://www.guysandstthomas.nhs.uk/resources/our-services/acute-medicine-gi-surgery/elderly-care/cam-diagnostic-algorithm.pdf

The Hospital Elder Life Program (HELP) for Prevention of Delirium is here: https://www.hospitalelderlifeprogram.org/

We discuss the ENGAGES trial here: https://www.topmedtalk.com/journal-club-1-14-jama-the-engages-randomized-clinical-trial/

More on the Women in Anaesthesia Research, a BJA Symposium, here: https://www.periopmedicine.org.au/2019prato

Presented by Desiree Chappell and Monty Mythen with Lis Evered, neuroscientist and Head of Research in the Department of Anaesthesia and Acute Pain Medicine, St Vincent’s Hospital, Melbourne. She has led an international group to standardise nomenclature for cognitive change associated with anaesthesia and surgery. She is an Editorial Board member of British Journal of Anaesthesia.

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Like this, want more?

Lis Evered also features on TopMedTalk here: https://www.topmedtalk.com/sunday-special-the-perioperative-cognition-workshop-part-1/

SCA | The Society of Cardiovascular Anesthesiologists Oct 16, 2020

After a short overview of the history of the Society of Cardiovascular Anesthesiologists (SCA) this conversation zones in on some of the hot topics that are being discussed in the field; devices and extracorporeal membrane oxygenation (ECMO) machines, as well as trans-esophageal echocardiography and how the practice has evolved. The conversation ends with a discussion about pre-habilitation in a resource stretched environment.

Presented by Desiree Chappell with Sol Aronson and Jamie Ramsey, Medical Director Cardiac ICU at UCF and Gerald Levy, MD at Duke University.

Prato 2019 | The PREVENTT Trial Oct 15, 2020

This piece focuses on the Preoperative Intravenous Iron To Treat Anaemia in major surgery (PREVENTT) trial; a randomized double-blind controlled phase III study to compare the efficacy and safety of intravenous ferric carboxymaltose with placebo in patients with anaemia undergoing major open abdominal surgery.

The main question is if we properly mobilize our patients, feed them and correct their anemia, do they do better? How can we get a patient fitter for surgery? Can we correct anemia before surgery? "We took people prior to major open abdominal surgery [...] and our question was, in two weeks prior to surgery, if we give them intravenous iron and treat the anemia, at operation do they receive less blood transfusion and post operatively recover without as many complications?".

Also, Are you a woman and anemic? Should you be taking iron supplements? Could you do with a dose of I.V. iron?

The Iron Clinic is here: https://www.theironclinic.com/

The PREVENTT website is here: https://preventt.lshtm.ac.uk/

Our guest also featured in the press where they dubbed him "Iron Man": https://www.dailymail.co.uk/femail/article-3932602/Hugely-popular-Australia-s-just-come-menopausal-women-benefit-iron-drip-stop-feeling-tired-time.html

Presented by Desiree Chappell with Monty Mythen and their guest Toby Richards, Professor, Anaesthesia Teaching & Research Faculty of Medicine, Nursing and Health Sciences Central Clinical School, Monash University.

EBPOM 2019 | Multi-modal Prehabilitation Oct 14, 2020

This panel discussion includes questions such as: In a prehabilitation service what screening tools should we use to assess nutritional risk? What tools are there related to patient self management? What advice would you give a patient about cannabis smoking cessation? Should denial of surgical procedures be used as a motivator for lifestyle change? Can the questions used in interventions sometimes be open to misinterpretation by patients? How do we assess and treat sleep disorders? If not a psychologist, what team members might handle psychological behaviour change? Does immunonutrition work? Are there sensitive approaches to addressing weight loss, physical activity and diet that the panel reccomend?

Panel discussion chaired by Sandy Jack and Daniel Santa Mina, featuring, David Yates, Consultant in Anaesthesia and Critical Care Medicine at York Teaching Hospital, Chloe Grimmett, National Institute of Health Research (NIHR) post-doctoral Research Fellow and Senior Research Fellow for the Macmillan Survivorship Research Group at the University of Southampton, Chris Snowden, Consultant Anaesthetist, Freeman Hospital, Newcastle upon Tyne and Senior lecturer at the Institute of Cellular Medicine at Newcastle University, Chelsia Gillis, Registered Dietitian, Canadian Vanier Scholar, and PhD Candidate in Epidemiology at the University of Calgary, Canada, she is leading the first prehabilitation program for colorectal surgery in Alberta.

EBPOM Highlight | ERAS Colorectal surgery Oct 13, 2020

"ERAS in Colorectal Surgery" - was 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 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 Anthony Senagore, Professor and Vice Chair Western Michigan University-Homer Stryker MD School of Medicine Borgess Medical Center Kalamazoo, MI.

African Surgical Outcomes Study (ASOS-2) |Prato 2019 Oct 12, 2020

This piece focuses upon the African Surgical Outcomes Study (ASOS-2). More than a thousand people across Africa have combined forces to make this research into perioperative medicine in a resource limited environment happen. We know patients in Africa are twice as likely to die following surgery when compared to the global average, why is this? How does "failure to rescue" play into this?

The website mentioned in this piece for more details: https://www.asos.org.za

Presented by Desiree Chappell with Monty Mythen and their guest Bruce Biccard, consultant anaesthetist at the University of Kwazulu-Natal, Director, Perioperative Research Unit, Department of Anaesthetics, Nelson R Mandela School of Medicine from

TopMedTalk | The psychology of change Oct 11, 2020

"There seems to be a little extra buzz in the cardiac community".

This conversation focuses upon the psychology of change, specifically regarding the leadership role presented within perioperative medicine to anaesthesiologists. How can perfectionism, as a barrier to change, be overcome? How do practitioners build the confidence to make a difference? Furthermore, how do we engage in 'internal marketing' where we promote success within our own institutions?

More information on The Morpheus Consortium here: http://morpheusconsortium.org/

Check out the article here: https://jamanetwork.com/journals/jamasurgery/fullarticle/2732511

Find out more about NorthStar here: https://northstaranesthesia.com/

The "Masters of Scale" podcast is here: https://mastersofscale.com/

This piece was originally released live from "ERAS cardiac: Center of excellence training conference", an Edwards Life Sciences sponsored conference in North Carolina.

Presented by Monty Mythen and Desiree Chappell with their guest Bob Booth, Regional Chief Medical Officer, Vice President of Physician Operations at NorthStar Anesthesia, P.A.

Like this, want more?

Brian Woods from NorthStar features on TopMedTalk here: https://www.topmedtalk.com/topmedtalk-the-goal-is-more-important-than-the-role/

EBPOM 2019 | Ernest Henry Starling Plenary Lecure, Andrew Shaw, Fluid therapy in the 2020s Oct 10, 2020

This hugely important talk was the centerpiece of EBPOM 2019 and, appropriately enough, it focuses on a big topic for us here at TopMedTalk; the future of fluid therapy.

Originally given as the EBPOM 2019 Ernest Henry Starling plenary lecture the talk is complimented by this piece which was recorded on the same day: https://www.topmedtalk.com/desirees-roundtable-fluids-in-the-2020s/

Where is the latest thinking on fluid therapy, what new evidence and understandings do we now have?

Presented by Dr Andrew Shaw, Chairman, Department of Anesthesiology and Pain Medicine at The University of Alberta, Edmonton, Alberta and Zone Clinical Department Head for Anesthesia, Alberta Health Services Edmonton Zone. He is also a Fellow of the Royal College of Anaesthetists (UK), the American College of Critical Care Medicine and the Faculty of Intensive Care Medicine (UK).

Covid 19 - ventilation strategies | EBPOM Ireland 2020 Oct 09, 2020

Dingle 2020 is now on! Make sure you check out www.ebpom.org for more details.

Today's TopMedTalk is another sampler from the conference, made available because this vital piece deals with a variety of issues related to COVID-19; what we know and what we know we do not know:

- Similarities and differences between COIVD-19 and Aqute Respiratory Distress Syndrome (ARDS) - The most useful information observed by practitioners at the bedside, conscious of the lack of Randomised Controlled Trials (RCTs) in this area - The controversy regrading early invasive ventilation versus non-invasive ventilation - What are the aerosolization risks? - Pragmatic patient prioritization - The role of anti-coagulation - The role of continuous positive airwave pressure (CPAP) - who benefits and why?

Presented by Professor Mervyn Singer, Intensive Care Medicine at University College London.

Don't miss out on our next conference, make sure you go now to www.ebpom.org

Protecting Your Healthcare Practice - Compliance and Enforcement | AANA 2019 Oct 08, 2020

What are some of the major issues regarding billing? What are the most common mistakes when it comes to documentation? How do we keep the focus on great healthcare, as well as good book keeping? How does "the false claims act" impact on billing?

If you find a mistake or an issue in your note keeping the advice here is clear; deal with it the moment it is discovered. Also, under recording is an obvious issue, can the same be said of 'excessive documentation'?

The bottom line is that practitioners must remain educated, stay aware of what is going on and rely on the fact that patient care is crucial and has to remain at the heart of any healthcare practice.

This piece was part of our coverage of The American Association of Nurse Anesthetists (AANA) 2019 Annual Congress in Chicago, Illinois.

Check out the AANA here: https://www.aana.com/

If you would like to contact our guest he has allowed us to post his email here: msilberman@beneschlaw.com

Presented by Desiree Chappell and Monty Mythen with Sol Aronson, a tenured professor at Duke University and Executive Vice Chairman in the Department of Anesthesiology and their guest, Mark Silberman, Partner, Benesch Law Chair, White Collar, Government Investigations, & Regulatory Compliance Vice-Chair, Health Care.

TopMedTalks to ... Bob Thiele | EBPOM Ireland 2020 Oct 07, 2020

This piece is a chance to hear more about the work of our guest, who made a big impact as a guest on a recent edition of TopMedTalk: https://www.topmedtalk.com/topmedtalk-computer-gamer-to-life-saver/

The Perioperative Quality Initiative (POQI) is here: www.poqi.org

This piece covers cerebral oximetry with near-infrared spectroscopy (NIRS), often used during the perioperative period of cardiovascular operations.

Article here:

"American Society for Enhanced Recovery and Perioperative Quality Initiative Joint Consensus Statement on the Role of Neuromonitoring in Perioperative Outcomes"

https://journals.lww.com/anesthesia-analgesia/Abstract/9000/American_Society_for_Enhanced_Recovery_and.95500.aspx

We're celebrating Evidence Based Perioperative Medicine's (EBPOM) Dingle conference which holds a special place in the hearts of TopMedTalk listeners. We've covered it for the last few years in detail, making many hours of valuable educational information accessible to a global audience of thousands of medical professionals each week. If you'd like to find out more about EBPOM's groundbreaking online proposition please checkout www.ebpom.org

Presented by Desiree Chappell and Monty Mythen with their guest Robert Thiele, Associate Professor, Departments of Anesthesiology and Biomedical Engineering, Division Chief, Critical Care Anesthesiology, Board of Directors, University Physicians Group, University of Virginia School of Medicine. He has a background in engineering and has been using technology to improve education since his residency in 2008. He is co-founder of www.OpenAnesthesia.org which lead to the development of Self-Study, and also authored one of the first iBooks focused on cardiac and critical care ultrasound.

ASA | The Global Council on Brain Health Oct 06, 2020

The American Associaton of Retired People (AARP), an organisation with a membership almost equal to the entire voting population of the United Kingdom, are focusing on brain health, in response to the demands of their members.

Further conversation includes how practitioners both explain the risks of surgery and also calm possible misunderstandings or fears regarding them, as well as wider reflections on 'The Brain Health Initiative'.

Presented by Desiree Chappell with Mike Grocott and their guests Lee Fleisher, Professor of Anesthesiology and Critical Care, University of Pennsylvania and Sarah Lock, Senior Vice President for policy at the American Association of Retired People (AARP) and the director of 'The Global Council on Brain Health'.

Joff Lacey visits the Ether Dome in Boston Oct 06, 2020

Joff and his guests visit the hallowed turf that is the Boston Ether Dome, in the Bulfinch Building, Massachusetts General Hospital. How have times moved on since those early pioneering days when the relatively young profession of Anaesthesia was born? Back then the word wasn't as widely used and the gentlemen in question described their activities as "rendering people insensible using sulphuric ether for the conduct of surgery".

Remember - if you've not yet subscribed to our mailing list you're only getting half of the TopMed talk experience, go to our website now: www.topmedtalk.com

Recorded last year this piece has Dr Joff Lacey paying tribute to the birthplace of Anaesthesia. Joined by Dr Liam Brennan, President of The Royal College of Anaesthetists (RCoA) and Dr Andy Bailey, Addenbrooke's Hospital, Cambridge.

ASA | Henrik Kehlet: Recovery is all about inflammation! Oct 05, 2020

On the morning of the first day of the 2018, annual conference, of the American Society of Anesthesiologists (ASA) Monty Mythen and Desiree Chappell were lucky enough to get an exclusive interview with Professor Henrik Kehlet.

Henrik Kehlet is a gastrointestinal surgeon and former professor of surgery, Copenhagen University, and now professor of perioperative therapy and Head of Section of Surgical Pathophysiology, Rigshospitalet, Copenhagen University.

He has published more than 650 articles within perioperative pathophysiology, pain relief and surgical outcome summarized into the concept of 'fast-track surgery', which also includes a focus on perioperative fluid management.

ASA | Highlights from 2019 Oct 05, 2020

This piece is a reflection upon and celebration of conversations that were made possible by both The American Society of Anesthesiologists and Edwards Life Sciences, a key sponsor for TopMedTalk.

If you would like to hear these conversations in full please follow the links below:

Greg Fischer, Chairman, Department of Anesthesiology & Critical Care Medicine at Memorial Sloan Kettering Cancer Center:

https://www.topmedtalk.com/anes19-greg-fischer/

Tim Miller, Associate Professor of Anesthesiology from Duke University Medical Centre:

https://www.topmedtalk.com/anes19-tim-miller/

The Perioperative Quality Initiative (POQI) is here: https://thepoqi.org/

Michael Scott, Professor and Division Director, Critical Care Anesthesiology- Virginia Commonwealth University:

https://www.topmedtalk.com/anes19-michael-scott/

Also - congratulations to the American Society of Anesthesiologists on the success of this year's online proposition, find out more at www.asahq.org

And don't forget Evidence Based Perioperative Medicine are continuing the momentum of the hugely successful Chicago and London, online meetings - check out www.ebpom.org for more details.

Carol Peden | ASA 2019 Oct 04, 2020

Recorded at the American Society of Anesthesiologists' Annual General Meeting in 2019; "The Power of The Interdisciplinary Team"; introducing the Enhanced Recovery team from Keck Medical Center at The University of Southern California (USC).

Our guests kindly share an email address you can contact them on: Enhanced.Recovery@med.usc.edu

Presented by Desiree Chappell and Monty Mythen with their guests Professor Carol Peden, Robin Cresner, CCRN, Dr Shane Dickinson, anesthesiologist and Snow Shoo Son; The Enhanced Recovery Team from Keck Medical Center at USC.

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Like this, want more?

There's a fascinating conversation with Carol Peden here: https://www.topmedtalk.com/talks-to-carol-peden/

ASA | Life at The Extremes - trials on Everest & adapting to hypoxia Oct 04, 2020

A discussion about oxygen and the Xtreme Everest research studies into human adaptation to hypoxia. How does the human body adapt to extreme conditions? We assume it will inevitably cause damage but this is not always the case. How do people who have inherited a tolerance for low levels of oxygen manage?

Monty Mythen, Mike Grocott and Joff Lacey are joined by special guest Dr Dan Martin OBE, Consultant in Intensive Care and Everest summiteer.

ASA | Frailty and the perioperative patient - enhancing recovery. Oct 04, 2020

Where is perioperative medicine as a specialty in the US? How do frail patients benefit from the perioperative process? Age and physical fitness are important factors when deciding if you're going to put a patient through major surgery, how do these factors allow us to differentiate between those who are likely to have a poor outcome? How common is cardiopulmonary exercise testing (CPET) in the US?

Presented by Desiree Chappell and Monty Mythen with their guest Bobbie Jean Sweitzer, Director of Perioperative Medicine at Northwestern.

Our guest's excellent book is here: https://www.amazon.co.uk/Preoperative-Assessment-Management-BobbieJean-Sweitzer-ebook/dp/B07DWLNW8Y

ASA | 2017 - Anaesthesia and Global Health - an expert view Oct 03, 2020

"We need to work together more, it needs to be multidisciplinary"

A fascinating and still essential discussion - from a truly global perspective - featuring guest presenter Dr Liam Brennan, President of the Royal College of Anaesthetists and his guests; Dr Gonzalo Barreiro, President of the World Federation of Societies of Anaesthesiologists (WFSA), Julian Gore-Booth, CEO of WFSA and Dr Paul Clyburn, President of the Association of Anaesthetists of Great Britain and Ireland, to discuss the unmet global need for safe and accessible anaesthesia.

ASA | The practical applications of innovation. Oct 03, 2020

How do new technologies impact the postoperative elements of Enhanced Recovery? We discuss ward monitoring 3.0 and the technology available, or in the pipeline, to improve outcomes. How do we best use this information and these innovations?

There is also a refreshing conversation about Artificial Intelligence (AI) alongside discussion about "bed sensors" and "facial recognition". Some dementia units are using new technology to monitor patient movement both in and out of their beds, how does this tie into the issue of early mobilisation? Furthermore - what will the consequences be when facial recognition and monitoring is ubiquitous within institutions?

The website mentioned in the podcast is here: https://www.michardconsulting.com/

Presented by Desiree Chappell with Monty Mythen and their guest Frederic Michard of MiCo Consulting.

ASA | Regional anaesthesia associated with improved cancer survival Oct 03, 2020

This piece is a deep dive into regional anaesthesia for Enhancing Recovery. Hear how paravertebral nerve blocks can be used in breast cancer surgery, how does this effect long term outcomes for patients? There is then further discussion regarding regional anaesthesia for Ambulatory Surgery.

There is also a long form discussion of electromyographic (EMG) objective monitoring on a neuromuscular blockade. How can this help reduce and discover potential poor outcomes?

Further questions from the online audience are addressed such as "can you send knee surgery patients home on the day of surgery, how do you manage pain?"

Since this piece was recorded it's worth nothing that these important studies were subsequently finished and published:

"Recurrence of breast cancer after regional or general anaesthesia: a randomised controlled trial " https://pubmed.ncbi.nlm.nih.gov/31645288/

"Influence of perioperative anaesthetic and analgesic interventions on oncological outcomes: a narrative review " https://pubmed.ncbi.nlm.nih.gov/3125529/

"How Anesthetic, Analgesic and Other Non-Surgical Techniques During Cancer Surgery Might Affect Postoperative Oncologic Outcomes: A Summary of Current State of Evidence"

https://pubmed.ncbi.nlm.nih.gov/31035321/

Presented by Desiree Chappell and Monty Mythen with their guest Professor Stuart Grant, MB ChB, FRCA Director, Medical Student Education, Duke University School of medicine.

The evolution of a profession | ASA 2017 Oct 02, 2020

This piece is a look at the very beginnings of your favorite medical podcast. Today we celebrate the American Society of Anesthesiologists (ASA) and their annual general meetings, which we have covered every year since 2017. Find out how TopMedTalk pioneered its first live transmissions from that meeting in Boston and began providing free medical information for an ever growing online audience.

This piece features a timeless conversation about the profession of Anesthesia, from its inception to the diverse and exciting role we find today. Are we right to say that its a role which is rightly evolving toward a broader focus on perioperative medicine? Can we be sure that those in this profession are right to take a leadership role as evidence of the life saving benefits of the perioperative method become recognised internationally?

Presented by Monty Mythen, Smiths Medical Professor of Anaesthesia and Critical Care at University College London and TopMedTalk's Editor in Chief, with, Mike Grocott, Professor of Anaesthesia and Critical Care Medicine at the University of Southampton, Joff Lacey, now a Consultant Anaesthetist at St George's Hospital in South West London and Sol Aronson, tenured Professor at Duke University.

Please check out the ASA's website here: www.asahq.org

The fuller conversations from this podcast are available here:

Podcast 1: Live from Boston ASA 2017 – Anaesthesia and the Perioperative Medicine movement

https://www.topmedtalk.com/podcast-1-live-from-boston-asa-2017-anaesthesia-and-the-perioperative-medicine-movement/

Live from Boston ASA 2017 - Perioperative Medicine in USA

https://www.topmedtalk.com/live-from-boston-asa-2017-perioperative-medicine-in-the-usa/

ASA | Prehabilitation, the word of the year Oct 02, 2020

This piece tackles "prehabilitation", TopMedTalk's word of the year. What is it, why is it so important, who is doing it and why are some people reticent about something that is so obviously good for their health? Furthermore, what are the transatlantic nuances to this 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 Mike Grocott, Professor of Anaesthesia and critical care at the University of Southampton.

Recorded at Anesthesiology 2019 at the Orange County Convention Center in Orlando, over 14,000 delegates, clinicians, thought leaders and professionals; the largest gathering of Anesthesiologists and Anesthesia providers in the world.

The ASA has gone virtual, check them out here: www.asahq.org

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Like this, want more?

Sol Aronson's excellent talk "EBPOM 2018| Perioperative medicine is Population Health Management" is here: https://www.topmedtalk.com/ebpom-2018-perioperative-medicine-is-population-health-management/

And Mike Grocott co-chair's a gripping debate about prehabilitation, "EBPOM 2019 | System wide change for prehabilitation", is here: https://www.topmedtalk.com/ebpom-2019-system-wide-change-for-prehabilitation/

Emotional Intelligence and Occupational Stress | AANA 2019 Oct 01, 2020

Emotional intelligence is the ability to perceive, integrate, understand and utilize emotions in an effective and meaningful way in order to cope and adapt to the situation. It's a hot topic at the moment, here we speak with the first CRNA to be certified in emotional intelligence. Stress and burn out is a common problem in the CRNA community, handling that could have a real impact on performance and outcomes.

Our guest mentions the Mayer-Salovey-Caruso Emotional Intelligence Test™ which can be found here: https://www.mhs.com/

She also advocates "The Student EQ Edge: Emotional Intelligence and Your Academic and Personal Success: Student Workbook" which can be found on Amazon here: https://www.amazon.co.uk/Student-EQ-Edge-Emotional-Intelligence/dp/1118094603

Our guest kindly allowed us to share her email with you: andrea.bittinger@beaumont.org

Presented by Desiree Chappell and Monty Mythen with their guest, Andrea Bittinger, CRNA at William Beaumont Hospital.

EBPOM 2019 | Perioperative blood pressure, panel discussion. Sep 30, 2020

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 scrubbed and ready? If we had better, more specific or sensitive ways to monitor tissue perfusion rather than blood pressure and now - almost discounted - urine output, would this lead to better care? Is it the case that minimally invasive cardiac output technology may be of much greater value in the ward than in theatre?

Presented by Desiree Chappell with Monty Mythen and Dr Simon Davies, Consultant Anaesthetist at York Teaching Hospital NHS Foundation Trust with Timothy Miller, Associate Professor of Anaesthesiology from Duke University Medical Centre.

EBPOM 2019 | Enhanced Recovery After surgery - plus! Sep 29, 2020

This piece gives you clear practical suggestions which you might want to include in your practice and institution. How do we improve the physiological reserve of patients? Is there a way to do enhanced recovery with an extra edge? Specifically, how do we reduce pulmonary complications? What is 'surgery school'? How does 'icough' fit into this? How can practitioners and admin staff help to reduce anxiety as surgery comes closer?

Visit the I COUGH UK website here: https://mft.nhs.uk/mri/services/i-cough-uk/

Make sure you check out the surgery school on the ERAS+ website here: https://www.erasplus.co.uk/How/SurgerySchool

Presented by Dr Daniel Conway, consultant in anaesthesia and critial care at University Hospitals Manchester.

EBPOM London 2020 | Prehabilitation Update Sep 28, 2020

This year was always expected to be a big one for prehabilitation, the advent of a global pandemic has only increased the importance of this exciting field of medicine.

Various questions from EBPOM 2020 attendees were tackled by the panel: Can you use "Timed Up and Go" (TUG) and The Duke Activity Status Index (DASI) to screen out unnecessary cardio-pulminary exercise testing (CPET)? What exactly is prehabilitation and what's its natural scope? How important is nutrition? Is it possible to standardise these areas more? What areas are being significantly worked on in prehabilitation medicine in the UK this year? What about - in these COVID 19 times - remote screening and assessment? Also, what about the possibilities regarding aerosolisation, particularly of COVID-19, during CPET? Can prehabilitation work to minimise time spent in hospital?

Presented by Mike Grocott, Professor of Anaesthesia and Critical Care Medicine at the University of Southampton with Karen Kerr, Consultant Anaesthetist, Departmental Lead for CPET, Sheffield Teaching Hospitals (STH) and featuring panelists; Denny Levett, Professor in Perioperative Medicine and Critical Care at the University of Southampton and a Consultant in Perioperative Medicine at Southampton University Hospital NHS Foundation trust (UHS), June Davis, Director of Allied Health Solutions, Allied Health Professions Advisor (part time) for Macmillan Cancer Support and a professional advisor to the Care Quality Commission and Steve Wootton, OBE, Associate Professor in Nutrition at the University of Southampton with an honorary appointment with University Hospital Southampton in Clinical Nutrition.

Part 2 of TRIPOM USA | Sunday Special Sep 27, 2020

Trainees with an interest in perioperative medicine (TRIPOM) is an ever growing organisation set to continue the global push for perioperative care. This high energy podcast gives you a taste of the enthusiasm people pick up as they learn more about the value of these ideas. Moving more obviously into the perioperative period this piece continues on from last week's talk regarding mitochondrial health where 'healthy ageing' was the focus. The panel now draw the conversation into areas such as nutrition, the impact of frailty on outcomes regarding surgery and patient assessment. How does this gripping research impact upon our work during the perioperative period? Presented by John Whittle, assistant Professor at Duke University Medical Centre and one of the founders of TRIPOM, with a panel including, Mike Grocott, Professor of Anaesthesia and critical care at the University of Southampton, Dr Brant Inman, Urologist at Duke University Medical Center, Dr Amy Pastva, immunologist, physiologist and researcher at Duke University School of Medicine, Dr Paul Wishmeyer, Professor of the Department of Anesthesiology, Duke University.

Managing OR Capacity In a Post #COVID19 World | EBPOM USA - Chicago 2020 Sep 26, 2020

How do we manage our operating room capacity and restore elective surgery in a post-COVID19 world? A world where conditions change week by week, sometimes day by day.

Managing capacity was always a challenge but now we need to think differently in order to stay resilient and agile. How has COVID19 changed the landscape now?

What are the tools that exist to handle it? What are the systems and best practice guidelines that are helping institutions cope? How do we look at supply and demand within the constraints of what's available to us?

Finally the possibility of a "second wave" is investigated, how should it be tackled should it arise?

Presented by Sanjeev Agrawal, President, LeanTaas.

TopMedTalk | The heart of the debate Sep 25, 2020

What are the hot topics in the cardiac world at the moment? This piece tackles; the need for gender balance when composing panels and building a successful event; the need to do what we know and do it well; how quality improvement benefits from simplicity; the need to keep younger practitioners involved and finally the need for a fuller engagement with the multidisciplinary aspect of cardiac care.

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.

Innovators in Anesthesia | AANA 2019 Sep 24, 2020

This piece tells the story of two different innovators in the field of an anesthesia. The first is, The Pediatric Device for Induction of Anesthesia (PeDIA), a mask-free anesthesia delivery system designed for kids. The second is the Error Recovery and Mitigation Aide (ERMA), a reworking of the traditional needle box whereby a clear reservoir is inserted between the re-entry proof top and opaque terminal disposal portion, allowing practitioners to have visualization of all the syringes and vials used during the course of a procedure. At the end of a single procedure, a trap door in the bottom of the reservoir is released to allow those sequestered vials and syringes to drop into the bottom of the needle box for terminal disposal. This allows providers to recognise, check and confirm possible errors in a timely fashion.

Also during this piece there is a wide ranging and fascinating discussion about patents and patenting. How does the process work, how can you patent your ideas and how does the advent of block chain technology potentially change this forever?

Google Patents is here: https://patents.google.com/

Check out the PeDIA website here: https://www.pediallc.com/

For more information about ERMA go here: https://ii4change.com/how-we-innovate/products/error-recovery-and-mitigation-aide/

The Facebook Group "CRNA Inventors and Innovators" mentioned in this piece is here: https://www.facebook.com/groups/2150893568464906/

This piece was part of our coverage of The American Association Nurse Anesthetists (AANA) 2019 Annual Congress in Chicago, Illinois.

Check out the AANA here: https://www.aana.com/

Presented by Desiree Chappell and Monty Mythen with their guests Diane Miller, Pediatric Devices for Induction of Anesthesia | Product Development | PeDIA, LLC and Jean Snyder, CRNA Inc. Co-owner Goodwin and Snyder Anesthesia Associates, PLLC.

TopMedTalk | The AI Doctor will see you now Sep 23, 2020

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/S0007-0912(19)30047-9/fulltext

Presented by Desiree Chappell and Monty Mythen with, Feras Hatib, Phd, Director, Research and Development, Algorithms and Signal Processing at Edwards Lifesciences.

TopMedTalk | Education, anaesthesia and you. Sep 22, 2020

Discussion begins with thoughts about University College London (UCL)'s Masters Course in Perioperative Medicine, moving further to the various ways in which people can learn more about the specialty

The wider conversation reaches out into the field of anaesthesia and the constant shortage of practitioners that there is in the UK and more widely around the world.

Also, if you're intrigued, here's the link to the free 4 week course discussed in this podcast:

https://www.ucl.ac.uk/lifelearning/courses/perioperative-medicine

Presented by Desiree Chappell and Monty Mythen with their guests David Walker, Professor in Anaesthesia and Critical Care Medicine, University College London Hospitals, Honorary Senior Lecturer UCL and Dr Rob Stephens, Consultant in Anaesthesia, UCLH, Hon Senior Lecturer in Anaesthesia, UCL.

EBPOM Highlight | PQIP Pain: from individual case to systems management Sep 21, 2020

"PQIP Pain: from individual case to systems management" - originally streamed live from The Institute of Engineering and Technology (IET) in London during EBPOM 2018 on www.topmedtalk.com

If you're looking for the talk mentioned here featuring Paul Wishmeyer it is here: https://www.topmedtalk.com/topmedtalks-to-dr-paul-wischmeyer/

If you have any comments or questions you'd like to send to the team email: contact@topmedtalk.com

Presented by Dr Natasha Curran, consultant in anaesthesia and pain management University College London Hospital (UCLH) and Medical Director at the Health Innovations Network, South London.

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EBPOM | Dingle - the hottest tickets in anaesthesia and perioperative medicine - go now to the website: https://www.ebpom.org/

Part 1 of TRIPOM USA | Sunday Special Sep 20, 2020

Trainees with an interest in perioperative medicine (TRIPOM) is an ever growing organisation set to continue the global push for perioperative care. This high energy podcast gives you a taste of the enthusiasm people pick up as they learn more about the value of these ideas. The focus here is on promoting healthy aging across two primary domains: cognitive function and physical ability. Discover how multiple features of aging—including physical and cognitive decline—are strongly associated with the bioenergetic profiles of circulating cells. Could the ability to diagnose mitochondrial health address central challenges in geriatric medicine, such as the need for personalized health care based on an individual’s unique physiology and “biological age”? How does this gripping research impact upon our work during the perioperative period? Co-Presented by Rob Schiller MD, Temple University School of Medicine and Anaeshesia, resident at Duke University and Vice-Chair of TRIPOM USA and Bridger Back MD, University of Utah School of Medicine and Anaesthesia resident at Duke University and Chair of TRIPOM USA. This podcast features a talk from Anthony J. Molina, PhD, Associate Professor, Gerontology and Geriatric Medicine. It also contains a contribution from John Whittle, assistant Professor at Duke University Medical Centre and one of the founders of TRIPOM.

EBPOM Highlight | Enhanced Recovery After Cardiac Surgery Sep 19, 2020

"Enhanced Recovery After Cardiac 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

If you have any comments or questions you'd like to send to the team email: contact@topmedtalk.com

Daniel Engelman is the Medical Director of the Heart, Vascular and Critical Care Units at Baystate Medical Center. He is an Associate Professor of Surgery at The University of Massachusetts-Baystate. He started the ERAS® Cardiac Collaborative to internationally standardize best practices.

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EBPOM | Dingle - the hottest tickets in anaesthesia and perioperative medicine - go now to the website: https://www.ebpom.org/

Periop SIG 2019 | Improving the quality of the patient surgical journey Sep 18, 2020

What are the latest developments in quality improvement programs that help operative teams around the world take what they do to the next level? When does the surgical journey begin? How has a focus upon patients prior to surgery improved outcomes? What are "the five phases of care"? How has data collection and management helped us to continually improve a patient's surgical journey?

This piece is a talk which was given during the 8th Australian and New Zealand Symposium of Perioperative Medicine Special Interest Group: “Updates in Perioperative Medicine 360” which took place between November 7th-9th 2019

Presented by Clifford Ko, Professor of Surgery at UCLA, Director of the Division of Research and Optimal Patient Care at the American College of Surgeons.

Opioids: Pain, Euphoria, and a New Surgical Complication. Are Your Patients Safe? | AANA 2020 Sep 17, 2020

"4-10% of opioid naïve patients will continue to use opioids more than 90 days after surgery"

Opioids are good for pain control but there's another issue, they also numb emotional pain. How do we responsibly deal with this? It's important to remember: "When you give patients high doses, you're putting them at risk".

Long term listeners will recall TopMedTalk spent the best part of our launch year on this topic. If you're one of our many new listeners please use this huge resource of podcasts to help update your practice and cut down unnecessary risk: https://www.topmedtalk.com/?s=opioid

"We should be minimizing opioids every chance we can", if you want to cut straight to our groundbreaking talk on opioid free anesthesia please go here: https://www.topmedtalk.com/ebpom-2019-opioid-free-anaesthesia-2/

Presented by Desiree Chappell and Monty Mythen with their guest Jennifer Lanzillotta-Rangeley, CRNA, PhD, Assistant Professor, College of Nursing, University of Cincinnati, Cincinnati, Ohio.

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EBPOM | Dingle - the hottest tickets in anaesthesia and perioperative medicine - go now to the website: https://www.ebpom.org/

Delaying surgery to adequately prepare? | EBPOM World Congress 2019 Sep 16, 2020

A quick surprising poll of perioperative practitioners sets the tone for a robust advocation of the responsibility of surgeons and practitioners to do surgery right; as opposed to being inclined to feeling it must be done "right now!". A data driven approach combined with a patient focused attitude are at the centre of the argument. How do these factors combine to produce a business case which all institutions, practitioners and patients can understand?

In terms of time spent, what do we mean when we say "delay"? How do we overcome a patient's attitudes towards healthcare professionals, if they feel there has already been a delay in 'getting treatment'? How can the pathways from diagnosis to recovery be shortened or made more flexible? Can a case manager help this process? Is eight weeks an acceptable waiting time, can we reasonably expect it to be less than that?

Presented by Gerrit Slooter, MD, PhD, Surgical Oncologist, Maxima Medical Centre, The Netherlands.

TopMedTalk | Gezz Van Zwanenberg, Matt Wiles and Marcus Peck. Sep 15, 2020

What insights does a history of working in military healthcare bring? How do we cut back on readmissions to hospital after time spent in the intensive care unit? How serious an issue is 'burn out' within healthcare? How did standardisation help when designing an award winning patient transfer bag? What's the best way to transfer a patient from ward to ward or from institution to institution? How do we handle data during this period? What do we think about remote supervision and monitoring? Could a dedicated transfer team be useful? Could a new anaesthesia drug be on the way for the NHS soon? How can training in ultrasound be improved? And lastly, will improvements in artificial intelligence ultimately cost us our jobs?

Recorded live at the Association of Anaesthetists' Winter Scientific Meeting 2020, from The Queen Elizabeth II Centre, London, UK.

This piece follows on from part one, which you can find here: https://www.topmedtalk.com/topmedtalk-matt-wiles-and-marcus-peck-live-from-london/

Presented by Monty Mythen featuring guests, Gezz Van Zwanenberg, Nurse and Project Lead North West London Critical Care Network, Matt Wiles, Consultant Anaesthetist & Senior Clinical Lecturer at Sheffield Teaching Hospitals NHS Trust and University of Sheffield and Marcus Peck, NHS Consultant in Anaesthesia and Intensive Care Medicine at Frimley Park Hospital and Chair of Focused Intensive Care Society’s (FICE) Committee.

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EBPOM | Dingle - the hottest tickets in anaesthesia and perioperative medicine - go now to the website: https://www.ebpom.org/

Matt Wiles and Marcus Peck | TopMedTalks to... Sep 14, 2020

Recorded live at the Association of Anaesthetists' Winter Scientific Meeting 2020 in the centre of London from The Queen Elizabeth II Centre. Hear the conversation and questions asked by our online audience.

In our online world is there still a place for a paper based journal? What are the big stories and hot topics of 2020 going to be? What about hyperoxia? How does what we do effect the environment? What are the latest thoughts about 'depth of anaesthesia'?

The podcast mentioned in this piece is here: https://www.topmedtalk.com/anes19-timothy-short-and-kate-leslie/

This link takes you to the trial: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(19)32315-3/fulltext

Is there a future for volatile anaesthesia? What's the future for pediatric intensive care units? How can we use ultrasound technologies to enhance patient care? Will the iconic stethoscope end up with dust on it? What's the future for ultrasound in the intensive care unit?

Presented by Monty Mythen with his guests Matt Wiles, Consultant Anaesthetist & Senior Clinical Lecturer at Sheffield Teaching Hospitals NHS Trust and University of Sheffield and Marcus Peck, NHS Consultant in Anaesthesia and Intensive Care Medicine at Frimley Park Hospital and Chair of Focused Intensive Care Society’s (FICE) Committee.

DINGLE 2019 | The Power of Perception Sep 13, 2020

How can we learn more by seeing more? This fascinating piece looks at how learning and the zone of proximal development (ZPD) of a student can be used to help the process. We are learning about learning, thanks partly to the use of algorithms that monitor our progress and performance. This talk asks challenging questions; "In terms of performance, just think technical procedures at the moment, is there such a thing as an 'expert performance' of any of the techniques we do daily"? How do we get training to produce clinically meaningful performances?

The articles mentioned in this piece are here:

"Looking and seeing" by Roger Kneebone: https://www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736(19)30507-0.pdf

"Machine Learning Identification of Surgical and Operative Factors Associated With Surgical Expertise in Virtual Reality Simulation", published by The Journal of the American Medical Association (JAMA) is here: https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2740782

And, "Proficiency-based progression training: an ‘end to end’ model for decreasing error applied to achievement of effective epidural analgesia during labour: a randomised control study" is here: https://bmjopen.bmj.com/content/8/10/e020099

This talk, originally titled "Recent research articles in medical education", presented by George Shorten, Professor, Anaesthesiology and Intensive Care Medicine and Consultant Anaesthesiologist at Cork University Hospital, at last year's "21st Current Controversies in Anaesthesia & Peri-Operative Medicine and SIAA Autumn Congress" at the Dingle Skellig Hotel, Ireland.

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EBPOM | Dingle - the hottest tickets in anaesthesia and perioperative medicine - go now to the website: https://www.ebpom.org/

TopMedTalk | Computer gamer to life saver Sep 12, 2020

What happens when cutting edge computer game creators, fresh from working on top titles in their industry such as 'Hunger Games' and 'Mission Impossible', use their skills to simulate high stress moments from the real world of anesthesia and surgery? Using "the neuro-science of game design" to help accelerate learning within the profession:

"The motivation for starting Level Ex, what if we actually took the top game designers and developers in the industry? We're talking the executive producer of "Mortal Kombat", the creative director of "Call of Duty", the marketing director of "Words with Friends"; put them with top physicians from multiple specialties, to capture the challenges of the practice of medicine using video game mechanics".

"This doesn't recreate the mannequin, what this does replace is the five hundred live patients you need to train on in order to encounter those five to ten rare scenarios because we can recreate the rare and the difficult and then we can help you train your visualization skills, your recognition skills, your deductive reasoning skills, on those cases."

The key point here is not that motor function is being copied by a screen interactive experience but instead the aim is to "optimise cognitive load" and recreate the thought process alongside an emotional experience.

"We're not introducing you to how to do a fiber optic intubation, we're going to present dozens of rare difficult challenging once in a lifetime cases". Here computer games can currently excel in their teaching ability, "it's a cognitive skill, it's a decision making algorithm". As time ticks by in the simulation "you do get to a point where there's no return and you have like three minutes to do this successfully and so your algorithm and decision making is absolutely crucial". It's about taking in data and making decisions in a way that is not possible on a mannequin or ethical on a live patient.

"Everything that goes into the app is peer reviewed" and, with any computer game you can earn points as you go along; this game though gives you (Continuing Medical Education) CME points.

Google Play: https://play.google.com/store/apps/details?id=com.levelex.airwayex&hl=en_GB

Apple: https://apps.apple.com/us/app/airway-ex/id1154656060

Open Anesthesia is here: https://www.openanesthesia.org/

Presented by Desiree Chappell and Monty Mythen with their guests. Sam Glassenberg, CEO and Founder of Level Ex, before which he was CEO of the leading independent game publisher in Hollywood, releasing games based on popular films, including The Hunger Games and Mission: Impossible, he also led the DirectX graphics team at Microsoft, where he accepted a Technical Emmy on behalf of his team for advancing the visual realism of video games across the industry. His career began at LucasArts, creating Star Wars games for PlayStation and Xbox. Sam serves on numerous industry advisory boards and speaks internationally on video games in medicine. Robert H. Thiele, Associate Professor, Departments of Anesthesiology and Biomedical Engineering, Division Chief, Critical Care Anesthesiology, Board of Directors, University Physicians Group, University of Virginia School of Medicine. He has a background in engineering and has been using technology to improve education since his residency in 2008. He is co-founder of www.OpenAnesthesia.org which lead to the development of Self-Study, and also authored one of the first iBooks focused on cardiac and critical care ultrasound.

EBPOM Chicago | Go to EBPOM dot org now Sep 11, 2020

EBPOM Chicago is now underway - go to www.EBPOM.org now and discover all the latest conversation in the global perioperative sphere.

TopMedTalk | Iron Man vs Anemia Sep 10, 2020

"You've given us all a lot to think about" - a randomized controlled trial regarding intravenous iron does not go 'as expected'.

"I mean, look, I've built my entire career on thinking this was the best thing since sliced bread, the silver bullet, the magic wand ..."

A great scientist follows accurate data to wherever it may lead, what now? More trials, more time, more questions? How common is anemia? Are there any nuggets of hope buried within these data? What have we learned?

Evidence Based Perioperative Medicine sticks to the facts and there's nothing more important than data; make sure you listen to the end, there are interesting details that give many a sense of optimism.

Preoperative intravenous iron to treat anaemia before major abdominal surgery (PREVENTT): a randomised, double-blind, controlled trial is here: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)31539-7/fulltext

Toby is a popular contributor to TopMedTalk - check out his earlier piece here: https://www.topmedtalk.com/prato-2019-toby-richards/

Presented by Monty Mythen and Mike Grocott with their guest Toby Richards, Professor, Anaesthesia Teaching & Research Faculty of Medicine, Nursing and Health Sciences Central Clinical School, Monash University.

TopMedTalk | World Suicide Prevention Day Sep 10, 2020

"We take care of the world but we don't take care of ourselves"

This piece is focused on suicide and emotional stress, the latter has been a theme on TopMedTalk for some time now. Here you'll find out how to tackle this significant health concern, how to identify it, what the warning signs are, how to develop emotional intelligence and information regarding drug free novel therapies including the arts and music.

It features conversations from the following pieces:

AANA 2020 | Suicide Prevention in Anesthesia: CRNAs and SRNAs

https://www.topmedtalk.com/aana-2020-suicide-prevention-in-anesthesia-crnas-and-srnas/

This piece featuring Catherine Horvath DNP, CRNA, Assistant Professor and Program Director of the Doctor of Nursing Practice Nurse Anesthesiology Track at Johns Hopkins School Of Nursing, Baltimore MD, Chuck Griffiths, PhD, CRNA, USC, Assistant Clinical Professor at the UCLA School of Nursing, Faculty, USC Doctor of Nurse Anesthesia Practice Program and Fara Lekhnych, MSN, CRNA, The Johns Hopkins Hospital, Baltimore.

AANA 2019 | Emotional Intelligence and Occupational Stress: https://www.topmedtalk.com/aana-2019-emotional-intelligence-and-occupational-stress/

This piece features Andrea Bittinger, CRNA from William Beaumont Hospital.

TopMedTalk | WHO is looking at the arts and health?

https://www.topmedtalk.com/topmedtalk-who-is-looking-at-the-arts-and-health/

This features Katherine Taylor, Clinical psychologist, Arts & Mental Health Innovation Programme Manager at GMiTHRIVE.

World Suicide Prevention Day is covered in more detail here:

https://www.iasp.info/wspd2020

There's also an interesting resource on the World Health Organisation website here:

https://www.who.int/mental_health/prevention/suicide/wspd/en/

The AANA has a page with more information about Jan Stewart here:

https://www.aana.com/practice/health-and-wellness-peer-assistance/about-health-wellness/wellness-and-substance-use-disorder-education/jan-stewart-memorial-wellness-lecture-series/jan-stewart-in-memoriam

The Social Prescribing Network is here: https://www.socialprescribingnetwork.com/

AANA Peer Assistance Helpline: 1 800 654 5167 US National Suicide Hotline: 1-800-273-talk (8255)

Depression and Suicidal Ideation is tackled further on the AANA website here:

https://www.aana.com/practice/health-and-wellness-peer-assistance/about-health-wellness/emotional-and-mental-well-being/depression-and-suicidal-ideation

Presented by Nick Margerrison with interviews also conducted by Desiree Chappell and Monty Mythen.

Michael Ramsay | TopMedTalks to... Sep 09, 2020

The Patient Safety Movement Foundation (PSMF) has ambitious targets to limit preventable deaths in healthcare, this piece explains how they intend to reduce them down to zero. They need your help, this is a global movement with an action plan to improve the world in an important but achievable way. Their website is here: https://patientsafetymovement.org/

Monty Mythen and Desiree Chappell speak with their guest Michael Ramsay, Chairman, Department of Anesthesiology and Pain Management, Baylor University Medical Center, and President of Baylor Scott & White Research Institute.

POCAPALOOZA | Los Angeles-USA Sep 08, 2020

"Coming out of this pandemic, and this crisis, I think the future for perioperative medicine is very bright and we should definitely take the opportunity and really build on that now..."

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 specifically.

"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" how can innovations like tele-medicine help us to do better? Are we right to be optimistic about our specialty in this difficult time? What are "the four M's"?

The International Board for Perioperative Medicine is here: https://www.internationalboardpom.org/

The Global Health Data @ Work team - which both our guests contribute to - are an invaluable resource; visit them here: https://ghdatwork.com/team

The Hartford Foundation is here: https://www.hfpg.org/

"Perioperative medicine journal" is here: https://perioperativemedicinejournal.biomedcentral.com/

Listeners will also doubtless enjoy this paper - highlighted in the conversation - here: "The Brain-Heart Connection: GCBH Recommendations to Manage Cardiovascular Risks to Brain Health" - https://www.aarp.org/content/dam/aarp/health/brain_health/2020/02/gcbh-heart-health-report-english.doi.10.26419-2Fpia.00099.001.pdf

Presented by Desiree Chappell with Lee Fleisher, Professor and Chair of Anesthesiology and Critical Care, University of Pennsylvania and Carol Peden, Professor of Anesthesiology and Exec. Director of the Center for Health System Innovation, University of Southern California, University of Bath and the Institute for Healthcare Improvement (IHI).

If you loved this piece please enjoy another episode of TopMedTalk featuring Lee Fleisher here: https://www.topmedtalk.com/ebpom-2019-brain-health-peri-operative-quality-initiative-poqi-6-what-can-we-do-tomorrow-2/

Or check out some more of Carol Peden's work here: https://www.topmedtalk.com/women-in-anaesthesia-part-6-carol-peden/

Attentive listeners will also recall that we mention the impressive work of Maurizio Cecconi; we profile him here: https://www.topmedtalk.com/topmedtalks-to-maurizio-cecconi/

And finally we mention change management, a theme on TopMedtalk. Check out this classic piece here: ERAS Team Working and managing change - https://www.topmedtalk.com/eras-team-working-and-managing-change/

EBPOM London 2020 | Perioperative care: A new paradigm for the next decade Sep 07, 2020

"Patients undergo surgery for important reasons, we need to improve surgical outcomes to the point where anyone can have surgery - and I believe that is do-able; we need to implement what we know, we need to avoid missed opportunities and we need to conduct more research. We should learn from the history of anesthesiology and how intraoperative care so dramatically improved outcomes"

This powerful data based talk sets a bold standard for the year, a highlight from the momentous (Evidence Based Perioperative Medicine) EBPOM 2020 - Live From London, it featured as this year's Ernest Henry Starling Plenary Lecture, entitled: "Perioperative Care: A new paradigm for the next decade".

Introduced by Mike Grocott and presented by P.J. Devereaux, MD, PhD, FRCP(C), McMaster University, cardiologist, clinical epidemiologist, and perioperative care physician. Director of the Division of Perioperative Care at McMaster University he is the Associate Deputy Director of the Population Health Research Institute. He is also the Scientific Leader of the Anesthesiology, Perioperative Medicine, and Surgical Research Group at the Population Health Research Institute. A full Professor in the Departments of Health Research Methods, Evidence, and Impact (HEI) and Medicine at McMaster University. He has published over 330 peer reviewed papers and over 80 book chapters, editorials, and commentaries. He has given over 900 lectures and research presentations in 40 countries. He is supported by the McMaster University/ Hamilton Health Sciences Chair in Perioperative Care and a Tier 1 Canadian Research Chair in Perioperative Medicine. He's also the President of the Society of Perioperative Research and Care.

EBPOM 2019 | Nutrition and surgery- a Dietician’s perspective Sep 06, 2020

What are the two prime components of any good nutrition programme? How is avoiding malnutrition different from supporting anabolism? What's the best way to screen patients for malnutrition risk? How can a patient's anthropomitry be assesed alongside their stated needs and preferred outcomes? How important are protein supplements? What are the wider benefits of a good diet? How do we devise nutrition care plans for malnurished patients who need a more aggressive approach? Is it fair to say that everybody can benefit from some nutritional consultation day a dietician? What are the data and studies which support prehabilitation nutritional programmes?

Presented by Chelsia Gillis, Registered Dietitian, Canadian Vanier Scholar, and PhD Candidate in Epidemiology at the University of Calgary, Canada, she is leading the first prehabilitation program for colorectal surgery in Alberta.

Professor Monty Mythen | TopMedTalks to... Sep 05, 2020

What is TopMedTalk and how did it come about? Why is perioperative medicine such an inspiration to us? Why is our Editor in Chief such an advocate? What is the opioid crisis?

Broadcaster Nick Margerrison speaks with Monty Mythen our Editor in Chief about TopMedTalk and perioperative medicine.

We regularly enjoy reading your feedback: contact@topmedtalk.com

EBPOM 2019 | Methadone - the overlooked Opiate? Sep 04, 2020

Is methadone "the opioid sparing opioid"? This talk looks at where we are at as regards opioids, in the shadow of a national crisis for the USA; is it possible that methapone might offer us answers?

This piece looks at the idea that methadone might be a way to deliver a better more effective, multimodal, opioid sparing, analgesia with a reduced chance of a post operative repiratory events and decreased post-operative pain.

This talk is complimented well by our consersation, live from the conference, which you can find here: https://www.topmedtalk.com/prehab-periop-world-congress-evan-kharasch/

The World Health Organisation's analgesic ladder is here: https://www.who.int/cancer/palliative/painladder/en/

Presented by Evan Kharasch, MD, PhD, Professor and Vice Chair for Innovation in the Department of Anesthesiology at Duke University, Director of Academic Entrepreneurship, Duke University School of Medicine.

EBPOM 2019 | The Barcelona experience Sep 03, 2020

What can the experiences of a team who helped to introduce pre-operative assesment and prehabilitation to Barcelona teach us about how to most effectively implement and sustain similar programmes where we are?

How and why is prehabilitation helpful in terms out outcomes and value based care? How long can the benefits of prehabilitation be maintained? What is the value of nutritional consultation, how important is it to asses your patients pre-operative protien intake? Would it help to offer all of your patients mindfullness sessions? How important is it to include patient's partners or carers in sessions?

Also, is it possible for you to tap into and harness the enthusiasm of sporting professionals?

Presented by Graciela Martinez-Palli, Consultant in the Department of Anaesthesia and Perioperative Care at Hospital Clinic, Barcelona. She attends as anaesthesiologist for oncologic digestive surgery and liver transplantation.

EBPOM 2019 | Prehab trials; international study Sep 02, 2020

The International PREHAB trial. This short piece explains the trial's protocol and the scope of the study.

Presented by Charlotte Molenaar, PhD Candidate, multimodal prehabilitation in colorectal cancer care, BIJ Maxima Medisch Centrum, Coordinator of the international PREHAB trial.

POCAPALOOZA | Hong Kong, Mike Irwin Sep 02, 2020

EBPOM might be over but the global perioperative festival, the POCAPALOOZA, continues. Either we've locked our team in their rooms and forced them to continue broadcasting or they're driven by a raw enthusiasm for the results of perioperative care to be shared around the world, either way this piece is our penultimate installment before we return to Cape Town.

What's the situation like, in terms of medicine, in Hong Kong at the moment in the wake of COVID 19?

"Early intervention and people taking it seriously is a big thing"

The conversation evolves as our guest speaks to the realities of moving internationally to pursue your career in medicine. Can a truly global perspective better position the medical community when it comes to international co-operation?

The World Congress of Anaesthesiologists is here: https://www.wcaprague2020.com/

For more about the African Perioperative Research Group (APORG) start here: https://onlinelibrary.wiley.com/doi/epdf/10.1111/anae.14934

Also, what's the future of medical conferencing in the world of COVID 19 and the global pandemic?

Presented by Desiree Chappell and Monty Mythen with Mike Irwin, Professor, Head and Chief of Service, Anaesthesiology HKU, Gleneagles Hospital

Joe Kiani | TopMedTalks to... Sep 01, 2020

The concern for patient safety naturally flows throughout the healthcare continuum. In our discussion with Masimo Founder, Joe Kiani, we discuss the 'planning for zero’ initiative and how we can realistically reach perfection in this area.

The Patient Safety Movement Foundation is an organization dedicated to a goal of ZERO in-hospital preventable deaths by 2020. They request that you and your organization get involved and commit to this goal. Find out more at www.patientsafetymovement.org

Presented by Desiree Chappell and Monty Mythen with their guest Joe Kiani, Founder, Chairman & CEO of Masimo, Cercacor & Patient Safety Movement Foundation.

EBPOM 2019 | The Science of High Performance: Insights From Elite Sport Aug 31, 2020

Insights and perspectives on the science of prehabilitation from a very different angle. It's often said on TopMedTalk that preparing for an operation is not unlike getting ready for a marathon; how do the insights of professionals who work with elite sports men and women to ensure they are fully prepared to do their physical best, on the world stage? Also, what about the teamwork inherent in such activities as the pitstop of a formula one car? Athletes, coaches and a wide number of different experts come into play ensuring a multidisciplinary team converge with essentially the same end in sight as a perioperative prehabilitation team; optimum performance at a crucial time.

Challenges are similar between the two disciplines; how do we foster a culture of learning and teamwork in a high pressure environment where the bottom line carries enormous life changing consequences?

Regular listeners to TopMedTalk may recall the unofficial preamble to this talk, "Prehab Periop World Congress: Gerard Danjoux, Ken Van Someren": https://www.topmedtalk.com/prehab-periop-world-congress-gerard-danjoux-ken-van-someren/

Presented by Ken Van Someren, Director KvS Performance Ltd.

EBPOM 2019 | The Manchester devolution revolution Aug 30, 2020

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 patients affected by cancer, over 2 years?

The GM teams are very happy to host teams in Manchester who may want to visit MFT and see Surgery School in action and show colleagues what they are aiming to achieve with GM Cancer Prehab. Email John on John.moore@mft.nhs.uk or john.moore@erasplus.co.uk

ERAS+ website is here: https://www.erasplus.co.uk/

NHS Innovation Accelerator website: https://nhsaccelerator.com/

GM Active are here: https://www.gmactive.co.uk/

Presented by John Moore, consultant in anaesthetics and critical care medicine from Manchester, UK, Clinical Head of the Division of Anaesthetics, Peri-operative medicine and Critical Care at Manchester University Hospital NHS Foundation Trust.

TopMedTalk | New treatments for Post Operative Nausea and Vomiting Aug 29, 2020

This piece gives us a look at some of the latest thinking on Post Operative Nausea and Vomiting (PONV). It includes a discussion about Amisulpride and discusses new, yet to be published, consensus guidelines for PONV.

The original guidelines are here: https://www.ncbi.nlm.nih.gov/pubmed/24356162

Also, you may like to check out the details of this paper here: Amisulpride: A New Dopamine Antagonist for Treatment of Postoperative Nausea and Vomiting https://www.ncbi.nlm.nih.gov/pubmed/31094771

Presented by Desiree Chappell and Monty Mythen with their guest Tong Joo (TJ) Gan, Professor and Chairman at Stoney Brook in New York.

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Like this, want more?

Check out TJ Gan's masterful presentation "EBPOM USA Part 5| Practical realities; How and why multimodal Analgesia matters" here: https://www.topmedtalk.com/ebpom-usa-part-5-a-perioperative-practicum-with-tj-gan/

TopMedTalk | Prehabilitation, the word of the year? Aug 28, 2020

Is it fair to say that prehabilitation is the new direction for practitioners of Enhanced Recovery After Surgery (ERAS)?

Discussion expands into patient awareness initatives, The Macmillan Cancer Support, Principles and guidance for prehabilitation guide mentioned is here: https://www.macmillan.org.uk/about-us/health-professionals/resources/practical-tools-for-professionals/prehabilitation.html

Age care naturally follows as the roundtable discussion continues. This piece gives a truly pan-national perspective with informed comment from prominent perioperative opinion leaders from The UK, Australia and America. How do those different systems work and what can they each learn from the others?

The journal article mentioned in this piece is here: https://jamanetwork.com/journals/jamasurgery/fullarticle/2732511

Presented by Desiree Chappell with Monty Mythen and Lee A. Fleisher, Professor and Chair of Anesthesiology and Critical Care, University of Pennsylvania and Ross Kerridge, John Hunter Hospital, Newcastle, Australia, often cited as 'the father of Modern Perioperative Medicine'.

Anesthesia Patient Safety Foundation - Mark Warner | ASA 2018 Aug 27, 2020

This piece focuses upon patient safety and the work of our guest. How does perioperative medicine fit into the picture, are anesthetists right to take the lead in this field?

You can find the Anesthesia Patient Safety Foundation here: https://www.apsf.org/

Learn more about the Perioperative Surgical Home here: https://www.asahq.org/psh

Presented by Desiree Chappell with Monty Mythen and Henry Howe alongside their guest Mark Warner, Annenberg Professor of Anesthesiology at the Mayo Clinic in Rochester, 2019 American Society of Anesthesiologists (ASA) recipient of 'The Distinguished Service Award' and President of the Anesthesia Patient Safety Foundation (APSF).

The evolution of a community-based Prehabilitation service | EBPOM World Congress 2018 Aug 26, 2020

"POETTS 2018 | The evolution of a community-based Prehabilitation service" - 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 Gerard Danjoux, consultant in Anaesthesia and Sleep Medicine at South Tees Hospitals NHS Trust.

POCAPALOOZA | EBPOM USA, PASS clinic and shared decision making Aug 25, 2020

The focus for the first part of this POCAPALOOZA was Duke University's PASS clinic.

Find out more about the PASS clinic: https://www.dukehealth.org/locations/duke-pre-anesthesia-testing-center-clinic-2d

"So it's a new approach to really changing the paradigm from just evaluating a patient and sort of passing that information forward to the receiving team [...] rather we take a much more proactive progressive approach to identify those chronic co-morbid conditions and try to bend that curve, we try to modify that which may be modifiable"

If you've heard Sol's passion and want to transform your practice get more detail from these two excellent pieces from Anesthesia and Analgesia here:

Roadmap for Transforming Preoperative Assessment to Preoperative Optimization https://journals.lww.com/anesthesia-analgesia/Abstract/2020/04000/Roadmap_for_Transforming_Preoperative_Assessment.4.aspx?context=FeaturedArticles&collectionId=4

Preoperative Optimization: A Continued Call to Action https://journals.lww.com/anesthesia-analgesia/Citation/2020/04000/Preoperative_Optimization__A_Continued_Call_to.3.aspx

There follows an engaging conversation about prehabilitation, "it's like Rocky Balboa training to get in the ring". For more resources here please check this website from the Choosing Widely campaign: https://www.choosingwisely.co.uk/about-choosing-wisely-uk/

Also - regular listeners will be excited to hear our lead presenter Desiree Chappell's news towards the end of the podcast!

Presented by Desiree Chappell with Monty Mythen and Sol Aronson, tenured Professor at Duke University and their guests Jeanna D. Blitz, Associate Professor of Anesthesiology, Medical Director, Duke PASS Clinic Director, Perioperative Medicine Fellowship, Denny Levett, Professor in Perioperative Medicine and Critical Care, Consultant in Perioperative Medicine, Southampton University Hospital NHS Foundation trust (UHS), President of the Perioperative Exercise Testing and Training Society (POETTS) and Mike Grocott Professor of Anaesthesia and critical care at the University of Southampton.

Hugh Montgomery | TopMedTalks to... Aug 24, 2020

Some of the big questions: Is the pulmonary artery catheter back? What have been some of the big take aways in nutrition? Why should you feed a cold and starve a fever? More Protein or less?

Finally, ‘humanizing intensive care’ is discussed, do we need more ITU pets?

Presented by Desiree Chappell and Monty Mythen confer on the events of the day with their guest Hugh Montgomery, Intensive Care Society Board Member and, Professor of Cardiovascular Genetics and Critical Care University College London.

Simulation in Education | AANA 2019 Aug 23, 2020

Learn how and why the benefits of real-life health care simulation situations are used by institutions such as Northern Kentucky University. Interviewing a patient, reading an X-ray, or administering an injection, in a convincing virutal environment. The St. Elizabeth Healthcare Simulation Center features seven simulation rooms including an operating room and intensive care unit.

What are the future applications we can look forward to? Furthermore how is the AANA developing the way in which simulation is used to train anesthesia providers?

Checkout the Simulation Centre here: https://nku.edu/ihi/health-innovation-center-2/simulation-center.html

Our guest kindly shares their email: Kendonb1@nku.edu

This piece was part of our coverage of The American Association of Nurse Anesthetists (AANA) 2019 Annual Congress in Chicago, Illinois.

Check out the AANA here: https://www.aana.com/

Presented by Desiree Chappell with Monty Mythen and their guest Brett Kendon, DNP, CRNA, CHSE, Assistant Clinical Professor, Assistant Program Director, Nurse Anesthesia Program, Northern Kentucky University.

Periop SIG | Care of older people in surgery (COPS) Aug 22, 2020

Care of older people in surgery (COPS). Are you properly assesing your patients for cognition? Surgery can be appropriate for some to reduce pain in palliative care, how do we make decisions regarding a possible intervention? How important is frailty in this process?

The slides from this talk are here: http://www.anzca.edu.au/documents/03-jacqueline-close_care-of-older-people-in-surger.pdf

Presented by Professor Jacqueline Close, Geriatrician, Prince Of Wales Hospital, Clinical Director, Falls, Balance and Injury Research Centre

--

Brought to you by the Perioperative Medicine Special Interest Group (SIG) in association with the Australian and New Zealand Society for Geriatric Medicine and the Internal Medicine Society of Australia and New Zealand at the 7th annual Australasian Symposium of Perioperative Medicine.

The Perioperative Medicine Special Interest Group (SIG) has three aims; improve patient safety and outcomes, share knowledge and collaborate with specialty groups, develop the specialty of perioperative medicine with various craft groups.

For more information follow this link here: http://www.anzca.edu.au/fellows/special-interest-groups/perioperative-medicine

TopMedTalks to... | Konstantin Balonov Aug 21, 2020

This discussion begins with a focus upon some of the networking and information sharing events that go on in our field;

The Society for Perioperative Assessment and Quality Improvement (SPAQI, website here: https://www.spaqi.org/2020/ )

The 17th World Congress of Anaesthesiologists, September 5-9, 2020, Prague, Czech Republic (website: https://www.wcaprague2020.com/ ).

Discussion then moves to specific "The SQUEEZE Study"; A prospective multi-centre international observational study of postoperative vasopressor use (website: https://www.esahq.org/research/clinical-trial-network/planned-trials/squeeze/ )

Presented by Desiree Chappell and Monty Mythen with their guest Konstantin Balonov, Anesthesiologist; Vice Chair for Perioperative Medicine; Chair, Competency Committee; Assistant Professor, Tufts University School of Medicine.

Like this, want more?

"The Perioperative Medicine Summit", organised by The Society for Perioperative Assessment and Quality Improvement (SPAQI), is covered in detail here: https://www.topmedtalk.com/desirees-roundtable-what-is-the-perioperative-medicine-summit/

Perioperative haemodynamic management - making sure you deliver more | ASA 2019 Aug 20, 2020

"It's like running an election campaign..."

Perioperative hemodynamic management; how do you make it really work within an institution? With extensive reference to real life experience hear first hand stories from our guest and Editor in Chief's experience of doing just that. How do you get people both in and outside of the team to understand the importance of it? Hear about new developments in Enhanced Recovery After Surgery (ERAS) and perioperative haemodynamic management. Find out how new technologies, techniques and information are being applied in this piece.

Also, when dealing with an institution, how important is the value proposition? "Are they up on the deal?"

We discuss The RELIEF trial in more detail here: https://www.topmedtalk.com/ebpom-highlight-1-30-visiting-professor-plenary-lecturer-results-of-the-relief-trial/

We discuss the INPRESS trial in more detail here: https://www.topmedtalk.com/ebpom-london-2018-any-answers-part-3-the-big-trials/

Presented by Desiree Chappell and Monty Mythen with Michael Scott, M.B., Ch.B. Professor of Anesthesiology at the University of Pennsylvania.

POCAPALOOZA 2020 | Cape Town; The African Surgical Outcomes Study Aug 19, 2020

The POCAPALOOZA story begins with our fascination with The African Surgical Outcomes Study. Over the last year regular listeners have heard key parts of the narrative fall into place during TopMedTalk interviews and discussions. Learn how the European Surgical Outcomes Study (EUSOS), presented at a previous Evidence Based Perioperative Medicine (EBPOM) conference, helped to inspire the African Surgical Outcomes Study ASOS which then went on to inspire us all; after an international gathering in Prato. A truly global community - the perioperative medical community - has now been galvanised into action. Determined to further the research and increase the data at the last count we have all helped to raise over £7,000! Thank you for your help.

This piece was the first of our Pocapalooza specials; "Poc" standing for "perioperative care" and "palooza" meaning festival. This piece is an update on The African Surgical Outcomes Study (ASOS) and the African Perioperative Research Group (APORG): "Everybody in the audience was overwhelmed by the quality and importance of the work being done ... in the African study"; "Finding African solutions to the problems that we're having"

You will also find a discussion regarding the Prato conference we covered extensively here on TopMedTalk, a fascinating gathering of people interested in international collaborative trails, and we cover The UK Perioperative Medicine Clinical Trials Network, see link below, before moving on to ASOS in detail.

The Perioperative Medicine UK Clinical Trials Network is here: https://pomctn.org.uk/home

Presented by Desiree Chappell with Monty Mythen and their guests Paul Myles, Director, Anaesthesiology and Perioperative Medicine, Alfred Hospital and Monash University, 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 enjoyed this piece please find more Bruce Biccard here: https://www.topmedtalk.com/topmedtalk-african-surgical-outcomes-study-asos-2/

We discuss Rupert Pearse in this podcast, it's worth listening to this piece with him discussing the Clinical Trials Network here: https://www.topmedtalk.com/anaesthesia-2019-the-clinical-trials-network-and-optimising-shared-decision-making/

Paul Myles is a firm favourite on TopMedTalk, enjoy more of his incisive observations here: https://www.topmedtalk.com/prato-2019-paul-myles/

How to "ACE" pediatric emergence! | AANA 2020 Aug 18, 2020

Pediatric patients can present quite a challenge when emerging from anesthesia. Here we discuss ways to “ACE” your transition to PACU! “A”void Emergence Agitation, and discover the latest evidence about “C"riteria for “E”xtubation in this challenging population. How do the protocols and standard of care compare between the UK and US. What does the evidence tell us? Also, how is Enhanced Recovery After Surgery progressing in pediatrics?

Presented by Desiree Chappell and Monty Mythen with their guest Kristin Henderson, DNAP, CRNA, CHSE, CPT, USAR Assistant Professor, Wake Forest School of Medicine, Nurse Anesthesia Program

Emergence Delirium in US Veterans: Best Practice Recommendations | AANA 2020 Aug 17, 2020

After working at a Veterans Affair Medical Center, hear how our guests moved into the field of emergence delirium: "upon emergence our patients were swinging and very aggressive ... there must be some way to prevent this".

This fascinating piece enjoys an engaging discussion about an important topic for both patients and practitioners; how important is it for you to know a patient may suffer from post traumatic stress disorder? Do different anesthetics promote or avoid emergence delirium? Can emergence delirium cause further long term trauma? How do we deal with US military veterans specifically?

Patient Health Questionnaire 9 (PHQ-9) is here: https://patient.info/doctor/patient-health-questionnaire-phq-9

The State Trait Anxiety Inventory is here: https://www.advancedassessments.co.uk/resources/Mental-Health-Test.pdf

Presented by Desiree Chappell and Monty Mythen with Kristen Roman, MSN, MFA, SRNA, Ignacio Diaz, BSN, SRNA and Jena Borgonia, BSN, SRNA, student registered nurse anesthetists (SRNAs) at The University of Southern California.

E-cigarettes and their impact on patients undergoing anesthesia | AANA 2020 Aug 16, 2020

The electronic cigarette market is a $14 billion industry worldwide. As of August 2019, 215 cases of severe pulmonary illness related to e-cigarette use are being investigated in the United States. The known hazards of e-cigarette use are rapidly coming to light with the sudden onset of serious bronchiolitis-related pulmonary disease in otherwise healthy people who were known to use e-cigarettes. Learn also how COVID 19 has increased these dangers.

Presented by Desiree Chappell with Monty Mythen and Bernard Gilligan, III, DNP, CRNA, APRN, Program Assistant Director, Assistant Professor, Cedar Crest College Nurse Anesthesia Program, Allentown, PA.

Sex, race and social class disparities in pain | AANA 2020 Aug 15, 2020

Pain is a subjective experience that affects all segments of the population. However, there are inter-individual differences in pain. The biopsychosocial model proposes that the intersection of biological, psychological, and social factors create a pain experience and pain outcomes that differ by sex, race, and socioeconomic status.

"The minority stress theory ... the idea that for racial minorities, especially blacks, they are exposed to chronic stress; the stress of daily racism"

Could epigenetics hold the key to understanding how social factors compound differences between patients? How does this impact on you and your practice?

Further reading is to be found here:

https://pubmed.ncbi.nlm.nih.gov/19411059/

https://pubmed.ncbi.nlm.nih.gov/32487870/

https://pubmed.ncbi.nlm.nih.gov/30863142/

Presented by Desiree Chappell and Monty Mythen with Edwin N. Aroke, Ph.D., CRNA, Assistant Professor, Associate Scientist, Minority Health and Health Disparities Research Center, Associate Scientist, Comprehensive Arthritis, Musculoskeletal, Bone, & Autoimmunity Center, The University of Alabama, Birmingham, US.

Periop SIG | The Perioperative Cognition Workshop - Part 1 Aug 15, 2020

This invaluable piece is a chance to attend a workshop which looks at the latest thinking on "perioperative cognition" and 'post-operative cognitive dysfuntion'.

We advise you use this link here to find the PDF of the paper being discussed: https://bjanaesthesia.org/article/S0007-0912(17)54082-9/fulltext

Presented by David Scott, Professor, University of Melbourne, Director, Anaesthesia and Acute Pain Medicine, St Vincent’s Hospital, Melbourne and Lis Evered, Scientific Head of Research, Department of Anaesthesia, St. Vincent's Hospital, Melbourne.

This is Part 1, to find Part 2 go here:

https://www.topmedtalk.com/sunday-special-the-perioperative-cognition-workshop-part-2/

Part 3 is here:

https://www.topmedtalk.com/sunday-special-the-perioperative-cognition-workshop-part-3/

Part 4 is here:

https://www.topmedtalk.com/sunday-special-the-perioperative-cognition-workshop-part-4/

Brought to you by the Perioperative Medicine Special Interest Group (SIG) in association with the Australian and New Zealand Society for Geriatric Medicine and the Internal Medicine Society of Australia and New Zealand at the 7th annual Australasian Symposium of Perioperative Medicine.

The Perioperative Medicine Special Interest Group (SIG) has three aims; improve patient safety and outcomes, share knowledge and collaborate with specialty groups, develop the specialty of perioperative medicine with various craft groups.

For more information follow this link here: http://www.anzca.edu.au/fellows/special-interest-groups/perioperative-medicine

Ketamine Infusion Centers: From Inception to Infusion | AANA 2020 Aug 14, 2020

"My first thought was - why can't we do this here?"

What is ketamine, what sort of drug is it and how is it used? How was it first synthesized? Was it intentionally found or another of science's happy accidents?

This piece is a fascinating look into the history and future of ketamine with a focus on outpatient infusion centers. Could this unusual and "dirty" drug - meaning it acts on many parts of the body and is not fully understood - have incredibly useful consequences for people who face the grueling task of handling depression or a post traumatic stress disorder?

We look at the research and evidence base regarding ketamine, how it is effective for different disease processes and how the drug might be more widely used in the future. It appears to have come into something of a renaissance, "thank you for getting the word out about ketamine".

Check out the clinic here: https://www.neuromendcenter.com/

Presented by Desiree Chappell and Monty Mythen with Tracy Young, MSNA, MBA, CRNA, CEO of YPS Anesthesia, he also a two time past State President for the Louisiana State Association of Nurse Anesthetists as well as currently sitting on several other boards.

Opioids: Pain, Euphoria, and a New Surgical Complication. Are Your Patients Safe? | AANA 2020 Aug 14, 2020

"4-10% of opioid naïve patients will continue to use opioids more than 90 days after surgery"

Opioids are good for pain control but there's another issue, they also numb emotional pain. How do we responsibly deal with this? It's important to remember: "When you give patients high doses, you're putting them at risk".

Long term listeners will recall TopMedTalk spent the best part of our launch year on this topic. If you're one of our many new listeners please use this huge resource of podcasts to help update your practice and cut down unnecessary risk: https://www.topmedtalk.com/?s=opioid

"We should be minimizing opioids every chance we can", if you want to cut straight to our groundbreaking talk on opioid free anesthesia please go here: https://www.topmedtalk.com/ebpom-2019-opioid-free-anaesthesia-2/

Presented by Desiree Chappell and Monty Mythen with their guest Jennifer Lanzillotta-Rangeley, CRNA, PhD, Assistant Professor, College of Nursing, University of Cincinnati, Cincinnati, Ohio.

Suicide Prevention in Anesthesia: CRNAs and SRNAs | AANA 2020 Aug 14, 2020

"Our job is to tell them; there is another solution ... there's another way to solve this problem and I can help you"

This piece takes a bold and honest look at suicide in anesthesia, although it has a US set of contributors the issues here are to do with everyone in healthcare. TopMedTalk is keen to promote the fact help is available, please seek it out if you are concerned you might be affected by these issues.

AANA Peer Assistance Helpline: 1 800 654 5167 National Suicide Hotline: 1-800-273-talk (8255)

How does the tactic of Question Persuade Refer (QPR) work? Should we directly discuss suicide with colleagues? What are the basic causes of this complicated problem? Can we simplify our approach by being more direct and honest? What does the evidence tell us is the best way to deal with the situation?

Presented by Desiree Chappell with her guests Catherine Horvath DNP, CRNA, Assistant Professor and Program Director of the Doctor of Nursing Practice Nurse Anesthesiology Track at Johns Hopkins School Of Nursing, Baltimore MD, Chuck Griffiths, PhD, CRNA, USC, Assistant Clinical Professor at the UCLA School of Nursing, Faculty, USC Doctor of Nurse Anesthesia Practice Program and Fara Lekhnych, MSN, CRNA, The Johns Hopkins Hospital, Baltimore.

Mike Swart | TopMedTalks to... Aug 14, 2020

How do you become well known in the NHS for being innovative, particularly in the perioperative area regarding evaluation and communication of risk? How can cardiopulmonary exercise testing lead to shared decision making? Hear how aortic aneurysms are dealt with by a world class professional perioperative physician. Learn how that process and its success then spread out into other areas of healthcare within his institution. Do you need to develop a broad knowledge of all surgery and medicine so that you understand what is going on within the different surgical specialities? Following this discussion is had about the GIRFT (Getting It Right First Time) project. The stated aim is 'to help improve the quality of care within the NHS by reducing unwarranted variations, bringing efficiencies and improving patient outcomes'. This piece gives you the detail from one of the joint clinical leads. Presented by Monty Mythen, Joff Lacey and Desiree Chappell with their guest Dr Michael Swart, Consultant in Anaesthesia and Critical Care Medicine at Torbay Hospital and advisor to the UK Department of Health for the Enhanced Recovery Programme.

Hypotension Index: Data drives change | ASA 2019 Aug 13, 2020

This piece looks at innovations in our field, through the lens of the Hypotension Prediction Index (HPI). Innovations in medicine are always exciting, "neuro-monitoring" is discussed "if you told me two years ago that I was going to be able to understand an EG waveform I would have laughed at you".

"Data is what drives any change", how can new insights regarding hypotension potentially revolutionize your practice? Adoption of any new technology is complicated, how do you handle resistance to such innovations? When it comes to change management, if the new change takes more than "300 seconds" then, "unless there is an emotional tug ... it is hard". The value proposition has to be strong, what's the verdict on the H.P.I. monitor?

This piece is part of our coverage of Anesthesiology 2019 at the Orange County Convention Center in Orlando. With over 14,000 delegates, clinicians, thought leaders and professionals, it's the largest gathering of Anesthesiologists and Anesthesia providers in the world.

Presented by Desiree Chappell and Sol Aronson with their guest Neal Fleming, Professor, Anesthesiology and Pain Medicine, UC Davis.

EBPOM Highlight | Perioperative nutrition should be a key part of Enhanced Recovery Aug 12, 2020

"Perioperative nutrition should be a key part of Enhanced Recovery" - 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 Paul Wischmeyer, Professor of the Department of Anesthesiology, Duke University.

Enhanced Recovery with Lynn Reede | AANA 2019 Aug 11, 2020

"Thank you for taking this meeting beyond these walls" - this piece was the final part of our coverage of The American Association of Nurse Anesthetists (AANA) 2019 Annual Congress in Chicago, Illinois. We begin with the global audience in mind and break down what it is to be a Nurse Anesthetist. It's a role which is expanding in scope, our guest walks us through how and why that's the case.

This wide ranging conversation then moves to the future of enhanced recovery and the AANA's future development.

For more on the Drink Eat Mobilise topic go here: https://www.topmedtalk.com/periop-coach-2-02-eras-whats-the-secret-sauce/

Check out the AANA here: https://www.aana.com/

Presented by Desiree Chappell and Monty Mythen with their guest Lynn Reede, Associate Clinical Professor, Northeastern University Nurse Anesthesia Program.

EBPOM 2019 | Delivering Personalised Care: aligning prehabilitation with healthcare policy Aug 10, 2020

How can we align personalised care with prehabilitation? "Personalised care is where people have more choice and control over how their health and care needs are met" where we recognise "people themselves can sometimes be the best integrators of health and care". In this context our role is to support them to "live as independently as they wish". With shared decision making and personal choice at the heart of this we allow patients to be "experts in their own lives, health and care".

The increase in life expectancy means more long term conditions and comorbidities in patients, what opportunities does this present? How do we hone in on what matters to patients and help them manage the cumulative burden of long term health difficulties? How comfortable are healthcare practitioners when talking about physical activity?

Is it possible that personalised care could eventually be business as usual?

The NHS Long Term Plan has a website which you can see here: https://www.longtermplan.nhs.uk/

The NHS website is here: www.england.nhs.uk

Presented by Anna Lowe, Programme manager, National Centre for Sport and Exercise Medicine, Lead Allied Health Physical Activity Clinical Champion at Public Health, England.

Burn out? | Sunday Special Aug 09, 2020

This piece focuses on the question of looking after yourself as a practitioner and interlinking into your team. How important is it to listen to your team? What is "burn out"? How does it express itself in people? What signs should we look for in our friends and colleagues?

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.becomebraveenough.com/

Periop Medicine SIG | Armed with data to improve perioperative outcomes Aug 08, 2020

This piece is about the application of data, how do we use it and when should we gather it? How important is it to "just get started and find out what the problem is"?

Further reading is available here: https://bjanaesthesia.org/article/S0007-0912(17)33828-X/fulltext

If you're interested in hearing more about the Enhanced Peri-Operative Care for High-risk patients (EPOCH) trial go here: https://www.topmedtalk.com/desirees-roundtable-carol-peden-epoch-qa/

Presented by Professor Carol Peden, Executive Director of the Center for Heath System Innovation and Professor of Anesthesiology at the Keck School of Medicine of the University of Southern California, Fellow of the Institute for Healthcare Improvement (IHI).

EBPOM 2019 | Perioperative Blood Pressure, Q&A Aug 07, 2020

As a general rule, should ward monitoring be increased? Should continuous blood pressure monitoring be more frequent?

This short piece follows on from Tim Miller's talk "Perioperative Blood Pressure (PeriOperative Quality Initiative: POQI 3) how low can you safely go?".

Presented by Desiree Chappell and Monty Mythen with Tim Miller, Associate Professor of Anesthesiology from Duke University Medical Centre.

EBPOM 2019 | Troponin Screening - essential or the Emperor's new clothes? Aug 06, 2020

This panel discussion and extended question and answer session focuses upon troponin screening. Where is the latest evidence as regards this debate? Is MINS ( Myocardial injury after noncardiac surgery) the most common postoperative complication associated with death and if so why is there a transatlantic divide as regards the evidence? Is there a place for troponin screening preoperatively for risk stratification? What should one do with an asymptomatic post operative patient with raised troponin? Does MINS cause hypotension?

This is part 3 of 3 from The EBPOM 2019 TopMedTalk session which debated the issue.

Chaired by Monty Mythen, TopMedTalk's Editor in Chief, with, Mike Grocott, Professor of Anaesthesia and critical care at the University of Southampton and frequent TopMedTalk contributor, Denny Levett, Professor in Perioperative Medicine and Critical Care, Consultant in Perioperative Medicine, Southampton University Hospital NHS Foundation trust (UHS), President of the Perioperative Exercise Testing and Training Society (POETTS) and 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.

EBPOM Highlight | Pain Management to Enhance Recovery after joint replacements Aug 05, 2020

"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.

Protecting Your Healthcare Practice - Compliance and Enforcement | AANA 2019 Aug 04, 2020

What are some of the major issues regarding billing? What are the most common mistakes when it comes to documentation? How do we keep the focus on great healthcare, as well as good book keeping? How does "the false claims act" impact on billing?

If you find a mistake or an issue in your note keeping the advice here is clear; deal with it the moment it is discovered. Also, under recording is an obvious issue, can the same be said of 'excessive documentation'?

The bottom line is that practitioners must remain educated, stay aware of what is going on and rely on the fact that patient care is crucial and has to remain at the heart of any healthcare practice.

This piece was part of our coverage of The American Association of Nurse Anesthetists (AANA) 2019 Annual Congress in Chicago, Illinois.

Check out the AANA here: https://www.aana.com/

If you would like to contact our guest he has allowed us to post his email here: msilberman@beneschlaw.com

Presented by Desiree Chappell and Monty Mythen with Sol Aronson, a tenured professor at Duke University and Executive Vice Chairman in the Department of Anesthesiology and their guest, Mark Silberman, Partner, Benesch Law Chair, White Collar, Government Investigations, & Regulatory Compliance Vice-Chair, Health Care.

Practical tips for preoperative risk assessment | EBPOM Ireland 2019 Aug 03, 2020

"Some practical tips you can take away and implement in your hospital..."

In the UK there is a legal imperative to minimalise and individualise risk now but it's widely understood to be helpful if you want to provide better value and patient outcomes. How can risks be identified and minimised? How can these risks then help to provide better quality shared decision making? How can plan a perioperative pathway tailored to these needs?

Presented by Ramani Moonsinghe, Professor of Perioperative Medicine at University College London (UCL).

IMPORTANT NOTE: We discuss "The Montgomery Case" in more detail here; this piece is very relevant to you and your patients, legally speaking, if you work in the UK: https://www.topmedtalk.com/sunday-special-being-on-the-right-side-of-the-law-2/

TopMedTalk | Education, perioperative medicine, anaesthesia and you. Aug 02, 2020

Discussion begins with thoughts about University College London (UCL)'s Masters Course in Perioperative Medicine, moving further to the various ways in which people can learn more about the specialty

The wider conversation reaches out into the field of anaesthesia and the constant shortage of practitioners that there is in the UK and more widely around the world.

Also, if you're intrigued, here's the link to the FREE 4 week course discussed in this podcast:

https://www.ucl.ac.uk/lifelearning/courses/perioperative-medicine

Presented by Desiree Chappell and Monty Mythen with their guests David Walker, Professor in Anaesthesia and Critical Care Medicine, University College London Hospitals, Honorary Senior Lecturer UCL and Dr Rob Stephens, Consultant in Anaesthesia, UCLH, Hon Senior Lecturer in Anaesthesia, UCL.

Periop SIG | Part 2, Delirium: The brain and the older surgical patient Aug 01, 2020

"Delirium: The brain and the older surgical patient Part 2" was a talk originally given at the 8th Australian and New Zealand Symposium of Perioperative Medicine Special Interest Group: “Updates in Perioperative Medicine 360” which took place between November 7th-9th 2019.

This piece is a look at some of the new technology which is becoming more widely used. A leadless pacemaker is a small implantable "bullet like" device that sends electrical pulses to the heart whenever it senses that the heartbeat is too slow. Also new implantable cardioversion defibrillators are discussed as are implantable cardiac monitors. There is also discussion regarding cardiac resynchronization therapy.

"Aqute brain failure is really the concept we're talking about"

Find out more about ANZCA here: http://www.anzca.edu.au/

Presented by Professor Alison Mudge, Conjoint Professor of Medicine, Royal Brisbane Clinical Unit, Faculty of Medicine and Gideon Caplan Associate Professor of Geriatrics, Prince Of Wales Hospital, Sydney.

Houman Javedan | TopMedTalks to... Jul 31, 2020

The Silver Tsunami is coming, are you prepared to assess the elderly patient? Mature patients present unique and interesting opportunities to perioperative practitioners. New ways of thinking and different approaches are always necessary.

The British Geriatric Society's "Fit For Frailty" is here: https://www.bgs.org.uk/resources/resource-series/fit-for-frailty

Presented by Desiree Chappell and Monty Mythen with their guest Houman Javedan, MD. Geriatrician at Brigham and Women’s Hospital, assistant program director of the HMS Multi-Campus Fellowship in Geriatric Medicine, and Clinical Director for the Division of Aging in the Department of Medicine.

ASA 2019 | 'We advocate good public health, within the crucible of surgery' Jul 30, 2020

Originally broadcast live from Anesthesiology 2019, this piece focuses on the mission to advocate and apply prehabilitation, pre-optimisation and enhanced recovery. Defined here as "good public health [...] with the crucible of surgery".

How do we do that in a way that both patients and front line providers understand the value of it? Can this message help to allow for delays in surgery?

Also, how do we take our message to social media, specifically Twitter? Listen in for some excellent tips before you make a point of following our guest's twitter account here: https://twitter.com/jeffsimmons

Presented by Desiree Chappell and Mike Grocott with Jeff Simmons, Associate Professor, Medical Director for UAB’s Preoperative Assessment, Consultation, and Treatment Clinics and all Paranesthesia Care Units. Co-Chair of the Operating Room Executive and Perioperative Oversight Committees.

EBPOM Highlight | Exercise capacity and sarcopenia Jul 29, 2020

"Exercise capacity and sarcopenia" - 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

If you have any comments or questions you'd like to send to the team email: contact@topmedtalk.com

Presented by John Whittle, assistant Professor at Duke University Medical Centre.

Substance Use Disorder - Peer Support: An Empathetic Information Resource | AANA 2019 Jul 28, 2020

"I know how to manage pain medication [...] addiction was the absolute last thing that would happen to me".

This podcast helps tackle the difficult subject of Substance Use Disorder in healthcare practitioners. How do we, from a caring and helpful perspective, address this issue either within ourselves or others?

This piece was part of our coverage of The American Association of Nurse Anesthetists (AANA) 2019 Annual Congress in Chicago, Illinois.

Check out the AANA here: https://www.aana.com/

The Peer Assistance section of the AANA’s website is here: www.AANAPeerAssistance.com. Also see www.AANA.com/AboutPeerAssistance for additional facts and information.

The phone number we share in the podcast is: (800) 654-5167

Furthermore there is an interesting article about Parkdale here: https://www.aana.com/docs/default-source/wellness-aana.com-web-documents-(all)/aana-parkdale-partnership-jan-2019.pdf?sfvrsn=bd8f51b1_2

Presented by Desiree Chappell and Monty Mythen with their guests, Linda Stone, DNP, CRNA Assistant Program Director at Raleigh School of Nurse Anesthesia and Rodrigo Garcia, CEO Parkdale; APN, MSN, CRNA, MBA.

Enhanced Recovery with Monty and Desiree | EBPOM Ireland 2019 Jul 27, 2020

TopMedTalk has recently engaged with a large number of new listeners, we are delighted to have you join our family of perioptimists! This piece works as a primer, it explains what lies at the core of the world's favorite perioperative medicine podcast; enhanced recovery. What is it? How do you implement it? And, what are its core principles?

If you've never heard TopMedTalk before but you are a medical practitioner this piece is a great place to start; if you're already onboard it will be a welcome refresher regarding the ideas we all gather around daily.

How widespread is enhanced recovery after surgery and, perhaps more importantly, how widespread are its principles? Are patients living the drinking, eating and mobilising early on and so "living the (drink, eat, mobilise) dream?".

The "POWER" study "Association Between Use of Enhanced Recovery After Surgery Protocol and Postoperative Complications in Colorectal Surgery: The Postoperative Outcomes Within Enhanced Recovery After Surgery Protocol (POWER) Study" is here: https://pubmed.ncbi.nlm.nih.gov/31066889/

The App Store has our app here: https://apps.apple.com/gb/app/topmedtalk/id1438159784

Google Play has it here: https://play.google.com/store/apps/details?id=com.topmedtalk.android.medtalk&hl=en_GB

There is a recent conversation with Henrik Kehlet here: https://www.topmedtalk.com/topmedtalk-henrik-kehlet-and-nick-scott/

There's also a recent one with Angela Bader here: https://www.topmedtalk.com/covid-19-angela-bader-the-need-for-end-of-life-conversations/

Our famous Bill Clinton piece is here: https://www.topmedtalk.com/sunday-special-bill-clinton-at-the-world-patient-safety-science-technology-summit-2/

The excellent Chris Snowden piece we mention is here: https://www.topmedtalk.com/dingle-2019-the-opportunity-in-variability/

(Enhanced Recovery After Surgery) ERAS Guidelines are here "Guidelines for Perioperative Care in Cardiac SurgeryEnhanced Recovery After Surgery Society Recommendations" : https://jamanetwork.com/journals/jamasurgery/fullarticle/2732511?guestAccessKey=04f7090d-122c-4e94-a46f-22e49dab7c51

The Perioperative Quality Initiative is here: https://thepoqi.org/

Presented by Desiree Chappell and Monty Mythen.

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Have you heard the incredible news about EBPOM Chicago yet? Go now to ebpom.org and find out more!

Michelle Chew | TopMedTalks to... Jul 26, 2020

"Excellent teamwork"; the key to good outcomes.

This piece features an in depth discussion of post operative acute kidney injury (AKI), are there fresh approaches we can take? Could more data help us? The conversation then moves to myocardial injury after noncardiac surgery (MINS). What should our thoughts be as regards postoperative troponin levels?

Presented by Desiree Chappell and Monty Mythen with their guest Michelle Chew, Professor, Senior Consultant, Faculty of Medicine, Linköping University; Associate Professor, Faculty of Health and Medical Sciences, UCPH; Associate Professor, Consultant, Department of Anaestheisa and Intensive Care Medicine, Hallands Sjukhus Halmstad.

Periop SIG 2019 | Part 1, Delirium: The brain and the older surgical patient Jul 25, 2020

"Delirium: The brain and the older surgical patient Part 1" was a presentation originally given at the 8th Australian and New Zealand Symposium of Perioperative Medicine Special Interest Group: “Updates in Perioperative Medicine 360” which took place between November 7th-9th 2019.

"Acute brain failure is really the concept we're talking about", this piece covers delirium and dives into why this common and long discussed condition is not yet something we can always predict and prevent.

Find out more about ANZCA here: http://www.anzca.edu.au/

Presented by Professor Alison Mudge, Conjoint Professor of Medicine, Royal Brisbane Clinical Unit, Faculty of Medicine and Gideon Caplan Associate Professor of Geriatrics, Prince Of Wales Hospital, Sydney.

TopMedTalk | A step between a simple monitor and a fully automated system Jul 24, 2020

This piece focuses upon goal directed fluid therapy, with an automated system, for decision support; "a step between a simple monitor and a fully automated system".

The "proof of concept" paper we highlight towards the end of the podcast, "Feasibility of closed-loop titration of norepinephrine infusion in patients undergoing moderate - and high-risk surgery" has now been published and can be found here: https://bjanaesthesia.org/article/S0007-0912(19)30443-X/abstract

This paper here "Perioperative goal directed therapy using automated closed-loop fluid management: the future?" is also referenced: https://www.ncbi.nlm.nih.gov/pubmed/26578397

You may also find this piece, which our guest is also part of, here interesting: https://www.ncbi.nlm.nih.gov/pubmed/29068831

Presented by Desiree Chappell and Monty Mythen with their guest Alexandre Joosten, Anesthetist at Hospital Erasme.

ASA 2019 | A data based conversation about payment methods Jul 23, 2020

Away from the world of politics there is a sensible debate to be had about payment methods for healthcare. Here you will find evidence, shared goals and specific payment models from the US being looked at in detail. It's a debate about total cost of care and a two sided risk model that could potentially be cheaper and better for both patients and providers.

Bundle payments provoke debate, "the interesting question is; 'post operatively, do you need that expensive care'?" Population health is an inevitable terrain for the discussion, could alternative payment models benefit wider society?

"Healthy people don't need anything other than wellness care, the poorly managed chronically co-morbid medical conditions are the population that is costing us and driving the cost of care up disproportionately greater than everyone else"; how do the needs of these two groups knit together in a way that is helpful and equitable financially?

How is enhanced recovery and perioperative medicine helping to reduce the cost of healthcare? Can prehabilitation help reduce costs even further?

The Centers for Medicare and Medicaid services (CMS) website is here: https://www.cms.gov/

Presented by Desiree Chappell with Monty Mythen, Sol Aronson and their guest Lee Fleisher, Professor and Chair of Anesthesiology and Critical Care, University of Pennsylvania.

If you enjoyed this conversation you will certainly find value in this piece as well: https://www.topmedtalk.com/roundtable-highlight-the-maryland-funding-experiment/

EBPOM Highlight | Pain Strategies with methadone Jul 22, 2020

"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

If you have any comments or questions you'd like to send to the team email: contact@topmedtalk.com

Presented by Glenn Murphy, Jeffery S. Vender Chair of Anesthesiology Research and Education and Director of Cardiac Anesthesia and Clinical Research at NorthShore University HealthSystem, a hospital affiliated with the University of Chicago Pritzker School of Medicine.

A Novel Use of the Erector Spinae Block in the Austere Environment | AANA 2019 Jul 21, 2020

In the military Forward Surgical Teams (FSTs) are deployed into challenging environments to deliver "damage control surgery". They help people who have been injured, relieve the pain, stop the bleeding, 'patch the holes' and move them to a safer environment. It's from this background that our two contributors come, learn how they have been forced to innovate and what insights they can give to practitioners working in more familliar and well resourced contexts.

Hear how a 25 year-old male presented with penetrating chest trauma and an Erector Spinae Block was utilized in an incredibly dramatic context.

This inteview works well in tandem with this link to the paper discussed in the piece: https://www.ncbi.nlm.nih.gov/pubmed/31247096

This piece was part of our coverage of The American Association of Nurse Anesthetists (AANA) 2019 Annual Congress in Chicago, Illinois.

Check out the AANA here: https://www.aana.com/

Presented by Desiree Chappell and Monty Mythen with their guests Robert Fabich, Doctor of Nursing Practice, CRNA, Veteran and Sharrod R. Greene, CRNA, Sentara Anesthesiology Specialists.

Can medicine be cured? | EBPOM Ireland 2019 Jul 20, 2020

Warning; this piece may make for uncomfortable listening. It is a fascinating look at the recent history of medicine and how our profession may in fact be sick. Contained within the story is a message of hope, evidence alongside a message that may contain the cure.

In our recent history we seem to have enjoyed something of a "Golden Age" of medicine which, by raising quality of life so dramatically, has transformed our understanding of concepts such as "public health" and even "standard of living". However, running alongside that is an industry and society that is primarily interested in business and profit above evidence and health. Has the industry which built up around our profession during the 'Golden Age' now become a parasite which weakens its host to the point of near exhaustion?

After a concise critique of the current culture of research this talk asks why we are wasting time on research that is not reliable, not useful and does not impact care. Could it be that market forces have strangely made us less efficient? Evidence based medicine is the way forward but can we overcome the inherent bias behind the fact that often big business funds the evidence gathering and its publication?

Some assumed the period of rapid development, which included discovering the DNA helix, successful organ transplant and vaccinations, would soon inevitably be followed by equally epoch transforming breakthroughs, others are less optimistic. Are genomics and big data more often 'science' than medicine? Is "digital health" "simply one part of what has now been called surveillance capitalism"?

This challenging but ultimately hopeful and inspirational talk was given at the EBPOM Dingle conference last year, please share it to as wide an audience of your peers as you can to help make this important and healing conversation happen.

Presented by Seamus O'Mahony, Consultant Gastroenterologist at Cork University Hospital, associate editor for medical humanities of the Journal of the Royal College of Physicians of Edinburgh and is a regular contributor to the Dublin Review of Books.

EBPOM Highlight | Hypotension probability in practice Jul 19, 2020

"Hypotension probability in practice" - 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 Mike Spiro, anaesthetic consultant at the Royal Free Hospital and Jez Fabes, Speciality Registrar and Academic Clinical Fellow of Anaesthesia at University College London (UCL) Hospitals.

TopMedTalk | Lancet profile on Salome Maswime Jul 18, 2020

"We've had the opportunity to catch up with some friends from Africa to tell us more about what is happening in their neck of the woods with perioperative medicine..."

We reference this piece in The Lancet here: https://www.thelancet.com/journals/lancet/issue/vol396no10243/PIIS0140-6736(20)X0027-4

The African Surgical Outcomes Study (ASOS) is discussed in more detail here: https://www.topmedtalk.com/topmedtalk-african-surgical-outcomes-study-asos-2/

The above piece inspired the Evidence Based Perioperative Medicine (EBPOM) team to take action and organise a ground breaking night of live music and conversation about cutting edge scientific research; the now famous "POCAPALOOZA" - POC, perioperative care and "APALOOZA" meaning some form of festival.

In spite of the global pandemic, one of the world's leading medical communites, decided to organise an online international academic conference followed by a massive fundraising effort for perioperative research, in Africa.

For more about the African Perioperative Research Group (APORG) start here: https://onlinelibrary.wiley.com/doi/epdf/10.1111/anae.14934

"People in Africa are twice as likely to die from surgical complications.."

If you want to help, donations welcome at: https://www.justgiving.com/crowdfunding/protea-live?utm_id=1&utm_term=ZKW35J94X

Current total at the time of press: £7,581 - Thank you!

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.

Press media inquiries: contact@topmedtalk.com

The 5th Collaborative Clinical Trials in Anaesthesia biennial conference |Prato 2019 Jul 17, 2020

This piece focuses upon the unique 'Collaborative Clinical Trials in Anaesthesia biennial conference', of which this was the fifth, organised in Prato, Italy, by Monash University.

TopMedTalk was given the chance to listen in on this cutting edge gathering of trialists, academics and practitioners as it happened. We take a deeper dive on the history behind this very special meeting, how it works and special moments from the meeting.

Learn how some of the big trials gather pace and how major studies get established.

The ANZCA Clinical Trials Network is here: http://www.anzca.edu.au/ctn

More detail on the African Surgical Outcomes Study - 2 (ASOS-2) here: https://www.asos.org.za/index.php/about-the-study

Presented by Desiree Chappell with Monty Mythen and their guest Paul Myles, Director, Anaesthesiology and Perioperative Medicine, Alfred Hospital and Monash University.

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Like this, want more?

Bruce Biccard is interviewed here: https://www.topmedtalk.com/prato-2019-bruce-biccard/

Also, check out EBPOM Chicago now for exclusive ticket offers: www.ebpom.org

ASA 2019 | Poster presenters, Dane Grenda and Noreen Tiangco Jul 16, 2020

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 overcome?

Presented by Desiree Chappell with Mike Grocott and their guests Dane Grenda and Noreen Tiangco, Residents at Temple University Hospital.

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Like this, want more?

We reference this podcast here: https://www.topmedtalk.com/sca-poster-presenters/

TopMedTalk | Research and development during COVID and beyond Jul 15, 2020

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 does product development actually work these days? How important have standards of proof become? Should we celebrate the fact hardware appears to be being pushed toward a similar evidence standard needed to take a new drug to market? How are research and development administered? How can we make a clinical and economic argument that makes sense to everyone?

Also, how has the Covid Crisis galvanized the medical industry and shown them that things can be achieved at speed in our profession?

The Ventilator Training App episode we reference is here: https://www.topmedtalk.com/covid-19-the-ventilator-training-alliance-app/

Presented by Desiree Chappell and Monty Mythen with their guests, Vafa Jamali, Senior Vice President and President of Respiratory, Gastrointestinal & Informatics (RGI) within Medtronic's Minimally Invasive Therapies Group (MITG) and Jennifer Doyle, Global Vice President, Medical Affairs - Respiratory, Gastrointestinal & Informatics and MITG at Medtronic.

EBPOM 2019 | Perioperative blood pressure, panel discussion. Jul 14, 2020

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 scrubbed and ready? If we had better, more specific or sensitive ways to monitor tissue perfusion rather than blood pressure and now - almost discounted - urine output, would this lead to better care? Is it the case that minimally invasive cardiac output technology may be of much greater value in the ward than in theatre?

Presented by Desiree Chappell with Monty Mythen and Dr Simon Davies, Consultant Anaesthetist at York Teaching Hospital NHS Foundation Trust with Timothy Miller, Associate Professor of Anaesthesiology from Duke University Medical Centre.

EBPOM 2019 | Who delivers Prehab? Jul 13, 2020

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 important to perioperative medicine?

The ELLICSR Kitchen is here: https://www.ellicsr.ca/en/clinics_programs/ellicsr_kitchen

Presented by Daniel Santa Mina, Assistant Professor at University of Toronto & Scientist in ELLICSR at the Princess Margaret Cancer Centre.

TopMedTalk | Gender and racial diversity Jul 12, 2020

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 integration of evidence-based practices, interventions and policies into routine health care and public health settings.

More about Athena SWAN (Scientific Women's Academic Network) here: https://www.ecu.ac.uk/equality-charters/athena-swan/

Presented by Desiree Chappell with Monty Mythen and their guest Meghan Fall-Lane, Assistant Professor of Anesthesiology and Critical Care at the Perelman School of Medicine; Co-Director of the Penn Center for Perioperative Outcomes Research and Transformation; and Senior Fellow at the Leonard Davis Institute of Health Economics, University of Pennsylvania.

ASA 2019 | Lifebox Jul 11, 2020

"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/

Recorded live at Anesthesiology 2019, Orange County Convention Center, Orlando and presented by Desiree Chappell, with Sol Aronson, and their guests Alexander Hannenberg, M.D. Senior Research Scientist, Ariadne Labs; Principal Consultant, ORDx&Rx Surgical Safety Solutions, 2010 president of the American Society of Anesthesiologists (recently served as its Chief Quality Officer) and by Kris Torgeson, Global CEO, Lifebox Foundation.

Find out more here: https://www.lifebox.org

Caring for the transgender patient | AANA 2019 Jul 10, 2020

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: https://www.nhs.uk/conditions/gender-dysphoria/guidelines/

Presented by Desiree Chappell and Monty Mythen with Jose Castillo, PhD, CRNA Faculty, Texas Wesleyan University, AANA Diversity and Inclusion Committee.

EBPOM 2019 | Perioperative Haemodynamic Management - how to best treat or avoid a low BP? Jul 09, 2020

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.

EBPOM 2019 | Perioperative Blood Pressure (PeriOperative Quality Initiative: POQI 3) how low can you safely go? Jul 08, 2020

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 INPRESS Trial is discussed here: https://www.topmedtalk.com/ebpom-london-2018-any-answers-part-3-the-big-trials/

We speak with Dan Sessler here: https://www.topmedtalk.com/topmedtalks-to-dan-sessler-2/

Presented by Tim Miller, Associate Professor of Anesthesiology from Duke University Medical Centre.

Check out www.ebpom.org for more details on EBPOM Chiago!

EBPOM 2019 | Troponitis, does it matter? Jul 07, 2020

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 University of Southampton and frequent TopMedTalk contributor.

Critical care for the very elderly patient | EBPOM Ireland 2019 Jul 06, 2020

"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 institution?

Presented by Brian Marsh, Anaesthesia, Critical Care Medicine, Extracorporeal Life Support, The Mater Hospital, Dublin.

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Go now to www.ebpom.org for details regarding EBPOM Chicago - exclusive offer now available!

The opportunity in variability | EBPOM Ireland 2019 Jul 05, 2020

"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 former being a particular problem in America with the financial incentives associated with some forms of treatment and care.

Learn how a pilot study regarding orthopedics lead ultimately to variability becoming a widely recognised crucial area of improvement in medicine. More on this can be found on The British Orthopaedic Association's website here: https://www.boa.ac.uk/standards-guidance/getting-it-right-first-time.html

This talk empowers you with the detail regarding an area that now looks set to become a huge opportunity for perioperative practitioners world wide. Sharing processes, standardising care and allowing our focus to go where the evidence leads. How can we help as implementation teams are assembled both in the UK and elsewhere?

When it comes to patients; "we play a very small part in their life ... but that part can be massive if we get it wrong - so we have to get it right!"

The Getting It Right First Time website (GIRFT) is here: https://gettingitrightfirsttime.co.uk/

Presented by Chris Snowden, Consultant Anaesthetist, Freeman Hospital, Newcastle upon Tyne and Senior lecturer at the Institute of Cellular Medicine at Newcastle University.

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If you love this, you'll also enjoy this fantastic piece "EBPOM Highlight | Getting it right first time": https://www.topmedtalk.com/ebpom-highlight-getting-it-right-first-time/

Exclusive limited time only "EBPOM Chicago" ticket offer on now, go to: www.ebpom.org

EBPOM 2019 | Troponin Screening - essential? Jul 04, 2020

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.

EBPOM Highlight | Intraoperative hypotension doesn’t happen to me Jul 03, 2020

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 this here via our large selection of podcasts on the topic: https://www.topmedtalk.com/?s=hypotension

For those who are already across the data the next question is, how do we detect it and prevent it, ideally before it even occurs? Here the HPI monitor comes into play, a cutting edge piece of technology which uses artificial intelligence to analyse the data and make predictions which could save your patient from a problematic outcome.

Presented by Dr Simon Davies, Consultant Anaesthetist, York Teaching Hospitals, NHS Foundation Trust.

POCAPALOOZA | Cape Town Final Comments Jul 03, 2020

"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 London please accept our thanks for helping to show the world how passionate we in the medical community are about safe perioperative care for all, stay tuned for more on our next event: EBPOM Chicago!

Check out the ebpom.org website now for more details.

Presented by Desiree Chappell and Monty Mythen with Bruce Biccard, consultant anaesthetist at the University of Kwazulu-Natal, Director, Perioperative Research Unit, Department of Anaesthetics, Nelson R Mandela School of Medicine, Salome Maswime, Obstetrician and Gynaecologist and Professor of Global Surgery at the University of Cape Town and Paul Myles, Director, Anaesthesiology and Perioperative Medicine, Alfred Hospital and Monash University.

If you'd like to hear more of Paul Myles please go here: https://www.topmedtalk.com/prato-2019-paul-myles/

If you'd like to hear more of Bruce Biccard he appears here: https://www.topmedtalk.com/prato-2019-bruce-biccard/

POCAPALOOZA | Sydney Jul 02, 2020

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 developed countries". We hear that TopMedTalk engaging with the African Perioperative Research Group (APORG) has helped move the cause of perioperative care forward, both in Africa and elsewhere.

The conversation further evolves:- Once educated how do we demonstrate the value of perioperative practice? How do we launch projects that will really make a difference? Where, from a research perspective, do the more fruitful areas of investigation present themselves? Would a minimum data set help? Moving to clinical trials we hear how research is being conducted, both the challenges and the sources of success.

"Perioperative medicine is a team sport" - how do we use the interdisciplinary aspect of what we do to enhance our educational options?

Regular listeners to TopMedTalk may recall the series we did about the Perioperative Special Interest Group (SIG) - if you want more details of http://www.anzca.edu.au/fellows/special-interest-groups/perioperative-medicine

The ANZCA Clinical Trials Network can be found at http://www.anzca.edu.au/ctn

Also, The International Board of Perioperative Medicine is here: https://www.internationalboardpom.org/

Further, make sure you check out https://www.periopmedicine.org.uk/ for more information on the perioperative medicine short course we discuss.

Presented by Desiree Chappell alongside co-host Ross Kerridge, Anaesthetist from Newcastle in Australia - sometimes called the 'Father of Perioperative Medicine'. Guests are Jill Van Acker, Staff Specialist Anaesthetist and Clinical Lead Perioperative Services, Canberra Hospital, and Chair of the ANZ Perioperative Special Interest Group; Vanessa Beavis, President, Australian & New Zealand College of Anaesthetists, & until recently Director of Perioperative Services, Auckland District Health Board; Prof. Jackie Close Orthogeriatrician at the Prince of Wales Hospital in Sydney and Clinical Director of the Falls, Balance and Injury Research Centre at Neuroscience Research Australia; Prof. Dave Story, Head of the ANZCA Clinical Trials Network, and Chair of the Anaesthesia, Perioperative and Pain Medicine Unit within the University of Melbourne Medical School. Joel Symons, Anaesthetist at the Alfred Hospital in Melbourne and Senior Lecturer at Monash University, Leader in the development of Educational Programs based at Monash University and member of International Board of Perioperative Medicine.

POCAPALOOZA | Chicago Jul 02, 2020

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 Fellowship.

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We're raising money for APORG this year, if you enjoy listening to TopMedTalk please make a generous donation: https://www.justgiving.com/crowdfunding/protea-live?utm_id=1&utm_term=ZKW35J94X

POCAPALOOZA | Los Angeles-USA Jul 02, 2020

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 after COVID and we should build on that". How can innovations like telemedicine help us to do better? Are we right to be optimistic about our specialty in this difficult time?

The international board for perioperative medicine is here: https://www.internationalboardpom.org/

The Hartford Foundation is here: https://www.hfpg.org/

"Perioperative medicine journal" is here: https://perioperativemedicinejournal.biomedcentral.com/

Presented by Desiree Chappell with Lee Fleisher, Professor and Chair of Anesthesiology and Critical Care, University of Pennsylvania and Carol Peden, Professor of Anesthesiology and Exec. Director of the Center for Health System Innovation, University of Southern California, University of Bath and the Institute for Healthcare Improvement (IHI).

Make sure you ride the POCAPALOOZA - to the good health of perioperative care - all the way round the world. Next stop? Hong Kong!

We're raising money for APORG this year, if you enjoy listening to TopMedTalk please make a generous donation: https://www.justgiving.com/crowdfunding/protea-live?utm_id=1&utm_term=ZKW35J94X

If you enjoyed this piece why not try out another episode of TopMedTalk featuring Lee Fleisher here: https://www.topmedtalk.com/ebpom-2019-brain-health-peri-operative-quality-initiative-poqi-6-what-can-we-do-tomorrow-2/

Or check out Carol Peden here: https://www.topmedtalk.com/women-in-anaesthesia-part-6-carol-peden/

POCAPALOOZA | Live from London! Jul 02, 2020

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 their negotiating tool to reform practices and provide better, healthier outcomes for all. The question arises, where next? Education has always been at the heart of the mission, could COVID 19 and the increased use of online learning add momentum to that which would previously have been impossible to imagine?

We then move into a discussion of The Centre for Perioperative Care (CPOC) "what about today calling it 'CPOC-APALOOZA?'".

The intention here is to bring all aspects of perioperative care together, multidisciplinary and collaborative.

Presented by Desiree Chappell with Monty Mythen and their guests Mike Grocott a frequent TopMedTalk anchor and Professor of Anaesthesia and critical care at the University of Southampton and David Selwin, Medical Director at Sherwood Forest Hospitals NHS Foundation Trust.

*Why Pocapalooza? "Poc", being the short form of 'perioperative care' and "apalooza" being a festival of some kind.

Roundtable | Salome Maswime and Bruce Biccard Jul 02, 2020

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 content from this year's EBPOM 2020 Live from London please contribute to our Just Giving page set up to raise money for the African Perioperative Research Group (APORG) this year, if you enjoy listening to TopMedTalk please make a generous donation: https://www.justgiving.com/crowdfunding/protea-live?utm_id=1&utm_term=ZKW35J94X

POCAPALOOZA | Cape Town Jul 02, 2020

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 (ASOS) and the African Perioperative Research Group (APORG).

We're raising money for APORG this year, if you enjoy listening to TopMedTalk please make a generous donation: https://www.justgiving.com/crowdfunding/protea-live?utm_id=1&utm_term=ZKW35J94X

"Finding African solutions to the problems that we're having"

You will also find a discussion regarding the Prato conference we covered extensively here on TopMedTalk, a fascinating gathering of people interested in international collaborative trails, and we cover The UK Perioperative Medicine Clinical Trials Network, see link below, before moving on to ASOS in detail.

The Perioperative Medicine UK Clinical Trials Network is here: https://pomctn.org.uk/home

Presented by Desiree Chappell with Monty Mythen and their guests Paul Myles, Director, Anaesthesiology and Perioperative Medicine, Alfred Hospital and Monash University, 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 enjoyed this piece please find more Bruce Biccard here: https://www.topmedtalk.com/topmedtalk-african-surgical-outcomes-study-asos-2/

We discuss Rupert Pearse in this podcast, why not listen to a piece with him discussing the Clinical Trials Network here: https://www.topmedtalk.com/anaesthesia-2019-the-clinical-trials-network-and-optimising-shared-decision-making/

Paul Myles is a firm favourite on TopMedTalk, enjoy more of his incisive observations here: https://www.topmedtalk.com/prato-2019-paul-myles/

EBPOM LIVE from LONDON | Innovation during COVID and beyond? Jul 01, 2020

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 back?"

This piece focuses on opioid toxicity, nociception monitoring and pain management.

To learn more about NOL® technology and the clinical evidence on the benefits of nociception monitoring please visit: www.medasense.com

Presented by Desiree Chappell and Monty Mythen with their guests Frank Chan, Vice President & General Manager, Patient Monitoring at Medtronic, Jason Case, Vice President, R&D, Patient Monitoring at Medtronic and Michelle Jones, Senior Director, Global Marketing, Patient Monitoring and Minimally Invasive Therapies, Medtronic.

EBPOM Live From London | Procedural Sedationists and monitoring Jul 01, 2020

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 Mythen and Jim Down, Intensivist and Consultant Anaesthetist, University College London Hospital and Amit Prakash, Consultant Anaesthesia & Perioperative medicine at Cambridge university hospital, Addenbrookes NHS trust.

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You've downloaded a free sample of the incredible conference currently being live streamed to an audience of thousands on EBPOM.org - go now to find out more. Join some of the finest medical minds in the world as we adapt to the global pandemic with a ground breaking live perioperative medicine event like no other.

Pain monitoring | EBPOM World Congress 2020 Jul 01, 2020

"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.

EBPOM LONDON IS LIVE TODAY! | EBPOM World Congress 2020 Jul 01, 2020

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!

Australian Perspective on shared decision making | EBPOM World Congress 2020 Jun 30, 2020

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 only.

This piece explores perioperative shared decision making from a variety of angles. Where is the latest research? Is it something we can reasonably out source? Does it always play in the favour of the patient or do we as practitioner benefit from this process also? How do we implement it without 'bulldozing' through years of experience?

Link to video featuring patient "Doug": http://www.petermac.org/sdm

Presented by Desiree Chappell and Ross Kerridge, "The Father of Perioperative Medicine", Debra Leung, Anaesthesiologist , Peter MacCallum Cancer Centre, Melbourne, Aisling Fleury, Geriatrician at Logan Hospital, Brisbane, Jon Gani, Conjoint Professor of Surgery at the University of Newcastle and an Honorary Medical Officer at John Hunter and Belmont District Hospitals, Pragya Ajitsaria is a staff Specialist Anaesthetist at John Hunter Hospital, Conjoint Lecturer at the University of Newcastle.

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If you are attending EBPOM Live from London please check www.ebpom.org for more information on the education, community and entertainment we have prepared for perioperative practitioners globally.

TopMedTalk | EBPOM LONDON IS LIVE TODAY! Jun 30, 2020

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!

EBPOM 2019 | "My experience ... of esophageal cancer" Jun 29, 2020

"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 a similar situation and have agreed to be a point of contact for patients and their families, be able to offer reassurance and support at your practice?

Someone your patient can rely on who can honestly say to them; 'Yes, I know exactly what you mean, I know exactly how that feels'.

The Macmillan Cancer Support website is here: https://www.macmillan.org.uk/

Presented by Mo Cottrell, a retired nurse who underwent a 5 week course of Chemoradiotherapy followed by successful surgery for Oesophageal Cancer at Southampton General Hospital in January 2017.

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Go now to www.ebpom.org and find out about EBPOM Live From London!

EBPOM Highlight | The Patient Safety Movement Foundation Jun 28, 2020

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 presentation are sourced from the PSMF's YouTube channel, find it here: https://www.youtube.com/channel/UCLLtyscblA8aquiXSSrZ1bA

Their official website is here: https://patientsafetymovement.org/

You can find out more about Mike Ramsay and his work there by listening the "TopMedTalks to..." series, where we discuss healthcare with global thought leaders from around the world: https://www.topmedtalk.com/topmedtalks-to-michael-ramsey/

Presented by Michael Ramsay, Chairman, Department of Anesthesiology and Pain Management, Baylor University Medical Center; President, Baylor Scott & White Research Institute with an introduction from Sol Aronson, tenured professor at Duke University and Executive Vice Chairman in the Department of Anesthesiology.

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Looking for more about EBPOM Live from London? Go now to www.ebpom.org

IMPORTANT | EBPOM LIVE FROM LONDON ANNOUNCEMENT!! Jun 27, 2020

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.topmedtalk.com/the-topmedtalk-top-ten-the-roundtable-on-nela-and-shared-decision-making/

Methadone, a forgotten friend? https://www.topmedtalk.com/topmedtalk-methadone-a-forgotten-friend-2/

The NHS - over 70 | EBPOM World Congress 2018 Jun 26, 2020

The NHS, a national institution beloved by the people of the United Kingdom is over 70 years old. EBPOM celebrated this fact with a talk that gets right to the heart of why this institution is so special and also how it can move forward in the brave new world we find ourselves in now.

This piece was streamed live, from the IET at EBPOM, on www.topmedtalk.com

Sir Bruce Keogh KBE, FRCS, FRCP, is a giant in the world of UK healthcare. A British surgeon and physician who specialises in cardiac surgery he was, until this year, Medical Director of the National Health Service in England and National Medical Director of the NHS Commissioning Board (NHS England).

Go check out the EBPOM website and secure last minute tickets to EBPOM Live From London now: www.ebpom.org

EBPOM 2019 | Nutrition and surgery- a Dietician’s perspective Jun 25, 2020

What are the two prime components of any good nutrition programme? How is avoiding malnutrition different from supporting anabolism? What's the best way to screen patients for malnutrition risk? How can a patient's anthropomitry be assesed alongside their stated needs and preferred outcomes? How important are protein supplements? What are the wider benefits of a good diet? How do we devise nutrition care plans for malnurished patients who need a more aggressive approach? Is it fair to say that everybody can benefit from some nutritional consultation day a dietician? What are the data and studies which support prehabilitation nutritional programmes?

Presented by Chelsia Gillis, Registered Dietitian, Canadian Vanier Scholar, and PhD Candidate in Epidemiology at the University of Calgary, Canada, she is leading the first prehabilitation program for colorectal surgery in Alberta.

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EBPOM Live From London is on, check out ebpom.org

EBPOM 2019 | The Opioid Crisis - Q&A Jun 24, 2020

This question and answer session is a valuable insight into where the latest thinking is as regards tackling the opioid crisis. How do we get to an understanding where the entire continuum of care is on the same page as regards pain relief? What's the level of adoption for opioid free anaesthesia? Can re-languaging pain or "re-writing the narrative" help, for example is it better to speak of 'comfort levels' as opposed to pain? What's the latest thinking as regards caffeine as an aid to comfort? Should we be worried about post operative delerium as regards ketamine use? What about gabapentinoids in the elderly? What about Midazolam? What should we send patients home with afterwards?

Presented by Michael Manning, MD, PhD, Assistant Professor at Duke University Medical Center, Director of research for the Perioperative Medicine Fellowship at Duke.

EBPOM Highlight | Rehabilitation post critical care Jun 23, 2020

"Rehabilitation post critical care" - 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 have any comments or questions you'd like to send to the team email: contact@topmedtalk.com

Presented by Linda Denehy, Head of the Melbourne School of Health Sciences and Professor of Physiotherapy at The University of Melbourne, Australia.

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Have you heard? EBPOM 2020 – live from London – is on!

Go now to: https://ebpom.org/EBPOM2020

EBPOM 2019 | Cleveland Clinic London Jun 22, 2020

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.

Presented by Nick Fletcher, Chair of the Institute of Anaesthesia and Critical Care at the Cleveland Clinic London, Consultant in Anaesthesia and Critical Care, St Georges University Hospital NHS Foundation Trust.

The Balanced Anesthesia Study |Prato 2019 Jun 21, 2020

This piece focuses on The Balanced Anesthesia Study, 'A Prospective Randomized Clinical Trial of Two Levels of Anesthetic Depth on Patient Outcome After Major Surgery'. How can delerium be measured and standardised in a multi-centre trial?

More on the study here: https://journals.lww.com/anesthesia-analgesia/FullText/2015/08000/Rationale_and_Design_of_the_Balanced_Anesthesia.14.aspx

More on the Confusion Assesment Method here: https://www.guysandstthomas.nhs.uk/resources/our-services/acute-medicine-gi-surgery/elderly-care/cam-diagnostic-algorithm.pdf

The Hospital Elder Life Program (HELP) for Prevention of Delirium is here: https://www.hospitalelderlifeprogram.org/

We discuss the ENGAGES trial here: https://www.topmedtalk.com/journal-club-1-14-jama-the-engages-randomized-clinical-trial/

More on the Women in Anaesthesia Research, a BJA Symposium, here: https://www.periopmedicine.org.au/2019prato

Presented by Desiree Chappell and Monty Mythen with Lis Evered, neuroscientist and Head of Research in the Department of Anaesthesia and Acute Pain Medicine, St Vincent’s Hospital, Melbourne. She has led an international group to standardise nomenclature for cognitive change associated with anaesthesia and surgery. She is an Editorial Board member of British Journal of Anaesthesia.

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Like this, want more?

Lis Evered also features on TopMedTalk here: https://www.topmedtalk.com/sunday-special-the-perioperative-cognition-workshop-part-1/

ASA 2019 | Perioperative Quality Initiative P.O.Q.I. news Jun 20, 2020

"Every fourth operation there is evidence of a modifiable risk factor".

The Perioperative Quality Initiative (POQI) is our starting point for this conversation, seven concensus conferences focusing on various topics of interest to the perioperative practitioner. Check out their extensive open source resources here: www.poqi.org

Hypotension and Mean Arterial Pressure (MAP) are discussed in detail; how are patients now being managed? How can a 'hazard index' help?

"25% of our patients experience hypotension!"; regular TopMedTalk listeners know this has been frequently highlighted as an issue for patient mortality.

Also, 26 minutes in, hear about the recent POQI and Acute Dialysis Quality Initiative (ADQI) meeting of 2019. "There is no such thing as a bit of a creatinine bump that is 'normal'".

Presented by Desiree Chappell, Monty Mythen and a surprise appearance from Sol Aronson, with their guest Andrew Shaw, Chairman, Department of Anesthesiology and Pain Medicine at The University of Alberta, Edmonton, Alberta and Zone Clinical Department Head for Anesthesia, Alberta Health Services Edmonton Zone. He is also a Fellow of the Royal College of Anaesthetists (UK), the American College of Critical Care Medicine and the Faculty of Intensive Care Medicine (UK).

Like this, want more?

Find out more about POQI here: "Desiree's Roundtable | What is the Perioperative Medicine Summit?" https://www.topmedtalk.com/desirees-roundtable-what-is-the-perioperative-medicine-summit/

For more regarding the papers published by POQI, referenced in this piece, go here: "Sunday Special | Blood Pressure" https://www.topmedtalk.com/sunday-special-blood-pressure/

We speak with Dan Sessler here: https://www.topmedtalk.com/topmedtalks-to-dan-sessler-2/

Also, if you enjoyed Andrew Shaw's take on these issues go listen to this fascinating conversation: "Desiree's Roundtable | Fluids in the 2020's" https://www.topmedtalk.com/desirees-roundtable-fluids-in-the-2020s/

Finally, Professor Sol Aronson, tenured, Duke University, who features on this podcast, delivered a talk you're bound to love here: "Perioperative Medicine is population health" https://www.topmedtalk.com/poet-6-01-perioperative-medicine-is-population-health/

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EBPOM "Live from London" - the hottest tickets in anaesthesia and perioperative medicine - go now to the website: https://www.ebpom.org/EBPOM2020

EBPOM 2019 | Brain Health (Peri-Operative Quality Initiative: POQI 6) - what can we do tomorrow? Jun 19, 2020

This piece discusses The Brain Health Initiative and the sixth Peri-Operative Quality Initiative which focused upon delirium. How can progress in these areas be built upon and encouraged? Where is the data in regards to detecting and dealing with delirium?

Beers Criteria Medication List; Potentially Inappropriate Medications for the Elderly According to the Revised Beers Criteria is here: https://dcri.org/beers-criteria-medication-list/

The website for the AARP is here: https://www.aarp.org/

Presented by Lee A. Fleisher Professor and Chair of Anesthesiology and Critical Care, University of Pennsylvania. There is a short question and answer session at the end hosted by Desiree Chappell and Monty Mythen.

TopMedTalk | The Anesthesia Patient Safety Foundation Jun 18, 2020

This piece focuses on the great work done by The Anesthesia Patient Safety Foundation. We turn to their specific focus on COVID 19 and then look at the wider benefits of a network dedicated to patient safety in our field.

Their section on COVID 19 is here: https://www.apsf.org/news-updates/perioperative-considerations-for-the-2019-novel-coronavirus-covid-19/

Furthermore there is a remarkably prescient article by Mike Grocott and Monty Mythen on there in which we discuss, Perioperative Fluid Management: Cheers to the Dream of Moderation: https://www.apsf.org/article/perioperative-fluid-management-cheers-to-the-dream-of-moderation/

Presented by Desiree Chappell and Monty Mythen with their guest Steven Greenberg, MD, FCCP, FCCM, Editor-in-Chief, Anesthesia Patient Safety Foundation (APSF) Newsletter, Vice Chairperson, Education, Department of Anesthesiology, Director of Critical Care Services, Evanston Hospital NorthShore University HealthSystem, Clinical Professor, Department of Anesthesiology Critical Care, University of Chicago, Pritzker School of Medicine

EBPOM 2020 is Live from London, go now to find out more: www.ebpom.org

Your essential guide to EBPOM Live from London! | EBPOM World Congress 2020 Jun 17, 2020

"We are getting super excited about EBPOM Live from London at the end of June..." - thousands of you already have your tickets, this podcast is your essential primer; a fascinating rundown of what attendees to the virtual conference "EBPOM Live From London!" can expect.

As a listener to TopMedTalk you are part of a movement which aims to help save lives every year around the world. The practice of evidence based perioperative medicine guarantees healthcare as a whole, and surgery in particular, is done to the best of our medical understanding and ability. By doing our best at every point of contact between healthcare patient and provider we know we get better value and more positive outcomes. Thanks to your help this message is about to go truly global!

TopMedTalk is the broadcasting arm of Evidence Based Perioperative Medicine, EBPOM, who for many years have organised world class international conferences aimed at sharing the strategies and results perioperative practitioners have used to both save money and improve lives in healthcare globally.

The crisis of COVID 19 has been difficult for many and one of the casualties, for the forseeable future, has to be large social gatherings. However, curiously we had already been working on an alternative; EBPOM Live from London, the virtual conference. This event in fact represents a culmination of years of planning; initially inspired by the environmental concerns of many of its founders and described back then as 'carbon friendly conferencing'. The same idea was in part the inspiration behind TopMedTalk and now studios - purpose built to help ease our environmental impact - are being deployed to maintain our global community in a world where international travel makes less practical sense.

We're two weeks away from a truly historic moment in the development of a global vision; a perioperative medicine conference which you can attend without having to leave your home! The technology is here, the interest in the subject is out there and you are reading this now. Help us to bring more people to the cause, like, subscribe to and share TopMedTalk; free medical information for all, while looking forward to hearing some of the pieces which the conference attendees will be enjoying, later in the year. Or, join the conference and prepare yourself for a learning experience that could immediately change the way you save people's lives forever.

Check out ebpom.org for low ticket prices.

"It's been fantastic seeing the network of people involved in perioperative medicine growing around the world", says our guest Ross Kerridge, often cited as 'the Father of perioperative medicine', a Senior Staff Specialist Anaesthetist Clinician at the John Hunter Hospital, Newcastle, Australia and Associate Professor at the University of Newcastle. Join in the conversation as he, Desiree Chappell, Monty Mythen and Mike Grocott consider the future of one of the world's most important medical conferences.

Finally, make sure you listen in for exclusive details on the Chicago meeting!

Innovators in anesthesia: Anesthesia electronic medical records | AANA 2019 Jun 16, 2020

"Data is destiny"; this piece looks at way we can unlock it for Anesthetists. The Open-Source Anesthesia Electronic Medical Record (OSAEMR) was developed specifically for Nurse Anesthetists. Its focus is on solo or small-practice nurse anesthetists operating in environments with limited or no network and computing resources other than an iPad. One patient, one nurse anesthetist, and one iPad. It can now be scaled to larger multi-provider practices outside of CRNAs. Hear how this innovation came about.

This piece was part of our coverage of The American Association of Nurse Anesthetists (AANA) 2019 Annual Congress in Chicago, Illinois.

Check out the AANA here: https://www.aana.com/

The Open-Source Anesthesia Electronic Medical Record (OSAEMR) website is here: https://www.osaemr.com/

Presented by Monty Mythen and Desiree Chappell with John T. "Jack" Hitchens, CRNA, BA, ARNP, partner in a CRNA owned and operated Anesthesia Practice, Watchful Care and Dan Simonson, CRNA, MHPA retired as Chief CRNA and managing partner of the Spokane Eye Surgery Center, adjunct faculty at the Washington State University College of Nursing’s Department of Health Policy and Administration.

ASA 2019 | Depth of anaesthesia Jun 15, 2020

"We believe these results are applicable to a very broad population"

Focusing on a study of over 6,000 patients, this hugely important piece attempts to finally move forward discussion regarding the long term consequences of deep anaesthesia?

There is no difference in the survival rate of patients who have had a "deep level" of anaesthesia, which is still strictly within the bounds of normal clinical practice. Could this research lead to us using less anaesthesia overall and improving our environmental impact?

The paper being discussed, "Anaesthetic depth and complications after major surgery: an international, randomised controlled trial" is here:

https://www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736(19)32315-3.pdf

We discuss the RELIEF trial briefly, if you want more on that go here: https://www.topmedtalk.com/ebpom-highlight-1-30-visiting-professor-plenary-lecturer-results-of-the-relief-trial/

We also discuss the work of Dan Sessler, who we interviewed here: https://www.topmedtalk.com/topmedtalks-to-dan-sessler-2/

A fuller look into The Clinical Trials Network is here: https://www.topmedtalk.com/anaesthesia-2019-the-clinical-trials-network-and-optimising-shared-decision-making/

Presented by Desiree Chappell and Monty Mythen with their guests Kate Leslie, Honorary Professor, Monash University, Melbourne, VIC, Australia, Specialist Anaesthetist, The Royal Melbourne Hospital & North Western Mental Health and Non-Executive Director, Australian Medical Council and Timothy Short, Clinical Anaesthetist and Honorary Professor at Auckland University Hospital, New Zealand.

Black and Minority Ethnic (BAME) death rates - Update from the UK | COVID 19 Jun 14, 2020

"The NHS is composed by about 20% of non-white individuals"

This piece takes a data driven look at a controversial area, how well informed are we about the risks associated with the coronavirus behind this unprecedented global pandemic?

"The background issues of gender and ethnicity may out weigh the issues related to comorbidities" but, in terms of data, "it's a moving target".

There have been theories regarding vitamin D absorption, genetics and other hypotheses but in this piece we also ask if this data is driven by social factors and other issues which most prefer to ignore.

The bottom line, in terms of safety; "age trumps everything" but, for reasons we are not clear on, "being non white is an important risk factor".

Also in this piece, "if you had an antibody test and it came back positive, would your attitude to returning to work change?"

We frequently mention this paper here: https://www.medrxiv.org/content/10.1101/2020.05.06.20092999v1

The COVID 19 information hub mentioned is here: https://icmanaesthesiacovid-19.org/

The Health Service Journal is here: https://www.hsj.co.uk/

Our guest is also a prolific Twitter user here, https://twitter.com/doctimcook

He contributed to this excellent article here "Exclusive: deaths of NHS staff from covid-19 analysed" : https://www.hsj.co.uk/exclusive-deaths-of-nhs-staff-from-covid-19-analysed/7027471.article

Presented by Desiree Chappell with Monty Mythen and their guests, Mike Grocott Professor of Anaesthesia and critical care at the University of Southampton and Tim Cook, Consultant in Anaesthesia and ICM, Royal United Hospitals, Bath.

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EBPOM "Live from London" - the hottest tickets in anaesthesia and perioperative medicine - go now to the website: https://www.ebpom.org/EBPOM2020

The Power of Perception | EBPOM Ireland 2019 Jun 13, 2020

How can we learn more by seeing more? This fascinating piece looks at how learning and the zone of proximal development (ZPD) of a student can be used to help the process. We are learning about learning, thanks partly to the use of algorithms that monitor our progress and performance. This talk asks challenging questions; "In terms of performance, just think technical procedures at the moment, is there such a thing as an 'expert performance' of any of the techniques we do daily"? How do we get training to produce clinically meaningful performances?

The articles mentioned in this piece are here:

"Looking and seeing" by Roger Kneebone: https://www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736(19)30507-0.pdf

"Machine Learning Identification of Surgical and Operative Factors Associated With Surgical Expertise in Virtual Reality Simulation", published by The Journal of the American Medical Association (JAMA) is here: https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2740782

And, "Proficiency-based progression training: an ‘end to end’ model for decreasing error applied to achievement of effective epidural analgesia during labour: a randomised control study" is here: https://bmjopen.bmj.com/content/8/10/e020099

This talk, originally titled "Recent research articles in medical education", presented by George Shorten, Professor, Anaesthesiology and Intensive Care Medicine and Consultant Anaesthesiologist at Cork University Hospital, at last year's "21st Current Controversies in Anaesthesia & Peri-Operative Medicine and SIAA Autumn Congress" at the Dingle Skellig Hotel, Ireland.

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EBPOM "Live from London" - the hottest tickets in anaesthesia and perioperative medicine - go now to the website: https://www.ebpom.org/EBPOM2020

COIVD 19 | EBPOM Live from London Jun 12, 2020

Evidence Based Perioperative Medicine (EBPOM) is the reason TopMedTalk exists; the vast majority of the content we love everyday comes from conferences organised by this important global initiative designed to promote high value perioperative practice around the world. Here on TopMedTalk, as you have heard, we immediately reacted as firmly as we could to the news of the novel coronavirus COVID 19. However we realised our dreams of a conference that truely moves the debate forward on perioperative medicine had to change shape slightly, after much consideration we think we might have constructed an ideal alternative.

EBPOM Live From London is here!

To help us promote this exiting new virtual conference we are joined by Lee Fleisher - who will be part of this year's incredible event - Professor and Chair of Anesthesiology and Critical Care, University of Pennsylvania. Hear how EBPOM has revolutionised the way thought leaders integrate and approach the principles of perioperative medicine into the wider world of medicine, psychology and politics.

Discover the piece our guest mentions, "The Contagion We Can Control" here: https://hbr.org/2020/03/the-contagion-we-can-control

We mention this piece "Normalizing High-Value Care: Findings of the National Quality Task Force", here: https://catalyst.nejm.org/doi/full/10.1056/CAT.20.0063

EBPOM 2020 – Live from London – is on!

For those who have listened to Desiree’s special announcement go now to: https://ebpom.org/EBPOM2020

Periop SIG 2019 | A physician’s perspective Jun 11, 2020

How does an experienced physician, health service changer, improver and researcher see the process of re-engineering perioperative care pathways? What are the challenges we face when we try to rework or improve the culture of an institution? How do we tackle common issues, which nowadays seem less acceptable, such as delirium?

This piece is part of a series of talks regarding "re-engineering perioperative care pathways" which were given during the 8th Australian and New Zealand Symposium of Perioperative Medicine Special Interest Group: “Updates in Perioperative Medicine 360” which took place between November 7th-9th 2019

Presented by Professor Alison Mudge, Conjoint Professor of Medicine, Royal Brisbane Clinical Unit, Faculty of Medicine.

TopMedTalk | CPET Cardio Pulmonary Exercise Testing Jun 10, 2020

Everything you ever wanted to know about CPET (Cardio Pulmonary Exercise Testing) but were too afraid to ask; this conversation is a fascinating deep dive into the topic with two experts in the field. Discover how widely practiced this technique is across the UK, hear about the advantages people who use it have in terms of outcomes and patient safety. Also, what do institutions then do with the data and how does that increase our understanding of the human body?

Some of the UCL podcasts mentioned in the piece are available here:

Introduction to Cardio Pulmonary Exercise Testing - https://www.youtube.com/watch?v=U_0Gi0gozgU

Cardio Pulmonary Exercise Testing: Setup - https://www.youtube.com/watch?v=qW9KFo0kiMk

Check out their YouTube channel for more: https://www.youtube.com/channel/UC_NlyaSqWQngSCFF1LLHW8w

The POETTS website is here: https://poetts.co.uk/

Finally, our excellent Xtreme Everest podcast archive is here: https://www.topmedtalk.com/category/conferences/xtreme-everest/

Presented by Desiree Chappell with Monty Mythen and their guests Jeroen Molinger, Clinical Medical Exercise Physiologist at Duke University Medical Center, Department of Anesthesiology & ICU and John Whittle, assistant Professor at Duke University Medical Centre.

Treating anemia in the perioperative process | The RoundTable Jun 09, 2020

How does the treatment of anemia fit into the perioperative process? How far should patient optimisation extend to treatment of this condition?

Live from the hugely successful EBPOM USA conference, directly after their presentation Desiree Chappell talks with her guests; Dr Lori Heller, Cardiac Anesthesiologist, Swedish Medical Center, through US anaesthesia partners and acting instructor at the University of Washington, Seattle and Dr Bobbie Jean Sweitzer, Associate Professor and Director of pre-operative medicine at the University of Chicago.

Dan Martin, OBE | TopMedTalks to... Jun 08, 2020

Desiree and Monty catch up with Dan Martin, OBE, and speak with him about treating infectious diseases and in particular patients with ebola. Presented by Desiree Chappell and Monty Mythen with their guest Dan Martin, OBE anaesthetist and intensivist at the Royal Free Hospital and Reader at University College London (UCL).

EBPOM 2019 | Financial aspects of prehabilitation Jun 07, 2020

This piece presents the prehabilitation 'business case'; why it's important to care about costs, how outcomes and value based care can help and why money has to be important in healthcare.

How do we convert health benefits and risk management into something which explains the financial bottom line?

Can we really argue that a process which appears, at the point of practice, to take more time, resources and involve a shorter length of stay for patients, is actually cheaper for institutions in the long run and better value for patients?

Is there in fact more than one 'business case' for a proper perioperative prehabilitation clinic at your practice?

The Fit 4 Surgery website (Netherlands) is here: http://fit4surgery.nl/

Presented by Stefan van Rooijen, surgical resident in Maxima Medical Center, The Netherlands, lecturer at the first Health Innovation School (Ministry of Health, Welfare and Sport and Reshape innovation), Surgical resident, Department of Surgery at Maxima Medical Center (ANIOS).

We've saved twelve million dollars! | The RoundTable Jun 06, 2020

Discussion begins with a hugely successful Enhanced Recovery program at a large community hospital, continued improvements and service line expansion. Learn about both the advantages and the challenges of a perioperative practice here. Presented by Desiree Chappell and Monty Mythen with their guests Kim Duggan, Perioperative Surgical Home (PSH) - Enhanced Recovery After Surgery (ERAS) Manager, New Hanover Medical Centre and Robin Davis, Clinical Education Specialist II at New Hanover Regional Medical Center.

Periop SIG 2019 | Updates in cardiac devices Part 2 Jun 05, 2020

"Updates in cardiac devices, Part 2" was a talk originally given at the 8th Australian and New Zealand Symposium of Perioperative Medicine Special Interest Group: “Updates in Perioperative Medicine 360” which took place between November 7th-9th 2019.

This piece is focused upon transcatheter aortic valve implantation (TAVI) devices. "A balloon valvular plasti in comparison to a TAVI is 90% of the risk, 10% of the gain" you're trading one problem with another, argues our speaker.

Find out more about ANZCA here: http://www.anzca.edu.au/

Presented by Dr Karl Poon, TAVI specialist at St Andrews War Memorial Hospital, Physician Proctor, Edwards LifeSciences, Senior Lecturer, University of Queensland Interventional cardiologist, The Prince Charles Hospital, Brisbane.

Periop SIG 2019 | Updates in cardiac devices, Part 1 Jun 04, 2020

"Updates in cardiac devices, Part 1" was a talk originally given at the 8th Australian and New Zealand Symposium of Perioperative Medicine Special Interest Group: “Updates in Perioperative Medicine 360” which took place between November 7th-9th 2019.

This piece is a look at some of the new technology which looks set to become more widely used. A leadless pacemaker is a small implantable "bullet like" device that sends electrical pulses to the heart whenever it senses that the heartbeat is too slow. Also new implantable cardioverter defibrillators are discussed as are implantable cardiac monitors. There is also discussion regarding cardiac resynchronization therapy.

The TYRX™ Absorbable Antibacterial Envelope is here: https://www.medtronic.com/us-en/healthcare-professionals/products/cardiac-rhythm/infection-control.html

The CardioMEMS™ Heart Failure System: https://www.cardiovascular.abbott/us/en/hcp/products/heart-failure/cardiomems-hf-system.html

Find out more about ANZCA here: http://www.anzca.edu.au/

Presented by Dr Stephen Pavia, Cardiologist and Cardiac Electrophysiologist at The Wesley Hopsital.

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EBPOM "Live from London" - the hottest tickets in anaesthesia and perioperative medicine - go now to the website: https://www.ebpom.org/EBPOM2020

Tackling the pain of the opioid crisis | AANA 2019 Jun 03, 2020

The opioid crisis "a unique American problem". This piece uncovers the origin of some of the misinformation about opioids, the consequences of calling pain a "fifth vital sign" and the absurd practice of waking patients up in the middle of the night to ask them if they are in any pain.

As these factors combined fatalities started to spiral into the crisis we see today. Recent statistics make for grim reading, in 2017 it was estimated over 47,000 Americans died from an opioid overdose. However action is now being taken; learn how The American Association of Nurse Anesthetists (AANA) has pushed forward with a sensible, responsible, pain management strategy which tackles the crisis head on.

Opioids are a last resort, many cases do not need them at all and a 30 day prescription to a highly addictive substance is something practitioners should never take lightly. Furthermore ensure patients are well informed, not 'opioid naive' and ideally do not have a family history of opioid dependence.

If you enjoyed this piece we have more on the topic here: https://www.topmedtalk.com/periop-coach-3-06-is-pain-the-fifth-vital-sign/

Also, if you've not yet heard Paul Wishmeyer's powerful take on this topic we highly reccomend you go here: https://www.topmedtalk.com/treating-patients-properly-ebpom-usa/

The Center For Disease Control's guidelines, mentioned in this piece, are here: https://www.cdc.gov/drugoverdose/prescribing/guideline.html

The PDF our guest mentions "The PAIN MANAGEMENT BEST PRACTICES INTER-AGENCY TASK FORCE REPORT" is here: https://www.hhs.gov/sites/default/files/pain-mgmt-best-practices-draft-final-report-05062019.pdf

This piece was part of our coverage of The AANA 2019 Annual Congress in Chicago, Illinois.

Check out the AANA here: https://www.aana.com/

Presented by Monty Mythen and Desiree Chappell with their guest, Bruce Schoneboom, PhD, CRNA, FAAN, Associate Dean for Practice, Innovation and Leadership at Johns Hopkins School of Nursing.

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EBPOM "Live from London" - the hottest tickets in anaesthesia and perioperative medicine - go now to the website: https://www.ebpom.org/EBPOM2020

Civil Liberties and Public Health | COVID 19 Jun 02, 2020

This piece takes some time to reflect on where we're at in the UK - and wider Western World - with regard to civil liberties, human rights and the essentials of a functioning 'first world' country.

How important is social justice and human rights in a world where a global pandemic puts all that we hold dear at risk?

The Liberty website is here: https://www.libertyhumanrights.org.uk/

For more information on the UK Government's plan to track and trace British subjects via a mobile phone app The Guardian covers the piece here: https://www.theguardian.com/world/2020/may/27/government-unveils-covid-19-test-and-trace-strategy-for-england

The UK Government website - at the time of publication - has this to offer: https://www.gov.uk/guidance/nhs-test-and-trace-how-it-works#the-nhs-coronavirus-app

If you'd like to hear Martin's talk, about the Grenfell Inquiry, it was recorded exclusively on TopMedTalk last year, please go here: https://www.topmedtalk.com/topmedtalk-the-grenfell-inquiry/

Presented by Desiree Chappell with Nick Margerrison and Martin Howe of Howe and Co, a human rights law firm. He is a recipient of the Ross McWhirter Award for his campaigning work and twice has been a runner up for the Human Rights Practitioner of the Year Award. Furthermore, as a member of the Gurkha Justice Campaign, Martin won the prestigious Human Rights Award from Justice and Liberty in 2009.

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EBPOM "Live from London" - the hottest tickets in anaesthesia and perioperative medicine - go now to the website: https://www.ebpom.org/EBPOM2020

Periop SIG | Ward Based postoperative care; where should we focus? Jun 01, 2020

This wide ranging talk asks where and how we should focus on the needs of postoperative care patients. "Brain care has an impact way beyond the acute surgical episode"; how do we minimise the risks of a poor outcome when it comes to postoperative care?

"Advanced recovery from anaesthesia and surgery" is a talk originally given at the 8th Australian and New Zealand Symposium of Perioperative Medicine Special Interest Group: “Updates in Perioperative Medicine 360” which took place between November 7th-9th 2019.

Presented by Professor Jacqueline Close, Principal Research Fellow, NeuRA Conjoint Professor, UNSW Consultant Geriatrician, Prince of Wales Hospital.

SIG 2019 | Shared decision making and risk prediction in the emergency setting May 31, 2020

"Shared decision making and risk prediction in the emergency setting: Can we achieve it?" is a talk originally given at the 8th Australian and New Zealand Symposium of Perioperative Medicine Special Interest Group: “Updates in Perioperative Medicine 360” which took place between November 7th-9th 2019.

This talk discusses survival after admission to intensive care. How do we incorporate concepts like shared decision making and value based care into this high stress, time limited environment?

Presented by Dr John Carlisle, anaesthetist, Torbay and South Devon NHS Foundation Trust. He also works as an intensivist in the intensive care unit, as well as the preoperative assessment clinic.

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EBPOM 2020 - Live from London - is on!

For those who have listened to Desiree's special announcement go now to: https://ebpom.org/EBPOM2020

If you liked this podcast and want more, our speaker mentions the excellent journal Anaesthesia, there's an interview with the editor here:

https://www.topmedtalk.com/topmedtalk-andy-klien-editor-in-chief-of-anaesthesia/

TopMedTalks to ... | Dan Longrois on nociception May 30, 2020

This piece is a fascinating discussion regarding research and safety in anaesthesia management; "in the past five or six years there's been a shift from high risk patients to all types of patients". How are we improving methods, evaluation and monitoring? What are some of the more essential elements of the process? Where is the latest research? What is a sensible policy when it comes to opioids?

Presented by Desiree Chappell and Monty Mythen with their guest Dan Longrois, Professor of Anaesthesia and Intensive Care Medicine, Department of Anaesthesia and Intensive care, Bichat Hospital.

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EBPOM 2020 - Live from London - is on!

For those who have listened to Desiree's special announcement go now to: https://ebpom.org/EBPOM2020

EBPOM 2019 | Opioid-free anaesthesia May 29, 2020

This piece dives into the latest thinking behind opioid-free anaesthesia; how can we improve? Is the challenge of the opioid crisis being met head on by perioperative medicine? Is it realistic to expect to reach a point where opioids are removed from the equation entirely?

Presented by Michael Manning, MD, PhD, Assistant Professor at Duke University Medical Center, Director of research for the Perioperative Medicine Fellowship at Duke.

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EBPOM 2020 - Live from London - is on!

For those who have listened to Desiree's special announcement go now to: https://ebpom.org/EBPOM2020

Innovators in Anesthesia | AANA 2019 May 28, 2020

This piece tells the story of two different innovators in the field of an anesthesia. The first is, The Pediatric Device for Induction of Anesthesia (PeDIA), a mask-free anesthesia delivery system designed for kids. The second is the Error Recovery and Mitigation Aide (ERMA), a reworking of the traditional needle box whereby a clear reservoir is inserted between the re-entry proof top and opaque terminal disposal portion, allowing practitioners to have visualization of all the syringes and vials used during the course of a procedure. At the end of a single procedure, a trap door in the bottom of the reservoir is released to allow those sequestered vials and syringes to drop into the bottom of the needle box for terminal disposal. This allows providers to recognise, check and confirm possible errors in a timely fashion.

Also during this piece there is a wide ranging and fascinating discussion about patents and patenting. How does the process work, how can you patent your ideas and how does the advent of block chain technology potentially change this forever?

Google Patents is here: https://patents.google.com/

Check out the PeDIA website here: https://www.pediallc.com/

For more information about ERMA go here: https://ii4change.com/how-we-innovate/products/error-recovery-and-mitigation-aide/

The Facebook Group "CRNA Inventors and Innovators" mentioned in this piece is here: https://www.facebook.com/groups/2150893568464906/

This piece was part of our coverage of The American Association Nurse Anesthetists (AANA) 2019 Annual Congress in Chicago, Illinois.

Check out the AANA here: https://www.aana.com/

Presented by Desiree Chappell and Monty Mythen with their guests Diane Miller, Pediatric Devices for Induction of Anesthesia | Product Development | PeDIA, LLC and Jean Snyder, CRNA Inc. Co-owner Goodwin and Snyder Anesthesia Associates, PLLC.

EBPOM 2019 | POETT Controversies Panel discussion May 27, 2020

Doesn't the decision to delay surgery depend upon the type of cancer? Can you measure complications as an outcome? What's the cause of non cardiac complications that are related to lack of exercise? Can we change the mindset of prehabilitation by explaining that prehabilitation is the start of treatment? How do we convince patients and decision makers that delaying surgery is a good idea? How involved are oncologists in perioperative decisions?

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 and Gerrit Slooter, MD, PhD, Surgical Oncologist, Maxima Medical Centre, The Netherlands.

Testing the Hypotension Prediction Index in practice | Euroanaesthesia 2019 May 26, 2020

"We wanted to know if goal directed therpy using a (Hypotension Prediction Index) HPI monitor can prevent hypotension". This piece looks in detail at the HPI monitor in practice- what is the benefit of this piece of technology in relation to hypotensive episodes? Furthermore how else is it to be tested and when will these tests be carried out?

Presented by Desiree Chappell and Monty Mythen with their guest Marit Habicher, Specialist, Department of Anesthesia and Critical Care at UKGM Giessen.

EBPOM 2019 | The Opioid Crisis (Peri-Operative Quality Initiative: POQI 4) - can we kick the habit? May 25, 2020

Some practitioners habitually prescribe opioids, the consequences in America are now described as a national crisis. Essentially the focus here is "better opioid stewardship" and a "move away from the traditional fundamental principle of opioids first".

Presented by Michael Manning, MD, PhD, Assistant Professor at Duke University Medical Center, Director of Research for the Perioperative Medicine Fellowship at Duke.

SCA | The Society of Cardiovascular Anesthesiologists May 24, 2020

After a short overview of the history of the Society of Cardiovascular Anesthesiologists (SCA) this conversation zones in on some of the hot topics that are being discussed in the field; devices and extracorporeal membrane oxygenation (ECMO) machines, as well as trans-esophageal echocardiography and how the practice has evolved. The conversation ends with a discussion about pre-habilitation in a resource stretched environment.

Presented by Desiree Chappell with Sol Aronson with Jamie Ramsey Medical Director Cardiac ICU at UCF and Gerald Levy, MD at Duke University.

Anaesthesia 2019 | UK Centre for Perioperative Care May 23, 2020

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 aim is to improve quality of care, support patients and professionals as well as influence policy, technology, research and innovation.

CPOC launched on 20 May 2019 at the Anaesthesia 2019 event.

Follow them on Twitter at @CPOC_News

There is a page on the Royal College of Anaesthetists' website here: https://www.rcoa.ac.uk/cpoc

Presented by Mike Grocott, Professor of Anaesthesia and critical care at the University of Southampton and frequent TopMedTalk contributor.

Anaesthesia 2019 | The Centre for Perioperative Care (CPOC) May 22, 2020

This piece focuses on The Centre for Perioperative Care (CPOC). How does it work, what are its goals and who is involved?

Also, what digital innovations will CPOC be looking towards?

For more information check out the website here: https://cpoc.org.uk/

Originally recorded live at Anaesthesia 2019; where world-renowned experts presented the latest advances in perioperative medicine, critical care and pain medicine.

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).

Anaesthesia 2019 | Tim Cook and Paul Wischmeyer May 21, 2020

The Royal College of Anaesthetist's National Audit Projects (NAP) are frequently fascinating and always important, here we get a look at NAP7, which will examine Perioperative Cardiac Arrest. The conversation also explores the Sprint National Anaesthesia Projects (SNAP) organised by the National Institute of Academic Anaesthesia. There's also discussion regarding muscle quality, malnourishment and ultrasound.

The conversation progresses to Quality Improvement and the latest evidence there. This includes discussion of The National Emergency Laparotomy Audit (NELA). Their website is here: https://www.nela.org.uk/

Find out more about Emergency Laparotomy Quality Improvement Care Bundle - ELPQuiC - here: https://www.ncbi.nlm.nih.gov/pubmed/25384994

Find out more about the Emergency Laparotomy Collaborative here: https://wessexahsn.org.uk/projects/95/emergency-laparotomy-collaborative

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/

Finally Carol Peden gets mentioned frequently in this talk, she appears on TopMedTalk here: https://www.topmedtalk.com/desirees-roundtable-carol-peden-epoch-qa-2/

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.

Presented by Monty Mythen with Tim Cook, Consultant in Anaesthesia and ICM, Royal United Hospitals, Bath and Paul Wischmeyer, Professor of the Department of Anesthesiology, Duke University.

Anaesthesia 2019 | Developmental neurotoxicity May 20, 2020

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, Professor and Chair of Anesthesiology at Weill Cornell Medicine.

Anaesthesia 2019 | The Future of Anaesthesia May 19, 2020

This excellent conversation explores how Anaesthesia as a profession will the profession evolve as the years pass; change is inevitable and the direction of it is becoming clearer but what it's pace will be is still uncertain. How will we adapt to the new roles and requirements we can see coming towards us in the near future? Will "the computers take over" or do we see a future where roles will be made simpler and more automated? Should Anaesthetists expect to tackle more of a leadership role in the future?

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 super computers we imagine doing our work in years to come and might these differences be unique advantages that can never be emulated?

Originally broadcast live from Anaesthesia 2019; a 'must-attend event' for the specialty where world-renowned experts present the latest advances in perioperative medicine, critical care and pain medicine.

Presented by Joff Lacey with Mike Swart, Consultant in Anaesthesia and Critical Care Medicine at Torbay Hospital and advisor to the UK Department of Health for the Enhanced Recovery Programme.

Anaesthesia 2019 | Paul Wischmeyer May 18, 2020

"Keeping the care in healthcare", is the agenda for this powerful and wide ranging conversation with one of our most popular contributors. How do we keep the priority of what we do at the forefront of our minds? Does the information we've learned recently on TopMedTalk about "burn out" impact on our understanding of poor levels of care in healthcare? Is it possible to rate providers on how much care they display?

Also; "what is a microbiome"? The second half of this conversation is a deep dive into "the bugs that make us whole". How can this remarkable area of research help to improve our overall well being and health? How does it impact upon our understanding of cesarean delivery (c section)?

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 fascinating conversation about "burn out" is here: https://www.topmedtalk.com/topmedtalks-to-sasha-shillcutt/

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 Department of Anesthesiology, Duke University.

Maurizio Cecconi | TopMedTalks to... May 17, 2020

This piece focuses on intensive care, the use of data and the future of fluid therapy research and its related physiological outcomes.

The article mentioned in this podcast is here: "Perioperative haemodynamic therapy for major gastrointestinal surgery: the effect of a Bayesian approach to interpreting the findings of a randomised controlled trial" https://bmjopen.bmj.com/content/9/3/e024256

Presented by Desiree Chappell and Monty Mythen with their guest Maurizio Cecconi, Head of the Anaesthesia and Intensive Care Department at Humanitas Research Hospital; President-elect of the European Society of Intensive Care Medicine (ESICM) for 2020-2021, Chair Division of Scientific Affairs at ESICM; Director of the Master in Patient Blood Management at Humanitas University.

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Like this, want more?

Rupert Pearse, one of the co-authors of the above article, was interviewed on TopMedTalk here: https://www.topmedtalk.com/anaesthesia-2019-rupert-pearse/

SNAP-2 - EPICCS | EBPOM World Congress 2019 May 16, 2020

The 2nd Sprint National Anaesthesia Project: Epidemiology of Critical Care after Surgery (SNAP-2 - EPICCS) study launched in March 2017 around the UK. More than 2,200 investigators at more than 250 sites across the UK were signed up to take part. The observational study collected data on all patients undergoing inpatient surgery during a one-week period (21 March to 27 March) in UK NHS hospitals.

The website is here: https://www.niaa-hsrc.org.uk/SNAP-2-EpiCCS?newsid=1710

This talk explains the study and its far reaching implications.

Another talk on SNAP-2 is available here: https://www.topmedtalk.com/what-is-snap-2/

Presented by Ramani Moonesinghe, Professor of Perioperative Medicine at University College London (UCL).

Periop SIG18 | Risk prediction and research - panel discussion May 15, 2020

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 and Pain Medicine Unit (APPMU), Melbourne Medical School, University of Melbourne; Director, Melbourne Clinical and Translational Sciences (MCATS) research platform and Dr Doug Campbell, Anaesthesia Specialist at Auckland City Hospital.

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Brought to you by the Perioperative Medicine Special Interest Group (SIG) in association with the Australian and New Zealand Society for Geriatric Medicine and the Internal Medicine Society of Australia and New Zealand at the 7th annual Australasian Symposium of Perioperative Medicine.

The Perioperative Medicine Special Interest Group (SIG) has three aims; improve patient safety and outcomes, share knowledge and collaborate with specialty groups, develop the specialty of perioperative medicine with various craft groups.

For more information follow this link here: http://www.anzca.edu.au/fellows/special-interest-groups/perioperative-medicine

Anaesthesia 2019 | The Clinical Trials Network and Optimising Shared Decision Making May 14, 2020

We begin with a conversation about The UK Perioperative Medicine Clinical Trials Network, their website is here: https://www.pomctn.org.uk/

This piece focuses on the Optimising Shared decision-makIng for high-RIsk major Surgery (OSIRIS) programme. Shared decision making can be very challenging when we're not sure what the risks are and older patients with chronic diseases often make very different decisions when informed. How do we make this process more evidence based? How do we better understand this group and communicate with them? Are there technological answers to these questions?

If you'd like to see the OSIRIS section there here's the link: https://www.pomctn.org.uk/OSIRIS

You can find the OSIRIS website here: https://osiris-programme.org/

Recorded at Anaesthesia 2019; where world-renowned experts presented the latest advances in perioperative medicine, critical care and pain medicine.

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.

Diversity and Inclusion | AANA 2019 May 13, 2020

Mentorship, diversity and inclusion are key parts of any socially responsible institution's practice. This piece speaks to how we make medicine more diverse and inclusive overall, there is much work to be done but an active focus coupled with mentorship programes is shown here to be an effective way forward.

This piece was part of our coverage of The American Association of Nurse Anesthetists (AANA) 2019 Annual Congress in Chicago, Illinois. Check out the AANA here: https://www.aana.com/

Check out the AANA's page on diversity here: https://www.aana.com/about-us/aana-diversity-and-inclusion

Presented by Desiree Chappell and Monty Mythen with their guests Debra Diaz, DNP, CRNA, APRN, CDR, AANA Board of Directors, Lena Gould, CRNA, Founder, Diversity in Nurse Anesthesia Mentorship Program, John Bing, Owner, JBing and Assoc Anesthesia Services, AANA Board of Directors.

Geriatric care and the value of teamwork | The RoundTable May 12, 2020

How do we best negotiate working in a multidisciplinary team? Generalisations regarding surgeons and anaesthetists only ever work generally, the specifics of each practitioner and their priorities inevitably contrast. How do we keep sight of these broad differences without falling foul of stereotypes?

The conversation evolves; how does the surgical journey fully utilise the team based perioperative approach? With specific focus on geriatric care there is further discussion regarding shared decision making, something which has been part of that discipline for many years.

The debate regarding when a patient becomes geriatric is explored. Is it age which defines that or do symptoms and comorbidities qualify the term?

Recorded on the first day of the Royal College of Anaesthetists' annual conference at The British Museum.

Desiree Chappell and Monty Mythen interview their guests Professor Jenifer Weller, Head of the Centre for Medical and Health Sciences Education, University of Auckland and Dr Jugdeep Dhesi, Clinical Lead, POPS and Consultant Geriatrician, Guys and St Thomas' NHS Trust.

TopMedTalk | Fluids in the 2020's May 11, 2020

This piece gets into the detail regarding one of the big talking points in perioperative medicine over the last year or so; what is the impact of intraoperative hypotension on post operative outcomes?

Further discussion encompases the modern uses of a pulmonary artery catheter.

If you enjoyed hearing Andy Shaw's take on these topics further listening can be found here; https://www.topmedtalk.com/hemodynamic-monitoring-and-the-pulmonary-artery-catheter/

Presented by Desiree Chappell with Monty Mythen, Joff Lacey and their guest Dr Andrew Shaw, Chairman, Department of Anesthesiology and Pain Medicine at The University of Alberta, Edmonton, Alberta and Zone Clinical Department Head for Anesthesia, Alberta Health Services Edmonton Zone. He is also a Fellow of the Royal College of Anaesthetists (UK), the American College of Critical Care Medicine and the Faculty of Intensive Care Medicine (UK).

Hypoxia and the Brain | Xtreme Everest May 10, 2020

This special four part series explores the fascinating story of Xtreme Everest – the ground-breaking, research programme that has pursued a novel approach to scientific exploration. Over the last decade, this innovative team has performed large scale studies at high altitude to mimic some of the effects of critical illness. The objective is for their findings to be brought “from the mountainside to the bedside” so that the care for our sickest patients may be improved.

In this podcast, Chris Imray, describes the physiological changes within the brain when exposed to the hypoxic conditions of high altitude and how our understanding of this may change the management of patients.

Presented by Joff Lacey with his guest Chris Imray, a Consultant Vascular Surgeon at University Hospitals Coventry and Warwickshire NHS Trust and a Professor at Warwick Medical School. Chris is a passionate climber and has long been involved in altitude research. He was the deputy climbing leader for the 2007 Xtreme Everest expedition and was part of the summit team.

Unlocking the Secrets of the Mighty Mitochondria | Xtreme Everest May 09, 2020

This special four part series explores the fascinating story of Xtreme Everest – the ground-breaking, research programme that has pursued a novel approach to scientific exploration. Over the last decade, this innovative team has performed large scale studies at high altitude to mimic some of the effects of critical illness. The objective is for their findings to be brought “from the mountainside to the bedside” so that the care for our sickest patients may be improved.

In this podcast, Andrew Murray, discusses the findings from his studies on Everest in which he has investigated novel mechanisms that control mitochondrial function under hypoxic conditions. It is hoped that his discoveries will facilitate major breakthroughs in tailoring medical interventions to improve the outcome of critical care patients.

Presented by Joff Lacey with his guest; Andrew Murray a reader in metabolic physiology at the University of Cambridge. Since 2005, Andrew has been a member of the Xtreme Everest research group, studying mitochondrial function in cardiac and skeletal muscle at high altitude.

Mental well being for the patient | TopMedTalk & MacMillan Cancer Special May 08, 2020

TopMedTalk in Collaboration with MacMillan Cancer Support in the UK developed this podcast series to support patients during their cancer journey amidst the COVID 19 crisis.

"It's very normal to sit with some difficult thoughts and feelings" after a cancer diagnosis. Broadly there are two types of mindsets; anxiety, which can be helpful, an element of wanting to 'do something' and, on the other hand, low mood, a feeling of not wanting to do anything, this can be unhelpful if not addressed at a certain level. We should expect both of these mindsets the question is 'how does the latest scientific research show can we control them'? Your body and mind are not separate, one effects the other, this is why it is so important we look at mental health as part of an overall approach.

"You can do quite a lot of things [...] that put you into a better mood"; exercise, meditation, even simple breathing exercises. Spending time communicating with friends and family is another suggestion.

Recorded at the height of the COVID 19 crisis this podcast also reflects upon how this is applied in the context of a global pandemic; how important is it that people engage with online facilities and opportunities to maintain relationships? "In an odd way the relationships seem to intensify".

It's not about ignoring negative feelings though, anxiety and low mood are very common for people with a cancer diagnosis. Hear how it is important to allow yourself to reflect, part of understanding your mental health is about regaining control, we are allowed to let ourselves feel difficult thoughts as part of the process of monitoring and working with them.

This podcast also contains a reminder about the importance of goal setting in allowing people to regain control over their lives. Small, realistic and specific, short term goals are useful at this particular stage of life; "start with the thing you are most confident you are able to change [...] make a day and a time that you'll stick to".

Presented by Nick Margerrison with his guests Judit Varkonyi-Sepp psychologist, psychology lead for the Wesfit prehabilitation programme and Chloe Grimmett, behavioural scientist and lead for Wesfit prehabilitation.

For more information, in the UK, phone: 0808 808 00 00

Email: CancerPrehabilitation@macmillan.org.uk

Twitter: @macmillancancersupport

The Significance of the Microcirculation | Xtreme Everest May 07, 2020

This special four part series explores the fascinating story of Xtreme Everest – the ground-breaking, research programme that has pursued a novel approach to scientific exploration. Over the last decade, this innovative team has performed large scale studies at high altitude to mimic some of the effects of critical illness. The objective is for their findings to be brought “from the mountainside to the bedside” so that the care for our sickest patients may be improved.

In this podcast, Dan Martin, explains the fascinating discoveries that his team have made about the microcirculation and how it may adapt to the challenge of hypoxia. Alterations to the microcirculation may be instrumental in the body’s ability to cope under hypoxic conditions and could be become a target for interventions in critical illness.

Dan Martin is a reader in perioperative and critical care medicine at UCL and consultant in critical care at the Royal Free Hospital in London. He was the research lead for Xtreme Everest in 2007 and expedition lead in 2013.

Bring on the vaccine! | COVID 19 May 07, 2020

This piece is a look at the fightback against COVID 19; the search is on for a safe and effective vaccine against coronavirus. A group of investigators in the UK are about to begin trialing a vaccine using a ChAdOx virus vector. This piece gets into the detail of the trial and how the vaccine might work.

Presented by Joff Lacey with his guest Professor Paul Heath, consultant in pediatric infectious diseases, at St George's Hospital in London. He co-leads the Pediatric Infectious Disease research group and is a director of the vaccines institute also at St George's.

TopMedTalk | The Ventilator Training Alliance App May 06, 2020

"There's no advertisements popping up, non of that nonsense, this is just the data you need on the front lines to help save time and save lives"

This piece focuses on the Ventilator Training Alliance APP, developed to meet the need practitioners have to use and understand ventilation equipment which may be new or unfamiliar to them. Download the APP now and share it with all friends and colleagues who may find themselves in this situation.

The app is here: https://www.allego.com/ventilator-training-alliance/

Don't forget if you have any comments or questions, email us contact@topmedtalk.com

Presented by Desiree Chappell with Monty Mythen and Michelle Jones, Senior Director, Global Marketing, Patient Monitoring and Minimally Invasive Therapies, Medtronic, and their guests Pat Berges, Vice President of Global Commercial Capabilities, Medtronic and Ariel Mactavish, Vice President, General Manager of Respiratory Interventions, Medtronic.

Healthy eating and cancer | TopMedTalk & MacMillan Cancer Special May 06, 2020

TopMedTalk in Collaboration with MacMillan Cancer Support in the UK developed this podcast series to support patients during their cancer journey amidst the COVID 19 crisis.

We know food gives us energy "but it also provides so much more". This podcast looks at the raw materials you'll need, when facing a cancer diagnosis, to get a better outcome; the vitamins, minerals and proteins, as well as the energy sources you're best using.

What is a balanced diet when you have cancer? "We're talking about eating well to stay well [...] we're not really looking for people to lose weight"; it's often important for people to try to maintain their weight during a cancer diagnosis, should you track your weight throughout your cancer journey?

Recorded at the height of the COVID 19 crisis this podcast also reflects upon how this information is applied in the context of a global pandemic. What foods can we store which also contain the vital building blocks of our body's natural defenses?

Presented by Nick Margerrison with his guest Clare Shaw, consultant Dietician at The Royal Marsden NHS Foundation Trust.

For more information, in the UK, phone: 0808 808 00 00

email: CancerPrehabilitation@macmillan.org.uk

Twitter: @macmillancancersupport

The Problem with Hypoxia – the inception of Xtreme Everest | Xtreme Everest May 05, 2020

This special four part series explores the fascinating story of Xtreme Everest – the ground-breaking, research programme that has pursued a novel approach to scientific exploration. Over the last decade, this innovative team has performed large scale studies at high altitude to mimic some of the effects of critical illness. The objective is for their findings to be brought “from the mountainside to the bedside” so that the care for our sickest patients may be improved.

In this podcast, Denny Levett explains the complex and unpredictable nature of hypoxia, its prevalence in critical care and why there was the scientific demand to head to the world’s highest mountain in search of answers to this clinical challenge.

Presented by Joff Lacey with his guest Denny Levett, a consultant in perioperative medicine and critical care at Southampton University Hospital and deputy research leader for the Xtreme Everest expedition in 2007.

Get active and feel good? | TopMedTalk & MacMillan Cancer Special May 04, 2020

TopMedTalk in Collaboration with MacMillan Cancer Support in the UK developed this podcast series to support patients during their cancer journey amidst the COVID 19 crisis.

It's vital you remain active after a cancer diagnosis, why is this? Hear the fascinating story behind the discovery that activity not only reduces your overall levels of fatigue but also improves your chances of recuperation. "You have to pace yourself [...] listen to your body"; but any physical activity will help fight feelings of tiredness. In short, if you get active you feel good.

Also in this podcast, with direct reference to medical trials and studies, our guests give you the mechanism behind incredibly helpful changes caused by moderate exercise in cancer patients, evidence which has led medics to conclude that "exercise is real medicine".

"When we're talking about being active during cancer it's at any stage of the cancer journey: from prehabilitation through recovery". Prehabilitation is the process by which people prepare their bodies for a major obstacle such as an operation or chemotherapy. It's like rehabilitation but it takes place before the event.

Just as when you start your recovery after treatment you would expect to get your body back to full health, here you try to achieve the best possible physical health before you start. The key point is that the medicine of exercise can be useful from diagnosis right through to full recovery and beyond.

Again, with direct reference to the evidence, find out how incredible research into prehabilitation is changing the way we think about cancer and recovery.

Recorded specifically at the height of the COVID 19 crisis hear how this research is being applied in the context of a global pandemic. Group forms of exercise are not an option while social distancing restrictions are in place, can exercising with other people bring us special benefits? If so, can those benefits be matched if we use the internet to continue the social side of going to a gym or a class?

The YouTube link mentioned in this piece is here: https://www.youtube.com/playlist?list=PL4YhGgVzlQXjhq6UYbX7idSDYcPX5PRy9

Presented by Nick Margerrison with the Professor of Clinical Exercise Science, Anna Campbell, MBE, of Edinburgh Napier University and the director of CAN Rehab and the Professor of Prehabilitation Medicine, Sandy Jack, a consultant clinician scientist from The University of Southampton and University of Southampton NHS Foundation Trust .

For more information, in the UK, phone: 0808 808 00 00

email: CancerPrehabilitation@macmillan.org.uk

Twitter: @macmillancancersupport

EBPOM 2019 | Malnutrition and functional capacity May 04, 2020

This piece is taken from the free papers presentations given at EBPOM 2019. Malnutrition and functional capacity; what is the effect of multimodal prehabilitation? What can the six minute walk test really show us? Does nutritional status predict preoperative change in a six minute walk test in colorectal cancer patients following a prehabilitation programme?

Presented by Lauren Richer, Director, Nutritional Services, Keyto, Registered Dietician, Greene Family Medicine Clinic and Montreal General Hospital, Montreal, Quebec.

Where are all our patients? | COVID 19 May 03, 2020

The Covid 19 crisis - and our collective response to it - has had an immediate and, in some instances worrying, drop off in cases that are not directly related to the virus.

As the normalisation process in medicine begins and we find a way to live with this new virus in our midst how do we adapt and promote healthcare? What are the exciting opportunities available for patient optimisation? Further, there is a detailed and engaging discussion about fluid management.

Presented by Desiree Chappell with Monty Mythen and Dr Arthur Martella, Cardiothoracic surgeon in Camden, New Jersey.

Thank you to our sponsor Edwards Lifesciences.

Edwards clinical education (ECE): https://www.edwards.com/clinicaleducation

Obstetrics in the pandemic | COVID 19 May 02, 2020

"Babies are still being born"

This piece looks at the area of obstetrics in the midst of an unprecedented global crisis regarding the COVID 19 outbreak. How can the delicate balance between reducing infections and social distancing be interwoven with the needs of modern childbirth.

Should we be concerned that some patients may shun hospital assisted births for fear of contagion? How has the data from China, much of which focused upon cesarean section births, been useful to us in the West? Why do the data have that angle?

Are there benefits to the new ways in which we have found to communicate during this global crisis which can be moved into a new life with COVID present but in a more manageable form?

Presented by Desiree Chappell and Monty Mythen with Sam Bampoe, University College London Hospital, Consultant Anesthetist, Director, Trainees with an Interest in Perioperative Medicine (TRIPOM), Nuala Lucas, Consultant Anesthetist at Northwick Park Hospital, Executive Committee Member for the Obstetric Anesthetists’ association and Pat O'Brien, Consultant Obstetrician at University College London Hospital, Vice President of Royal College of Obstetricians and Gynecologists.

Thank you to our sponsor Edwards Lifesciences.

Edwards clinical education (ECE): https://www.edwards.com/clinicaleducation

Improving Readiness | COVID 19 May 01, 2020

"I'm also a United States Air Force Officer and reservist and on April 4th was activated and given approximately 48hrs to deploy on a C-5 Galaxy Military Aircraft to the epicenter, New York City and I've been here for approximately, it's been almost a month now"

This piece follows on from a previous exclusive conversation regarding the US military deployment to New York; here we get more detail and spend time thinking about how Enhanced Recovery must be an essential part of any "new normal".

The fascinating Carol Peden piece is here: https://www.topmedtalk.com/covid-19-disruptive-innovation/

And Bobbie Jean Sweitzer is here: https://www.topmedtalk.com/covid-19-promote-your-anemia-clinics-in-the-pandemic-era

The previous conversation we mention is here: https://www.topmedtalk.com/covid-19-rapid-deployment-of-us-national-reserves-ease-stress-in-new-york/

Presented by Desiree Chappell with Captain Joel Sherwood, United States Air Force Reserves and Medical Science Liaison, National Director, Government Affairs, Pacira Pharmaceuticals.

Thank you to our sponsor Edwards Lifesciences.

Edwards clinical education (ECE): https://www.edwards.com/clinicaleducation

POQI 5- New Publication and Relevance to ICU Care | COVID 19 Apr 30, 2020

The Perioperative Quality Initiative (POQI) is a vital part of the process needed to more widely implement sensible practice which, using a clear evidence base, provides better value care with more positive outcomes for the patient. POQI continues to provide its work in an attempt to clarify fundamental concepts in perioperative care. The fact this one focuses upon fluid management makes it particularly appropriate in these times.

Link to the paper: https://perioperativemedicinejournal.biomedcentral.com/articles/10.1186/s13741-020-00142-8

Presented by Desiree Chappell with Monty Mythen and their guests Tim Miller, Associate Professor of Anesthesiology from Duke University Medical Centre and Greg Martin Professor of Medicine, Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Emory University School of Medicine

Thank you to our sponsor Edwards Lifesciences.

Edwards clinical education (ECE): https://www.edwards.com/clinicaleducation

Like this, want more?

Try our popular in depth series "Fluid Matters" http://topmedtalk.libsyn.com/fluid-matters-1

TopMedTalk provides world leading information about perioperative medicine like this every day. Dr Greg Martin's deeper dive into these issues is here: http://topmedtalk.libsyn.com/fluid-matters-3

The Ventilator Training Alliance App | COVID 19 Apr 30, 2020

"There's no advertisements popping up, non of that nonsense, this is just the data you need on the front lines to help save time and save lives"

This piece focuses on the Ventilator Training Alliance APP, developed to meet the need practitioners have to use and understand ventilation equipment which may be new or unfamiliar to them. Download the APP now and share it with all friends and colleagues who may find themselves in this situation.

The app is here: https://www.allego.com/ventilator-training-alliance/

Don't forget if you have any comments or questions, email us contact@topmedtalk.com

Presented by Desiree Chappell with Monty Mythen and Michelle Jones, Senior Director, Global Marketing, Patient Monitoring and Minimally Invasive Therapies, Medtronic, and their guests Pat Berges, Vice President of Global Commercial Capabilities, Medtronic and Ariel Mactavish, Vice President, General Manager of Respiratory Interventions, Medtronic

Getting back to the new normal | COVID 19 Apr 29, 2020

"If you have major surgery and you are COVID positive at the time your outcomes are severely reduced"

This piece takes a look at how we try to move back to some semblance of "normal" as the peak appears in many parts of the Western world to have reacted to social distancing measures. How have thought leaders and anesthesiologists tried to come together to produce guidance for each other? What should that guidance be? What specific areas of practice have been changed by the pandemic?

Also - more widely - what are we learning about the issues presented by COVID 19 and how do we move forward in a constructive way?

Links to the papers here:

Adult Cardiac Surgery and the COVID-19 Pandemic: Aggressive Infection Mitigation Strategies are Necessary in the Operating Room and Surgical Recovery: https://www.sciencedirect.com/science/article/pii/S0022522320310114

Adult cardiac surgery during the COVID-19 Pandemic: A Tiered Patient Triage Guidance Statement: https://www.sciencedirect.com/science/article/abs/pii/S0022522320308904

Also, the Cardiothoracic Surgery in the COVID Crisis: Global Summit on Reactivating Cardiothoracic Surgery Programs is here: https://www.sts.org/meetings/calendar-of-events/cardiothoracic-surgery-covid-crisis-global-summit-reactivating-cardiothoracic-surgery-programs

Presented by Desiree Chappell with Monty Mythen and their guest Dan Engelman, Director CIVCU, Baystate Medical, MA (unit now managing COVID patients). President of ERAS Cardiac

Thank you to our sponsor Edwards Lifesciences.

Edwards clinical education (ECE): https://www.edwards.com/clinicaleducation

EBPOM 2019 | Community-based Prehabilitation Apr 29, 2020

In the UK community based prehabilitation is being spearheaded by the Prepwell Initiative, supported by a grant from Sports England. Their pioneering work is a great example of the way in which prehabilitation is gathering pace at the moment.

The “PREP: Preoperative Risk Education Package” website is here: https://www.prepwell.co.uk/

What are the economics of such a programme? Why did the project start to get referrals from initially sceptical surgeons? How did the programme impact the lives and treatment of patients?

Presented by Gerard Danjoux, Consultant in Anaesthesia and Sleep Medicine at South Tees Hospitals NHS Foundation Trust.

An Irish Voice | COVID 19 Apr 28, 2020

Mixed in with conversation about EBPOM's plans to push forward with online conferencing and other ideas this piece asks how Ireland has and is faring in the battle against COVID. Decisive and brave action began with cancelling the world famous St Patrick's Day celebrations. How have things progressed from there?

Presented by Desiree Chappell with Monty Mythen and Jan Brohan, Consultant in Anaesthesia and Intensive Care Medicine in Cork University Hospital.

Thank you to our sponsor Edwards Lifesciences.

Edwards clinical education (ECE): https://www.edwards.com/clinicaleducation

Rapid deployment of US National Reserves ease stress in New York | COVID 19 Apr 28, 2020

The war against COVID 19 is ongoing but some relief has reached the frontlines in New York. Hear how a rapid response military team, United States Air Force Reserves, deployed into the "war zone" built and supported the first wave of our battle against this terrible virus.

How has this effort been received and implemented? What is the significance for this unprecedented move in the US? What lessons are being learned and could the end result improve healthcare for all?

Presented by Desiree Chappell with Monty Mythen and their guests USAF Col Jennifer 'Robyn' Ratcliff, Orthopedic surgeon, Orlando VA Hospital, USAF Lt Col Reco Evans CRNA, Temple TX VA Hospital and Captain Joel Sherwood, Medical Science Liaison, National Director, Government Affairs, Pacira Pharmaceuticals

Thank you to our sponsor Edwards Life Sciences.

Edwards clinical education (ECE): https://www.edwards.com/clinicaleducation

How you can protect yourself | COVID 19 Apr 27, 2020

“When you start to think about how we can protect ourselves; we have some reasonably robust literature for a few interventions [..] that do seem to associate with the prevention of viral infections…”; maintain a normal vitamin D level, probiotics, vitamin C.

This piece is an edited highlight of a fascinating conversation with a TopMedTalk favorite. How can we optimise ourselves for an oncoming viral attack? How can we make sure our patients get the best possible care and are as informed as they can be? What research is being carried out into COVID 19?

Presented by Desiree Chappell with her guest Paul Wischmeyer, Professor of the Department of Anesthesiology and Critical Care, Duke University.

Thank you to our sponsor Edwards Lifesciences.

Edwards clinical education (ECE): https://www.edwards.com/clinicaleducation

TopMedTalk | Should direct laryngoscopy be consigned to the history books? Apr 27, 2020

The debate 'Direct laryngoscopes should be consigned to history', was hosted by The Royal College Of Anaesthetists and carried out by our two guests on this piece.

Here we get into the advantages and challenges behind the two techniques; video laryngoscopy and direct laryngoscopy. The conversation explores the fact that these skills are a key part of the job of practitioners, are we "de-skilling" the profession in an overly enthusiastic race toward new technology or are some resisting it simply because it's not what they are used to?

Where do you stand on this fascinating debate? Send us your thoughts on email: contact@topmedtalk.com

Presented by Joff Lacey and Monty Mythen with their two guests; Professor Tim Cook, Consultant in Anaesthesia and ICM, Royal United Hospitals, Bath and Dr William Harrop-Griffiths, St Mary's Hospital, Imperial College Healthcare NHS Trust.

ACE inhibitors- Right or Wrong? | COVID 19 Apr 26, 2020

ACE inhibitors (angiotensin converting enzyme inhibitors) have been mentioned frequently in this series over the last month. This piece sees the long promised focus on ACE and the effects of estrogen as a way of dealing with some of the potentially fatal symptoms caused by COVID 19.

It's still early days in the battle against this terrible virus, this piece presents some speculation as to where the conflict may head to. TopMedTalk provides evidence based discussions, here we ask how more evidence can be gathered as tantalizing theories emerge about dealing more effectively with these patients.

Presented by Desiree Chappell with Monty Mythen and additional questions from Mike Grocott, alongside their guest Hugh Montgomery, Intensive Care Society Board Member and, Professor of Cardiovascular Genetics and Critical Care University College London.

Thank you to our sponsor Edwards Lifesciences.

Edwards clinical education (ECE): https://www.edwards.com/clinicaleducation

EBPOM 2019 | Alcohol Matters Apr 26, 2020

The healthcare profession has a mixed history when it comes to messaging around alcohol. Nowadays, from a public health perspective, it is clear that overall it is not helpful for our physiology and well being.

How often do you have alcohol? How many units do you drink? How often do you have a binge? What are the age groups where drinking problems are most apparent? Where is the latest research regarding a perioperative approach to alcohol consumption? How effective is intervention for risky drinkers, should it also be considered for dependent drinkers?

How have studies and evidence been arranged around this topic and where should it lead us? Is there a need for more research?

Presented by Chris Snowden, Consultant Anaesthetist, Freeman Hospital, Newcastle upon Tyne and Senior lecturer at the Institute of Cellular Medicine at Newcastle University, he has recently secured grant funding from the NIAA (RCOA /BJA) to develop prehabilitative training in the elderly surgical patient.

Vital information direct from experts in Italy | COVID 19 Apr 25, 2020

"You're a bit further down the line with managing these patients. Any particular advice?"

Italy, the situation is difficult but there are now clear lessons to be learned as the first chapter in the front line battle against the consequences of a global pandemic is written.

Hear how the story regarding treatment for this disease evolved in Italy and consequently around the world. Has the debate regarding acute respiratory distress syndrome (ARDS) been a red herring? What is the effectiveness of continuous positive airway pressure (CPAP) in these cases? Are all COVID 19 patients the same? Crucially - what can cardiac dysfunctions in these patients tell us?

This podcast is essential listening for students and medical practitioners who want to hear a real life discussion about one of the most important medical and population health emergencies the world has ever faced.

Presented by Joff Lacey with Monty Mythen and additional questions from Desiree Chappell alongside their guest, Maurizio Cecconi, Head of the Anaesthesia and Intensive Care Department at Humanitas Research Hospital; President-elect of the European Society of Intensive Care Medicine (ESICM) for 2020-2021, Chair Division of Scientific Affairs at ESICM; Director of the Master in Patient Blood Management at Humanitas University.

Thank you to our sponsor Edwards Lifesciences.

Edwards clinical education (ECE): https://www.edwards.com/clinicaleducation

EBPOM 2019 | Moving as medicine Apr 25, 2020

"Moving as medicine; is it the most underused but proven health promotion and healthcare practice?"

Prehabilitation and population health naturally walk alongside each other. Learn here how Sport England's ambitious strategy to reduce inactivity and improve the nation’s physical and mental health is connected to prehabilitation and Enhanced Recovery After Surgery. Should patients be seeking expert condition specific advice before becoming active? How do we improve the quality of conversations between practitioner and patient?

The excellent Moving Medicine website can be found here: http://movingmedicine.ac.uk/

Presented by Sarah Ruane, Sport England’s national lead for health, she joined in January 2016 from local government where she oversaw public health, leisure and cultural services.

Avoiding the Tsunami? The power of preparation and information | COVID 19 Apr 24, 2020

This piece is something of a ray of hope, here we learn how New Zealand appears to have managed the crisis remarkably well, a low level of infections overall. What lessons can be learned from the political leadership and tactic deployed here? Is there a downside to this, as regards to 'herd immunity', or is the reality that all of us must wait for a vaccine?

Presented by Desiree Chappell and Monty Mythen with Julian Fuller, Anaesthetist in Auckland, New Zealand.

Thank you to our sponsor Edwards Lifesciences.

Edwards clinical education (ECE): https://www.edwards.com/clinicaleducation

Like this, want more? We mention our Editor in Chief's bought of COVID 19 here, why not listen to this piece which tells the story in full: https://www.topmedtalk.com/covid-19-case-study-professor-monty-mythen-01/

Heroism in medicine - Remembering ANZAC Day | COVID 19 Apr 24, 2020

This piece is a catch up with a popular contributor on TopMedTalk, Ross Kerridge, John Hunter Hospital, Newcastle, Australia, (often cited as 'the father of Modern Perioperative Medicine), for an update on how Australia appears to have managed to broadly keep a lid on this crisis. Social distancing, quick action and border controls appear to have worked to forestall the impending crisis.

Our guest writes regularly and is a very popular opinionator, find some of his work here: Newcastle's 'quiet heroes' who helped the sick and injured in wartime https://www.newcastleherald.com.au/story/6725101/the-birth-of-intensive-care-in-newcastle/?cs=4464

Presented by Desiree Chappell and Monty Mythen.

Thank you to our sponsor Edwards Lifesciences.

Edwards clinical education (ECE): https://www.edwards.com/clinicaleducation

Take time to relax | COVID 19 Apr 24, 2020

"It's really important just to talk about the situation and not keep it bottled up“

Psychological stress is inevitable at this time for medical practitioners, that's why we here at TopMedTalk are keen to both raise money for the Intensive Care Society (ICS) charity and to remind our listeners of the importance of mental health and self care.

There's a wealth of resources on this topic in the TopMedTalk archive. Here's a good piece to start with: https://www.topmedtalk.com/topmedtalks-to-sasha-shillcutt/

Find our guest's Facebook page here, click like to get an alert when he goes live: https://www.facebook.com/jeremysassoon

Presented by Desiree Chappell and Monty Mythen with Jeremy Sassoon.

Thank you to our sponsor Edwards Lifesciences.

Edwards clinical education (ECE): https://www.edwards.com/clinicaleducation

TopMedTalk | Are you really using ultrasound? Apr 24, 2020

"Our mission is to make sure everybody in intensive care can learn [ultrasound]". How important and how possible is it to use ultrasound in your practice? Hear how it can transform the way you diagnose issues with pocket sized point of care ultrasound. Lung ultrasound is discussed as is its use with eyeballs. Hear how one of the pioneers in this area, Professor Sol Aronson, reacts to an enthusiast in the field. "Wherever you are, however novice or new, it just makes you smarter".

Recorded live at the Association of Anaesthetists' Winter Scientific Meeting 2020 in the centre of London from The Queen Elizabeth II Centre. This piece followed on from these two pieces:

TopMedTalk | Matt Wiles and Marcus Peck, Live from London: https://www.topmedtalk.com/topmedtalk-matt-wiles-and-marcus-peck-live-from-london/

TopMedTalk | Gezz Van Zwanenberg, Live from London Part 2: https://www.topmedtalk.com/topmedtalk-gezz-van-zwanenberg-live-from-london-part-2/

Find out more Focused Ultrasound in Intensive Care (FUSIC) here: https://www.ics.ac.uk/ICS/accreditation.aspx

Presented by Desiree Chappell and Monty Mythen with contributions from Sol Aronson, tenured Professor at Duke University and their guest Marcus Peck, NHS Consultant in Anaesthesia and Intensive Care Medicine at Frimley Park Hospital and Chair of Focused Intensive Care Society’s (FICE) Committee.

Like this, want more? Marcus Peck featured on TopMedTalk previously here: https://www.topmedtalk.com/intensive-care-society-point-of-care-ultrasound/

Healthcare leaders examine staff deaths | COVID 19 Apr 23, 2020

"It's heartbreaking - we have to recognise the fact, and continue to think; 'we've all got it, we can all get it and we can all give it!'"

This urgent release from TopMedTalk will force the many leaders in our profession to tackle a very serious and important subject, what does the data reveal regarding COVID deaths among staff members and healthcare workers?

Stark questions need to be asked; why is there a disproportionate number of fatalities from black and minority ethnic groups (BAMEs)? The detail, contained within, is surprising.

Are we doing enough to mitigate these dangers? Why, beyond the obvious, is it so vital to look after the health of our staff? Are there lessons we can learn going forward.

We implore you to spread this story as far as you can, this debate is vital to our personal health and the wider battle against this virus.

Much of the source material for this podcast can be found here: "Exclusive: deaths of NHS staff from covid-19 analysed" Health Service Journal HSJ - https://www.hsj.co.uk/exclusive-deaths-of-nhs-staff-from-covid-19-analysed/7027471.article

Presented by Desiree Chappell and Monty Mythen.

We interview Tim Cook here: https://www.topmedtalk.com/8316-2/

Thank you to our sponsor Edwards Lifesciences.

Edwards clinical education (ECE): https://www.edwards.com/clinicaleducation

Surrounded by risks, are we mitigating them at all? | COVID 19 Apr 23, 2020

The Intubate Covid project is an essential contribution to an evidence based answer to the issue posed by dangers of health care workers contracting and spreading the virus. By both collecting and sharing data the project gives you both a track record of where you are, in relation to your own safety, as well as the knowledge you are contributing to vital research.

Find out more about the project by joining now: www.intubatecovid.org

Presented by Joff Lacey with his guest Kariem El-Boghdadly, Consultant Anaesthetist at Guy's & St Thomas' NHS Foundation Trust, London and Scientific Officer for UK's Difficult Airways Society (DAS).

Thank you to our sponsor Edwards Lifesciences.

Edwards clinical education (ECE): https://www.edwards.com/clinicaleducation

Disruptive Innovation | COVID 19 Apr 22, 2020

"The concept of 'disruptive innovation' in healthcare and that's what this has been; a major challenge to healthcare has forced us to do something very differently, very quickly."

This piece starts with a quick update on the current situation from Monty and Desiree regarding where they are, London and Louisville Kentucky, in both the US and UK respectively.

We then move to the fascinating and inevitably - rapidly expanding - area of 'tele-medicine'. Hear how our guest has helped to pioneer this and managed to increase value, achieving things which were simply not possible 'the old fashioned way'.

The global COVID crisis brings this subject into sharp relief however; "this isn't just about, what's happening now. How do we use these technologies better going forward?": How can you include relatives in difficult ICU bedside conversations without these technologies? How can you use this technology in your practice? Finally, how can the new parameters of this domain be defined?

Presented by Desiree Chappell with Monty Mythen and their guest Carol Peden, Professor of Anesthesiology and Exec. Director of the Center for Health System Innovation, University of Southern California.

Thank you to our sponsor Edwards Lifesciences.

Edwards clinical education (ECE): https://www.edwards.com/clinicaleducation

Case study: Professor Monty Mythen - Part 02 | COVID 19 Apr 22, 2020

This is the second and concluding part of our real life case study of a COVID 19 patient. In this instance our Editor in Chief Monty Mythen has - during the course of presenting this series - contracted COVID 19. Fortunately for us, it was a comparatively mild case. This short documentary takes the story up right after Monty's decision to take a test to see if his symptoms were as we feared.

Presented by Nick Margerrison, part 1 is available of download here: https://www.topmedtalk.com/covid-19-case-study-professor-monty-mythen-01/

The longer conversations which these clips were part of can be found here:

COVID 19 | Professor Monty Mythen has tested positive: https://www.topmedtalk.com/covid-19-professor-monty-mythen-has-tested-positive/

COVID 19 | Dr Joff Lacey: https://www.topmedtalk.com/covid-19-dr-joff-lacey/

COVID 19 | Special Charity Concert with Jeremy Sassoon 5pm UK time: https://www.topmedtalk.com/covid-19-special-charity-concert-with-jeremy-sassoon-5pm-uk-time/

Thank you to our sponsor Edwards Lifesciences.

Edwards clinical education (ECE): https://www.edwards.com/clinicaleducation

Case study: Professor Monty Mythen - Part 01 | COVID 19 Apr 21, 2020

This piece looks at our recent archive and pieces together the story of our Editor in Chief, Monty Mythen's bout of COVID 19. From the start TopMedTalk was keen to reflect the global battle against this terrible virus and - as you will hear - concerns for our friends and contributors in the medical world was never far from our minds.

In retrospect it is particularly interesting listening to how evidence and best practice were in this instance vital to the health of our team and the people they care about.

Presented by Nick Margerrison, this is part one of a two part series.

The clips used in this piece are taken from fuller conversations which you can hear here:

COVID 19 | Desiree and Monty: https://www.topmedtalk.com/covid-19-desiree-and-monty/

COVID 19 | Hugh Montgomery – North London UK: https://www.topmedtalk.com/covid-19-hugh-montgomery-north-london-uk/

COVID 19 | From the front line; Desiree and Monty: https://www.topmedtalk.com/covid-19-from-the-front-line-desiree-and-monty/

COVID 19 | UK, Southampton and London: Mike Grocott and Monty: https://www.topmedtalk.com/covid-19-uk-southampton-and-london-mike-grocott-and-monty/

COVID 19 | Does one of our team have COVID 19? https://www.topmedtalk.com/covid-19-does-one-of-our-team-have-covid-19/

COVID 19 | Critical Care Update; optimizing care for patient and provider: https://www.topmedtalk.com/covid-19-critical-care-update-optimizing-care-for-patient-and-provider/

Thank you to our sponsor Edwards Lifesciences.

Edwards clinical education (ECE): https://www.edwards.com/clinicaleducation

Delaying surgery to adequately prepare? | EBPOM World Congress 2019 Apr 21, 2020

A quick surprising poll of perioperative practitioners sets the tone for a robust advocation of the responsibility of surgeons and practitioners to do surgery right; as opposed to being inclined to feeling it must be done "right now!". A data driven approach combined with a patient focused attitude are at the centre of the argument. How do these factors combine to produce a business case which all institutions, practitioners and patients can understand?

In terms of time spent, what do we mean when we say "delay"? How do we overcome a patient's attitudes towards healthcare professionals, if they feel there has already been a delay in 'getting treatment'? How can the pathways from diagnosis to recovery be shortened or made more flexible? Can a case manager help this process? Is eight weeks an acceptable waiting time, can we reasonably expect it to be less than that?

Presented by Gerrit Slooter, MD, PhD, Surgical Oncologist, Maxima Medical Centre, The Netherlands.

Junior Doctors sent to frontline in UK (REPEAT) | COVID 19 Apr 20, 2020

The UK has accelerated the graduation of medical students to help fight COVID 19. We speak to some of Britain's newest doctors to hear what it's like getting ready for - and going into - action against one of the most dramatic health crisis in living memory. Discussions about palliative care, end of life decisions and rapid patient decline are just some of the experiences they are learning to cope with, fresh out of medical school.

Presented by Desiree Chappell and Dr Henry Howe with Dr Dolcie Paxton, Dr Chloe Hall, Dr Beth Robinson, Dr Jessica Hatrick of Southmead Hospital in Bristol.

Thank you to our sponsor Edwards Lifesciences.

Edwards clinical education (ECE): https://www.edwards.com/clinicaleducation

Promote your anemia clinics in the pandemic era? | COVID 19 Apr 19, 2020

All treatments have unintended consequences, "locking down" most of The Western World is certainly no exception. In the medical world we're faced with a familiar set of problems which has been intensified thanks to the sidelining and postponement of treatment for people who do not have the corona virus. It's a complicated debate, with many strands, here we focus upon how prehabilitation, specifically regarding anemia, is actually now more important than it ever has been. There is an opportunity for perioperative practitioners, specifically you, the TopMedTalk listener, to advocate these ideas now as loudly as possible in order to secure long term benefits for the healthcare profession and population health a whole.

Learn how iron infusions are helping countless people to prepare for a better outcome after their delayed surgery, are there innovations you can take at your practice which will similarly be an obvious help to your patients? Furthermore, hear how online networking is being used to assess patients, could you more widely use these technologies at your practice?

The paper being discussed in parts of this piece is here: https://anesthesiology.pubs.asahq.org/article.aspx?articleid=2763405

Presented by Desiree Chappell with Monty Mythen and their guest, Professor Bobbi Jean Sweitzer, The Associate Chair for Clinical Perioperative Practice, Northwestern University in Chicago, Illinois.

Thank you to our sponsor Edwards Lifesciences.

Edwards clinical education (ECE): https://www.edwards.com/clinicaleducation

This piece is also co-featuring as part of the "Women in Anaesthesia" series this year. Check out the last in the series here: https://www.topmedtalk.com/women-in-anaesthesia-part-6-carol-peden/

The British Journal of Anaesthesia article, which inspired the "Women in Anaesthesia" series, is here: https://bjanaesthesia.org/article/S0007-0912(20)30003-9/fulltext

Essential knowledge; management of the COVID patient | COVID 19 Apr 18, 2020

This piece digs deep into the realities of coping with COVID 19 patients who have had their care escalated to the Intensive Care Unit (ICU); "we don't seem to be looking at our typical sepsis patients who get multiple organ failure in the classical way" and "you're surprised at how young some of the patients are...".

Our guest provides us further insight; a 'household name' in the haemodynamic monitoring space; he is treating patients in a medium sized hospital (500 beds) with mostly COVID patients in Spain. How are things going there, how does it compare to Italy? How are the patients being dealt with, what can we learn about the basics here, airway, breathing, ventilation (ABC)?

There is also a gripping discussion regarding dynamic arterial elastance. If you'd like to know more about that do check out our discussion here: https://www.topmedtalk.com/periop-coach-2-09-haemodynamic-monitoring/

The webinar mentioned in this piece can be found here: https://www.esicm.org/education/webinars/

Presented by Desiree Chappell and Monty Mythen with their guest Dr. Manuel Ignacio Monge García who works in an ICU in the South of Spain.

Thank you to our sponsor Edwards Lifesciences.

Edwards clinical education (ECE): https://www.edwards.com/clinicaleducation

Mike Irwin, Hong Kong | COVID 19 Apr 18, 2020

"It was taken pretty seriously, right from the start"

After a quick update with both Monty, UK, and Desiree, US, we join one of our friends and colleagues at the University of Hong Kong; what's the situation there?

What useful comparisons can be drawn from speculation about the differences between Hong Kong's response in contrast to ours? How can it be that in spite of such proximity to the epicenter of the global pandemic they appear to be managing a situation we are having such problems with? As well as the possible hygiene benefits is there a symbolic power to the use of masks, by members of the public, that actually helps? What role can fear, not panic, but genuine healthy "respect", play in preparation for things of this nature?

How sensible is the track and trace method, in comparison to the 'herd immunity' approach mooted in the UK?

We also revisit the concept of a "micromort" and see how it applies to a global pandemic.

Mike sent us this fascinating article here: https://medium.com/wintoncentre/how-much-normal-risk-does-covid-represent-4539118e1196

Presented by Desiree Chappell and Monty Mythen with Mike Irwin,

If you enjoyed Mike's take on things, check out his previous appearance here: https://www.topmedtalk.com/measuring-risk-in-surgery-what-is-a-micromort/

If you'd like to hear our summary of the last time we spoke to him, and the conversation which prompted us to discuss fear as a motivator to sensibly prepare for pandemics go here: https://www.topmedtalk.com/covid-19-you-must-learn-the-epidemiology/

Thank you to our sponsor Edwards Lifesciences.

Edwards clinical education (ECE): https://www.edwards.com/clinicaleducation

ICU - not just another day at work | COVID 19 Apr 17, 2020

"It's airway, breathing, circulation"

This piece focuses upon treating patients outside of Philidelphia at an "all COVID unit"; what can we learn from someone who stands at the cutting edge of fighting this terrible virus?

How are staffing concerns being dealt with? What about on the job training and upskilling? How do we maximise human resources during this crisis?

There is also a detailed conversation about the care of COVID patients, the changing thoughts on ventilation and continuous positive airwave pressure (CPAP); what are 'the basics' of caring for these patients?

There is also time for reflections about the pressures of being a healthcare provider, how do we face difficult personal challenges and yet still remain ready to be at our best?

The article mentioned in this piece, by Luciano Gattinoni, is here:

https://www.esicm.org/wp-content/uploads/2020/04/684_author-proof.pdf

Presented by Desiree Chappell with Monty Mythen and Kathy Crawford, MSN, RN, CCRN, critical care nurse with 29 years of experience, Philidelphia.

Thank you to our sponsor Edwards Lifesciences.

Edwards clinical education (ECE): https://www.edwards.com/clinicaleducation

TopMedTalk | Why is maternal mortality so high in the USA? Apr 17, 2020

Why does the US have the highest maternal mortality rate of any developed country? This piece tackles a very controversial issue in healthcare head on, could the problem be due to racism? The chances of a serious issue is "substantially higher if you come from a minority group, in particular if you are African-American".

We also cover the issue of postpartum hemorrhage, what are the key signs that a patient is at risk? Furthermore, how are quality care initiatives and standardization of care helping improve the field of obstetrics? Also, what is the latest thinking on home births, are they a financial decision for some?

The California Maternal Quality Care Collaborative is here: https://www.cmqcc.org/

For more info on the Society for Obstetric Anesthesia and Perinatology (SOAP) go to www.soap.org

Presented by Desiree Chappell and Monty Mythen with their guest Alexander J Butwick, Obstetric Anesthesiologist and Researcher in maternal hemorrhage, pain relief in labor, and obstetric epidemiology at Stanford University.

--

Like this, want more?

On the subject of obstetrics find out more here:

EBPOM Highlight 1.27 | Obstetric anaesthesia - https://www.topmedtalk.com/ebpom-highlight-1-27-obstetric-anaesthesia/

ASA 2018 San Francisco | Smith’s Medical Symposium on Enhanced Recovery – Part 5 - https://www.topmedtalk.com/asa-2018-san-francisco-smiths-medical-symposium-on-enhanced-recovery-part-5/

Periop Coach 4.10 | Enhanced Recovery for obstetrics https://www.topmedtalk.com/periop-coach-4-10-enhanced-recovery-for-obstetrics/

Stevie Wonder - LIVE Saturday night fundraising concert with Jeremy Sassoon | COVID 19 Apr 16, 2020

This piece sees the welcome return of our favorite live musician, Jeremy Sassoon, intended as a chance for listeners to TopMedTalk to both raise money for the effort to tackle COVID 19 and fight the 'burnout blues' while doing so.

If you enjoyed this piece please check out this live video (which features on the podcast) here: https://www.youtube.com/watch?v=HbdJAFpRz34

And find Jeremy Sassoon here: https://www.facebook.com/jeremysassoon

Presented by Monty Mythen with Desiree Chappell and their guest Jeremy Sassoon.

--

Although this is a fun piece there is a very important side to what it represents. Having fun is something you should be serious about - particularly if you are a medical professional and want to maintain a high level of focus and productivity.

TopMedTalk has previously provided extensive evidence behind why it is important to relax here:

TopMedTalk | Burn out – a frank discussion https://www.topmedtalk.com/topmedtalk-burn-out-a-frank-discussion/

Sunday Special | Burn out? https://www.topmedtalk.com/sunday-special-burn-out/

AANA | Emotional Intelligence and Occupational Stress https://www.topmedtalk.com/aana-emotional-intelligence-and-occupational-stress/

Angela Bader - the need for 'end of life' conversations | COVID 19 Apr 16, 2020

"The peak keeps getting pushed..."

What's the difference between a strategy of rationing as compared with one where the aim is concordence?

As the crisis rumbles on, how do we decide who should have surgery, as well as the pressing question of how and where? The principles of perioperative medicine kick in here, pre-optimisation and enhanced recovery are uniquely suited within the profession to assist in the worldwide battle against this pandemic.

What about the need for end of life conversations? How does the process of informed decision making apply here, how also does it apply to providers? How can we protect our essential human resources?

Finally, the conversation wraps with an important nod from the healthcare profession to the overwhelming goodwill being expressed around the world to people in medicine who are risking their lives to defeat this virus.

Presented by Desiree Chappell and Monty Mythen with their guest Professor of Anesthesia, Angela Bader, Harvard Medical School and Vice Chair of Perioperative Medicine at Mass General Brigham.

If you loved Angela Bader's incisive take why not listen to this popular interview we previously featured here on TopMedTalk: https://www.topmedtalk.com/topmedtalks-to-angela-bader/

We also mention an upcoming appearance form TopMedTalk favourite Carol Peden, why not check out her appearance here: https://www.topmedtalk.com/talks-to-carol-peden/

Regular listeners will also be pleased to hear Bobbie Jean Sweitzer is also to appear on TopMedTalk soon, why not listen to this popular piece featuring her here: https://www.topmedtalk.com/periop-medicine-sig18-perioperative-frailty-panel-discussion/

Thank you to our sponsor Edwards Lifesciences.

Edwards clinical education (ECE): https://www.edwards.com/clinicaleducation

TopMedTalk | Methadone, a forgotten friend Apr 15, 2020

"Increasing the richness and the reach of what we do" is the mantra of 'Anesthesiology'; hear from its Editor in Chief how it managed to self study and discover the essential idea behind the journal: "trusted evidence, from discovery to practice".

Conversation then moves on to methadone, the overlooked opiate; where do you use it and what sort of dose is appropriate? What are the benefits of including this in your practice and should it really be considered in the same category as most other opioids?

The podcasts mentioned are here: https://anesthesiology.pubs.asahq.org/multimedia.aspx?mediaType=Podcasts

Presented by Desiree Chappell and Monty Mythen with Korey Springman and their guest Evan Kharasch, Professor of Anesthesiology, Vice Chair for Innovation, Director, Academic Entrepreneurship, Duke University School of Medicine and Editor-in- Chief, Anesthesiology.

Innovation through evidence | COVID 19 Apr 14, 2020

"If you ring up and start to apply pressure to them to say 'have you thought about giving my loved one drug A or drug B?' It might be helping them to get better but you might be encouraging them to do something that might hurt your loved one; so we have to do this with trials".

This piece gets into one of the debates surrounding the treatment of COVID 19. What do we mean when we suggest people think outside the box? Do we still need to bother about ideas and principles such as evidence and data collection or should a more cavalier approach be taken to medicine in this unusual time?

The following articles are discussed in this piece:

"Incidence of thrombotic complications in critically ill ICU patients with COVID-19" https://doi.org/10.1016/j.thromres.2020.04.013

"Chloroquine diphosphate in two different dosages [...];" https://www.medrxiv.org/content/10.1101/2020.04.07.20056424v1.full.pdf

"Effectiveness of Hydroxychloroquine in Covid-19 Patients (Covid)" https://clinicaltrials.gov/ct2/show/NCT04328272

"Infectious Diseases Society of America Guidelines on the Treatment and Management of Patients with COVID-19" https://www.idsociety.org/practice-guideline/covid-19-guideline-treatment-and-management/

Presented by Desiree Chappell with Monty Mythen.

Thank you to our sponsor Edwards Lifesciences.

Edwards clinical education (ECE): https://www.edwards.com/clinicaleducation

Junior Doctors sent to frontline in UK | COVID 19 Apr 13, 2020

The UK has accelerated the graduation of medical students to help fight COVID 19. We speak to some of Britain's newest doctors to hear what it's like getting ready for - and going into - action against one of the most dramatic health crisis in living memory. Discussions about palliative care, end of life decisions and rapid patient decline are just some of the experiences they are learning to cope with, fresh out of medical school.

Presented by Desiree Chappell and Dr Henry Howe with Dr Dolcie Paxton, Dr Chloe Hall, Dr Beth Robinson, Dr Jessica Hatrick of Southmead Hospital in Bristol.

Thank you to our sponsor Edwards Lifesciences.

Edwards clinical education (ECE): https://www.edwards.com/clinicaleducation

Herbert Patrick, Jefferson Hospital, USA (REPEAT)| COVID 19 Apr 12, 2020

(REPOST)

After a quick update from Desiree and Monty this piece focuses on Philadelphia Pennsylvania and gets into specifics regarding caring for COVID 19 positive patients.

As regards The Jefferson Hospital; where has the ICU "take over" expanded to? Have critical care ventilators been deployed to all new ICU beds or have acceptable compromises been made? "Staffing is tougher than the equipment" but how has a "critical care pool" system, prepared over a year ago, helped? What does the typical COVID 19 critical care patient look like? Enormous quantities of oxygen are being used by institutions to care for them, have there been issues with supply? What about aerosolisation issues regarding the virus? How many of these patients can be proned?

Crucially we get into the important differences between this - and the way it is treated - and acute respiratory distress syndrome (ARDS) patients. How do COVID 19 patients differ from 'usual' cases where ventilation or breathing assistance is used?

"What the renal teams are saying I respect, they've never seen anything like this" we're told, "the climb of creatinine, had a trajectory that is inconsistent with a cardio renal syndrome".

"This is a climb that is pushing us into almost round the clock use of the dialysis nurses to handle these patients [...] because they're encephalopathic, their BUN's [blood urea nitrogen] are very, very high - and because the creatinine trajectory has gone from '1' on Monday, to '3' on Tuesday, to '9' on Wednesday! This is astonishing."

Also, hear how a comprehensive approach to planning and innovative ideas about nurse training, upskilling and basic critical care education have helped.

Presented by Monty Mythen and Desiree Chappell with their guest, Herbert Patrick, Pulmonologist and Critical care physician, Jefferson Hospital, Philadelphia, Pennsylvania.

Thank you to our sponsor Edwards Lifesciences.

Edwards clinical education (ECE): https://www.edwards.com/clinicaleducation

Special Charity Concert with Jeremy Sassoon 5pm UK time | COVID 19 Apr 11, 2020

This piece is intended as a chance for listeners to TopMedTalk to both raise money for the effort to tackle COVID 19 and have a bit of relaxation and entertainment while doing so.

Our Editor in Chief Monty Mythen will be joining our guest, Jeremy Sassoon live on Facebook at 5pm on Saturday 11th of April.

In advance of that this piece explains how the two of them got to know each other along with some live music from Jeremy and reflections on how this crisis is effecting everyone.

Presented by Desiree Chappell with Monty Mythen, Sol Aronson and their guest Jeremy Sassoon.

--

Although this is intended as a fun piece, having fun is something you should be serious about; TopMedTalk has previously provided extensive evidence behind why it is important to relax here:

TopMedTalk | Burn out – a frank discussion https://www.topmedtalk.com/topmedtalk-burn-out-a-frank-discussion/

Sunday Special | Burn out? https://www.topmedtalk.com/sunday-special-burn-out

AANA | Emotional Intelligence and Occupational Stress https://www.topmedtalk.com/aana-emotional-intelligence-and-occupational-stress/

Online Charity Concert Saturday 5pm UK time | COVID 19 Apr 10, 2020

This piece is both a chance to relax and an opportunity to join the TopMedTalk team online as we unwind to our favourite Jazz musician, Jeremy Sassoon. As well as being an excellent and renowned musical talent he also happens to be a school friend of Monty's so we managed to convince him to join us for an exclusive interview tomorrow, in advance of which we're giving you a heads up that he will be live in concert on Facebook raising money for NHS Charities Together.

Follow this link and click "interested": https://www.facebook.com/events/215607516450867/

Find out more details here: https://uk.virginmoneygiving.com/JeremySassoon

The music featured comes from here: https://youtu.be/cyiarwJe008

The online performance starts at 5pm UK time on FACEBOOK LIVE.

More details on NHS Charities Together here: https://www.nhscharitiestogether.co.uk/

Presented by Desiree Chappell

EBPOM 2019 | Overview of perioperative smoking cessation Apr 10, 2020

Smoking is bad for you, there's little debate about that, even among users of the drug. However, further to the widely known consequences, the bottom line in the perioperative period is that smokers are 40% more likely to die after major surgery. Do patients also know this?

Tissue healing, increased risk of infection and increased possiblities of complications with the anaesthetic; with these risks in mind how do we cut through the ubiquitous, but often ignored, government health risk messaging and get patients to understand the increased risk for those undergoing surgery? How do we use smoking cessation techniques in the perioperative setting? How do we manage to start, ideally, six weeks before surgery? What is the latest thinking on the neuro psychiatric consequences of smoking cessation? How useful is the Fagerstrom test of nicotine dependence? What about "vaping", is it better than smoking from a perioperative perspective?

Presented by David Yates, Consultant in Anaesthesia and Critical Care Medicine at York Teaching Hospital, set up one of the UK’s first Perioperative Medicine Services in York, Anaesthesia, Perioperative Medicine and Pain Clinical Lead for the Yorkshire & Humber Comprehensive Research Network.

Get active and feel good? | TopMedTalk & MacMillan Cancer Special Apr 09, 2020

TopMedTalk in Collaboration with MacMillan Cancer Support in the UK developed this podcast series to support patients during their cancer journey amidst the COVID 19 crisis.

It's vital you remain active after a cancer diagnosis, why is this? Hear the fascinating story behind the discovery that activity not only reduces your overall levels of fatigue but also improves your chances of recuperation. "You have to pace yourself [...] listen to your body"; but any physical activity will help fight feelings of tiredness. In short, if you get active you feel good.

Also in this podcast, with direct reference to medical trials and studies, our guests give you the mechanism behind incredibly helpful changes caused by moderate exercise in cancer patients, evidence which has led medics to conclude that "exercise is real medicine".

"When we're talking about being active during cancer it's at any stage of the cancer journey: from prehabilitation through recovery". Prehabilitation is the process by which people prepare their bodies for a major obstacle such as an operation or chemotherapy. It's like rehabilitation but it takes place before the event.

Just as when you start your recovery after treatment you would expect to get your body back to full health, here you try to achieve the best possible physical health before you start. The key point is that the medicine of exercise can be useful from diagnosis right through to full recovery and beyond.

Again, with direct reference to the evidence, find out how incredible research into prehabilitation is changing the way we think about cancer and recovery.

Recorded specifically at the height of the COVID 19 crisis hear how this research is being applied in the context of a global pandemic. Group forms of exercise are not an option while social distancing restrictions are in place, can exercising with other people bring us special benefits? If so, can those benefits be matched if we use the internet to continue the social side of going to a gym or a class?

The YouTube link mentioned in this piece is here: https://www.youtube.com/playlist?list=PL4YhGgVzlQXjhq6UYbX7idSDYcPX5PRy9

Presented by Nick Margerrison with the Professor of Clinical Exercise Science, Anna Campbell, MBE, of Edinburgh Napier University and the director of CAN Rehab and the Professor of Prehabilitation Medicine, Sandy Jack, a consultant clinician scientist from The University of Southampton and University of Southampton NHS Foundation Trust .

For more information, in the UK, phone: 0808 808 00 00

email: CancerPrehabilitation@macmillan.org.uk

Twitter: @macmillancancersupport

Healthy eating and cancer | TopMedTalk & MacMillan Cancer Special Apr 09, 2020

TopMedTalk in Collaboration with MacMillan Cancer Support in the UK developed this podcast series to support patients during their cancer journey amidst the COVID 19 crisis.

We know food gives us energy "but it also provides so much more". This podcast looks at the raw materials you'll need, when facing a cancer diagnosis, to get a better outcome; the vitamins, minerals and proteins, as well as the energy sources you're best using.

What is a balanced diet when you have cancer? "We're talking about eating well to stay well [...] we're not really looking for people to lose weight"; it's often important for people to try to maintain their weight during a cancer diagnosis, should you track your weight throughout your cancer journey?

Recorded at the height of the COVID 19 crisis this podcast also reflects upon how this information is applied in the context of a global pandemic. What foods can we store which also contain the vital building blocks of our body's natural defenses?

Presented by Nick Margerrison with his guest Clare Shaw, consultant Dietician at The Royal Marsden NHS Foundation Trust.

For more information, in the UK, phone: 0808 808 00 00

email: CancerPrehabilitation@macmillan.org.uk

Twitter: @macmillancancersupport

TopMedTalk & MacMillan Cancer Support | TopMedTalk & MacMillan Cancer Special Apr 09, 2020

TopMedTalk in Collaboration with MacMillan Cancer Support in the UK developed this podcast series to support patients during their cancer journey amidst the COVID 19 crisis.

"It's very normal to sit with some difficult thoughts and feelings" after a cancer diagnosis. Broadly there are two types of mindsets; anxiety, which can be helpful, an element of wanting to 'do something' and, on the other hand, low mood, a feeling of not wanting to do anything, this can be unhelpful if not addressed at a certain level. We should expect both of these mindsets the question is 'how does the latest scientific research show can we control them'? Your body and mind are not separate, one effects the other, this is why it is so important we look at mental health as part of an overall approach.

"You can do quite a lot of things [...] that put you into a better mood"; exercise, meditation, even simple breathing exercises. Spending time communicating with friends and family is another suggestion.

Recorded at the height of the COVID 19 crisis this podcast also reflects upon how this is applied in the context of a global pandemic; how important is it that people engage with online facilities and opportunities to maintain relationships? "In an odd way the relationships seem to intensify".

It's not about ignoring negative feelings though, anxiety and low mood are very common for people with a cancer diagnosis. Hear how it is important to allow yourself to reflect, part of understanding your mental health is about regaining control, we are allowed to let ourselves feel difficult thoughts as part of the process of monitoring and working with them.

This podcast also contains a reminder about the importance of goal setting in allowing people to regain control over their lives. Small, realistic and specific, short term goals are useful at this particular stage of life; "start with the thing you are most confident you are able to change [...] make a day and a time that you'll stick to".

Presented by Nick Margerrison with his guests Judit Varkonyi-Sepp psychologist, psychology lead for the Wesfit prehabilitation programme and Chloe Grimmett, behavioural scientist and lead for Wesfit prehabilitation.

For more information, in the UK, phone: 0808 808 00 00

Email: CancerPrehabilitation@macmillan.org.uk

Twitter: @macmillancancersupport

Herbert Patrick, Jefferson Hospital, USA | COVID 19 Apr 09, 2020

After a quick update from Desiree and Monty this piece focuses on Philadelphia Pennsylvania and gets into specifics regarding caring for COVID 19 positive patients.

As regards The Jefferson Hospital; where has the ICU "take over" expanded to? Have critical care ventilators been deployed to all new ICU beds or have acceptable compromises been made? "Staffing is tougher than the equipment" but how has a "critical care pool" system, prepared over a year ago, helped? What does the typical COVID 19 critical care patient look like? Enormous quantities of oxygen are being used by institutions to care for them, have there been issues with supply? What about aerosolisation issues regarding the virus? How many of these patients can be proned?

Crucially we get into the important differences between this - and the way it is treated - and acute respiratory distress syndrome (ARDS) patients. How do COVID 19 patients differ from 'usual' cases where ventilation or breathing assistance is used?

"What the renal teams are saying I respect, they've never seen anything like this" we're told, "the climb of creatinine, had a trajectory that is inconsistent with a cardio renal syndrome".

"This is a climb that is pushing us into almost round the clock use of the dialysis nurses to handle these patients [...] because they're encephalopathic, their BUN's [blood urea nitrogen] are very, very high - and because the creatinine trajectory has gone from '1' on Monday, to '3' on Tuesday, to '9' on Wednesday! This is astonishing."

Also, hear how a comprehensive approach to planning and innovative ideas about nurse training, upskilling and basic critical care education have helped.

Presented by Monty Mythen and Desiree Chappell with their guest, Herbert Patrick, Pulmonologist and Critical care physician, Jefferson Hospital, Philadelphia, Pennsylvania.

Thank you to our sponsor Edwards Lifesciences.

Edwards clinical education (ECE): https://www.edwards.com/clinicaleducation

TopMedTalk | Perioperative medicine and being a good sport Apr 09, 2020

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 in Anaesthesia and Sleep Medicine at South Tees Hospitals NHS Trust and Ken Van Someren, Director KvS Performance Ltd.

Periop SIG 2019 | Improving the quality of the patient surgical journey Apr 08, 2020

What are the latest developments in quality improvement programs that help operative teams around the world take what they do to the next level? When does the surgical journey begin? How has a focus upon patients prior to surgery improved outcomes? What are "the five phases of care"? How has data collection and management helped us to continually improve a patient's surgical journey?

This piece is a talk which was given during the 8th Australian and New Zealand Symposium of Perioperative Medicine Special Interest Group: “Updates in Perioperative Medicine 360” which took place between November 7th-9th 2019

Presented by Clifford Ko, Professor of Surgery at UCLA, Director of the Division of Research and Optimal Patient Care at the American College of Surgeons.

Barbara McLean, Grady Memorial, USA | COVID 19 Apr 08, 2020

We get a quick update from Monty, how is his return to work going after quarantining at home with COVID 19

Further conversation takes a look at the care being given to COVID 19 patients and their providers. What is PPE fatigue? Where is the debate regarding COVID 19 positive patients and fluid management? A lot of it boils down to the mantra "keep it simple", do the job as correctly and properly as possible and know what you are capable of.

Please listen to the end of this piece for a vitally important discussion regarding temperature variation in COVID 19 patients.

Link to Nicole Cupchick her: https://nicolekupchikconsulting.com/media-resources/

Barbra McClean can be found here: http://barbaramclean.com/

The story mentioned by our guest "Coronavirus: Tiger at Bronx Zoo tests positive for Covid-19" is reported by The BBC here: https://www.bbc.co.uk/news/world-us-canada-52177586

Presented by Desiree Chappell and Monty Mythen with their guest Barbara McLean, Critical Care Clinical Specialist, Grady Memorial, Atlanta, GA.

Thank you to our sponsor Edwards Lifesciences.

Edwards clinical education (ECE): https://www.edwards.com/clinicaleducation

Dr Joff Lacey | COVID 19 Apr 07, 2020

This piece sees us catch up with a the TopMedTalk team favorite; Joff Lacey. A popular presenter here on TopMedTalk, Joff tells us of his first hand experiences in the ongoing battle against COVID 19 in South London.

We also get an update on Monty's condition.

Presented by Desiree Chappell with Dr Joff Lacey, Consultant Anaesthetist at St George's Hospital in South West London.

Thank you to our sponsor Edwards Lifesciences.

Edwards clinical education (ECE): https://www.edwards.com/clinicaleducation

Emotional Intelligence and Occupational Stress | AANA 2019 Apr 07, 2020

Emotional intelligence is the ability to perceive, integrate, understand and utilize emotions in an effective and meaningful way in order to cope and adapt to the situation. It's a hot topic at the moment, here we speak with the first CRNA to be certified in emotional intelligence. Stress and burn out is a common problem in the CRNA community, handling that could have a real impact on performance and outcomes.

Our guest mentions the Mayer-Salovey-Caruso Emotional Intelligence Test™ which can be found here: https://www.mhs.com/

She also advocates "The Student EQ Edge: Emotional Intelligence and Your Academic and Personal Success: Student Workbook" which can be found on Amazon here: https://www.amazon.co.uk/Student-EQ-Edge-Emotional-Intelligence/dp/1118094603

Our guest kindly allowed us to share her email with you: andrea.bittinger@beaumont.org

Presented by Desiree Chappell and Monty Mythen with their guest, Andrea Bittinger, CRNA at William Beaumont Hospital.

Desiree and Monty | COVID 19 Apr 06, 2020

This week begins with an update on Monty's progress after his COVID 19 diagnosis. Have the symptoms returned or is he back to his usual self?

One thing we know for certain when it comes to this virus and our treatment of it's symptoms; it is a dynamic situation. Management of the COVID patient is constantly changing. Do we treat our patients as having Acute respiratory distress syndrome (ARDS) or do we take a standard approach to ventilation? This piece looks at how our understanding of COVID 19 is developing as more evidence comes in.

There then follows a conversation about the various uses medical research might be able to put Monty's blood to, now he's a recovering COVID 19 patient.

Are there possible treatments on the horizon? Inevitably this requires evidence and rapid trials; "equipoise" is the word of the moment.

The International Society on Thrombosis and Haemostasis (ISTH) - mentioned in this piece - can be found here: https://www.isth.org/

Presented by Desiree Chappell with Monty Mythen.

Thank you to our sponsor Edwards Lifesciences.

Edwards clinical education (ECE): https://www.edwards.com/clinicaleducation

TopMedTalk | Burn out - a frank discussion Apr 06, 2020

Burn out and stress management have been an important theme on TopMedTalk recently, here we have a top medical professional sharing their story in relation to the topic. How do we describe "burn out", are certain words a barrier to discussion? How do we cut through to people who are most likely to suffer from this incredibly dangerous condition? Is the medical profession finally making progress here?

Our interview with Sasha Shillcut is here "Sunday Special | Burn out": https://www.topmedtalk.com/sunday-special-burn-out/

This piece was originally streamed live from ‘The Society of Cardiovascular Anesthesiologists’ (SCA) annual conference, 2019.

Presented by Desiree Chappell and Monty Mythen with Sol Aronson, Tenured Professor, Duke University and Executive Vice Chairman in the Department of Anesthesiology, and their guest Tjorvi Perry, Assistant Professor, Department of Anesthesiology, University Minnesota

EBPOM 2019 | Ernest Henry Starling Plenary Lecure, Andrew Shaw, Fluid therapy in the 2020s Apr 05, 2020

This hugely important talk was the centerpiece of EBPOM 2019 and, appropriately enough, it focuses on a big topic for us here at TopMedTalk; the future of fluid therapy.

Originally given as the EBPOM 2019 Ernest Henry Starling plenary lecture the talk is complimented by this piece which was recorded on the same day: https://www.topmedtalk.com/desirees-roundtable-fluids-in-the-2020s/

Where is the latest thinking on fluid therapy, what new evidence and understandings do we now have?

Presented by Dr Andrew Shaw, Chairman, Department of Anesthesiology and Pain Medicine at The University of Alberta, Edmonton, Alberta and Zone Clinical Department Head for Anesthesia, Alberta Health Services Edmonton Zone. He is also a Fellow of the Royal College of Anaesthetists (UK), the American College of Critical Care Medicine and the Faculty of Intensive Care Medicine (UK).

Carol Peden | Women in Anaesthesia Apr 05, 2020

This week's Women In Anaesthesia focuses in on TopMedTalk favourite Carol Peden.

The British Journal of Anaesthesia article, which inspired this series, is here: https://bjanaesthesia.org/article/S0007-0912(20)30003-9/fulltext

--

"The Power of The Interdisciplinary Team"; introducing the Enhanced Recovery team from Keck Medical Center at The University of Southern California (USC).

Our guests kindly share an email address you can contact them on: Enhanced.Recovery@med.usc.edu

Presented by Desiree Chappell and Monty Mythen with their guests Professor Carol Peden, Robin Cresner, CCRN, Dr Shane Dickinson, anesthesiologist and Snow Shoo Son; The Enhanced Recovery Team from Keck Medical Center at USC.

--

Like this, want more?

There's a fascinating conversation with Carol Peden here: https://www.topmedtalk.com/talks-to-carol-peden/

TopMedTalk | African Surgical Outcomes Study (ASOS-2) Apr 04, 2020

This piece focuses upon the African Surgical Outcomes Study (ASOS-2). More than a thousand people across Africa have combined forces to make this research into perioperative medicine in a resource limited environment happen. We know patients in Africa are twice as likely to die following surgery when compared to the global average, why is this? How does "failure to rescue" play into this?

The website mentioned in this piece for more details: https://www.asos.org.za

Presented by Desiree Chappell with Monty Mythen and their guest Bruce Biccard, consultant anaesthetist at the University of Kwazulu-Natal, Director, Perioperative Research Unit, Department of Anaesthetics, Nelson R Mandela School of Medicine.

An update on patient, Professor Monty Mythen | COVID 19 Apr 04, 2020

This piece is a reliable first hand account of COVID 19, directly from a patient, our Editor in Chief Monty Mythen.

"This kind of reassurance that seemed to go with it, to seem to say to people: 'nah, nah, nah, it's ok; you've just got a bit of a sore throat and a bit of a dribbly nose, crack on!' Was not supported by the available evidence at all"

How is Monty feeling? What are the actual symptoms of COVID 19? Why has misleading information been apparently knowingly released regarding this? What are the details on The Nightingale Hospital in London? Further discussion includes best practice related to COVID 19 patient care including ventilatory strategies and fluid management. Previous information is reviewed in the light of new evidence. We also congratulate our partner in TopMedTalk Dr Henry Howe who has graduated today!

Presented by Desiree Chappell with Monty Mythen.

Dr Henry Howe featured on TopMedTalk here: https://www.topmedtalk.com/covid-19-uk-calls-on-medical-students-to-join-the-fight/

COVER IMAGE:

In this image: Colorized scanning electron #micrograph of an apoptotic cell (red) heavily infected with #SARS-COV-2 virus particles (yellow), isolated from a patient sample. Image captured at the @niaid Integrated Research Facility

Thank you to our sponsor Edwards Lifesciences.

Edwards clinical education (ECE): https://www.edwards.com/clinicaleducation

Professor Tim Cook, Bath, UK | COVID 19 Apr 03, 2020

"We're not a big teaching hospital [...] and I think there is a slightly different perspective..."

This piece focuses on the realities of preparing for and dealing with COVID 19 patients in the town of Bath in the UK. Innovation with staff training, cautionary tales regarding our advance warning of the current situation and fluctuating guidelines are the opening points of discussion before a fascinating deep dive into the potential merits of video laryngoscopy.

Further discussion includes reflections on the anaesthetics and forms of treatment which might be used in such a case.

Presented by Desiree Chappell and Monty Mythen with their guest Professor Tim Cook, Consultant in Anaesthesia and ICM, Royal United Hospitals, Bath.

Email us contact@topmedtalk.com

If you found this piece interesting there is more from Tim Cook here: https://www.topmedtalk.com/sunday-special-should-direct-laryngoscopy-be-consigned-to-the-history-books/

Thank you to our sponsor Edwards Lifesciences.

Edwards clinical education (ECE): https://www.edwards.com/clinicaleducation

Periop Medicine SIG | It's a team sport - panel discussion Apr 03, 2020

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 Notre Dame, Australia School of Medicine, Sydney and Don Campbell, Professor of Medicine at Monash University and Head of General Medicine at Southern Health.

TopMedTalk | Wireless wearables on the ward, the new www revolution? Apr 02, 2020

This piece dives into "The new www revolution?: Wireless Wearables on the Ward". Improving the monitoring of patients on the wards is an exciting prospect for any modern practitioner and as personal health monitoring technology becomes mainstream for the public it's surely an inevitable part of the future of medicine.

The website mentioned in the podcast is here: https://www.michardconsulting.com/

The Global burden of postoperative death - The Lancet is here: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(18)33139-8/fulltext?rss=yes

This paper in The Lancet is also mentioned: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(12)61148-9/fulltext

Presented by Desiree Chappell and Monty Mythen with their guest Frederic Michard of MiCo Consulting.

Like this, want more?

Our guest previously featured on TopMedTalk here:

https://www.topmedtalk.com/asa-2018-san-francisco-the-practical-applications-of-innovation/

Resource management, COVID patient management and innovation from New Jersey, USA | COVID 19 Apr 01, 2020

This piece takes a look at the frontline fight against COVID 19 at Penn Medicine Princeton Medical Center in New Jersey, USA. Details of airway, ventilation and hemodynamic management are discussed with the director of Critical care and Anesthesiology. Resource management is a clear front runner as the virus creates a public health emergency for medics to try to battle. Additional beds and treatment facilities are being prepared, what other innovations are being brought to the fore.

Presented by Desiree Chappell with Monty Mythen and their guests Michael Scott, M.B., Ch.B. Professor of Anesthesiology at the University of Pennsylvania, Jasmeet Bajaj, MD, Chief of Critical Care and Bridget Ruscito, MD Chair of the Dept of Anesthesiology at the Penn Medicine Princeton Medical Center and Jesse James Kiefer, MD, Anesthesiologist Assistant Professor of Clinical Anesthesiology and Critical Care at the University of Pennsylvania.

If you found this interesting listen to more on the topic here: https://www.topmedtalk.com/covid-19-epidemiology-revisited-a-case-for-virtual-meetings/

Thank you to our sponsor Edwards Lifesciences.

Edwards clinical education (ECE): https://www.edwards.com/clinicaleducation

TopMedTalk | Predicting and preventing intraoperative hypotension. Apr 01, 2020

Extended periods of intraoperative hypotension are firmly associated with harm. This piece looks into the detail behind concerns regarding hypotension. Are we now in a position where we can eliminate it entirely?

The paper mentioned in this piece, "Ability of an Arterial Waveform Analysis–Derived Hypotension Prediction Index to Predict Future Hypotensive Events in Surgical Patients", is here: https://journals.lww.com/anesthesia-analgesia/Abstract/publishahead/Ability_of_an_Arterial_Waveform_Analysis_Derived.96240.aspx

Presented by Desiree Chappell and Monty Mythen with their guest Thomas Scheeren, Chair Cardiovascular Dynamics Section at European Society of Intensive Care Medicine (ESICM).

Like this, want more?

Our work regarding hypotension is here: https://www.topmedtalk.com/?s=Hypotension

Ross Kerridge, University of Newcastle in Australia | COVID 19 Mar 31, 2020

In this piece we look at how Australia is dealing with the COVID 19 crisis. What restrictions are being placed upon people and how strict are they? How does "the father of perioperative medicine" see the world which is now being asked to face one of its most urgent medical emergencies? Has the time come to honour 'the whole team' in the institutions where we work? How can medics help to rebuild our societies after the already devastating consequences of a global pandemic?

Presented by Desiree Chappell with her guest Ross Kerridge, Senior Staff Specialist Anaesthetist Clinician at the John Hunter Hospital, Newcastle, Australia and Associate Professor at the University of Newcastle.

The article mentioned is here: https://www.newcastleherald.com.au/story/6699930/honouring-our-courageous-frontline-force-in-the-fight-against-covid-19/

Thank you to our sponsor Edwards Lifesciences.

Edwards clinical education (ECE): https://www.edwards.com/clinicaleducation

EBPOM 2019 | Preoperative risk stratification Mar 31, 2020

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/

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.

Roneet Lev, San Diego | COVID 19 Mar 30, 2020

This piece takes a look at the San Diego front line of the global fight against COVID 19. What unique pressures are there here; the large homeless population is a particular challenge, how do psychiatric patients further the conundrum. Also, what about the assumption that patients are likely to be carrying the virus so should all be treated as if that is the case, does that apply here?

There is also a short update on our Editor in Chief, another front line medical provider, who tested positive for Corona Virus last week.

Presented by Desiree Chappell with Roneet Lev, MD FACEP, Chief Medical Officer, White House Office of National Drug Control Policy Director of Operations, Scripps Mercy Hospital Emergency Department San Diego.

Thank you to our sponsor Edwards Lifesciences.

Edwards clinical education (ECE): https://www.edwards.com/clinicaleducation

Monty and Desiree weekend update | COVID 19 Mar 30, 2020

"We keep being told we're one to two weeks away from the peak..."

This piece takes a look at how Monty is getting on with his diagnosis, COVID 19 symptoms infamously vary in severity throughout the infection. Now he has been diagnosed how, if at all, will his behaviour change? What is the UK's policy on practitioners who are COVID 19 positive? Further discussion includes the news that 'rapid tests' are being introduced in the battle against the global pandemic as well as 'drive through' testing. How reliable are they, how might they work?

Presented by Desiree Chappell and Monty Mythen.

Thank you for your emails, if you would like to contribute to the discussion please do: contact@topmedtalk.com

Thank you to our sponsor Edwards Lifesciences.

Edwards clinical education (ECE): https://www.edwards.com/clinicaleducation

TopMedTalk | Global Perspectives on Perioperative Medicine Mar 30, 2020

Australia has an interesting history both generally and with perioperative medicine specifically. Here the story is told and their current progress is revealed. How do comparisons between various countries help us to understand where improvements can be made? How do the differences between the way in which healthcare is funded impact patients and providers?

Moderated by Dr Mark Edwards, University College London Hospital, with his guests Ross Kerridge, John Hunter Hospital, Newcastle, Australia, often cited as 'the father of Modern Perioperative Medicine', Sol Aronson, tenured professor at Duke University and Executive Vice Chairman in the Department of Anesthesiology, Mike Grocott, Professor of Anaesthesia and critical care at the University of Southampton.

Jamie Harris and Carol Schmidt | Women in Anaesthesia Mar 29, 2020

"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?

Presented by Desiree Chappell with co-host Korey Sprigman and their guests, Jamie Harris, CRNA, Hillcrest Hospital, Tulsa, Oklahoma and Carol Schmidt, CRNA, Royal Oak, Michigan.

The British Journal of Anaesthesia article, which inspired this series, is here: https://bjanaesthesia.org/article/S0007-0912(20)30003-9/fulltext

TopMedTalks to ... | Michael Pedro Mar 28, 2020

This piece focuses on the SuperNO2VA mask, which delivers positive airway pressure to stent open the upper airway, allowing for the preoperative delivery of positive pressure ventilation and oxygen for patients with a decreased level of consciousness.

The website mentioned in the piece is here: https://www.vyaire.com/

Presented by Desiree Chappell with Monty Mythen and Michael Pedro, VP, Medical Director at Vyaire Medical.

Professor Monty Mythen has tested positive | COVID 19 Mar 27, 2020

"It is interesting how well you can feel, compared to the night time [...] it gives you this real false sense of wellness for a period of time and then it hits you, man it hits you hard, when it hits you."

The UK Prime Minister has tested positive for COVID 19 as has The UK's Health Secretary, Matt Hancock, MP. Yesterday we revealed there were concerns our Editor in Chief Monty Mythen had some of the symptoms, only days before he was set to return to active duty in Critical Care. Acting responsibly precautions were already being taken and the assumption was that it was likely, given its profusion in London where he lives, that he had the new virus. The test results confirmed that last night.

Also on this podcast we get into further discussion regarding Continuous Positive Airway Pressure (CPAP), something which we have discussed a lot in this series, see links below.

There is also an assortment of questions from the audience, if you'd like to add your thoughts to one of next week's podcasts email us now: contact@topmedtalk.com

Presented by Desiree Chappell with Monty Mythen, Editor in Chief of TopMedTalk.

The European Society of Anaesthesiology (ESA) webinar was here: https://www.esahq.org/event/webinar-on-covid-19/

Thank you to our sponsor Edwards Lifesciences.

Edwards clinical education (ECE): https://www.edwards.com/clinicaleducation

Critical Care Update; optimizing care for patient and provider | COVID 19 Mar 27, 2020

"When you start to think about how we can protect ourselves; we have some reasonably robust literature for a few interventions [..] that do seem to associate with the prevention of viral infections..."; maintain a normal vitamin D level, probiotics, vitamin C.

This piece is a fascinating conversation with a TopMedTalk favorite. How are preparations going at Duke University? How can we optimise ourselves for an oncoming viral attack? How can we make sure our patients get the best possible care and are as informed as they can be? What research is being carried out into COVID 19?

Presented by Desiree Chappell with her guest Paul Wischmeyer, Professor of the Department of Anesthesiology and Critical Care, Duke University.

Thank you to our sponsor Edwards Lifesciences.

Edwards clinical education (ECE): https://www.edwards.com/clinicaleducation

EBPOM 2019 | Psychology and behavioural change Mar 27, 2020

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 depression have been shown to effect outcomes.

How can psychological behaviour change techniques be embedded into encouragement to involve themselves in exercise training in advance of their operation?

For more on the Wesfit trial go here: http://www.wesfit.org.uk/

Presented by Chloe Grimmett, National Institute of Health Research (NIHR) post-doctoral Research Fellow and Senior Research Fellow for the Macmillan Survivorship Research Group at the University of Southampton; behavioural science lead for Wessex-Fit-for Surgery (WesFit) trial, a large randomised controlled trial of physical and psychological prehabilitation prior to cancer surgery and is a member of the National Cancer Research Institute clinical studies Lifestyle and Behaviour Change Group and the NIHR Cancer and Nutrition Collaborative.

UK calls on medical students to join the fight | COVID 19 Mar 26, 2020

The UK's fight back is now underway; the 'lockdown' is being largely adhered to and the efforts to support the National Health Service (NHS) from the public, medical students and retired professionals is inspiring to many.

This piece takes a look at the realities of students being given the chance to graduate and practice their skills a little earlier than previously planned.

Presented by Desiree Chappell with her guest, Henry Howe, a medical student at Bristol University, a frequent contributor and partner to TopMedTalk.

Thank you to our sponsor Edwards Lifesciences.

Edwards clinical education (ECE): https://www.edwards.com/clinicaleducation

TopMedTalk | The psychology of change Mar 26, 2020

"There seems to be a little extra buzz in the cardiac community".

This conversation focuses upon the psychology of change, specifically regarding the leadership role presented within perioperative medicine to anaesthesiologists. How can perfectionism, as a barrier to change, be overcome? How do practitioners build the confidence to make a difference? Furthermore, how do we engage in 'internal marketing' where we promote success within our own institutions?

More information on The Morpheus Consortium here: http://morpheusconsortium.org/

Check out the article here: https://jamanetwork.com/journals/jamasurgery/fullarticle/2732511

Find out more about NorthStar here: https://northstaranesthesia.com/

The "Masters of Scale" podcast is here: https://mastersofscale.com/

This piece was originally released live from "ERAS cardiac: Center of excellence training conference", an Edwards Life Sciences sponsored conference in North Carolina.

Presented by Monty Mythen and Desiree Chappell with their guest Bob Booth, Regional Chief Medical Officer, Vice President of Physician Operations at NorthStar Anesthesia, P.A.

Like this, want more?

Brian Woods from NorthStar features on TopMedTalk here: https://www.topmedtalk.com/topmedtalk-the-goal-is-more-important-than-the-role/

Does one of our team have COVID 19? | COVID 19 Mar 25, 2020

"I work in a houshold where my wife was working at a school and my student children have come home so, it's highly likely that I would get COVID 19"; the conversation begins with a discussion about the fact our Editor in Chief Monty Mythen has had some of the symptoms over the last few days. "For us as healthcare workers what we need to do is filter out the true head colds from the COVID 19s"; the symptoms could be caused by a number of factors but until a clear test result is available he is taking precautions.

It underlines the need for practitioners to adhere to distancing guidelines as the conversation moves to an update on the UK's measures to tackle the pandemic and how the global fight continues.

The "Nightingale Hospital" is covered in more detail here: https://www.telegraph.co.uk/global-health/science-and-disease/coronavirus-uk-lockdown-latest-news-non-essential-shops-close/

Presented by Desiree Chappell with Monty Mythen.

How is the fight against COVID 19 going where you are? We are very grateful to everyone who has emailed us since the crisis began. If you would like to reach out to TopMedTalk email contact@topedtalk.com

The clip of Professor Hugh Montgomery was taken from Coronavirus: How to Isolate Yourself, Channel 4. Find the full programme here: https://www.channel4.com/programmes/coronavirus-how-to-isolate-yourself

The UK Prime Minister's statement is available in full here: https://www.youtube.com/watch?v=iF5gpoj1lwg

Thank you to our sponsor Edwards Lifesciences.

Edwards clinical education (ECE): https://www.edwards.com/clinicaleducation

TopMedTalk | The Enhanced Recovery After Cardiac Surgery Society Mar 25, 2020

This piece focuses in upon the important work being done by The Enhanced Recovery After Cardiac Surgery Society, specifically the new guidelines which were published in May 2019. Furthermore, how is the society going to move forward, will it continue to push for a sensible combination of both care providers and academics and what areas of focus are most impactful when it comes to improving care and helping implementation?

The article discussed in this piece "Guidelines for Perioperative Care in Cardiac Surgery, Enhanced Recovery After Surgery Society Recommendations" is here: https://jamanetwork.com/journals/jamasurgery/fullarticle/2732511?guestAccessKey=04f7090d-122c-4e94-a46f-22e49dab7c51

The Enhanced Recovery After Cardiac Surgery website is here: https://www.erascardiac.org/

Presented by Desiree Chappell with her guest Kevin Lobdell, Director of Regional CVT Quality, Education, and Research.

From the frontlines- Atilla Kett in New Jersey, USA | COVID 19 Mar 24, 2020

"The guidelines, in fact, I found most useful were the Royal College's guidelines, all those info graphics and all those protocols"

This piece is an emotional conversation with a TopMedTalk favourite; how are things going in New Jersey? Has elective surgery come to a halt yet? What innovations are being deployed by medics are they face a global pandemic? What are the unique pressures which medics are being called upon to deal with in this crisis?

The collaborative resource from the UK https://icmanaesthesiacovid-19.org/

The Royal College of Nursing’s webpage regarding Personal Protection Equipment (PPE) is here: https://rcni.com/hosted-content/rcn/first-steps/personal-protective-equipment

Also, the recently released useful conversation about Oxygen shortages Dr Kett mentions - which featured Mike Grocott - can be found here: https://www.topmedtalk.com/covid-19-uk-southampton-and-london-mike-grocott-and-monty/

Presented by Desiree Chappell with Attilla Kett, Chair of Anesthesia at St Peter's University Hospital, New Brunswick, New Jersey.

Thank you to our sponsor Edwards Lifesciences.

Edwards clinical education (ECE): https://www.edwards.com/clinicaleducation

Epidemiology revisited - a case for virtual meetings | COVID 19 Mar 23, 2020

“The first case of COVID in China was the 8th of December…” this piece looks at the outbreak of the disease from the perspective of healthcare workers in Italy. Focusing on the community health approach to controlling this pandemic, our guest emphasizes the importance of understanding the epidemiology of COVID- 19.

Mirco Nacoti, Department of Anesthesia and Intensive Care, Pediatric Intensive Care Unit, Papa Giovanni XXIII Hospital, Bergamo, Italy, was subsequently featured in the New England Journal of Medicine where he along with Andrea Ciocca and Maurizio Cereda wrote this excellent article: https://catalyst.nejm.org/doi/full/10.1056/CAT.20.0080

Please share this information with as many colleagues and friends as you can. TopMedTalk is working with you, our listeners, to raise awareness at this crucial time.

REMINDER: PLEASE stop having in person meetings with administrators and departments to help stop the spread of CV19.

Presented by Monty Mythen and Desiree Chappell.

This podcast was originally released as part of a longer podcast which you can listen to here: https://www.topmedtalk.com/covid-19-you-must-learn-the-epidemiology/

Thank you to our sponsor Edwards Lifesciences.

Edwards clinical education (ECE): https://www.edwards.com/clinicaleducation

If you're still having face to face meetings - STOP NOW! | COVID 19 Mar 23, 2020

"'The disease is not complicated, the biology is not complicated, the treatment is not that complicated; our behavior patterns and our understanding of what it is truly like to be in a pandemic is the complicated bit' ... 'Yeah, this is not a drill'": the firm message in this piece is clear, use the internet and stop your face to face departmental meetings now.

More broadly we ask; how are things going in North Carolina, Louisville and London? Has elective surgery been cancelled yet? How are people facing the issue of personal protective equipment (PPE)? London practitioners are assuming they themselves have the virus, is this the case everywhere else? How are staff roles being changed in anticipation of the problem?

There's also a very frank conversation about the personal risks practitioners are being asked and deciding to take. Should they acknowledge and talk about their safety for both themselves and their loved ones? We wrap on a conversation about the reported interest in smoking cessation that has grown in the last few days.

Presented by Desiree Chappell and Monty Mythen with TopMedTalk regular and occasional co-host, Sol Aronson, tenured Professor at Duke University.

Thank you to our sponsor Edwards Lifesciences.

Edwards clinical education (ECE): https://www.edwards.com/clinicaleducation

UK, Southampton and London: Mike Grocott and Monty | COVID 19 Mar 22, 2020

This conversation sets the scene for the UK. London now having some hospitals which are overwhelmed, other parts of the UK still in the anticipation period. The conversation moves to the importance of enhanced recovery after surgery and its immediate relevance to the COVID 19 crisis. Then the topic of Personal Protection Equipment (PPE) is raised, possible shortages are discussed. The debate about non invasive ventilation, continuous positive airwave pressure (CPAP) and optiflow techniques. Oxygen economy is one thing to consider, service providers may face issues over this vital resource.

Presented by Monty Mythen with his guest Mike Grocott, occasional TopMedTalk anchor and Professor of Anaesthesia and critical care at the University of Southampton.

Thank you to our sponsor Edwards Lifesciences.

Edwards clinical education (ECE): https://www.edwards.com/clinicaleducation

TopMedTalk | Silent pandemic of surgical complications Mar 22, 2020

This remarkably prescient conversation was recorded at an Australian National Summit in Adelaide regarding the 'hidden pandemic of postoperative complications'. The dangers presented by them certainly suggest this area needs to be taken more seriously. Although staged in Australia this conversation is of global concern, particularly at a time when the world is realising the benefits of proper perioperative care.

For more about the National Emergency Laparotomy Audit go here: https://www.topmedtalk.com/ebpom-2018-12-the-importance-of-cpet-and-nela/

The article mentioned in this piece is here: https://bjanaesthesia.org/article/S0007-0912(18)30654-8/abstract

There's a good piece about the summit here: http://theleadsouthaustralia.com.au/industries/health-and-medical/summit-targets-post-op-pandemic/

Presented by Monty Mythen and Mike Grocott with their guest Guy Ludbrook Professor of Anaesthesia at the University of Adelaide and Royal Adelaide Hospital.

Carolyn Johnston | Women in Anaesthesia Mar 22, 2020

What are the benefits of Cardio Pulmonary Exercise Testing (CPET) in cancer patients? What is the evidence that suggests prehabilitation changes outcomes? Furthermore, what is the National Emergency Laparotomy Audit (NELA) and what are its benefits?

Presented by Joff Lacey and Desiree Chappell with their guests; Carolyn Johnston, consultant Anaesthetist in St Georges hospital in London and Improvement lead for the National Emergency Laparotomy Network (NELA.org.uk) and Malcolm West, National Institute for Health Research (NIHR) funded clinical lecturer in surgery and honorary colorectal surgical specialist registrar at the University of Southampton, United Kingdom.

Join in the debate: contact@topmedtalk.com

The British Journal of Anaesthesia article, which inspired this series, is here: https://bjanaesthesia.org/article/S0007-0912(20)30003-9/fulltext

EBPOM Highlight | Enhanced Recovery After Cardiac Surgery Mar 21, 2020

"Enhanced Recovery After Cardiac 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

If you have any comments or questions you'd like to send to the team email: contact@topmedtalk.com

Daniel Engelman is the Medical Director of the Heart, Vascular and Critical Care Units at Baystate Medical Center. He is an Associate Professor of Surgery at The University of Massachusetts-Baystate. He started the ERAS® Cardiac Collaborative to internationally standardize best practices.

USA, North Carolina: Vicki Morton joins Desiree and Monty | COVID 19 Mar 21, 2020

This piece is a detailed and reassuring look at how preparations are being made in North Carolina by our occasional host and regular contributor Vicki Morton. "I was told a few weeks ago [that] my focus was shifting to Covid preparedness"; hear how a taskforce was put together to prepare for the global pandemic. "Various different countries have been in denial" but now the fight back has begun in ernest. Will testing kits be made more widely available soon?

Questions for our listeners: Could a 'remote buddy system' - facilitated by online facetime or video communication - help practitioners to put on personal protection equipment in your practice? Do you have creative ways of dealing with children off school and the current pressures other providers like you might face? Are you prepared for more patients were you work? Do you consider cohorting to be the way forward? What are your thoughts on the plans where you work? Please email us: contact@topmedtalk.com and we will share them with the audience.

Presented by Monty Mythen and Desiree Chappell with Vicki Morton, Director of Clinical and Quality Outcomes at Providence Anesthesiology Associates, P.A.

Our conversation with Dan Martin is here: https://www.topmedtalk.com/covid-19-oxygen-economy-cpap-and-ventilators/

Our guest kindly shared her email with us: Vicki.Morton@provanesthesiology.com

Thank you to our sponsor Edwards Lifesciences.

Edwards clinical education (ECE): https://www.edwards.com/clinicaleducation

Oxygen economy, CPAP and ventilators | COVID 19 Mar 20, 2020

Our guest is an intensivist and specialist in dangerous transmissible diseases as well as being one of the scientists who took part in the Xtreme Everest expedition which investigated the effects of human tolerance of hypoxia.

What about continuous positive airway pressure (CPAP)? Information suggests this may be more useful as we head into the pandemic stage "based on the experience the Italians are describing to us".

This piece looks at how the UK is preparing to tackle the global pandemic before asking some important questions about oxygen supplies. There's a tendency for people to use more rather than less, should we look to reverse this? "We give people a range to put their oxygen saturation between and people naturally want to go for the higher end of that target," in this time of crisis and potential shortages is it important to change that habit?

"The whole National Health Service has changed its thinking..." the piece wraps with some thoughts about how enticing it is to see the UK's Government and health service move to stop medics being bound by red tape and overly strict guidelines.

Presented by Monty Mythen with his guest Dan Martin, OBE, Anaesthetist and Intensivist at the Royal Free Hospital and Reader at University College London (UCL).

Link to the story about the Critical Care Nurse who attracted the nation's sympathy in the press recently: https://www.standard.co.uk/news/uk/nurse-urges-public-stop-panic-buying-dawn-bilbrough-a4392596.html

For more of our COVID 19 coverage go here: https://www.topmedtalk.com/covid-19/

Thank you to our sponsor Edwards Lifesciences.

Edwards clinical education (ECE): https://www.edwards.com/clinicaleducation

EBPOM 2019 | Multimodal prehabilitation to prevent postoperative delerium and other complications in elderly patients after elective major abdominal surgery. Mar 20, 2020

Can delirium, the most frequent complication in an elderly patient, be tackled with multimodal prehabilitation? This piece explains how that challenge is being investigated at the moment. A link to the paper is here: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6564537/

Presented by Ties Lukas Janssen, General Surgery Resident at Amphia Ziekenhuis.

From the front line; Desiree and Monty | COVID 19 Mar 19, 2020

Desiree and Monty update each other on how it's going as both the US and UK healthcare services prepare for, and begin battle with, COVID 19. School closures in both the UK and the US; how do the practicalities of cancelling school attendance impact upon frontline providers? What do comparisons with other countries tell us about the oncoming tsunami?

Presented by Monty Mythen and Desiree Chappell.

Link to Hugh Montgomery's piece: https://www.topmedtalk.com/covid-19-hugh-montgomery-north-london-uk/

Link to NEJM: https://www.nejm.org/coronavirus

How to use PPE by The Center for Disease Control: https://www.youtube.com/watch?v=Ca66dpjPWZc

Desiree's tweet: https://twitter.com/ChappellDesiree/status/1240480154117451776

Thank you to our sponsor Edwards Lifesciences.

Edwards clinical education (ECE): https://www.edwards.com/clinicaleducation

Fitter Better Sooner | ASA 2019 Mar 19, 2020

A large part of the journey towards enhanced recovery, better outcomes and fewer complications, is to do with educating patients. How do we explain to patients that an operation is something which is ideally a collaboration between both practitioner and patient?

The "Fitter, Better, Sooner" toolkit, which this piece focuses on, 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 Royal College of Anaesthetists.

Go here for some of TopMedTalk's COVID-19 coverage: https://www.topmedtalk.com/covid-19-you-must-learn-the-epidemiology/

TopMedTalk | Enhanced Recovery Mar 18, 2020

"Thank you for taking this meeting beyond these walls" - this piece was the final part of our coverage of The American Association of Nurse Anesthetists (AANA) 2019 Annual Congress in Chicago, Illinois. We begin with the global audience in mind and break down what it is to be a Nurse Anesthetist. It's a role which is expanding in scope, our guest walks us through how and why that's the case.

This wide ranging conversation then moves to the future of enhanced recovery and the AANA's future development.

For more on the Drink Eat Mobilise topic go here: https://www.topmedtalk.com/periop-coach-2-02-eras-whats-the-secret-sauce/

Check out the AANA here: https://www.aana.com/

Presented by Desiree Chappell and Monty Mythen with their guest Lynn Reede, Associate Clinical Professor, Northeastern University Nurse Anesthesia Program.

Dingle update | COVID 19 Mar 17, 2020

"The parade here in Dingle is usually the first in Ireland..." but this year it is postponed. We speak to a Councillor in Dingle, a place much loved by many TopMedTalk listeners who attend the annual Evidence Based Perioperative Medicine (EBPOM) conference there.

Monty Mythen is joined by Cllr. Breandán Fitzgerald, County Councillor on Kerry County Council.

Thank you to our sponsor Edwards Lifesciences.

Edwards clinical education (ECE): https://www.edwards.com/clinicaleducation

"We can't be overprepared" | COVID 19 Mar 17, 2020

"Maintaining your staffing is key"; this piece is a conversation recorded immediately after a deeply concerning report regarding the situation in Bergamo, Italy. The risk of overwhelm at our institutions is present as the understanding sinks in regarding the fact this is a massive population health issue.

Presented by Desiree Chappell and Monty Mythen with their guests Dr Michael Scott, Professor of Anesthesiology at Virginia Commonwealth University, Maurizio Cereda, Associate Professor at Hospital of the University of Pennsylvania.

The conversation which preceded this is here: https://www.topmedtalk.com/covid-19-you-must-learn-the-epidemiology/

Thank you to our sponsor Edwards Lifesciences.

Edwards clinical education (ECE): https://www.edwards.com/clinicaleducation

"This is the level of the situation" | COVID 19 Mar 17, 2020

Preparations in London and the US are discussed before a frontline report regarding Italy and the consequences of the pandemic there.

Presented by Desiree Chappell and Monty Mythen with, Dr Michael Scott, Professor of Anesthesiology at Virginia Commonwealth University, Maurizio Cereda, Associate Professor at Hospital of the University of Pennsylvania and Andrea Ciocca from Naples.

This conversation preceeded the one in this piece here: https://www.topmedtalk.com/covid-19-you-must-learn-the-epidemiology/

Thank you to our sponsor Edwards Lifesciences.

Edwards clinical education (ECE): https://www.edwards.com/clinicaleducation

TopMedTalk | Automation and artifical intelligence Mar 17, 2020

This piece focuses upon the increasing development of artificial intelligence and automation within the medical profession. Can automated monitoring actually allow practitioners to live more "in the moment" while in the operating theater? How do we use algorithms to avoid information overload?

The book "Deep Medicine: How Artificial Intelligence Can Make Healthcare Human Again", your "anxiety antidote" to the AI discussion, is here: https://www.amazon.co.uk/Deep-Medicine-Artificial-Intelligence-Healthcare/dp/1541644638

This piece was originally streamed from ‘The Society of Cardiovascular Anesthesiologists’ (SCA) annual conference, 2019.

Presented by Desiree Chappell and Monty Mythen with Sol Aronson, Tenured Professor, Duke University and Executive Vice Chairman in the Department of Anesthesiology, and their guest Tjorvi Perry, Assistant Professor, Department of Anesthesiology, University Minnesota.

COVID 19 | Hugh Montgomery - North London UK Mar 16, 2020

"There hasn't been any griping, there hasn't been any ill temper and people are coming in to help out in any way..." this piece gives us an idea of how things are going in the UK, in this instance in Whittington, North London. A sense of preparation is in the air. Looking at other countries and the epidemiology "we're about to reach the inflection point when a little trickle of cases [become] a flood".

How can lessons from other nations help our preparation process? Should 'social isolation' be adopted by more potential service users? Why is this crisis so important for the UK to handle correctly? Is it currently more of a 'population health' issue than anything else?

Also, what about healthcare professionals, how should the care both for themselves and their patients? Will lessons learned regarding 'burn out' and self-care be learned and applied at this crucial time?

Presented by Monty Mythen with his guest Hugh Montgomery, Intensive Care Society Board Member and, Professor of Cardiovascular Genetics and Critical Care University College London.

There's a useful information hub referenced in this interview here: https://icmanaesthesiacovid-19.org/

Information Hub for the Intensive Care Society regarding COVID19: https://www.ics.ac.uk/COVID19.aspx?hkey=d176e2cf-d3ba-4bc7-8435-49bc618c345a&WebsiteKey=10967510-ae0c-4d85-8143-a62bf0ca5f3c

If you would like to contribute to TopMedTalk's ongoing coverage of the global crisis presented by COVID-19 please email: contact@topmedtalk.com

Thank you to our sponsor Edwards Lifesciences.

Edwards clinical education (ECE): https://www.edwards.com/clinicaleducation

"You must learn the epidemiology" | COVID 19 Mar 16, 2020

"The first case of COVID in China was the 8th of December..." this piece looks at the outbreak of the disease from the perspective of healthcare workers in both Hong Kong and Italy. It starts with a summary of a conversation with Professor Mike Irwin, University of Hong Kong. We then move to a conversation with Mirco Nacoti, specialist intensivist at Bergamo, Italy.

Presented by Monty Mythen and Desiree Chappell.

This piece is part of a longer conversation, which will be available in full soon.

Thank you to our sponsor Edwards Lifesciences.

Edwards clinical education (ECE): https://www.edwards.com/clinicaleducation

COVID19 | Desiree and Monty Mar 16, 2020

This piece is the first in a new series of programs we are making in response to COVID-19, now described by The World Health Organisation as a global pandemic.

How can we, the TopMedTalk community, rise to this challenge and help each other as we share information and experiences? Where can people look for the sort of information they would ordinarily have gained from the conference circuit this year? How can listeners to TopMedTalk get involved directly with us?

Presented by Desiree Chappell and Monty Mythen.

Thank you to our sponsor Edwards Lifesciences.

Edwards clinical education (ECE): https://www.edwards.com/clinicaleducation

Angela Bader | Women in Anaesthesia Mar 15, 2020

Does perioperative medicine alow institutions to take a broader view? Population health has been a theme on TopMedTalk, is it a logical extension of the perioperative process? How do we manage specialist care for the elderly and ensure high quality shared decision making? What lies behind the mindset change needed for some to accept surgery is not always the answer? Should we expect medical students to be taught the principles of perioperative medicine? What are some of the unique tensions in the US system that can frustrate the adoption of a truly perioperative practice? Presented by Desiree Chappell and Monty Mythen with their guest Angela Bader, Vice Chair of Perioperative Medicine at Brigham and Women's Hospital. The British Journal of Anaesthesia article, which inspired this series, is here: https://bjanaesthesia.org/article/S0007-0912(20)30003-9/fulltext

Joe Kiani | TopMedTalks to... Mar 14, 2020

The concern for patient safety naturally flows throughout the healthcare continuum. In our discussion with Masimo Founder, Joe Kiani, we discuss the 'planning for zero’ initiative and how we can realistically reach perfection in this area.

The Patient Safety Movement Foundation is an organization dedicated to a goal of ZERO in-hospital preventable deaths by 2020. They request that you and your organization get involved and commit to this goal. Find out more at www.patientsafetymovement.org

Presented by Desiree Chappell and Monty Mythen with their guest Joe Kiani, Founder, Chairman & CEO of Masimo, Cercacor & Patient Safety Movement Foundation.

EBPOM Highlight | ERAS Colorectal surgery Mar 13, 2020

"ERAS in Colorectal Surgery" - was 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 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 Anthony Senagore, Professor and Vice Chair Western Michigan University-Homer Stryker MD School of Medicine Borgess Medical Center Kalamazoo, MI.

TopMedTalk | Simulation in Education Mar 12, 2020

Learn how and why the benefits of real-life health care simulation situations are used by institutions such as Northern Kentucky University. Interviewing a patient, reading an X-ray, or administering an injection, in a convincing virutal environment. The St. Elizabeth Healthcare Simulation Center features seven simulation rooms including an operating room and intensive care unit.

What are the future applications we can look forward to? Furthermore how is the AANA developing the way in which simulation is used to train anesthesia providers?

Checkout the Simulation Centre here: https://nku.edu/ihi/health-innovation-center-2/simulation-center.html

Our guest kindly shares their email: Kendonb1@nku.edu

This piece was part of our coverage of The American Association of Nurse Anesthetists (AANA) 2019 Annual Congress in Chicago, Illinois.

Check out the AANA here: https://www.aana.com/

Presented by Desiree Chappell with Monty Mythen and their guest Brett Kendon, DNP, CRNA, CHSE, Assistant Clinical Professor, Assistant Program Director, Nurse Anesthesia Program, Northern Kentucky University.

The evolution of cardiac surgery | SCA 2019 Mar 11, 2020

How do cardiac surgeons adapt to the changing environment and information that we now have at our fingertips? Minimally invasive robotic surgery provides additional options to the perioperative patient, what unconventional therapies might compliment this? This piece gets into specifics regarding pain management and the multimodal approach. How do you prepare patients with an understanding regarding how and what you're doing? How important is collaboration with surgical colleagues?

This piece is presented by Desiree Chappell and Sol Aronson with their guest Himani Bhatt, Director of Cardiovascualar Anaesthesia at Mount Siani, Ichan School of Medicine, Assistant Professor of Cardiac Anesthesiology, at The Mount Sinai Hospital.

The malnourished surgery patient | The RoundTable Mar 10, 2020

This piece focuses on the article "The malnourished surgery patient, a silent epidemic in perioperative outcomes?" which you can find here: https://journals.lww.com/co-anesthesiology/Abstract/2019/06000/The_malnourished_surgery_patient__a_silent.23.aspx

The Perioperative Quality Initiative is here: www.poqi.org

Presented by Desiree Chappell with Monty Mythen and their guests Jeroen Molinger, Clinical Medical Exercise Physiologist at Duke University Medical Center, Department of Anesthesiology & ICU and John Whittle, assistant Professor at Duke University Medical Centre.

Physiological Principles of Goal Directed Fluid Therapy | Perioperative Coach Mar 09, 2020

This podcast covers the physiological principles of goal directed fluid therapy, fluid responsiveness, the stressed system and the glycocalyx.

Originally streamed live on www.topmedtalk.com

Presented by Dr Joff Lacey with his guest Dr Randall Dull of the University of Illinois, live from the ASA in 2017.

TopMedTalk | Mike Grocott's 2020 vision Mar 08, 2020

This piece takes a look at some of the big areas we expect to see over the next twelve months as Desiree Chappell and Monty Mythen are joined in the studio by TopMedTalk favourite Mike Grocott, Professor of Anaesthesia and critical care at the University of Southampton.

Could political change and necessity improve things in the UK? Hopefully this time next year will be a "champagne moment" rather than a "sham moment". As expected, the interest in prehabilitation over this year has been huge and the momentum seems likely to continue in 2020. Find out more about the Prehabilitation World Congress soon on the EBPOM website: https://www.ebpom.org

New listeners are encouraged to listen to the wide range of discussions we've had on this fascinating topic by going here: https://www.topmedtalk.com/?s=prehabilitation

Also, oxygen therapy has been a growing topic and we expect to hear more over the year; check out our work so far here: https://www.topmedtalk.com/?s=oxygen

The article we mention in this piece is here: "Hidden pandemic of postoperative complications—time to turn our focus to health systems analysis" https://bjanaesthesia.org/article/S0007-0912(18)30654-8/abstract

Ramani Moonsinghe | Women in Anaesthesia Mar 08, 2020

Learn here about The 2nd Sprint National Anaesthesia Project: Epidemiology of Critical Care provision after Surgery (SNAP-2: EpiCCS).

Is anxiety the worst thing about an operation? How common a problem for patients is feeling thirsty? What about pain, how do we best manage it?

In the second part of the piece we a focus on "Women in Anaesthesia"; Is there an 'opportunity gap'? How do we correct imbalances in the profession? Most importantly, how do we avoid "tokenism"?

Is there room for a 'name and shame' strategy if we attend a meeting where there is a clear lack of gender balance or is that likely to be unhelpful?

Check out the Athena SWAN (Scientific Women's Academic Network) charter here: https://www.ecu.ac.uk/equality-charters/athena-swan/

The edition of the BJA which has inspired this series is here: https://bjanaesthesia.org/article/S0007-0912(20)30003-9/fulltext

This piece was originally recorded live at the 5th Collaborative Clinical Trials in Anaesthesiology Meeting, Prato, Italy.

Presented by Desiree Chappell with Monty Mythen and Ramani Moonesinghe, Professor of Perioperative Medicine at University College London (UCL).

EBPOM 2019 | "My experience ... of esophageal cancer" Mar 07, 2020

"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 a similar situation and have agreed to be a point of contact for patients and their families, be able to offer reassurance and support at your practice?

Someone your patient can rely on who can honestly say to them; 'Yes, I know exactly what you mean, I know exactly how that feels'.

The Macmillan Cancer Support website is here: https://www.macmillan.org.uk/

Presented by Mo Cottrell, a retired nurse who underwent a 5 week course of Chemoradiotherapy followed by successful surgery for Oesophageal Cancer at Southampton General Hospital in January 2017.

SCA | Improving your practice Mar 06, 2020

Hear how evidence based practices can reduce costs and improve outcomes. What are the key areas most institutions can work on to get the best and most rapid return on time invested? Neuro, atrial fibrillation, acute kidney injury (AKI) and blood management are big key areas.

The article discussed in this piece is here: https://www.scahq.org/Portals/0/Documents/Clinical%20Practice%20Guidelines/SCA_EACTA%20Practice%20Advisory.pdf

This piece was recorded live at 'The Society of Cardiovascular Anesthesiologists' (SCA) annual conference, 2019. The SCA website is here: https://www.scahq.org

Also in this piece, what's the future for the SCA? Where will their focus be as they increase the value of being an SCA member?

The Perioperative Quality Initiative (POQI) is here: https://thepoqi.org/

Presented by Desiree Chappell with her guests Andy Shaw, President of The Society of Cardiovascular Anesthsiology and Nanette Schwann, Cardiothoracic Anesthesiology, Critical Care Medicine, Professor and Vice Chair of Research and Education at Lehigh Valley Health Network.

TopMedTalk | Daniel Conway and the surgery school Mar 05, 2020

Enhanced Recovery After Surgery, (ERAS) is a familiar concept to the typical TopMedTalk listener but what is ERAS+?

How can you target high risk surgery patients with a comprehensive plan for them to help themselves get a better outcome? From managing expectations, to breathing exercises all the way up to significant lifestyle changes such as exercise and smoking cessation.

The ERAS+ website is here: https://www.erasplus.co.uk/

Presented by Joff Lacey with Desiree Chappell with their guest Daniel Conway, Consultant in Anaesthesia and Critical Care, Perioperative Medicine lead, Manchester Biomedical Research Centre.

EBPOM Highlight | Detecting and managing frailty Mar 04, 2020

Frailty is a common condition which has been topical in geriatric medicine for some time but now it is appearing in the surgical and anaesthetic literature. This talk explores how our understanding and discussion has improved regarding a condition that is still yet to have a clear, universally accepted, definition. How do we build a patient's physical reserve? What is the best way to conceptualise frailty? Are there any universal treatments available?

Presented by Dr Jugdeep Dhesi, Clinical Lead, POPS and Consultant Geriatrician, Guys and St Thomas' NHS Trust.

EBPOM 2019 | System wide change for prehabilitation Mar 03, 2020

Should prehabilitation be thought of also as "primary prevention" and used to avoid health problems occuring in the first place? If "exercise is real medicine" how do we change the culture so GPs are comfortable prescribing physical activity to patients? How can we get people to exercise more when the political mood is turning against Government interference and the so-called "nanny state"? What is 'the business case' for prehabilitation?

Co-chaired by Mike Grocott and Stefan van Rooijen and featuring: Graciela Martinez-Palli, Consultant in the Department of Anaesthesia and Perioperative Care at Hospital Clinic, Barcelona; Anna Lowe, Programme manager, National Centre for Sport and Exercise Medicine, Lead Allied Health Physical Activity Clinical Champion at Public Health, England; John Moore, Clinical Head of the Division of Anaesthetics, Peri-operative medicine and Critical Care at Manchester University Hospital NHS Foundation Trust; Sarah Ruane, Sport England’s national lead for health, she joined in January 2016 from local government where she oversaw public health, leisure and cultural services.

Introduction | Women in Anaesthesia Mar 02, 2020

This is TopMedTalk's first in a our series 'Women in Anaesthesia': a celebration of the women who drive academic research and perioperative practice around the world. Inspired by the British Journal of Anaesthesia's March edition of the same name this series will profile some of the women who take frontline roles in our profession, all of them contributors to TopMedTalk.

Angela Bader features on TopMedTalk here: https://www.topmedtalk.com/perioperative-medicine-summit-2019-1-03-angela-bader/

Carolyn Johnston features here: https://www.topmedtalk.com/ebpom-2018-12-the-importance-of-cpet-and-nela/

Ramani Moonsinghe's interview in this piece will be released next week but if you'd like to hear one of her other appearances go here: https://www.topmedtalk.com/ebpom-highlight-1-03-sprint-national-anaesthesia-project-snap/

Presented by Desiree Chappell.

The British Journal of Anaesthesia article, which inspired this series, is here: https://bjanaesthesia.org/article/S0007-0912(20)30003-9/fulltext

Bill Clinton at the World Patient Safety, Science & Technology Summit | Sunday Special Mar 01, 2020

Global health is something TopMedTalk listeners are naturally passionate about; here you can listen to the keynote address from the 42nd President of The United States, Bill Clinton, to the World Patient Safety, Science & Technology Summit.

273,077 lives have been saved over the last 7 years with over 90,000 of those in just the last year alone. 4,700 hospitals around the world that are part of this effort. 89 technology companies have committed to share data to help develop algorithms and predict dangerous trends. The patient safety movement now has 35 regional chairs leading local networks across 50 countries. This movement is growing rapidly now, PSMF would like to encourage further support.

Their website is here: https://patientsafetymovement.org

Presented by Bill Clinton, 42nd President of The United States and founder of The Clinton Global Initiative. He is introduced by Joe Kiani, Founder, Chairman & CEO of Masimo, Cercacor & the Patient Safety Movement Foundation.

Padma Gulur | TopMedTalks to... Feb 29, 2020

This podcast includes discussion about psychological optimisation for surgery; who should have it, what does it mean and how does it work? Further conversation moves into weaning patients off opioids in advance of surgery and cutting their dependency afterwards. Also, the question of consent to opioids during and after surgery comes up - should we be educating patients more and is it time to look more deeply at the issue of consent?

Hosted by Desiree Chappell and Vicki Morton featuring Dr. Padma Gulur, anesthesiologist and a Pain Medicine Specialist who sees patients at Davis Ambulatory Surgical Center, Duke Pain Medicine and Duke Perioperative Pain Care.

Join us on www.topmedtalk.com sign up for our email updates and never miss a live streamed conference again.

EBPOM Highlight | Does choice of opioid influence health outcomes? Feb 28, 2020

"Does choice of opioid influence health outcomes?" - 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 Padma Gulur, Professor of Anaesthesia and Executive Vice-Chair at Duke University.

TopMedTalk | Gezz Van Zwanenberg, Matt Wiles and Marcus Peck. Feb 27, 2020

What insights does a history of working in military healthcare bring? How do we cut back on readmissions to hospital after time spent in the intensive care unit? How serious an issue is 'burn out' within healthcare? How did standardisation help when designing an award winning patient transfer bag? What's the best way to transfer a patient from ward to ward or from institution to institution? How do we handle data during this period? What do we think about remote supervision and monitoring? Could a dedicated transfer team be useful? Could a new anaesthesia drug be on the way for the NHS soon? How can training in ultrasound be improved? And lastly, will improvements in artificial intelligence ultimately cost us our jobs?

Recorded live at the Association of Anaesthetists' Winter Scientific Meeting 2020, from The Queen Elizabeth II Centre, London, UK.

This piece follows on from part one, which you can find here: https://www.topmedtalk.com/topmedtalk-matt-wiles-and-marcus-peck-live-from-london/

Presented by Monty Mythen featuring guests, Gezz Van Zwanenberg, Nurse and Project Lead North West London Critical Care Network, Matt Wiles, Consultant Anaesthetist & Senior Clinical Lecturer at Sheffield Teaching Hospitals NHS Trust and University of Sheffield and Marcus Peck, NHS Consultant in Anaesthesia and Intensive Care Medicine at Frimley Park Hospital and Chair of Focused Intensive Care Society’s (FICE) Committee.

Matt Wiles and Marcus Peck | TopMedTalks to... Feb 26, 2020

Recorded live at the Association of Anaesthetists' Winter Scientific Meeting 2020 in the centre of London from The Queen Elizabeth II Centre. Hear the conversation and questions asked by our online audience.

In our online world is there still a place for a paper based journal? What are the big stories and hot topics of 2020 going to be? What about hyperoxia? How does what we do effect the environment? What are the latest thoughts about 'depth of anaesthesia'?

The podcast mentioned in this piece is here: https://www.topmedtalk.com/anes19-timothy-short-and-kate-leslie/

This link takes you to the trial: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(19)32315-3/fulltext

Is there a future for volatile anaesthesia? What's the future for pediatric intensive care units? How can we use ultrasound technologies to enhance patient care? Will the iconic stethoscope end up with dust on it? What's the future for ultrasound in the intensive care unit?

Presented by Monty Mythen with his guests Matt Wiles, Consultant Anaesthetist & Senior Clinical Lecturer at Sheffield Teaching Hospitals NHS Trust and University of Sheffield and Marcus Peck, NHS Consultant in Anaesthesia and Intensive Care Medicine at Frimley Park Hospital and Chair of Focused Intensive Care Society’s (FICE) Committee.

TopMedTalk | The SQUEEZE Study Feb 25, 2020

This piece is a discussion regarding the SQUEEZE Study: A prospective multi-centre international observational study of postoperative vasopressor use.

The website mentioned in this piece is here: https://www.esahq.org/research/clinical-trial-network/planned-trials/squeeze/

Our conversation with Konstantin Balonov is here: https://www.topmedtalk.com/euroanaes2019-konstantin-balonov/

Presented by Desiree Chappell with Monty Mythen and their guest Ben Creagh-Brown, Clinical Academic Intensivist, Director of Research and Development, Royal Surrey County Hospital NHS Foundation Trust and Co-Chief Investigator of the "Squeeze Study".

Assessing the risk of delirium | Perioperative Coach Feb 24, 2020

What can practitioners do to preoperatively screen for signs that their patients may have issues with post operative delirium? How do we get patients fit for surgery, particularly as regards delirium? Can you build up mental resilience in the run up to an operation, do suggestions that puzzles and mental activity such as sudoku and a good crossword help have any evidence behind them? This piece features Monty Mythen and Desiree Chappell in conversation with Dan Cole, professor of clinical anesthesiology at the David Geffen School of Medicine, University of California, Los Angeles and former president of the American Society of Anesthesiologists (ASA).

EBPOM 2019 | Prehabilitation and Perioperative Care, panel discussion Feb 23, 2020

This panel discussion reacts to various questions from the online audience and those in attendance.

Questions include; Is there any good evidence for the use of wearable tech in prehabilitation? How come, if the evidence is almost there, prehabilitation is not yet included in every pathway? In this respect, is change just around the corner? How do we have patients are partners rather than passive participants? What are the benefits of prehabilitation which can be seen in two weeks? How does one go about setting up a streamlined preoperative service? What would be the most important outcome for any prehabilitation trial? In a usually sedintary patient, how do we engage them in exercise training and prehabilitation?

Featuring; Mike Grocott, Professor of Anaesthesia and Critical Care Medicine, University of Southampton, Franco Carli Professor of Anesthesia at McGill University and Associate Professor in the School of Dietetics and Human Nutrition at McGill University, Staff anesthesiologist at the McGill University Health Centre and June Davis; June has 22 years of experience working in the NHS as a Dietitian, service and professional lead, general manager for a number of service areas within the acute setting and senior project lead for several large scale change projects across London; 10 years experience working as Head of Therapies for large acute Trusts. She is also a Director of Allied Health Solutions, Allied Health Professions Advisor (part time) for Macmillan Cancer Support and a professional advisor to the Care Quality Commission.

EBPOM 2019 | EBPOM Prehab trials; PREPARE-ABC Feb 22, 2020

This piece focuses on the "SupPoRtive Exercise Programmes for Accelerating REcovery after major ABdominal Cancer surgery" (PREPARE-ABC) trial. How do we establish the effectiveness of pre and post exercise plans? Do they really form a sensible part of a "value based care" package? This concise presentation gives you a clear idea of the aims and structure of the trial.

Prepare ABC tweet here: https://twitter.com/prepareabc

Their website is here: https://www.uea.ac.uk/prepare-abc

Presented by James Hernon, Consultant Colorectal Surgeon, Norfolk and Norwich University Hospital NHS Foundation Trust, Chair of the Anglia Cancer Colorectal Network, CO-CI for PREPARE ABC a NIHR HTA funded randomised clinical study.

Dru Riddle | TopMedTalks to... Feb 21, 2020

"Evidence ... is only as useful as the end user is willing to put it into practice".

This piece begins with a discussion about translational research, the way in which individual studies are looked at and combined into more accessible guidelines.

How do you become an 'informed consumer' of information and evidence?

Also, what is the latest thinking as regards "pharmacogenomics"? Is it true to say that "within the next ten years we're not going to see healthcare delivered ... without genetic information underpinning it"? How do genetics and research in that area come into play as regards anesthesia practice?

Finally how do practitioners take the initiative and become leaders in their field? This piece was recorded at the 2019 Annual Conference of The Oregan Association of Nurse Anesthetists.

The Joanna Briggs Institute is here: https://joannabriggs.org/

The Cochrane Central Register of Controlled Trials (CENTRAL) is here: https://www.cochranelibrary.com/

Their UK website is here: https://uk.cochrane.org/

Presented by Desiree Chappell with her guest Dru Riddle, Associate Professor of Professional Practice in the School of Nurse Anesthesia at Texas Christian University, Associate Professor of Medical Education, TCU School of Medicine, and Director of the Center for Translational Research: A JBI Center of Excellence and Cochrane US TCU Center.

Periop SIG18 | Management of anti-thrombotics: Fast-track warfarin reversal Feb 20, 2020

This piece gives you information that will empower you when using Warfarin in the perioperative period. How should you sensibly balance bleeding and thrombotic risk? Anti-coagulants are increasing in number, what are the principles behind them which we should learn? An understanding of patient, procedure and type of drug being used is essential, are there other factors that can come into play?

Here is a link to the slides used in this talk: http://www.anzca.edu.au/documents/02-kate-burbury_fast-track-warfarin-reversal.pdf

Presented by Kate Burbury, Associate Professor, Deputy Chief Medical Officer, Peter MacCallum Cancer Centre

EBPOM Highlight | Perioperative nutrition Feb 19, 2020

"Perioperative nutrition" - 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 Paul Wischmeyer, Professor of the Department of Anesthesiology, Duke University.

Avoiding the hypotension hazard | The RoundTable Feb 18, 2020

The Hypotension Prediction Index (HPI) Monitor takes 2.6 million features from a single waveform which it then applies to 150 million different wave forms looking for factors which can predict hypotension.

It's the first fully approved foray into predictive analyitics for the world of anaesthesia.

This conversation looks at how it works and how it is being adopted in detail.

Presented by Desiree Chappell with Monty Mythen and Feras Hatib Phd, Director, Research and Development, Algorithms and Signal Processing at Edwards Lifesciences and Dr Simon Davies, Consultant Anaesthetist at York Teaching Hospital NHS Foundation Trust.

ERAS what's the 'secret sauce'? | Perioperative Coach Feb 17, 2020

This piece starts with the question: Is there a hierarchy amongst the various elements of an enhanced recovery pathway? The conversation that follows tackles some of the essential elements of perioperative care.

This conversation is taken from a longer piece to be found here: https://www.topmedtalk.com/live-from-the-iseh-part-2/

For further expert discussion regarding the Drink, Eat, Mobilise, Sleep (DrEaMS) concept there is another short piece you can find here: https://www.topmedtalk.com/standardised-outcomes-from-surgery-drink-eat-mobilise-dream/

This edition of TopMedTalk was recorded at The Institute of Sport Exercise and Health (ISEH) live from an Enhanced Recovery After Surgery (ERAS) leadership forum.

The conversation features questioner Dr Vishal Patil, Consultant Anaesthetist at Cambridge University Hospitals NHS Foundation Trust, alongside Professor Monty Mythen and his two guests; Dr Simeon West, consultant anaethetist at (University College London Hospitals) UCLH who sits on the board at Regional Anaesthesia UK (RAUK) and Mark Harper Consultant Anaesthetist at Brighton and Sussex University Hospitals, with a research interest in the prevention of perioperative hypothermia and the use of cold water adaptation for thearaputic purposes.

Greater National Advocates | Sunday Special Feb 16, 2020

Please do all you can to help share this a hugely important piece, both for practitioners and patients. Adverse outcomes can be avoided, stories like the one on this podcast are fuel in the engine of those who advocate true perioperative care. If you want to help go to the Greater National Advocates website here: https://www.gnanow.org/

The Patient Safety Movement is here: https://patientsafetymovement.org/

Presented by Desiree Chappell and Monty Mythen with their guests L. Bradley Schwartz, president of Founder and President of Greater National Advocates he has served on the Board of Directors of both the National Association of Healthcare Advocacy Consultants (NAHAC) and the Patient Advocate Certification Board (PACB). Also in the conversation is Joseph Frankel, President, Frankel Design, Inc. - The Art of Brand Development & Promotional Marketing.

Tim Miller | TopMedTalks to... Feb 15, 2020

The Perioperative Quality Initiative (POQI) have featured frequently on TopMedTalk, here we discuss their focus on hypotension and blood pressure.

Perioperative Quality Initiative consensus statement on the physiology of arterial blood pressure control in perioperative medicine: https://bjanaesthesia.org/article/S0007-0912(19)30047-9/fulltext

Perioperative Quality Initiative consensus statement on preoperative blood pressure, risk and outcomes for elective surgery https://bjanaesthesia.org/article/S0007-0912(19)30057-1/fulltext

Perioperative Quality Initiative consensus statement on intraoperative blood pressure, risk and outcomes for elective surgery https://bjanaesthesia.org/article/S0007-0912(19)30050-9/fulltext

Perioperative Quality Initiative consensus statement on postoperative blood pressure, risk and outcomes for elective surgery https://bjanaesthesia.org/article/S0007-0912(19)30059-5/fulltext

Presented by Monty Mythen and Desiree Chappell with Joff Lacey, registrar in anaesthesia at St George’s Hospital in London, currently undertaking a fellowship in Perioperative Medicine at UCLH as well as being a regular presenter on TopMedTalk and Tim Miller, Associate Professor of Anaesthesiology from Duke University Medical Centre.

EBPOM Highlight | The Patient Safety Movement Foundation Feb 14, 2020

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 presentation are sourced from the PSMF's YouTube channel, find it here: https://www.youtube.com/channel/UCLLtyscblA8aquiXSSrZ1bA

Their official website is here: https://patientsafetymovement.org/

You can find out more about Mike Ramsay and his work there by listening the "TopMedTalks to..." series, where we discuss healthcare with global thought leaders from around the world: https://www.topmedtalk.com/topmedtalks-to-michael-ramsey/

Presented by Michael Ramsay, Chairman, Department of Anesthesiology and Pain Management, Baylor University Medical Center; President, Baylor Scott & White Research Institute with an introduction from Sol Aronson, tenured professor at Duke University and Executive Vice Chairman in the Department of Anesthesiology.

Periop Medicine SIG 18 | Australia and New Zealand Emergency Laparotomy Audit - Quality Improvement Feb 13, 2020

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-an-update.pdf

Presented by Ben Griffiths, consultant anesthetist at Auckland City Hospital, anaesthetic lead for ANZELA-QI.

EBPOM Highlight | Antibiotic stewardship in perioperative care Feb 12, 2020

"Antibiotic stewardship in perioperative care" - 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 Alison Holmes, Professor of Infectious Diseases at Imperial College, Fellow of the Academy of Medical Sciences and an Senior Investigator at the National Institute of Health Research (NIHR).

The Royal College of Anaesthetists: World Leading Healthcare | The RoundTable Feb 11, 2020

How has the Royal College of Anaethestists (RCoA) evolved over the years and why is perioperative medicine so crucial to its agenda? How has this leadership in perioperative medicine become a force for change and improvement worldwide and what are the common themes that emerge as we take a global perspective on the discipline?

The RCoA's global partnership programme is explained, how can perioperative medicine be part of helping less developed healthcare systems? The considerations are different but the principles remain the same.

The birth of the NHS gave parity of esteem to anaesthetists, the benefits of this are felt by us all in the Western world, could it be argued that this visionary decision might actually help other healthcare systems to evolve more rapidly?

Finally - where is the discipline these days? Leadership and the ability to see the bigger picture are part of it, as is communicating to that wider world with various innovations including this podcast which you, as a listener, are a part of.

Presented by Desiree Chappell and Monty Mythen with their guests Dr Liam Brennan, President of The Royal College of Anaesthetists (RCoA) and Professor Paul Myles, Director, Department of Anaesthesia and Perioperative Medicine, Alfred Hospital and Monash University, Melbourne, Australia.

Getting it right first time (GIRFT) | Perioperative Coach Feb 10, 2020

We begin with a question from the audience; 'how do we drive change in our institutions towards enhanced recovery after surgery?' The GIRFT (Getting It Right First Time) project is explained. The Health Foundation is also mentioned.

This edition of TopMedTalk was recorded at The Institute of Sport Exercise and Health (ISEH) live from an Enhanced Recovery After Surgery (ERAS) leadership forum.

The conversation features questioner Paul Hutchings, Consultant Anaesthetist at Norfolk and Norwich University Hospital, alongside Professor Monty Mythen and his two guests; Dr Simeon West, consultant anaethetist at (University College London Hospitals) UCLH who sits on the board at Regional Anaesthesia UK (RAUK) and Mark Harper, Consultant Anaesthetist at Brighton and Sussex University Hospitals, with a research interest in the prevention of perioperative hypothermia and the use of cold water adaptation for thearaputic purposes.

The POPS clinic at Guy's & St Thomas's | Sunday Special Feb 09, 2020

What is POPS (Proactive care for Older People undergoing Surgery) and how have things gone since this service was introduced to Guy's and St Thomas's back in 2004? How does the team apply the techniques of this programme to the perioperative pathway of a patient? Would a service like this be useful at your practice? Can your institution accommodate a fully comprehensive geriatric assessment and optimisation process?

Furthermore, should a programme like this be rolled out across the UK and could anything similar be considered in the US?

How does having a POPS team facilitate specialist education at the institution? What other opportunities are there for patients and staff as a result of innovations such as this?

Also - what are the drugs that anaesthetists commonly prescribe to patients which people who work on this side of the service aren't so keen on? What are the advantages of being able to safely discharge frail patients who may instead have ended up back in the hospital system?

How do we get undergraduates to learn the skills which simple demographics show are going to become more and more crucial as the trend towards a longer life span continues in the Western world? The Guy's and St Thomas's POPS team offer a fellowship, the final part of this Sunday Special covers both that and the wider issue of getting students and younger practitioners into this growing area of health care.

Desiree Chappell presents, with additional questions thrown in by Monty Mythen, as they speak with their guests; Magda Sbai, specialist registrar at Guy's and St Thomas's, Jason Cross, advanced nurse practitioner and Nursing lead for the POPS team, Claire Gallagher, Deputy clinical nurse specialist, Dr Judith Partridge, consultant geriatricians at Guy's and St Thomas's Hospital in London and Dr Jugdeep Dhesi, Clinical Lead, POPS and Consultant Geriatrician, Guys and St Thomas' NHS Trust.

William Wooden | TopMedTalks to... Feb 08, 2020

"Our hospital now has twice the capacity it had" cost of care and efficiency are up. Hear how enhanced recovery after surgery (ERAS) and the power of prehabilitation has dramatically shifted institutions towards better outcomes and a higher value of care.

Also in this piece; what is immunonutrition? How does stress alter our immune responses?

The piece mentioned in the podcast can be found here: https://journals.lww.com/annalsofsurgery/Abstract/2018/10000/Impact_of_a_Novel_Preoperative_Patient_centered.13.aspx

Presented by Desiree Chappell and Monty Mythen with their guest William Wooden, Director of Operative Services at Indiana University of Health.

EBPOM Highlight | Shared decision making in perioperative care Feb 07, 2020

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 Angela Coulter, a UK based health policy analyst and researcher.

TopMedTalk | How to get people to get things done; The Michigan Project Feb 06, 2020

Learn how to inspire a team to act, create change and get things done. How important are financial incentives, emotional connection and the relative ease of change?

Originally streamed live from the hugely successful EBPOM USA Dallas Master's course.

Presented by Michael Englesbe, Darling Sr. & Cyrenus G. Darling Jr. Professor of Surgery, Michigan.

EBPOM Highlight | QA, QI and Patient involvement Feb 05, 2020

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 Sarah Hare, of the National Emergency Laparotomy Audit (NELA).

Let your patients be 'partners in safety' | The RoundTable Feb 04, 2020

How is the AANA facilitating the care of patients? How can you make a patient a 'partner in safety'? How do we coordinate so many disaparate systems of information and care?

Patient records and data ownership is discussed, as is Paul Upton's excellent interview on TopMedTalk regarding "My Preop".

The original piece is here: https://www.topmedtalk.com/my-pre-op-empowering-patients-before-surgery/

How do we reach out to patients and inform them about the risks and choices which will be presented to them as part of their surgical pathway? Discussion here moves to the American Association of Retired Persons (AARP) and the incredible work they are doing.

For more on the AARP from TopMedTalk go here: https://www.topmedtalk.com/dont-ask-patients-what-is-the-matter-ask-them-what-matters/

Presented by Desiree Chappell and Monty Mythen with their guest Lynn Reede, CRNA and chief clinical officer at the American Association of Nurse Anesthetists (AANA).

EBPOM Highlight | Leading a large, single group towards excellence Feb 03, 2020

"Leading a large, single group towards excellence" - 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

If you have any comments or questions you'd like to send to the team email: contact@topmedtalk.com

Presented by Dr Elizabeth Cherot, Vice President of medical affairs at Axia Women’s Health, followed by a short break out session with Desiree Chappell, Monty Mythen and Sol Aronson alongside questions from the audience online and the delegates at the conference.

Medical Linguistic Anthropology and Patient Autonomy | Sunday Special Feb 02, 2020

How do the insights of a 'medical linguistic anthropologist' impact upon our understanding of 'shared decision making'? How do patients make decisions about surgery? When, in the perioperative process, do they decide what is best for them?

Does patient autonomy actually even exist?

A bubble bursting conversation with a frequent favourite on TopMedTalk, this podcast is bound to get you thinking!

Presented by Desiree Chappell and Monty Mythen with their guest Dr Lee Fleisher Professor and Chair of Anesthesiology and Critical Care, University of Pennsylvania.

What's your 2020 vision? | TopMedTalk Feb 01, 2020

What are the big things to watch in 2020? "Renablement, rehabilitation and readmission" from a patient perspective and "training compotence, resillience and 'burn out,'" from the practitioner's point of view, according to one of our contributors on this piece.

What about Enhanced Recovery, is that still set to be big in 2020? Is it methadone we should be thinking about? Is automation something on our collective horizon? What about the "B word", "Brexit"; will political change in the UK bring opportunity?

The ongoing issue in the US of opioid addiction and overuse is discussed. We also ask if the coming year will spread more light on what it really means to be "ready for surgery"? And, how and what should we be thinking about our profession's environmental impact?

Here's a link to the Perioperative Quality Initiative (PQIP) page: https://pqip.org.uk

Presented by Nick Margerrison, with Monty Mythen and Desiree Chappell interviewing our various contributors on this show, appearing in order; Gezz Van Zwanenberg, Nurse and Project Lead North West London Critical Care Network, Simon Davies, Consultant Anaesthetist at York Teaching Hospital NHS Foundation Trust, Mike Grocott, Professor of Anaesthesia and critical care at the University of Southampton, Sol Aronson, Tenured Professor, Duke University and Executive Vice Chairman in the Department of Anesthesiology, Andrew Klein, Cardiothoracic Anaesthetist at Royal Papworth Hospital in Cambridge and Editor in Chief of Anaesthesia, Tom Woodock, author and independent consultant in patient safety, medical law and ethics, Henrik Kehlet, a gastrointestinal surgeon and former professor of surgery, Copenhagen University, and now professor of perioperative therapy and Head of Section of Surgical Pathophysiology, Rigshospitalet, Copenhagen University and Matt Wiles, Consultant Anaesthetist & Senior Clinical Lecturer at Sheffield Teaching Hospitals NHS Trust and University of Sheffield.

Follow these links for fuller conversations:

TopMedTalk | Gezz Van Zwanenberg, Live from London Part 2 https://www.topmedtalk.com/topmedtalk-gezz-van-zwanenberg-live-from-london-part-2/

TopMedTalk | Simon Davies’s 2020 Vision https://www.topmedtalk.com/topmedtalk-simon-daviess-2020-vision/

TopMedTalk | Andy Klien, Editor in Chief of Anaesthesia https://www.topmedtalk.com/topmedtalk-andy-klien-editor-in-chief-of-anaesthesia/

TopMedTalk | Tom Woodcock https://www.topmedtalk.com/topmedtalk-tom-woodcock/

TopMedTalk | Henrik Kehlet and Nick Scott https://www.topmedtalk.com/topmedtalk-henrik-kehlet-and-nick-scott/

TopMedTalk | Matt Wiles and Marcus Peck, Live from London. https://www.topmedtalk.com/topmedtalk-matt-wiles-and-marcus-peck-live-from-london/

Fortnightly Digest | TopMedTalk Jan 31, 2020

The TopMedTalk fortnightly digest is your round up of the past 2 weeks. Make sure you never miss out on crucial episodes and are fully up-to-date with your favorite medical podcast.

Presented by TopMedTalk's senior producer Nick Margerrison.

EBPOM Highlight | Developing a national quality improvement network Jan 31, 2020

Learn how to develop a national Quality Improvement (QI) network which will increase both communication and knowledge implementation. What are the essential elements of a useful network, how do you build a community within one and solidify it as an essential part of your practice? Presented by Carolyn Johnston, consultant Anaesthetist in St Georges hospital in London.

TopMedTalk | Enhanced recovery after bariatric surgery Jan 30, 2020

"Enhanced recovery after bariatric 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

If you have any comments or questions you'd like to send to the team email: contact@topmedtalk.com

Presented by David Voellinger, Lead Physician, Novant Health Bariatric Solutions Charlotte, Medical Director, Novant Health Bariatric Center, Chief, Department of General Surgery, Novant Health Presbyterian Medical Center.

Prehabilitation and cancer | World Congress 2019 Jan 29, 2020

This piece starts with some words from patients; prehabilitation is "a set of actions that can be taken in advance of treatment to ease your passage through cancer". This vital talk explains how prehabilitation can leave cancer patients feeling personally empowered and ready to live well. Living is one thing, how do we get people to enjoy 'living well'? Further to this how do we do that in such a way that respects patient decisions and life choices? How can we get to a position where exercise, nutrition and psychological support are integral to a cancer diagnosis? Ideally prehabilitation gets to a point where all patients feel like the ones quoted in this talk; "It's a win win situation [...] do that and you'll be healthier".

Presented by June Davis; June has 22 years of experience working in the NHS as a Dietician, service and professional lead, general manager for a number of service areas within the acute setting and senior project lead for several large scale change projects across London; 10 years experience working as Head of Therapies for large acute Trusts. She is also a Director of Allied Health Solutions, Allied Health Professions Advisor (part time) for Macmillan Cancer Support and a professional advisor to the Care Quality Commission.

EBPOM Highlight | Improving perioperative outcomes, panel discussion Jan 28, 2020

Questions include: Do patients need to be advised about the possible hallucinatory side effects of ketamine? How do we ensure our perioperative pathway reaches patients at the earliest possible junction? Is there a standard pathway which can be applied to all?

Featuring; Natasha Curran, pain medicine University College London Hospital (UCLH) and Medical Director at the Health Innovation Network, Denny Levett, Professor in Perioperative Medicine and Critical Care, Consultant in Perioperative Medicine, Southampton University Hospital NHS Foundation trust (UHS), President of the Perioperative Exercise Testing and Training Society (POETTS), Ross Kerridge, John Hunter Hospital, Newcastle, Australia, often cited as 'the father of Modern Perioperative Medicine'.

TopMedTalk | A Novel Use of the Erector Spinae Block in the Austere Environment Jan 27, 2020

In the military Forward Surgical Teams (FSTs) are deployed into challenging environments to deliver "damage control surgery". They help people who have been injured, relieve the pain, stop the bleeding, 'patch the holes' and move them to a safer environment. It's from this background that our two contributors come, learn how they have been forced to innovate and what insights they can give to practitioners working in more familliar and well resourced contexts.

Hear how a 25 year-old male presented with penetrating chest trauma and an Erector Spinae Block was utilized in an incredibly dramatic context.

This inteview works well in tandem with this link to the paper discussed in the piece: https://www.ncbi.nlm.nih.gov/pubmed/31247096

This piece was part of our coverage of The American Association of Nurse Anesthetists (AANA) 2019 Annual Congress in Chicago, Illinois.

Check out the AANA here: https://www.aana.com/

Presented by Desiree Chappell and Monty Mythen with their guests Robert Fabich, Doctor of Nursing Practice, CRNA, Veteran and Sharrod R. Greene, CRNA, Sentara Anesthesiology Specialists.

Being on the right side of the law | Sunday Special Jan 26, 2020

A discussion about consent, staying on the right side of the law, shared decision making and 'The Montgomery case' which has defined a Doctor's duty in these sorts of areas.

Presented by Monty Mythen with Desiree Chappell and their guests Hugh Montgomery, and Paul Sankey, Enable Law partner and Clinical Negligence solicitor acting for patients, an accredited expert in his field.

Paul Pomerance | TopMedTalks to... Jan 25, 2020

The American Society of Anesthesiologists (ASA) continues to raise the standards of the medical practice of anesthesiology, as well as keeping a particular focus on improving patient care. This conversation is a chance to catch up with their work.

For more on the Patient Safety Movement Foundation go here: https://patientsafetymovement.org/

Finally, the wonderful Linda Mason interview which gets mentioned in this piece is here: https://www.topmedtalk.com/euroanaes2019-linda-mason/

Presented by Desiree Chappell and Monty Mythen with their guest Paul Pomerance, Chief Executive Officer of the American Society Of Anesthesiologists, Worldwide Executive Director at Drug Information Association, Inc.

POET 6.09 | If you need help ask for it Jan 24, 2020

'The Practitioner Health Programme' - why do anaesthetists suffer from mental health problems, what help is there available for them? Learn here how people in that profession are uniquely placed to deal with the inevitable pressures related to healthcare.

Presented by Desiree Chappell and Monty Mythen with their guest Dr Clare Gerada, Medical Director, Physician Health, Practitioner Health Service.

TopMedTalk| Leading a large, multi-state group to achieve excellence Jan 23, 2020

Hear how you can transform your practice through team leadership, courage and a finely tuned awareness of the financial aspects of what you are trying to achieve.

How can growth be tempered to suit the long term vision of a company? Why is teambuilding so crucial to large organisations? Can we determine the direction in which healthcare is evolving overall? Is 'population health in the perioperative space', a widely accepted future direction these days?

Presented by Brian Woods, Anesthesiologist and Vice President at NorthStar Anesthesia.

EBPOM 2019 | EBPOM Prehab trials; WesFit Jan 22, 2020

This piece focuses on the "Wessex Fit-4-Cancer Surgery Trial"; a unique multi-centre, efficacy pragmatic, factorial design, randomised controlled trial, with patient informed development and process evaluation

"You wouldn't run a marathon without preparing," why would you want an operation where you don't get ready for a physically stressful event such as surgery? Prehabilitation is an obvious advantage, gathering the data which proves that is essential to perioperative medicine because it means we can show the advantages clearly to both patients and practitioners as well as looking at ways of making the process more efficient.

For more on this go here: http://wesfit.org.uk/

Presented by Professor Sandy Jack, PhD, Consultant Clinician Scientist in the Anaesthesia and Critical Care Research Unit at University Hospital Southampton NHS Foundation Trust, Southampton and NIHR Southampton Respiratory Biomedical Research Unit and Integrated Physiology and Critical Illness Group, Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Honorary Senior Lecturer at the University of Liverpool, University of Southampton and University College London.

Desiree's Roundtable | Coordinating an Enhanced Recovery Program Jan 21, 2020

How important is it to have a dedicated member of your team focused on starting, maintaining and coordinating your enhanced recovery programme?

Does an enhanced recovery programme which comes from the grassroots need support early on in the process? How do you find the right people to support you once the process has begun? Also, how do you explain that these changes will actually reduce workload?

The conversation moves into managing pain, both the reality of pain and the expectations which can, if handled correctly, help to reduce it.

Finally, what are the three key aptitudes that an enhanced recovery coordinator needs?

Presented by Desiree Chappell with Korey Springman, Anesthesiologist and Perioperative Medicine Fellow at Duke University and Vicki Morton, Director of Clinical and Quality Outcomes at Providence Anesthesiology Associates and Courtney Fossen, Manager of Surgical Services at US Anesthesia Partners (USAP).

TopMedTalk | Fluid Physiology in detail Jan 19, 2020

This piece builds on last week's look at Fluid Physiology, with reference to the book linked to below.

"We did not have a concensus view on the very basic subject of fluid physiology and I needed to write a book".

The book Fluid Physiology is available now, check out the website here: http://fluidphysiology.org/

Tom's always entertaining twitter feed is here: https://twitter.com/thomaswoodcock

Tom's slightly shorter piece on this book is here: https://www.topmedtalk.com/topmedtalk-tom-woodcock/

Presented by Monty Mythen and Desiree Chappell with their guests Sol Aronson a tenured professor at Duke University and Executive Vice Chairman in the Department of Anesthesiology and Tom Woodcock author and independent consultant in patient safety, medical law and ethics.

Like this, want more? Tom Woodcock appears frequently on TopMedTalk: https://www.topmedtalk.com/?s=tom+woodcock

TopMedTalk | Listen to your brain Jan 18, 2020

This piece looks at The WAVi Headset which allows for a multi-faceted panoramic assessment of brain performance. Hear how this device is used to assess the health of one of our most vital organs.

For more detail check out the website here: https://wavimed.com/

Presented by Desiree Chappell with her guest Rob Martin, Chief Operating Officer at WAVi.

POET 6.08 | Thinking clearly on the brain Jan 17, 2020

What is "The Brain Health Initiative"? Why is it that so many aspects of brain function are so hard to understand? Why is cognitive dysfunction such a difficult topic to discuss? How far away are we from the days when we will have a biomarker that can help us in this area?

Desiree Chappell presents, with her guests; Dr Lee A. Fleisher Professor and Chair of Anesthesiology and Critical Care, University of Pennsylvania and Miles Berger, Neuroanesthesiologist at Duke University Medical Center.

TopMedTalk | Andy Klien, Editor in Chief of Anaesthesia Jan 16, 2020

Anaesthesia is the official journal of the Association of Anaesthetists with comprehensive coverage of publications in anaesthesia, ICU and pain. This piece gets into the detail of their hugely popular perioperative care supplement, a collaboration with BJS (formerly the British Journal of Surgery). Surgeons and Anaesthetists around the world are engaging in the debate as a result with thousands of tweets about the subject, after publication only days before the 2020 Winter Scientific Meeting.

Further discussion covers prehabilitation, which aspects are backed up by evidence? What are the big trials we should be looking towards?

The PREVENTT website is here: https://preventt.lshtm.ac.uk/

More detail on Surgery School is covered here: https://www.topmedtalk.com/?s=surgery+school

Anaesthesia's website is here: https://anaesthetists.org

An excellent blog is provided here: https://theanaesthesia.blog/

Anaesthesia tweet here: https://twitter.com/Anaes_Journal

Presented, from the Association of Anaesthetist's Winter Scientific Meeting 2020, by Monty Mythen with Desiree Chappell, Sol Aronson and their guest Andrew Klein, Cardiothoracic Anaesthetist at Royal Papworth Hospital in Cambridge and Editor in Chief of Anaesthesia.

Like this, want more? Andrew Klien's excellent and popular talk on Cardiac Anaesthesia and Anaemia is here: https://www.topmedtalk.com/ebpom-highlight-1-04-cardiac-anaesthesia-and-anaemia/

TopMedTalk | Henrik Kehlet and Nick Scott Jan 15, 2020

"It's all about safety and recovery, it's not about speed"; this conversation focuses on enhanced recovery, are we getting it right and where are people getting it wrong? How reliable and well understood is the data behind it? Also, what are the current thoughts on perioperative steroids? How do we refocus and move back to enhanced recovery after surgery rather than "enhanced discharge" after surgery.

Presented by Monty Mythen and Desiree Chappell with Sol Aronson, tenured Professor at Duke University, and their guests Henrik Kehlet, a gastrointestinal surgeon and former professor of surgery, Copenhagen University, and now professor of perioperative therapy and Head of Section of Surgical Pathophysiology, Rigshospitalet, Copenhagen University and Nick Scott, an early proponent of Enhanced Recovery in the UK who has spent the last six years as the Vice Chairman of Anesthesia and Perioperative Medicine at Hamad Medical Corporation in Qatar.

TopMedTalk | Simon Davies's 2020 Vision Jan 14, 2020

In this piece we're joined by a TopMedTalk favorite for a few predictions regarding the year 2020. Prehabilitation, "the word of the year" for 2019 and now something we expect to see break into the mainstream? How is anesthesia going to develop and what's the future for artificial intelligence in surgery?

PQIP link: https://pqip.org.uk

Multimodal analgesia: https://www.topmedtalk.com/ebpom-usa-part-5-a-perioperative-practicum-with-tj-gan/

TopMedTalk has covered methadone on a couple of occasions recently:

Methadone a forgotten friend: https://www.topmedtalk.com/topmedtalk-methadone-a-forgotten-friend/

Methadone the overlooked opiate: https://www.topmedtalk.com/ebpom-2019-methadone-the-overlooked-opiate/

Artificial intelligence is looked at in more detail here: https://www.topmedtalk.com/topmedtalk-the-ai-doctor-will-see-you-now/

The 13 Minutes To The Moon podcast is here: https://www.bbc.co.uk/programmes/w3csz4dn

Presented by Monty Mythen and Desiree Chappell with their guest Simon Davies, Consultant Anaesthetist at York Teaching Hospital NHS Foundation Trust.

Like this, want more? Simon also appears on this piece here: https://www.topmedtalk.com/prehab-periop-world-congress-feras-hatib-simon-davies/

EBPOM 2019 | Troponin Screening - essential or the Emperor's new clothes? Jan 13, 2020

This panel discussion and extended question and answer session focuses upon troponin screening. Where is the latest evidence as regards this debate? Is MINS ( Myocardial injury after noncardiac surgery) the most common postoperative complication associated with death and if so why is there a transatlantic divide as regards the evidence? Is there a place for troponin screening preoperatively for risk stratification? What should one do with an asymptomatic post operative patient with raised troponin? Does MINS cause hypotension?

This is part 3 of 3 from The EBPOM 2019 TopMedTalk session which debated the issue.

Chaired by Monty Mythen, TopMedTalk's Editor in Chief, with, Mike Grocott, Professor of Anaesthesia and critical care at the University of Southampton and frequent TopMedTalk contributor, Denny Levett, Professor in Perioperative Medicine and Critical Care, Consultant in Perioperative Medicine, Southampton University Hospital NHS Foundation trust (UHS), President of the Perioperative Exercise Testing and Training Society (POETTS) and 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.

TopMedTalk | Tom Woodcock Jan 12, 2020

To celebrate the launch of his book Fluid Physiology, A Handbook for Anaesthesia and Critical Care Practice: https://books.google.co.uk/books?id=F-m4DwAAQBAJ&printsec=copyright&redir_esc=y#v=onepage&q&f=false

What are Tom's big areas to watch in 2020? Also how are surgical teams similar to the team behind the moon landing and what should we be thinking about the use of steroids in surgery?

Check out Fluid Physiology: www.fluidphysiology.org

The 13 Minutes To The Moon podcast is here: https://www.bbc.co.uk/programmes/w3csz4dn

Presented by Monty Mythen with Desiree Chappell and their guest Tom Woodcock, author and independent consultant in patient safety, medical law and ethics.

Charles Brown | TopMedTalks to... Jan 11, 2020

"One of the best sessions of the entire conference" was presented by our guest on this piece. In this podcast there's a chance to really discuss perioperative optimisation, with a focus on delirium, in post operative patients. Are we getting to where we need to be or is there more work to be done?

Presented by Desiree Chappell with Sol Aronson and their guest Charles Brown, associate professor of anesthesiology and critical care medicine at the Johns Hopkins University School of Medicine.

TopMedTalk | Wireless wearables on the ward, the new www revolution? Jan 11, 2020

This piece dives into "The new www revolution?: Wireless Wearables on the Ward". Improving the monitoring of patients on the wards is an exciting prospect for any modern practitioner and as personal health monitoring technology becomes mainstream for the public it's surely an inevitable part of the future of medicine.

The website mentioned in the podcast is here: https://www.michardconsulting.com/

The Global burden of postoperative death - The Lancet is here: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(18)33139-8/fulltext?rss=yes

This paper in The Lancet is also mentioned: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(12)61148-9/fulltext

Presented by Desiree Chappell and Monty Mythen with their guest Frederic Michard of MiCo Consulting.

Like this, want more?

Our guest previously featured on TopMedTalk here:

https://www.topmedtalk.com/asa-2018-san-francisco-the-practical-applications-of-innovation/

POET 6.07 | Perioperative antibiotic stewardship Jan 10, 2020

This passionate talk is a call to action for the peioperative practitioners who are serious about the wider issue of population health. How can the protocols and pathways of your practice be adjusted to seriously contend with the global issue regarding the stewardship of one of medicine's most vital resources?

Presented by Alison Holmes, Professor of Infectious Diseases at Imperial College, Fellow of the Academy of Medical Sciences and an Senior Investigator at the National Institute of Health Research (NIHR).

To hear the fuller version of this talk go here: https://www.topmedtalk.com/ebpom-highlight-1-10-antibiotic-stewardship-in-perioperative-care/

TopMedTalk | Gezz Van Zwanenberg, Live from London Part 2 Jan 10, 2020

How serious an issue is 'burn out'? What's the best way to transfer a patient from ward to ward or from institution to institution? What do we think about remote supervision and monitoring? What problems will Artificial Intelligence help us solve?

Recorded live at the Association of Anaesthetists' Winter Scientific Meeting 2020, from The Queen Elizabeth II Centre, London, UK.

This piece follows on from part one, which you can find here: https://www.topmedtalk.com/topmedtalk-matt-wiles-and-marcus-peck-live-from-london/

Presented by Monty Mythen featuring guests, Gezz Van Zwanenberg Nurse and Project Lead North West London Critical Care Network, Matt Wiles, Consultant Anaesthetist & Senior Clinical Lecturer at Sheffield Teaching Hospitals NHS Trust and University of Sheffield and Marcus Peck, NHS Consultant in Anaesthesia and Intensive Care Medicine at Frimley Park Hospital and Chair of Focused Intensive Care Society’s (FICE) Committee.

TopMedTalk | Matt Wiles and Marcus Peck, Live from London. Jan 09, 2020

In our online world is there still a place for a paper based journal? What are the big stories and hot topics of 2020 going to be? What are the latest thoughts about 'depth of anaesthesia'? Can we use ultrasound technologies to enhance patient care?

Recorded live at the Association of Anaesthetists' Winter Scientific Meeting 2020 in the centre of London from The Queen Elizabeth II Centre.

Presented by Monty Mythen with his guests Matt Wiles, Consultant Anaesthetist & Senior Clinical Lecturer at Sheffield Teaching Hospitals NHS Trust and University of Sheffield and Marcus Peck, NHS Consultant in Anaesthesia and Intensive Care Medicine at Frimley Park Hospital and Chair of Focused Intensive Care Society’s (FICE) Committee.

Periop Medicine SIG 18 | Emergency surgery - panel discussion Jan 09, 2020

This is the panel discussion which tackles emergency surgery. Discussion begins with more detail regarding the Enhanced Peri-Operative Care for High-risk patients (EPOCH) trial.

Featuring, Professor Carol Peden, Executive Director of the Center for Heath System Innovation and Professor of Anesthesiology at the Keck School of Medicine of the University of Southern California, Fellow of the Institute for Healthcare Improvement (IHI), Ben Griffiths, consultant anesthetist at Auckland City Hospital, anaesthetic lead for ANZELA-QI and Michael Cox, Professor of Surgery, Nepean Hospital.

EBPOM Highlight 2.26 | ERAS in Obstetric Surgery Jan 08, 2020

"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 Clinical and Quality Outcomes at Providence Anesthesiology Associates, University of South Carolina.

Can Enhanced Recovery work for the critical care patient? | The RoundTable Jan 07, 2020

How do the insights from experience in Enhanced Recovery apply to critical care patients and postoperative care pathways? We also discuss utilization of advanced monitoring technology for the critically ill patient postoperatively.

Presented by Desiree Chappell with her guests Philip Corvo, Chairman of Surgery Stanley J Dudrick Dept of Surgery at Saint Mary's Hospital and Vicki Morton, DNP and Director of Clinical and Quality Outcomes at Providence Anesthesiology Associates University of South Carolina.

EBPOM 2019 | Troponitis, does it matter? Jan 06, 2020

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 University of Southampton and frequent TopMedTalk contributor.

"70 Years on: Our NHS" a panel discussion | Sunday Special Jan 05, 2020

This is the panel discussion which followed the address at EBPOM 2018 by Professor Sir Bruce Keogh on the eve of the 70th anniversary of the NHS.

Various questions from the audience are considered; where should we be in ten years from now, what are the disruptive forces headed our way?

The panel features; Sir Bruce Keogh, Professor Monty Mythen, University College London, Carol Peden, Professor of Anesthesiology and Exec. Director of the Center for Health System Innovation, University of Southern California, University of Bath and the Institute for Healthcare Improvement (IHI), Professor Sol Aronson, tenured professor at Duke University and Executive Vice Chairman in the Department of Anesthesiology, Mike Grocott, Professor of Anaesthesia and Critical Care Medicine, University of Southampton, NIHR Senior Investigator and Dr Ramani Moonesinghe, Director of the UK National Institute of Academic Anaesthesia Health Services Research Centre.

The full lecture from Sir Bruce Keogh 'Ernest Henry Starling Plenary Lecture 2018 “70 Years on: our NHS”' is available in full here: https://www.topmedtalk.com/ebpom-2018-3-sir-bruce-keogh-the-nhs-at-70/

Elena Koepke | TopMedTalks to... Jan 04, 2020

On the last occasion we spoke with our guest she was a Perioperative Medicine Fellow at Duke University; learn now how her experiences have helped change her practice and the edge she has dealing with healthcare. The conference is producing a number of talking points, the Measurement of Exercise Tolerance before Surgery (METS) Trial seems to have shifted opinions, does a genuine 'perioptimist' have a deeper insight into the issues there? Also - does North America really lack the resources, expertise and money to adpot Cardiopulmonary Exercise Testing (CPET)? Presented by Desiree Chappell and Monty Mythen with their guest Dr Elena Koepke, Assistant Professor at Moffitt Cancer Center/USF, Physician Anesthesiologist, Perioperative Medicine Specialist. You can find POETTS here: https://www.poetts.co.uk

POET 6.06 | Ward monitoring 3.0 Jan 03, 2020

How do new technologies impact the postoperative elements of Enhanced Recovery? Here we discuss "ward monitoring 3.0" and new technologies which are now available, or in the pipeline, to improve outcomes. How do we best use this information and these innovations?

The website mentioned in the podcast is here: https://www.michardconsulting.com/

Presented by Desiree Chappell with Monty Mythen and their guest Frederic Michard of MiCo Consulting.

Periop Medicine SIG18 | Perioperative frailty - panel discussion Jan 02, 2020

This panel discussion provides a vital and thought provoking insight into frailty in a perioperative patient. Further, as perioperative medicine evolves, how do we know enhanced recovery after surgery (ERAS) works? Are there any large randomised controlled trials that prove it?

This piece is moderated by Dr Ming Loh, Staff Specialist Geriatrician and Clinical Lecturer at Westmead Hospital and the University of Sydney, Clinical Lead for the Orthogeriatric Service, Subacute Rehabilitation Ward and Falls Clinic, and features; Ruth E. Hubbard, Professor in Geriatric Medicine at the University of Queensland, Consultant Geriatrician at the Princess Alexandra Hospital and Head of School for PA-Southside Clinical Unit, with Bobbie Jean Sweitzer, Professor of Anesthesiology and Director of Perioperative Medicine at Northwestern University in Chicago, Illinois, and David Storey, Head of Anaesthesia, Perioperative and Pain Medicine Unit (APPMU), Melbourne Medical School, University of Melbourne; Director, Melbourne Clinical and Translational Sciences (MCATS) research platform.

EBPOM 2019 | POETT Controversies Panel discussion Jan 01, 2020

Doesn't the decision to delay surgery depend upon the type of cancer? Can you measure complications as an outcome? What's the cause of non cardiac complications that are related to lack of exercise? Can we change the mindset of prehabilitation by explaining that prehabilitation is the start of treatment? How do we convince patients and decision makers that delaying surgery is a good idea? How involved are oncologists in perioperative decisions?

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 and Gerrit Slooter, MD, PhD, Surgical Oncologist, Maxima Medical Centre, The Netherlands.

EBPOM 2019 | The Opioid Crisis - Q&A Dec 31, 2019

This question and answer session is a valuable insight into where the latest thinking is as regards tackling the opioid crisis. How do we get to an understanding where the entire continuum of care is on the same page as regards pain relief? What's the level of adoption for opioid free anaesthesia? Can re-languaging pain or "re-writing the narrative" help, for example is it better to speak of 'comfort levels' as opposed to pain? What's the latest thinking as regards caffeine as an aid to comfort? Should we be worried about post operative delerium as regards ketamine use? What about gabapentinoids in the elderly? What about Midazolam? What should we send patients home with afterwards?

Presented by Michael Manning, MD, PhD, Assistant Professor at Duke University Medical Center, Director of research for the Perioperative Medicine Fellowship at Duke.

EBPOM 2019 | Troponin Screening - essential? Dec 30, 2019

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.

Enhanced Recovery After Surgery (ERAS) leadership | Sunday Special Dec 29, 2019

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 important is it to keep patients warm? Keeping patients and their environments warm is discussed, as is pre-warming, going beyond the standard blankets and patient insulation to include active warming and even patients exercising as a method of warming up. Further to this conversation, how do you measure a patient's temperature?

How do we drive change in our institutions towards enhanced recovery after surgery? The GIRFT (Getting It Right First Time) project is explained. The Health Foundation is also mentioned. The piece also includes patient communication and the question of 'how much is too much?', when administering a dose of morphine. Also, is there a hierarchy on the pathway of enhanced recovery after surgery?

The conversation features Professor Monty Mythen and his two guests; Dr Simeon West, consultant anaethetist at (University College London Hospitals) UCLH who sits on the board at Regional Anaesthesia UK (RAUK) and Mark Harper Consultant Anaesthetist at Brighton and Sussex University Hospitals, with a research interest in the prevention of perioperative hypothermia and the use of cold water adaptation for theraputic purposes. There are also attributed questions from the audience.

Frances Chung | TopMedTalks to... Dec 28, 2019

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.

POET 6.05 | Pain control for the perioperative patient Dec 27, 2019

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 Padma Gulur, Anaesthesia and Executive Vice-Chair at Duke University and Dr Natasha Curran, pain medicine University College London Hospital (UCLH) and Medical Director at the Health Innovation Network.

The fuller version of this conversation is available here: https://www.topmedtalk.com/ebpom-2018-14-the-realities-of-pain-management/

TopMedTalk | Holiday Special 2019 Annual Review P3 Dec 26, 2019

Our Holiday Special, part 3 of 3, is a sampling of our favorite conversations and lectures from 2019. It is a chance for new listeners to the hear the outstanding content that has made TopMedTalk the success it is after 2 amazing years. And for our regular listeners, a check in to make sure they've not missed some of the crucial pieces of the last year.

🙏🙏 All of us at TopMedTalk want to send a BIG thank you to ALL of our amazing fans and listeners. The support these past 2 years is inspiring and much appreciated. We want to thank our guests and lecturers from this past year as well. Your contribution to the show is what makes TopMedTalk so special. And a final THANK YOU to our Sponsors. Your generous support keeps TopMedTalk free open access to the world! Happy Holidays and Cheers to the New Year!! 🥂🥂🎉

More about caring for the transgender patient is here: https://www.topmedtalk.com/aana-2019-caring-for-the-transgender-patient/

Emotional intelligence is explored further here: https://www.topmedtalk.com/aana-2019-emotional-intelligence-and-occupational-stress/

Paul Myles is here: https://www.topmedtalk.com/live-from-asa-2017-paul-myles-3000-patients-in-study-of-fluid-restriction/

Joan Mythen may feature in the future on TopMedTalk.

The Grenfell fire episode is here: https://www.topmedtalk.com/topmedtalk-the-grenfell-inquiry-2/

The Dingle conference for 2020 is here: https://www.ebpom.org/Dingle2020

Carol Peden is here: https://www.topmedtalk.com/anes19-carol-peden-robin-cresner-shane-dickinson-snow-shoo-son/

Mike Scott is here: https://www.topmedtalk.com/anes19-michael-scott/

The interview with Andrew Shaw is here: https://www.topmedtalk.com/anes19-andrew-shaw/

Presented by Desiree Chappell with Monty Mythen alongside a selection of clips from the last year.

TopMedTalk | Holiday Special 2019 Annual Review P2 Dec 25, 2019

Our Holiday Special, part 2 of 3, is a sampling of our favorite conversations and lectures from 2019. It is a chance for new listeners to the hear the outstanding content that has made TopMedTalk the success it is after 2 amazing years. And for our regular listeners, a check in to make sure they've not missed some of the crucial pieces of the last year.

🙏🙏 All of us at TopMedTalk want to send a BIG thank you to ALL of our amazing fans and listeners. The support these past 2 years is inspiring and much appreciated. We want to thank our guests and lecturers from this past year as well. Your contribution to the show is what makes TopMedTalk so special. And a final THANK YOU to our Sponsors. Your generous support keeps TopMedTalk free open access to the world! Happy Holidays and Cheers to the New Year!! 🥂🥂🎉

Sol Aronson's inimitable style is on display here: https://www.topmedtalk.com/sca-poster-presenters/

Sasha Shillcut gets a mention, her piece is here: https://www.topmedtalk.com/topmedtalks-to-sasha-shillcutt/

The piece with Tjorvi Perry will be available next year.

Charles Brown gets a mention, his piece is here: https://www.topmedtalk.com/topmedtalks-to-charles-brown/

The piece regarding emergency laparotomys is here: https://www.topmedtalk.com/anaesthesia-2019-tim-cook-and-paul-wischmeyer/

The Fitter Better Sooner initiative is outlined here: https://www.topmedtalk.com/sunday-special-fitter-better-sooner/

Anaesthesia 2019 | Developmental neurotoxicity: https://www.topmedtalk.com/anaesthesia-2019-developmental-neurotoxicity/

Linda Mason's full interview is here: https://www.topmedtalk.com/euroanaes2019-linda-mason/

Paul Pomerance is here: https://www.topmedtalk.com/euroanaes2019-paul-pomerance/

Maurizio Cecconi is here: https://www.topmedtalk.com/euroanaes2019-maurizio-cecconi/

The piece featuring Dan Longrois is here: https://www.topmedtalk.com/euroanaes2019-dan-longrois/

The fascinating Paul Myles piece is here: https://www.topmedtalk.com/prato-2019-paul-myles/

Discover more about Bruce Biccard's work here: https://www.topmedtalk.com/prato-2019-bruce-biccard/

Find out more about WakeMed here: https://www.topmedtalk.com/eras-cardiac-2019-judson-williams-and-gina-mcconnell/

Ken Van Someren is here: https://www.topmedtalk.com/prehab-periop-world-congress-gerard-danjoux-ken-van-someren/

Find out more about our "forgotten friend" from Evan Karesh here: https://www.topmedtalk.com/topmedtalk-methadone-a-forgotten-friend/

Presented by Desiree Chappell with Monty Mythen alongside a selection of clips from the last year.

TopMedTalk | Holiday Special 2019 Annual Review P1 Dec 24, 2019

Our Holiday Special, part 1 of 3, is a sampling of our favorite conversations and lectures from 2019. It is a chance for new listeners to the hear the outstanding content that has made TopMedTalk the success it is after 2 amazing years. And for our regular listeners, a check in to make sure they've not missed some of the crucial pieces of the last year.

🙏🙏 All of us at TopMedTalk want to send a BIG thank you to ALL of our amazing fans and listeners. The support these past 2 years is inspiring and much appreciated. We want to thank our guests and lecturers from this past year as well. Your contribution to the show is what makes TopMedTalk so special. And a final THANK YOU to our Sponsors. Your generous support keeps TopMedTalk free open access to the world! Happy Holidays and Cheers to the New Year!! 🥂🥂🎉

In the order discussed on the podcast here are the pieces mentioned:

President Bill Clinton features on TopMedTalk here: https://www.topmedtalk.com/sunday-special-bill-clinton-at-the-world-patient-safety-science-technology-summit/

Joe Kiani from the Patient Safety Movement Foundation link: https://www.topmedtalk.com/topmedtalks-to-joe-kiani/

Angela Bader is here: https://www.topmedtalk.com/perioperative-medicine-summit-2019-1-03-angela-bader/

Periperative Cognition workshop: https://www.topmedtalk.com/sunday-special-the-perioperative-cognition-workshop-part-4-2/

Our discussion regarding muscle quality is here: https://www.topmedtalk.com/desirees-roundtable-the-malnourished-surgery-patient/

Our discussion with Rick Dutton is here: https://www.topmedtalk.com/topmedtalks-to-rick-dutton-2/

The TRIPOM series is here: https://www.topmedtalk.com/?s=tripom

Liz Pratt's interview is here: https://www.topmedtalk.com/desirees-roundtable-changing-the-culture-around-surgical-recovery/

Jamie Harris is here: https://www.topmedtalk.com/desirees-roundtable-aser-2019-jamie-harris-and-carol-schmidt/

Presented by Desiree Chappell with Monty Mythen alongside a collection of highlights from the last twelve months of TopMedTalk.

EBPOM 2019 | Brain Health (Peri-Operative Quality Initiative: POQI 6) - what can we do tomorrow? Dec 23, 2019

This piece discusses The Brain Health Initiative and the sixth Peri-Operative Quality Initiative which focused upon delirium. How can progress in these areas be built upon and encouraged? Where is the data in regards to detecting and dealing with delirium?

Beers Criteria Medication List; Potentially Inappropriate Medications for the Elderly According to the Revised Beers Criteria is here: https://dcri.org/beers-criteria-medication-list/

The website for the AARP is here: https://www.aarp.org/

Presented by Lee A. Fleisher Professor and Chair of Anesthesiology and Critical Care, University of Pennsylvania. There is a short question and answer session at the end hosted by Desiree Chappell and Monty Mythen.

Social media and the democratisation of education | Sunday Special Dec 22, 2019

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 their guest Avital O'Glasser, Assistant Professor of Medicine at OHSU, Oregon Health & Science University and member of the communications committee for SPAQI.

If you enjoyed this, carry on listening with this piece here:

Sunday Special | Social Media http://topmedtalk.libsyn.com/sunday-special-social-media

Amir Jaffer | TopMedTalks to... Dec 21, 2019

What is a "Respect Officer"? Why is respect so important in perioperative care? How does improving 'the culture of safety' also help to improve outcomes? Should we be overly concerned about high cancelation rates for surgery? And what are the advantages of a preoperative risk assessment clinic (PRAC)?

Presented by Desiree Chappell and Monty Mythen with their guest Amir Jaffer, Chief Medical Officer, New York Presbyterian / Queens.

POET 6.04 | Is paternalism always bad? Dec 20, 2019

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 contributions from Lee Fleisher, Professor of Anesthesiology and Critical Care, University of Pennsylvania and Sol Aronson, tenured Professor at Duke University, Dr Tim Miller, Duke University and Dr Attilla Kett, St Peter's University Hospital at New Jersey.

Periop SIG 18 | The war on postoperative complications, panel discussion Dec 19, 2019

This exciting panel discussion covers a wide variety of questions, including; what is the definition of high risk patients in your clinic? What is your criteria for referal regarding pre-op patients? Who is in the multidisciplinary pre-op team? How long does each patient appointment last? How should we prioritise antihypertensives? Should anaesthetists be more involved in the postoperative care of patients?

This piece is chaired by Dr Ar Kar Aun and features; Imogen Mitchell, Senior Staff Specialist, ICU, the Canberra HospitalDean, ANU Medical School, Vincent D'Intini, Senior staff specialist, Nephrologist, Alfred Hospital Melbourne, and Bobbie Jean Switzer, Professor of Anesthesiology and Director of Perioperative Medicine at Northwestern University in Chicago, Illinois.

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Brought to you by the Perioperative Medicine Special Interest Group (SIG) in association with the Australian and New Zealand Society for Geriatric Medicine and the Internal Medicine Society of Australia and New Zealand at the 7th annual Australasian Symposium of Perioperative Medicine.

The Perioperative Medicine Special Interest Group (SIG) has three aims; improve patient safety and outcomes, share knowledge and collaborate with specialty groups, develop the specialty of perioperative medicine with various craft groups.

For more information follow this link here: http://www.anzca.edu.au/fellows/special-interest-groups/perioperative-medicine

EBPOM Highlight 2.23 | Psychological Behavioural Change Interventions in Cancer Patients Dec 18, 2019

"POETTS 2018 | Psychological Behavioural Change Interventions in Cancer Patients" - 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 Chloe Grimmett, behavioural scientist from Southampton University. She works closely alongside the 'Fit for Surgery Team', providing the behavioural intervention which is part of the on-going WestFit prehabilitation trial.

Cancer outcomes drive enhanced recovery | The RoundTable Dec 17, 2019

"What drove enhanced recovery for us was not the short lengths of stay but the cancer outcomes" - this conversation explains how enhanced recovery gains traction in practice. Even after a relatively short period of application an evidence based approach is hard to refute.

Desiree Chappell presents 'The Roundtable blog'; in this piece she’s in conversation with Dr Michael Scott, Professor of Anesthesiology at Virginia Commonwealth University and Professor at The University of Pennsylvania, Dr Neil Seeley, Chief of Anesthesia for the Cancer Treatment Centres of America and Dr Kevin Watkins, Surgical Oncologist for the Cancer Treatment Centres of America.

EBPOM 2019 | Perioperative Blood Pressure, Q&A Dec 16, 2019

As a general rule, should ward monitoring be increased? Should continuous blood pressure monitoring be more frequent?

This short piece follows on from Tim Miller's talk "Perioperative Blood Pressure (PeriOperative Quality Initiative: POQI 3) how low can you safely go?".

Presented by Desiree Chappell and Monty Mythen with Tim Miller, Associate Professor of Anesthesiology from Duke University Medical Centre.

Pets as therapy | Sunday Special Dec 15, 2019

Pets as Therapy are a fantastic charity who have provided a practical theraputic service to various people in assorted contexts, here you can hear them work their magic on the TopMedTalk team. What are the advantages of taking pets into the ward? Can patients benefit from some therapy from our 'hairy friends'? Meet the volunteers and practitioners who have a dogged determination to cheer up our patients. Presented by Desiree Chappell and Monty Mythen with their guests; Hillary Burbage, with Matlock, Pamela Pearl, with Frankie, Suzy Emsden with Alfie the therapy dog and Matthew Robinson, national project co-ordinator for Pets as Therapy.

Davinder Ramsingh | TopMedTalks to... Dec 14, 2019

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, when, why and how you can use this incredible tool. Is it really a piece of bedside assessment equipment which is about to become as ubiquitous as a doctor's thermometer?

It's difficult not to get excited about the ability to take a quick look at a patient's cardiac function, at the bedside, with a handheld piece of kit. Scanning a patient's abdomen, seeing how to apply appropriate measures of care rapidly on the spot, these are just some of the advantages discussed in this piece.

See more here:

Acute Care and Perioperative Ultrasound Workshop Co-sponsored by the Departments of Anesthesiology at Loma Linda and UCLA Medical Centers.

www.pocusededucation.com

Evidence-Based Perioperative Ultrasound Educational Curriculum (created as a free, open-source, platform for point of care ultrasound education)

www.foresightultrasound.com

Professor Monty Mythen is presenting, with his guest, Davinder Ramsingh MD, Director of Research and Perioperative Ultrasound at Loma Linda University Medical Center - Dept. of Anesthesiology.

POET 6.03 | Surgery school Dec 13, 2019

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-inspiratory-muscle-training

TopMedTalk | Global Perspectives on Perioperative Medicine Dec 12, 2019

Australia has an interesting history both generally and with perioperative medicine specifically. Here the story is told and their current progress is revealed. How do comparisons between various countries help us to understand where improvements can be made? How do the differences between the way in which healthcare is funded impact patients and providers?

Moderated by Dr Mark Edwards, University College London Hospital, with his guests Ross Kerridge, John Hunter Hospital, Newcastle, Australia, often cited as 'the father of Modern Perioperative Medicine', Sol Aronson, tenured professor at Duke University and Executive Vice Chairman in the Department of Anesthesiology, Mike Grocott, Professor of Anaesthesia and critical care at the University of Southampton.

EBPOM Highlight 2.22 | Pre-operative Inspiratory Muscle Training Dec 11, 2019

"POETTS 2018 | Pre-operative Inspiratory Muscle Training" - 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 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.

What is the Perioperative Medicine Summit? | The RoundTable Dec 10, 2019

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 Orthopaedic Surgery; Chief, Section of Perioperative and Consultative Medicine; Froedtert and Medical College of Wisconsin and Steven L. Cohn, Professor Emeritus, Director – Medical Consultation Service, Jackson Memorial Hospital University of Miami Miller School of Medicine.

EBPOM 2019 | Perioperative Blood Pressure (PeriOperative Quality Initiative: POQI 3) how low can you safely go? Dec 09, 2019

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 INPRESS Trial is discussed here: https://www.topmedtalk.com/ebpom-london-2018-any-answers-part-3-the-big-trials/

We speak with Dan Sessler here: https://www.topmedtalk.com/topmedtalks-to-dan-sessler-2/

Presented by Tim Miller, Associate Professor of Anesthesiology from Duke University Medical Centre.

The Perioperative Cognition Workshop - Part 4 | Sunday Special Dec 08, 2019

This invaluable piece is a chance to attend a workshop which looks at the latest thinking on "perioperative cognition" and 'post-operative cognitive dysfuntion'.

We advise you use this link here to find the PDF of the paper being discussed: https://bjanaesthesia.org/article/S0007-0912(17)54082-9/fulltext

Presented by David Scott, Professor, University of Melbourne, Director, Anaesthesia and Acute Pain Medicine, St Vincent’s Hospital, Melbourne and Lis Evered, Scientific Head of Research, Department of Anaesthesia, St. Vincent's Hospital, Melbourne.

This is Part 4, to find Part 1 follow this link here: https://www.topmedtalk.com/sunday-special-the-perioperative-cognition-workshop-part-1/

Part 2 is here:

https://www.topmedtalk.com/sunday-special-the-perioperative-cognition-workshop-part-2/

Part 3 is here:

https://www.topmedtalk.com/sunday-special-the-perioperative-cognition-workshop-part-3/

Brought to you by the Perioperative Medicine Special Interest Group (SIG) in association with the Australian and New Zealand Society for Geriatric Medicine and the Internal Medicine Society of Australia and New Zealand at the 7th annual Australasian Symposium of Perioperative Medicine.

The Perioperative Medicine Special Interest Group (SIG) has three aims; improve patient safety and outcomes, share knowledge and collaborate with specialty groups, develop the specialty of perioperative medicine with various craft groups.

For more information follow this link here: http://www.anzca.edu.au/fellows/special-interest-groups/perioperative-medicine

Angela Bader | TopMedTalks to... Dec 07, 2019

Does perioperative medicine alow institutions to take a broader view? Population health has been a theme on TopMedTalk, is it a logical extension of the perioperative process? How do we manage specialist care for the elderly and ensure high quality shared decision making? What lies behind the mindset change needed for some to accept surgery is not always the answer? Should we expect medical students to be taught the principles of perioperative medicine?

What are some of the unique tensions in the US system that can frustrate the adoption of a truly perioperative practice?

Presented by Desiree Chappell and Monty Mythen with their guest Angela Bader, Vice Chair of Perioperative Medicine at Brigham and Women's Hospital.

POET 6.02 | Do you need a breathlessness clinic? Dec 06, 2019

When it comes to breathlessness how do we better diagnose and apply treatment? How do we overcome the fact that referring to a specialist can sometimes take a patient 'down the wrong route' with a condition that might not be just heart or lung related? Should we take a more perioperative approach to treatment and diagnosis?

"Nick, the patient" asks a few questions and demonstrates the misunderstanding that many sufferers might have; breathlessness is not always connected to your lungs.

"Johnny, the concerned family member" then speaks about his Mother, 84, who has recently experienced breathlessness; she didn't want to complain about it, how can we pick these issues up earlier?

This podcast is presented by Professor Monty Mythen and features contributions from; Ronan Astin, clinical consultant in respiratory medicine at UCL Hospital and finally 'the patients' Nick Margerrison and Johnny Themans.

TopMedTalk | Methadone, a forgotten friend Dec 05, 2019

"Increasing the richness and the reach of what we do" is the mantra of 'Anesthesiology'; hear from its Editor in Chief how it managed to self study and discover the essential idea behind the journal: "trusted evidence, from discovery to practice".

Conversation then moves on to methadone, the overlooked opiate; where do you use it and what sort of dose is appropriate? What are the benefits of including this in your practice and should it really be considered in the same category as most other opioids?

The podcasts mentioned are here: https://anesthesiology.pubs.asahq.org/multimedia.aspx?mediaType=Podcasts

Presented by Desiree Chappell and Monty Mythen with Korey Springman and their guest Evan Kharasch, Professor of Anesthesiology, Vice Chair for Innovation, Director, Academic Entrepreneurship, Duke University School of Medicine and Editor-in- Chief, Anesthesiology.

EBPOM Conference Highlight 2.21 | Lessons on EPOCH in the UK Dec 04, 2019

The results of the Enhanced Peri-Operative Care for High-risk patients (EPOCH) trial; where does it put perioperative practice in 2019? What have we learned?

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 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 Carol Peden, Professor of Anesthesiology and Exec. Director of the Center for Health System Innovation, University of Southern California, University of Bath and the Institute for Healthcare Improvement (IHI).

One of the best career decisions I've made | The RoundTable Dec 03, 2019

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 assistant, New York Presbyterian/Weill Cornell.

EBPOM 2019 | Perioperative Haemodynamic Management - how to best treat or avoid a low BP? Dec 02, 2019

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.

The Perioperative Cognition Workshop - Part 3 | Sunday Special Dec 01, 2019

This invaluable piece is a chance to attend a workshop which looks at the latest thinking on "perioperative cognition" and 'post-operative cognitive dysfuntion'.

We advise you use this link here to find the PDF of the paper being discussed: https://bjanaesthesia.org/article/S0007-0912(17)54082-9/fulltext

Presented by David Scott, Professor, University of Melbourne, Director, Anaesthesia and Acute Pain Medicine, St Vincent’s Hospital, Melbourne and Lis Evered, Scientific Head of Research, Department of Anaesthesia, St. Vincent's Hospital, Melbourne.

This is Part 3, to find Part 1 follow this link here: https://www.topmedtalk.com/sunday-special-the-perioperative-cognition-workshop-part-1/

Part 2 is here:

https://www.topmedtalk.com/sunday-special-the-perioperative-cognition-workshop-part-2/

Part 4 is here:

https://www.topmedtalk.com/sunday-special-the-perioperative-cognition-workshop-part-4/

Brought to you by the Perioperative Medicine Special Interest Group (SIG) in association with the Australian and New Zealand Society for Geriatric Medicine and the Internal Medicine Society of Australia and New Zealand at the 7th annual Australasian Symposium of Perioperative Medicine.

The Perioperative Medicine Special Interest Group (SIG) has three aims; improve patient safety and outcomes, share knowledge and collaborate with specialty groups, develop the specialty of perioperative medicine with various craft groups.

For more information follow this link here: http://www.anzca.edu.au/fellows/special-interest-groups/perioperative-medicine

Mike Grocott | ASER 2019 Nov 30, 2019

More of our coverage of the American Society of Enhanced Recovery (ASER) annual general meeting. Reflections regarding the rise of Cardiopulmonary Exercise Testing (CPET); a growing field, particularly in the US.

The "Prehabilitation World Congress in association with POETTS & EBPOM" meeting discussed in this podcast is here: https://ebpomusa.org/Prehab-2019

If you are interested in hearing more about the Measurement of Exercise Tolerance before Surgery (METS) trial: https://www.topmedtalk.com/journal-club-1-03-the-mets-trial/

Presented by Desiree Chappell and Monty Mythen with their guest Mike Grocott, Professor of Anaesthesia and critical care at the University of Southampton.

POET 6.01 | Perioperative medicine is population health. Nov 29, 2019

Perioperative medicine is defined here as: "the practice of patient centred multidisciplinary and integrated medical care of patients from the moment of contemplation of surgery until full recovery". Population health is defined as: "the health outcomes of a group of individuals including the distribution of such outcomes within the group". Do the two compliment each other? Use this concise 15 minute presentation to help build the case for a perioperative care programme at your institution. Presented by Sol Aronson, tenured professor at Duke University and Executive Vice Chairman in the Department of Anesthesiology.

Periop SIG18 | Can we improve the care of Older Vascular Surgical Patients? Nov 28, 2019

If we look at the evidence, is there a case for "vascular geriatrics"? Co-managed care in vascular surgery could be a way forward, this talk builds the case for change.

Readmission rates in this group are dissapointing, how do we reasonably tackle this issue? How do we balance questions regarding appropriateness and need for surgery in this area? What about the priorities of the patient, do they align with our aims?

Is it possible there are geriatiricans who are already doing co-management with vascular surgeons? Is it fair to say that vascular surgeons need help the most?

The talk is followed by a short case study regarding the model of care at Prince of Wales Hospital and Community Health Services, Department of Geriatrics.

Presented by Vasi Naganathan, Academic and Consultant Geriatrician at University of Sydney, Concord Repatriation Hospital, New South Wales, Australia; followed by a second brief 'case study' from Christina Norris, Prince of Wales Hospital and Community Health Services, Department of Geriatrics.

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Brought to you by the Perioperative Medicine Special Interest Group (SIG) in association with the Australian and New Zealand Society for Geriatric Medicine and the Internal Medicine Society of Australia and New Zealand at the 7th annual Australasian Symposium of Perioperative Medicine.

The Perioperative Medicine Special Interest Group (SIG) has three aims; improve patient safety and outcomes, share knowledge and collaborate with specialty groups, develop the specialty of perioperative medicine with various craft groups.

For more information follow this link here: http://www.anzca.edu.au/fellows/special-interest-groups/perioperative-medicine

EBPOM Highlight | Exercise prehabilitation for patients facing primary surgical resection of colorectal cancer Nov 27, 2019

This piece is taken from the free papers presentations given at EBPOM 2019. Can two weeks of prehabilitation really make a difference for patients facing primary surgical resection of colorectal cancer? How feasable is it to recruit patients into such a programme? Can we make a real change in their objectively measured fitness? Is there patient buy in? What is the strain on an institution's resources?

Presented by Andrew Bates, Senior Research Nurse at Royal Bournemouth Hospital NIHR Intern.

Can you bite your upper lip? Assessing patients to reduce post-op respiratory complications | The RoundTable Nov 26, 2019

Obstructive sleep apnea is important to identify in patients, this piece explains how; use the official STOP BANG website here: http://www.stopbang.ca/osa/screening.php

Opioids and pain management strategy is discussed, alongside reflections on the differences between the healthcare systems of Canada, the UK and America.

Finally, what is "the beard test" and "the upper lip bite test"?

Presented by Desiree Chappell and Monty Mythen with their guests, Frances Chung, Professor, Department of Anesthesiology and Pain Medicine, University of Toronto and Kurt J. Pfeifer, Professor of Medicine, General Internal Medicine, Medical Director, Preoperative Evaluation Clinic, Froedtert and Medical College Eye Institute, Medical College of Wisconsin, Milwaukee, WI.

EBPOM 2019 | The Opioid Crisis (Peri-Operative Quality Initiative: POQI 4) - can we kick the habit? Nov 25, 2019

Some practitioners habitually prescribe opioids, the consequences in America are now described as a national crisis. Essentially the focus here is "better opioid stewardship" and a "move away from the traditional fundamental principle of opioids first".

Presented by Michael Manning, MD, PhD, Assistant Professor at Duke University Medical Center, Director of Research for the Perioperative Medicine Fellowship at Duke.

The Perioperative Cognition Workshop - Part 2 | Sunday Special Nov 24, 2019

This invaluable piece is a chance to attend a workshop which looks at the latest thinking on "perioperative cognition" and 'post-operative cognitive dysfuntion'.

We advise you use this link here to find the PDF of the paper being discussed: https://bjanaesthesia.org/article/S0007-0912(17)54082-9/fulltext

This is Part 2, to find Part 1 follow this link here: https://www.topmedtalk.com/sunday-special-the-perioperative-cognition-workshop-part-1/

Part 3 is here:

https://www.topmedtalk.com/sunday-special-the-perioperative-cognition-workshop-part-3/

Part 4 is here:

https://www.topmedtalk.com/sunday-special-the-perioperative-cognition-workshop-part-4/

Presented by David Scott, Professor, University of Melbourne, Director, Anaesthesia and Acute Pain Medicine, St Vincent’s Hospital, Melbourne and Lis Evered, Scientific Head of Research, Department of Anaesthesia, St. Vincent's Hospital, Melbourne.

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Brought to you by the Perioperative Medicine Special Interest Group (SIG) in association with the Australian and New Zealand Society for Geriatric Medicine and the Internal Medicine Society of Australia and New Zealand at the 7th annual Australasian Symposium of Perioperative Medicine.

The Perioperative Medicine Special Interest Group (SIG) has three aims; improve patient safety and outcomes, share knowledge and collaborate with specialty groups, develop the specialty of perioperative medicine with various craft groups.

For more information follow this link here: http://www.anzca.edu.au/fellows/special-interest-groups/perioperative-medicine

William Wooden | TopMedTalks to... Nov 23, 2019

Perioperative nutrition is a topic which has fascinates us here on TopMedTalk. Ever evolving and moving forward the questions continue as we explore an area which will only keep growing. Should evidence based arguments be the way we make the case for true investment in this area? Presented by Korey Springman with her guest William Wooden, Director of Operative Services at Indiana University of Health.

EBPOM 2019 | Opioid-free anaesthesia Nov 22, 2019

This piece dives into the latest thinking behind opioid-free anaesthesia; how can we improve? Is the challenge of the opioid crisis being met head on by perioperative medicine? Is it realistic to expect to reach a point where opioids are removed from the equation entirely?

Presented by Michael Manning, MD, PhD, Assistant Professor at Duke University Medical Center, Director of research for the Perioperative Medicine Fellowship at Duke.

Periop Medicine SIG | It's a team sport - panel discussion Nov 21, 2019

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 Notre Dame, Australia School of Medicine, Sydney and Don Campbell, Professor of Medicine at Monash University and Head of General Medicine at Southern Health.

EBPOM Highlight | Leadership for QI - the Trust perspective Nov 20, 2019

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 Mark Hamilton, Consultant and Honorary Senior Lecturer in Anaesthesia & Critical Care Medicine, clinical lead for the Perioperative Assessment & Planning Unit, at St. George's Hospital and Medical School, member of the Surgical Outcomes Resource Centre at UCL, Co-Director of Evidence Based Perioperative Medicine (EBPOM), Editor in Chief of Perioperative Medicine, he also chairs the System Resilience Group, the Finance and Performance Committee and is a member of the Quality Committee.

'Our chief CRNA sent me a podcast from TopMedTalk' | The RoundTable Nov 19, 2019

"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?

Presented by Desiree Chappell with co-host Korey Sprigman and their guests, Jamie Harris, CRNA, Hillcrest Hospital, Tulsa, Oklahoma and Carol Schmidt, CRNA, Royal Oak, Michigan.

EBPOM 2019 | Cleveland Clinic London Nov 18, 2019

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 national and international leadership in clinical quality, echocardiography, research and education.

Presented by Nick Fletcher, Chair of the Institute of Anaesthesia and Critical Care at the Cleveland Clinic London, Consultant in Anaesthesia and Critical Care, St Georges University Hospital NHS Foundation Trust.

TopMedTalk | WHO is looking at the arts and health? Nov 17, 2019

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.euro.who.int/en/media-centre/sections/press-releases/2019/can-you-dance-your-way-to-better-health-and-well-being-for-the-first-time,-who-studies-the-link-between-arts-and-health

The Social Prescribing Network is here: https://www.socialprescribingnetwork.com/

The National Institute for Health and Care Excellence (NICE) guidance is here: https://www.nice.org.uk/guidance

The Culture Health and Wellbeing Alliance website is here: https://www.culturehealthandwellbeing.org.uk/

Katherine Taylor's twitter is here: https://twitter.com/communikatt

And her blog is here: https://artthouwell.com/

Presented by Nick Margerrison with his guest Katherine Taylor, Clinical psychologist, Arts & Mental Health Innovation Programme Manager at GMiTHRIVE.

Rick Dutton | TopMedTalks to... Nov 16, 2019

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 Master's Course. Presented by Monty Mythen with Rick Dutton, Chief Quality Officer at United States Anesthesia Partners Baltimore, Maryland Area with questions from both conference delegates and online listeners.

Periop SIG18 | Risk prediction and research - panel discussion Nov 15, 2019

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 and Pain Medicine Unit (APPMU), Melbourne Medical School, University of Melbourne; Director, Melbourne Clinical and Translational Sciences (MCATS) research platform and Dr Doug Campbell, Anaesthesia Specialist at Auckland City Hospital.

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Brought to you by the Perioperative Medicine Special Interest Group (SIG) in association with the Australian and New Zealand Society for Geriatric Medicine and the Internal Medicine Society of Australia and New Zealand at the 7th annual Australasian Symposium of Perioperative Medicine.

The Perioperative Medicine Special Interest Group (SIG) has three aims; improve patient safety and outcomes, share knowledge and collaborate with specialty groups, develop the specialty of perioperative medicine with various craft groups.

For more information follow this link here: http://www.anzca.edu.au/fellows/special-interest-groups/perioperative-medicine

TopMedTalk | The AI Doctor will see you now Nov 14, 2019

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/S0007-0912(19)30047-9/fulltext

Presented by Desiree Chappell and Monty Mythen with, Feras Hatib, Phd, Director, Research and Development, Algorithms and Signal Processing at Edwards Lifesciences.

EBPOM Highlight | Thinking about the system Nov 13, 2019

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 issues? How are you going to evaluate change?

Presented by Ross Kerridge, John Hunter Hospital, Newcastle, Australia, often cited as 'the father of Modern Perioperative Medicine'.

Carol Peden - EPOCH Q&A | The RoundTable Nov 12, 2019

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 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 with Desiree Chappell and Carol Peden, Professor of Anesthesiology and Exec. Director of the Center for Health System Innovation, University of Southern California, University of Bath and the Institute for Healthcare Improvement (IHI). Additional contributions from Sol Aronson, tenured professor at Duke University and Executive Vice Chairman in the Department of Anesthesiology as well as TopMedTalk listeners and conference delegates.

EBPOM 2019 | Preoperative risk stratification Nov 11, 2019

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/

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.

Preoperative Optimization: Framing up the value proposition | Sunday Special Nov 10, 2019

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 and the fee payer?

This piece is moderated by Sol Aronson, tenured Professor at Duke University, it features a talk from Michael Englesbe, Professor of Surgery, Michigan followed by a panel discussion which also features Dan Engleman, President of the enhanced Recovery after Cardiac surgery society, Baystate Health in Massachusetts, Medical Director, Heart, Vascular & Critical Care Services, Baystate Medical Center and Associate Professor of Surgery University of Massachusetts Medical School-Baystate and Tim Miller, Duke University; further discussion is provided with questions from online listeners and conference delegates posed by Vicki Morton, Doctor of Nursing Practice and Director of Clinical and Quality Outcomes at Providence Anesthesiology Associates.

Iain Moppett | TopMedTalks to... Nov 09, 2019

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 privacy concerns with the need for data to be accessible? Can such information be truly anonymised? Discussion moves here to 'Google flu tracker' and its, initially quite good, results.

Finally how do doctors adapt to the new world where they are being told in front of their patients what the right course of action is? Will patients retain trust in the Doctor's decisions?

Taken from day two of our coverage of the Royal College of Anaesthetists' annual conference at The British Museum in London.

Presented by Desiree Chappell, Monty Mythen and Joff Lacey, with their guest Professor Iain Moppett, Professor of Anaesthesia and Perioperative Medicine, University of Nottingham.

EBPOM 2019 | Delivery of Prehabilitation, panel discussion Nov 08, 2019

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 Medical Center, The Netherlands, lecturer at the first Health Innovation School (Ministry of Health, Welfare and Sport and Reshape innovation), Surgical resident, Department of Surgery at Maxima Medical Center (ANIOS); Gerard Danjoux, Consultant in Anaesthesia and Sleep Medicine at South Tees Hospitals NHS Foundation Trust; Ken Van Someren, Director KvS Performance Ltd.

TopMedTalk | Perioperative medicine and being a good sport Nov 07, 2019

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 in Anaesthesia and Sleep Medicine at South Tees Hospitals NHS Trust and Ken Van Someren, Director KvS Performance Ltd.

EBPOM Highlight 2.17 | Colloid vs Crystalloid - Goal Directed Therapy Nov 06, 2019

"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 and Critical Care at University College London.

Rick Dutton - Q&A Session | The RoundTable Nov 05, 2019

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 States Anesthesia Partners Baltimore, Maryland Area. Featuring questions and comments from, in this order; Jamie Harris, Tulsa Oklahoma, Tim Miller, Duke University, North Carolina, Sol Aronson, Duke University, Linda Marie Sutton, Duke Univeristy, Tony Senagore, Western Michigan University, Attilla Kett, St Peter's University Hospital at New Jersey, Dan Engleman, Springfield, Massachusetts.

EBPOM 2019 | Who delivers Prehab? Nov 04, 2019

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 important to perioperative medicine?

The ELLICSR Kitchen is here: https://www.ellicsr.ca/en/clinics_programs/ellicsr_kitchen

Presented by Daniel Santa Mina, Assistant Professor at University of Toronto & Scientist in ELLICSR at the Princess Margaret Cancer Centre.

TopMedTalk | The Grenfell Inquiry Nov 03, 2019

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 younger listeners may find disturbing.

Clare Gerada | TopMedTalks to... Nov 02, 2019

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.

EBPOM 2019 | UK Centre for Perioperative Care Nov 01, 2019

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 aim is to improve quality of care, support patients and professionals as well as influence policy, technology, research and innovation.

CPOC launched on 20 May 2019 at the Anaesthesia 2019 event.

Follow them on Twitter at @CPOC_News

There is a page on the Royal College of Anaesthetists' website here: https://www.rcoa.ac.uk/cpoc

Presented by Mike Grocott, Professor of Anaesthesia and critical care at the University of Southampton and frequent TopMedTalk contributor.

TopMedTalk | The Grenfell Inquiry - Part 3 Oct 31, 2019

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 listeners may find disturbing.

TopMedTalk | The Grenfell Inquiry - Part 2 Oct 30, 2019

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 listeners may find disturbing.

TopMedTalk | The Grenfell Inquiry - Part 1 Oct 29, 2019

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 Medicine and SIAA Autumn Congress, Dingle, Ireland, 2019.

Please note: This podcast contains information younger listeners may find disturbing.

EBPOM 2019 | Psychology and behavioural change Oct 28, 2019

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 depression have been shown to effect outcomes.

How can psychological behaviour change techniques be embedded into encouragement to involve themselves in exercise training in advance of their operation?

For more on the Wesfit trial go here: http://www.wesfit.org.uk/

Presented by Chloe Grimmett, National Institute of Health Research (NIHR) post-doctoral Research Fellow and Senior Research Fellow for the Macmillan Survivorship Research Group at the University of Southampton; behavioural science lead for Wessex-Fit-for Surgery (WesFit) trial, a large randomised controlled trial of physical and psychological prehabilitation prior to cancer surgery and is a member of the National Cancer Research Institute clinical studies Lifestyle and Behaviour Change Group and the NIHR Cancer and Nutrition Collaborative.

EBPOM Highlight | Heart disease in pregnancy Oct 27, 2019

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).

John Myburgh | TopMedTalks to... Oct 26, 2019

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 Professor John A Myburgh, Intensive Care Medicine, University of New South Wales; Director of the Division of Critical Care and Trauma at the George Institute for Global Health and Senior Intensive Care Physician at the St George Hospital, Sydney. He holds honorary Professorial appointments at the University of Sydney and Monash University School of Public Health and Preventive Medicine.

EBPOM 2019 | The Manchester devolution revolution Oct 25, 2019

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 patients affected by cancer, over 2 years?

The GM teams are very happy to host teams in Manchester who may want to visit MFT and see Surgery School in action and show colleagues what they are aiming to achieve with GM Cancer Prehab. Email John on John.moore@mft.nhs.uk or john.moore@erasplus.co.uk

ERAS+ website is here: https://www.erasplus.co.uk/

NHS Innovation Accelerator website: https://nhsaccelerator.com/

GM Active are here: https://www.gmactive.co.uk/

Presented by John Moore, consultant in anaesthetics and critical care medicine from Manchester, UK, Clinical Head of the Division of Anaesthetics, Peri-operative medicine and Critical Care at Manchester University Hospital NHS Foundation Trust.

TopMedTalk | The goal is more important than the role Oct 24, 2019

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 primary accountability be used to leverage performance within a team structure? Can incentive metrics and incentive pay really make the difference or is human behaviour motivated by other forces?

Presented by Monty Mythen with Desiree Chappell and their guest Brian Woods, MD President, Chief Medical Officer of Northstar Anesthesia. Additional contributions from Professor Sol Aronson, tenured professor at Duke University and Executive Vice Chairman in the Department of Anesthesiology as well as TopMedTalk listeners and conference delegates.

EBPOM 2019 | Patients’ views about preoperative vs long-term health behaviour change Oct 23, 2019

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.

ANES19 | Mark Warner Oct 22, 2019

The TopMedTalk team are live from Anesthesiology 2019 at the Orange County Convention Center in Orlando. With over 14,000 delegates, clinicians, thought leaders and professionals, it's the largest gathering of Anesthesiologists and Anesthesia providers in the world.

Check out the www.topmedtalk.com website now to hear live audio, while you are there remember to subscribe for updates so you can always be one step ahead of the crowd. Also, if you fancy watching the show as it happens go to our Twitter feed www.twitter.com/topmedtalk to see the team in action.

This piece focuses upon patient safety and the work of our guest. How does perioperative medicine fit into the picture, are anesthetists right to take the lead in this field?

You can find the Anesthesia Patient Safety Foundation here: https://www.apsf.org/

Presented by Desiree Chappell with Monty Mythen and Henry Howe alongside their guest Mark Warner, Annenberg Professor of Anesthesiology at the Mayo Clinic in Rochester, 2019 American Society of Anesthesiologists (ASA) recipient of 'The Distinguished Service Award' and President of the Anesthesia Patient Safety Foundation (APSF).

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Like this, want more?

Our guest mentions this excellent piece here: https://www.topmedtalk.com/anes19-alexander-hannenberg-kris-torgeson/

Further listening, regarding patient safety, globally, can be found here: https://www.topmedtalk.com/ebpom-highlight-1-19-the-patient-safety-movement-foundation/

ANES19 | Greg Fischer Oct 22, 2019

The TopMedTalk team are live from Anesthesiology 2019 at the Orange County Convention Center in Orlando. With over 14,000 delegates, clinicians, thought leaders and professionals, it's the largest gathering of Anesthesiologists and Anesthesia providers in the world.

Check out the www.topmedtalk.com website now to hear live audio, while you are there remember to subscribe for updates so you can always be one step ahead of the crowd. Also, if you fancy watching the show as it happens go to our Twitter feed www.twitter.com/topmedtalk to see the team in action.

This piece focuses upon cerebral oximetry. Can it help practitioners monitor cerebral oxygenation in situations in which pulse oximetry alone may not be fully indicative of the oxygen in the brain? How does it relate to hypoxia?

This piece is a deep dive into the technology and its front line applications.

Presented by Desiree Chappell and Monty Mythen with Mike Grocott, Professor of Anaesthesia and critical care at the University of Southampton and their guest, Greg Fischer, Chairman, Department of Anesthesiology & Critical Care Medicine at Memorial Sloan Kettering Cancer Center.

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Like this, want more?

Mike mentions the exciting research done during Xtreme Everest, hear his engaging lecture on that project here: https://www.topmedtalk.com/10-xtreme-everest-physiology-on-top-of-the-world/

ANES19 | Timothy Short and Kate Leslie Oct 22, 2019

The TopMedTalk team are live from Anesthesiology 2019 at the Orange County Convention Center in Orlando. With over 14,000 delegates, clinicians, thought leaders and professionals, it's the largest gathering of Anesthesiologists and Anesthesia providers in the world.

Check out the www.topmedtalk.com website now to hear live audio, while you are there remember to subscribe for updates so you can always be one step ahead of the crowd. Also, if you fancy watching the show as it happens go to our Twitter feed www.twitter.com/topmedtalk to see the team in action.

This piece focuses on a new article recently published in The Lancet: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(19)32315-3/fulltext

Find out more about the ANZCA Clinical Trials Network here: http://www.anzca.edu.au/research/anzca-clinical-trials-network/anzca-clinical-trials-network-executive

Presented by Desiree Chappell and Monty Mythen with their guests Kate Leslie, Honourary Professor, Monash University, Melbourne, VIC, Australia, Specialist Anaesthetist, The Royal Melbourne Hospital & North Western Mental Health and Non-Executive Director, Australian Medical Council and Timothy Short, Clinical Anaesthetist and Honoury Professor at Auckland University Hospital, New Zealand.

ANES19 | Lee Fleisher Oct 22, 2019

The TopMedTalk team are live from Anesthesiology 2019 at the Orange County Convention Center in Orlando. With over 14,000 delegates, clinicians, thought leaders and professionals, it's the largest gathering of Anesthesiologists and Anesthesia providers in the world.

Check out the www.topmedtalk.com website now to hear live audio, while you are there remember to subscribe for updates so you can always be one step ahead of the crowd. Also, if you fancy watching the show as it happens go to our Twitter feed www.twitter.com/topmedtalk to see the team in action.

This piece focuses on alternative payment models for healthcare. "We keep saying we're going to go to value based care rather than volume based care" and this movement now appears to be picking up pace. How is enhanced recovery and perioperative medicine helping to reduce the cost of healthcare? Can prehabilitation help reduce costs?

Presented by Desiree Chappell with Monty Mythen, Sol Aronson and their guest Lee Fleisher, Professor and Chair of Anesthesiology and Critical Care, University of Pennsylvania.

ANES19 | Tim Miller Oct 22, 2019

The TopMedTalk team are live from Anesthesiology 2019 at the Orange County Convention Center in Orlando. With over 14,000 delegates, clinicians, thought leaders and professionals, it's the largest gathering of Anesthesiologists and Anesthesia providers in the world.

Check out the www.topmedtalk.com website now to hear live audio, while you are there remember to subscribe for updates so you can always be one step ahead of the crowd. Also, if you fancy watching the show as it happens go to our Twitter feed www.twitter.com/topmedtalk to see the team in action.

This detailed discussion sheds more light on The Perioperative Quality Initiative (POQI), the resources available to you and the impact it is having on a global understanding of Enhanced Recovery and Perioperative Medicine.

Check out their website here: www.poqi.org

Further discussion delves into the evergreen fluid debate and walks us through the timeline of how attitudes toward them have changed in the perioperative sphere over the last ten years or so. "We should be fair to the originators of Enhanced Recovery who did not talk about fluid restriction but instead about avoidance of fluid excess"

Presented by Desiree Chappell and Monty Mythen with Sol Aronson, a tenured professor at Duke University and Executive Vice Chairman in the Department of Anesthesiology and their guests Mike Grocott, Professor of Anaesthesia and critical care at the University of Southampton and Tim Miller, Associate Professor of Anesthesiology from Duke University Medical Centre.

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Like this, want more?

Check out this fascinating series, "Fluid Matters". It's an opportunity to listen to a POQI meeting as if you were there in person. Part one, of six, is here: https://www.topmedtalk.com/fluid-matters-series-1-6-definite-definitions-fluid-physiology/

A deeper dive into Enhanced Recovery | The RoundTable Oct 22, 2019

Originally streamed live from the EBPOM USA 2019 conference in Dallas this piece looks into the realities of enhanced recovery. Patient satisfaction and outcomes rise to the top of the priority list as an institution invests in the idea, how long does it take for a clear financial return on the investments required to get it off the ground? How do we get a team motivated to work towards these ideas? Are there any disadvantages to enhanced recovery? How do patients react to it? Also, how does blockchain technology (the innovation behind cryptocurrencies such as Bitcoin) interlock into more practical transfers of patient data? What other innovations are on the horizon? Presented by Desiree Chappell with Monty Mythen and their guest Sabry Ayad, Professor of Anesthesiology, Cleveland Clinic Lerner College of Medicine at Case Western Reserve University.

ANES19 | Neal Flemming Oct 21, 2019

The TopMedTalk team are live from Anesthesiology 2019 at the Orange County Convention Center in Orlando. With over 14,000 delegates, clinicians, thought leaders and professionals, it's the largest gathering of Anesthesiologists and Anesthesia providers in the world.

Check out the www.topmedtalk.com website now to hear live audio, while you are there remember to subscribe for updates so you can always be one step ahead of the crowd. Also, if you fancy watching the show as it happens go to our Twitter feed www.twitter.com/topmedtalk to see the team in action.

This piece looks at innovations in our field, including the Hypotension Prediction Index (HPI)

Presented by Desiree Chappell and Sol Aronson with their guest Neal Fleming, Professor, Anesthesiology and Pain Medicine, UC Davis.

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Like this, want more?

Learn more about HPI here: https://www.topmedtalk.com/the-hypotension-prediction-index-hpi/

ANES19 | Carol Peden, Robin Cresner, Shane Dickinson, Snow Shoo Son Oct 21, 2019

The TopMedTalk team are live from Anesthesiology 2019 at the Orange County Convention Center in Orlando. With over 14,000 delegates, clinicians, thought leaders and professionals, it's the largest gathering of Anesthesiologists and Anesthesia providers in the world.

Check out the www.topmedtalk.com website now to hear live audio, while you are there remember to subscribe for updates so you can always be one step ahead of the crowd. Also, if you fancy watching the show as it happens go to our Twitter feed www.twitter.com/topmedtalk to see the team in action.

"The Power of The Interdisciplinary Team"; introducing the Enhanced Recovery team from Keck Medical Center at The University of Southern California (USC).

Our guests kindly share an email address you can contact them on: Enhanced.Recovery@med.usc.edu

Presented by Desiree Chappell and Monty Mythen with their guests Professor Carol Peden, Robin Cresner, CCRN, Dr Shane Dickinson, anesthesiologist and Snow Shoo Son; The Enhanced Recovery Team from Keck Medical Center at USC.

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Like this, want more?

There's a fascinating conversation with Carol Peden here: https://www.topmedtalk.com/talks-to-carol-peden/

ANES19 | Alexander Hannenberg, Kris Torgeson Oct 21, 2019

The TopMedTalk team are live from Anesthesiology 2019 at the Orange County Convention Center in Orlando. With over 14,000 delegates, clinicians, thought leaders and professionals, it's the largest gathering of Anesthesiologists and Anesthesia providers in the world.

Check out the www.topmedtalk.com website now to hear live audio, while you are there remember to subscribe for updates so you can always be one step ahead of the crowd. Also, if you fancy watching the show as it happens go to our Twitter feed www.twitter.com/topmedtalk to see the team in action.

Alongside some reflections on the American Society of Anesthesiologists this piece is focused upon a fascinating foundation, Lifebox, the only NGO devoted to safer surgery and anesthesia in low-resource countries.

Find out more here: https://www.lifebox.org

Presented by Desiree Chappell with Sol Aronson and their guest Alexander Hannenberg, M.D. Senior Research Scientist, Ariadne Labs; Principal Consultant, ORDx&Rx Surgical Safety Solutions, 2010 president of the American Society of Anesthesiologists and recently served as its Chief Quality Officer. They are joined also by Kris Torgeson, Global CEO, Lifebox Foundation.

ANES19 | Andrew Shaw Oct 21, 2019

The TopMedTalk team are live from Anesthesiology 2019 at the Orange County Convention Center in Orlando. With over 14,000 delegates, clinicians, thought leaders and professionals, it's the largest gathering of Anesthesiologists and Anesthesia providers in the world.

Check out the www.topmedtalk.com website now to hear live audio, while you are there remember to subscribe for updates so you can always be one step ahead of the crowd. Also, if you fancy watching the show as it happens go to our Twitter feed www.twitter.com/topmedtalk to see the team in action.

This piece focuses upon the Perioperative Quality Improvement Initiative (POQI) and perioperative hypotension.

Checkout the POQI website here: http://poqi.org/

Presented by Desiree Chappell and Monty Mythen with their guest Andrew Shaw, Chairman, Department of Anesthesiology and Pain Medicine at The University of Alberta, Edmonton, Alberta and Zone Clinical Department Head for Anesthesia, Alberta Health Services Edmonton Zone. He is also a Fellow of the Royal College of Anaesthetists (UK), the American College of Critical Care Medicine and the Faculty of Intensive Care Medicine (UK).

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Like this, want more?

Find out more about POQI here: "Desiree's Roundtable | What is the Perioperative Medicine Summit?" https://www.topmedtalk.com/desirees-roundtable-what-is-the-perioperative-medicine-summit/

For more regarding the papers published by POQI, referenced in this piece, go here: "Sunday Special | Blood Pressure" https://www.topmedtalk.com/sunday-special-blood-pressure/

Also, if you enjoyed Andrew Shaw's take on these issues go listen to this fascinating conversation: "Desiree's Roundtable | Fluids in the 2020's" https://www.topmedtalk.com/desirees-roundtable-fluids-in-the-2020s/

ANES19 | Michael Scott Oct 21, 2019

The TopMedTalk team are live from Anesthesiology 2019 at the Orange County Convention Center in Orlando. With over 14,000 delegates, clinicians, thought leaders and professionals, it's the largest gathering of Anesthesiologists and Anesthesia providers in the world.

Check out the www.topmedtalk.com website now to hear live audio, while you are there remember to subscribe for updates so you can always be one step ahead of the crowd. Also, if you fancy watching the show as it happens go to our Twitter feed www.twitter.com/topmedtalk to see the team in action.

This podcast is about new developments in ERAS and perioperative haemodynamic management. Find out how new technologies, techniques and information are being applied in this piece.

Presented by Desiree Chappell and Monty Mythen with their guest Michael Scott, Professor and Division Director, Critical Care Anesthesiology- Virginia Commonwealth University

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Like this, want more?

If you enjoyed the insights from Michael Scott in this piece you can hear more here: https://www.topmedtalk.com/asa-2018-san-francisco-optimising-the-perioperative-patient/

ANES19 | Desiree Chappell, Monty Mythen and Sol Aronson Oct 21, 2019

The TopMedTalk team are live from Anesthesiology 2019 at the Orange County Convention Center in Orlando. With over 14,000 delegates, clinicians, thought leaders and professionals, it's the largest gathering of Anesthesiologists and Anesthesia providers in the world.

Check out the www.topmedtalk.com website now to hear live audio, while you are there remember to subscribe for updates so you can always be one step ahead of the crowd. Also, if you fancy watching the show as it happens go to our Twitter feed www.twitter.com/topmedtalk to see the team in action.

A look ahead to the shows you can expect as our coverage continues. We also congratulate our Editor in Chief who has won a prestegious award. Discussion then moves towards the ongoing development of AI and "Alpha Zero".

Presented by Desiree Chappell with Monty Mythen, TopMedTalk's Editor in Chief and Sol Aronson, a tenured professor at Duke University and Executive Vice Chairman in the Department of Anesthesiology.

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Like this, want more?

Hugh Montgomery presented an excellent piece for TopMedTalk here: https://www.topmedtalk.com/sunday-special-nasogastric-feeding-2/

President Clinton's appearance on TopMedTalk is here: https://www.topmedtalk.com/sunday-special-bill-clinton-at-the-world-patient-safety-science-technology-summit/

ANES19 | Jeff Simmons Oct 20, 2019

The TopMedTalk team are live from Anesthesiology 2019 at the Orange County Convention Center in Orlando. With over 14,000 delegates, clinicians, thought leaders and professionals, it's the largest gathering of Anesthesiologists and Anesthesia providers in the world.

Check out the www.topmedtalk.com website now to hear live audio, while you are there remember to subscribe for updates so you can always be one step ahead of the crowd. Also, if you fancy watching the show as it happens go to our Twitter feed www.twitter.com/topmedtalk to see the team in action.

This piece focuses on the mission to advocate and apply prehabilitation, pre-optimisation and enhanced recovery. Defined here as "good public health [...] with the crucible of surgery".

How do we do that in a way that both patients and front line providers understand the value of it? Can this message help to allow for delays in surgery? Also, how do we take our message to social media, specifically Twitter? Listen in for some excellent tips.

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Like this, want more?

The "triple aim for populations" mentioned in this piece is expanded upon here: https://www.topmedtalk.com/ebpom-usa-chicago-2018-wrong-surgery-or-wrong-patient/

ANES19 | Dane Grenda and Noreen Tiangco Oct 20, 2019

The TopMedTalk team are live from Anesthesiology 2019 at the Orange County Convention Center in Orlando. With over 14,000 delegates, clinicians, thought leaders and professionals, it's the largest gathering of Anesthesiologists and Anesthesia providers in the world.

Check out the www.topmedtalk.com website now to hear live audio, while you are there remember to subscribe for updates so you can always be one step ahead of the crowd. Also, if you fancy watching the show as it happens go to our Twitter feed www.twitter.com/topmedtalk to see the team in action.

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 and 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.

Presented by Desiree Chappell with Mike Grocott and their guests Dane Grenda and Noreen Tiangco, Residents at Temple University Hospital.

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Like this, want more?

We reference this podcast here: https://www.topmedtalk.com/sca-poster-presenters/

Prehabilitation with Mike Grocott | ASA 2019 Oct 20, 2019

The TopMedTalk team are live from Anesthesiology 2019 at the Orange County Convention Center in Orlando. With over 14,000 delegates, clinicians, thought leaders and professionals, it's the largest gathering of Anesthesiologists and Anesthesia providers in the world.

Check out the www.topmedtalk.com website now to hear live audio, while you are there remember to subscribe for updates so you can always be one step ahead of the crowd. Also, if you fancy watching the show as it happens go to our Twitter feed www.twitter.com/topmedtalk to see the team in action.

This piece tackles "prehabilitation", TopMedTalk's word of the year. What is it, why is it so important, who is doing it and why are some people reticent about something that is so obviously good for their health? Furthermore, what are the transatlantic nuances to this 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 Mike Grocott, Professor of Anaesthesia and critical care at the University of Southampton.

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Like this, want more?

Sol Aronson's excellent talk "EBPOM 2018| Perioperative medicine is Population Health Management" is here: https://www.topmedtalk.com/ebpom-2018-perioperative-medicine-is-population-health-management/

And Mike Grocott co-chair's a gripping debate about prehabilitation, "EBPOM 2019 | System wide change for prehabilitation", is here: https://www.topmedtalk.com/ebpom-2019-system-wide-change-for-prehabilitation/

TopMedTalks to ... | Sasha Shillcutt Oct 19, 2019

--- IF YOU WANT TO HEAR THE FULL SERIES OF EDITOR'S PICKS YOU MUST SUBSCRIBE TO OUR NEWSLETTER ON www.topmedtalk.com NOW ---

This piece focuses on the question of looking after yourself as a practitioner and interlinking into your team. How important is it to listen to your team? What is "burn out"? How does it express itself in people? What signs should we look for in our friends and colleagues?

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.becomebraveenough.com/

--- IF YOU WANT TO HEAR THE FULL SERIES OF EDITOR'S PICKS YOU MUST SUBSCRIBE TO OUR NEWSLETTER ON www.topmedtalk.com NOW ---

TopMedTalks to... | Lee Fleisher and Ross Kerridge Oct 18, 2019

--- IF YOU WANT TO HEAR THE FULL SERIES OF EDITOR'S PICKS YOU MUST SUBSCRIBE TO OUR NEWSLETTER ON www.topmedtalk.com NOW ---

Is it fair to say that prehabilitation is the new direction for practitioners of Enhanced Recovery After Surgery (ERAS)?

Discussion expands into patient awareness initiatives; The Macmillan Cancer Support, Principles and guidance for prehabilitation guide mentioned is here: https://www.macmillan.org.uk/about-us/health-professionals/resources/practical-tools-for-professionals/prehabilitation.html

Age care naturally follows as the roundtable discussion continues. This piece gives a truly pan-national perspective with informed comment from prominent perioperative opinion leaders from The UK, Australia and America. How do those different systems work and what can they each learn from the others?

The journal article mentioned in this piece is here: https://jamanetwork.com/journals/jamasurgery/fullarticle/2732511

Presented by Desiree Chappell with Monty Mythen and Lee A. Fleisher, Professor and Chair of Anesthesiology and Critical Care, University of Pennsylvania and Ross Kerridge, John Hunter Hospital, Newcastle, Australia, often cited as 'the father of Modern Perioperative Medicine'.

--- IF YOU WANT TO HEAR THE FULL SERIES OF EDITOR'S PICKS YOU MUST SUBSCRIBE TO OUR NEWSLETTER ON www.topmedtalk.com NOW ---

EBPOM 2019 | Overview of perioperative smoking cessation Oct 18, 2019

Smoking is bad for you, there's little debate about that, even among users of the drug. However, further to the widely known consequences, the bottom line in the perioperative period is that smokers are 40% more likely to die after major surgery. Do patients also know this?

Tissue healing, increased risk of infection and increased possiblities of complications with the anaesthetic; with these risks in mind how do we cut through the ubiquitous, but often ignored, government health risk messaging and get patients to understand the increased risk for those undergoing surgery? How do we use smoking cessation techniques in the perioperative setting? How do we manage to start, ideally, six weeks before surgery? What is the latest thinking on the neuro psychiatric consequences of smoking cessation? How useful is the Fagerstrom test of nicotine dependence? What about "vaping", is it better than smoking from a perioperative perspective?

Presented by David Yates, Consultant in Anaesthesia and Critical Care Medicine at York Teaching Hospital, set up one of the UK’s first Perioperative Medicine Services in York, Anaesthesia, Perioperative Medicine and Pain Clinical Lead for the Yorkshire & Humber Comprehensive Research Network.

Periop SIG18 | Perioperative Evaluation of the Cancer Patient Oct 17, 2019

Cancer continues to present a seirous challenge to health care practitioners, particularly with elderly patients. Operations on cancer patients can occur for a variety of reasons, how do we ensure we make decisions that are right for them? Often cancer surgery is both urgent and emergent; the question of 'how long do we have to prepare' is paramount. How do we get patients to a surgical option that may be curative? How do we deal wirth "deconditioned" patients who have been subjected to difficult treatments as part of their cancer care? What are immune checkpoint inhibitors? What is 'targeted chemotherapy'? What are the pulmonary side effects of chemotherapy? Furthermore who do we deal with anemia in cancer Patients?

Finally the talk focuses upon post operative care.

The fuller version of this talk is supported by slides which you can see here: http://www.anzca.edu.au/documents/01-sunil-sahai_periop-evaluation-of-cancer-patient.pdf

Presented by Sunil K. Sahai, MD, FAAP, FACP, Co-Director, The PeriOperative Evaluation & Management Center Section Chief & Professor of Medicine, Section of Consultative Medicine, Department of General Internal Medicine, MD Anderson Cancer Centre.

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Brought to you by the Perioperative Medicine Special Interest Group (SIG) in association with the Australian and New Zealand Society for Geriatric Medicine and the Internal Medicine Society of Australia and New Zealand at the 7th annual Australasian Symposium of Perioperative Medicine.

The Perioperative Medicine Special Interest Group (SIG) has three aims; improve patient safety and outcomes, share knowledge and collaborate with specialty groups, develop the specialty of perioperative medicine with various craft groups.

For more information follow this link here: http://www.anzca.edu.au/fellows/special-interest-groups/perioperative-medicine

EBPOM Highlight | Improving quality, panel discussion Oct 16, 2019

Can you teach people to be leaders? Should the we be scared of using fear and greed as motivators? Do practitioners sometimes retain the right to clinical freedom to a degree that may not work in the interests of the patient? Can open and transparant institutions and practices exist without provoking a 'culture of blame'? Should risk scoring and funcitonal assesments be used for patients with aortic aneurysms?

Featuring; Dr Ramani Moonesinghe, Professor of Perioperative Medicine at University College London (UCL), Mark Hamilton, Consultant and Honorary Senior Lecturer in Anaesthesia & Critical Care Medicine, clinical lead for the Perioperative Assessment & Planning Unit, at St. George's Hospital and Medical School, member of the Surgical Outcomes Resource Centre at UCL, Co-Director of Evidence Based Perioperative Medicine (EBPOM), Editor in Chief of Perioperative Medicine, he also chairs the System Resilience Group, the Finance and Performance Committee and is a member of the Quality Committee and Carolyn Johnston, consultant Anaesthetist in St Georges hospital in London.

The Global Council on Brain Health | The RoundTable Oct 15, 2019

The American Associaton of Retired People (AARP), an organisation with a membership almost equal to the entire voting population of the United Kingdom, are focusing on brain health, in response to the demands of their members.

Further conversation includes how practitioners both explain the risks of surgery and also calm possible misunderstandings or fears regarding them, as well as wider reflections on 'The Brain Health Initiative'.

Presented by Desiree Chappell with Mike Grocott and their guests Lee Fleisher, Professor of Anesthesiology and Critical Care, University of Pennsylvania and Sarah Lock, Senior Vice President for policy at the American Association of Retired People (AARP) and the director of 'The Global Council on Brain Health'.

EBPOM 2019 | Multi-modal Prehabilitation Oct 14, 2019

This panel discussion includes questions such as: In a prehabilitation service what screening tools should we use to assess nutritional risk? What tools are there related to patient self management? What advice would you give a patient about cannabis smoking cessation? Should denial of surgical procedures be used as a motivator for lifestyle change? Can the questions used in interventions sometimes be open to misinterpretation by patients? How do we assess and treat sleep disorders? If not a psychologist, what team members might handle psychological behaviour change? Does immunonutrition work? Are there sensitive approaches to addressing weight loss, physical activity and diet that the panel reccomend?

Panel discussion chaired by Sandy Jack and Daniel Santa Mina, featuring, David Yates, Consultant in Anaesthesia and Critical Care Medicine at York Teaching Hospital, Chloe Grimmett, National Institute of Health Research (NIHR) post-doctoral Research Fellow and Senior Research Fellow for the Macmillan Survivorship Research Group at the University of Southampton, Chris Snowden, Consultant Anaesthetist, Freeman Hospital, Newcastle upon Tyne and Senior lecturer at the Institute of Cellular Medicine at Newcastle University, Chelsia Gillis, Registered Dietitian, Canadian Vanier Scholar, and PhD Candidate in Epidemiology at the University of Calgary, Canada, she is leading the first prehabilitation program for colorectal surgery in Alberta.

How should we teach perioperative medicine? | Sunday Special Oct 13, 2019

How do we develop an agreed curriculum that speaks to what perioperative medicine should be? Once that's in place, how should it be overseen? What sort of official endorsements would it need?

Running in parallel to this are the MOOCs - Massive Online Open Courses - that are being developed.

Developing a broad knowledge of the process is distinct from being a perioperative specialist, how do we develop that even further - without developing a schism? These complicated topics are discussed alongside more detail regarding the future of teaching this speciality.

Presented by Monty Mythen and Mike Grocott with their guests; Joel Symmons, Staff Consultant Anaesthetist in the Department of Anaesthesia and Perioperative Medicine at the Alfred Hospital, Perioperative Medicine Short Course Convenor, and a Senior Lecturer in Anaesthesia at Monash University, and Paul Myles, Head of Alfred Health's and Monash University's Department of Anaesthesia and Perioperative Medicine.

Dingle | TopMedTalks to... Desiree Chappell Oct 12, 2019

Coming from this year's "21st Current Controversies in Anaesthesia & Peri-Operative Medicine and SIAA Autumn Congress" at the Dingle Skellig Hotel, Ireland, this podcast gives you a chance to learn more about our lead presenter. What have been the highlights of her time working with the TopMedTalk team so far? Why did she become so compelled to advocate Enhanced Recovery and Perioperative Medicine? Also, what is the conference like and why do so many people rave about Dingle, Ireland?

Presented by Vicki Morton, Doctor of Nursing Practice and Director of Clinical and Quality Outcomes at Providence Anesthesiology Associates with her guest Desiree Chappell, lead presenter for TopMedTalk.

Periop SIG18 | Minimising risk, panel discussion Oct 11, 2019

What should we think about issues regarding the Perioperative Ischemic Evaluation Study (POISE)? Is it time to treat men and women equally when it comes to haemoglobin levels? What advice should we give to clinicians who are managing change at a hospital? What should our approach to iron be and can interventions make a real difference?

Featuring; Bruce Waxman, Adjunct Associate Professor (Honorary) at Monash University Dept. of Surgery School of Clinical Sciences, Monash Health and Chief Medical Officer, Bass Coast Health, Wonthaggi Hospital, South Gippsland Coast, Victoria, Kate Burbury, Associate Professor, Deputy Chief Medical Officer, Peter MacCallum Cancer Centre and Toby Richards, Academic Professor of Surgery, Vascular Surgeon, University Western Australia.

EBPOM Highlight | Prehabilitation Oct 10, 2019

Prehabilitation represents a real opportunity for practitioners to exploit a 'teachable moment' and realise long term positive behavioural changes. Making patients 'partners in their own care' is an essential part of this, with prehabilitation they have a chance to work with practitioners to increase their functional reserve, increase their rate of recovery and avoid difficult long term outcomes. The longer this partnership lasts the more effective it is. In this respect, how do we manage to emphasise the importance of early access to patients? The evidence of the benefits of exercise is overwhelming, even just two weeks of activity can make a huge difference, how do we articulate this to patients? How much focus should there be on nutrition?

Presented by Denny Levett, Professor in Perioperative Medicine and Critical Care, Consultant in Perioperative Medicine, Southampton University Hospital NHS Foundation trust (UHS), President of the Perioperative Exercise Testing and Training Society (POETTS).

Adverse outcomes and patient optimisation | The RoundTable Oct 08, 2019

Adverse outcomes, we all know they happen but how do we handle them, record them and avoid them in the first place? The discussion then moves to (Patient Recorded Outcome Measures) PROMS.

Patient optimisation is then discussed. Exercise, could it be so effective because it works as an anti inflammatory? A deep dive into the research on that is contained in this conversation.

The RELIEF trial is discussed as the team get into a discussion about what a patient sees as a good outcome. How do we communicate the risks, possible benefits and limitations, of surgery to patients?

The "P.R.E.P." website mentioned is here: https://www.prepwell.co.uk/

Desiree Chappell and Joff Lacey are presenting with their guests Dr Mark Edwards, Consultant in Anaesthesia and Perioperative Medicine at The University Hospital Southampton NHS Foundation Trust and Professor Gerard Danjoux, Consultant in Anaesthesia and Sleep Medicine at South Tees Hospitals NHS Foundation Trust.

EBPOM 2019 | Prehab trials; international study Oct 07, 2019

The International PREHAB trial. This short piece explains the trial's protocol and the scope of the study.

Presented by Charlotte Molenaar, PhD Candidate, multimodal prehabilitation in colorectal cancer care, BIJ Maxima Medisch Centrum, Coordinator of the international PREHAB trial.

Methadone - the overlooked Opiate? | EBPOM World Congress 2019 Oct 06, 2019

Is methadone "the opioid sparing opioid"? This talk looks at where we are at as regards opioids, in the shadow of a national crisis for the USA; is it possible that methapone might offer us answers?

This piece looks at the idea that methadone might be a way to deliver a better more effective, multimodal, opioid sparing, analgesia with a reduced chance of a post operative repiratory events and decreased post-operative pain.

This talk is complimented well by our consersation, live from the conference, which you can find here: https://www.topmedtalk.com/prehab-periop-world-congress-evan-kharasch/

The World Health Organisation's analgesic ladder is here: https://www.who.int/cancer/palliative/painladder/en/

Presented by Evan Kharasch, MD, PhD, Professor and Vice Chair for Innovation in the Department of Anesthesiology at Duke University, Director of Academic Entrepreneurship, Duke University School of Medicine.

Dan Cole | TopMedTalks to... Oct 05, 2019

What can practitioners do to preoperatively screen for signs that their patients may have issues with post operative delirium? How do we get patients fit for surgery, particularly with regard to delirium? Can you build up mental resilience in the run up to an operation? Do puzzles and mental activity - such as sudoku or a good crossword - help and is there any evidence of that?

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?

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 concentration of volatile anesthesia are said to face an increased risk of adverse outcomes?

This piece features Monty Mythen and Desiree Chappell in conversation with Dan Cole, professor of clinical anesthesiology at the David Geffen School of Medicine, University of California, Los Angeles and former president of the American Society of Anesthesiologists (ASA).

EBPOM 2019 | Moving as medicine Oct 04, 2019

"Moving as medicine; is it the most underused but proven health promotion and healthcare practice?"

Prehabilitation and population health naturally walk alongside each other. Learn here how Sport England's ambitious strategy to reduce inactivity and improve the nation’s physical and mental health is connected to prehabilitation and Enhanced Recovery After Surgery. Should patients be seeking expert condition specific advice before becoming active? How do we improve the quality of conversations between practitioner and patient?

The excellent Moving Medicine website can be found here: http://movingmedicine.ac.uk/

Presented by Sarah Ruane, Sport England’s national lead for health, she joined in January 2016 from local government where she oversaw public health, leisure and cultural services.

Periop SIG18 | Perioperative Anticoagulation Oct 03, 2019

Thrombosis is the commonest cause of death and disability worldwide, antithrombotic therapy is incredibly beneficial but it promotes bleeding; how then do we manage anticoagulation in the peri-operative period? How do you assess a patient's risk of bleeding? When should you consider bridging? What are we to think as regards the current status of asprin? How do we approach dual anti platelet therapy (DAPT) and does it promote more bleeding?

Lecture slides: http://www.anzca.edu.au/documents/03-harry-gibbs_periop-management-of-antiplatelet.pdf

Presented by Harry Gibbs, FRACP, FCSANZ, The Alfred, Melbourne.

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Brought to you by the Perioperative Medicine Special Interest Group (SIG) in association with the Australian and New Zealand Society for Geriatric Medicine and the Internal Medicine Society of Australia and New Zealand at the 7th annual Australasian Symposium of Perioperative Medicine.

The Perioperative Medicine Special Interest Group (SIG) has three aims; improve patient safety and outcomes, share knowledge and collaborate with specialty groups, develop the specialty of perioperative medicine with various craft groups.

For more information follow this link here: http://www.anzca.edu.au/fellows/special-interest-groups/perioperative-medicine

EBPOM Highlight | Panel; Best perioperative practice Oct 02, 2019

This panel discussion includes questions on; the multidisciplinary aspect of perioperative medicine, the drop off in Enhanced Recovery that some institutions experience, how to lead and coach an institution into an enhanced recovery programme, outcome data, informed decision making, the importance of strategic flexibility and the importance of good shared decision making when resources are stretched.

Chaired by Ramani Moonsinghe this piece features; Monty Mythen, Smiths Medical Professor of Anaesthesia and Critical Care, University College London; Chair, Evidence Based Perioperative Medicine (EBPOM), Founding Editor-in-Chief of Perioperative Medicine; Editorial Board British Journal of Anaesthesia; Founding Editor-in-Chief TopMedTalk; Founding Board Member Perioperative Quality Initiative (POQI); 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); Jugdeep Dhesi, Clinical Lead, POPS and Consultant Geriatrician, Guys and St Thomas' NHS Trust.

Population health in a 'fee for service' environment | The RoundTable Oct 01, 2019

How do you best work a pre-op clinic? Should they be places where you get your problems documented or where you get your problems 'fixed'? How do you convince your practice to optimise patients for life and not just 90 days? How do we encourage population health? How do we get round the fact that we're still in a 'fee for service world'? What is "PBPM"?

Featuring Desiree Chappell, Monty Mythen, Dr Lee A. Fleisher, Chair of Anesthesiology and Critical Care (University of Pennsylvania) and Vicki Morton DNP and Director of Clinical and Quality Outcomes at Providence Anesthesiology Associates University of South Carolina.

EBPOM 2019 | The Barcelona experience Sep 30, 2019

What can the experiences of a team who helped to introduce pre-operative assesment and prehabilitation to Barcelona teach us about how to most effectively implement and sustain similar programmes where we are?

How and why is prehabilitation helpful in terms out outcomes and value based care? How long can the benefits of prehabilitation be maintained? What is the value of nutritional consultation, how important is it to asses your patients pre-operative protien intake? Would it help to offer all of your patients mindfullness sessions? How important is it to include patient's partners or carers in sessions?

Also, is it possible for you to tap into and harness the enthusiasm of sporting professionals?

Presented by Graciela Martinez-Palli, Consultant in the Department of Anaesthesia and Perioperative Care at Hospital Clinic, Barcelona. She attends as anaesthesiologist for oncologic digestive surgery and liver transplantation.

EBPOM 2019 | Prehab trials; panel discussion Sep 29, 2019

Is it still ethically viable to have a standard arm in a prehabilitation trial? Which allied health professionals supervises the exercise part of these trials? What are the biggest reasons for non-adherence to home based exercise programmes? How do you address a possible selection bias with candidates? What is the best time to follow up a study with these patients?

Featuring; Krishna Moorthy Senior Lecturer, Consultant Surgeon, Imperial College London, Academic surgeon, with research interests in patient safety and quality of improvement in surgery, Co-lead of the PREPARE for surgery prehabilitation programme, BMJ Surgical Team of the year and Patient Participation awards 2017, Consultant Surgeon, BMI Healthcare, Consultant Surgeon the Wellington Hospital; Denny Levett, Professor in Perioperative Medicine and Critical Care at the University of Southampton and a Consultant in Perioperative Medicine at Southampton University Hospital NHS Foundation trust; Suzanne Mcdonald, Research Associate at The University of Queensland (Australia), Visiting Researcher at Newcastle University (UK) and registered Chartered Health Psychologist; Charlotte Molenaar, PhD Candidate, multimodal prehabilitation in colorectal cancer care, BIJ Maxima Medisch Centrum, Coordinator of the international PREHAB trial; Professor Sandy Jack, PhD, Consultant Clinician Scientist in the Anaesthesia and Critical Care Research Unit at University Hospital Southampton NHS Foundation Trust, Southampton and NIHR Southampton Respiratory Biomedical Research Unit and Integrated Physiology and Critical Illness Group, Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Honorary Senior Lecturer at the University of Liverpool, University of Southampton and University College London; James Hernon, Consultant Colorectal Surgeon, Norfolk and Norwich University Hospital NHS Foundation Trust, Chair of the Anglia Cancer Colorectal Network, CO-CI for PREPARE ABC a NIHR HTA funded randomised clinical study.

EBPOM 2019 | The Science of High Performance: Insights From Elite Sport Sep 28, 2019

Insights and perspectives on the science of prehabilitation from a very different angle. It's often said on TopMedTalk that preparing for an operation is not unlike getting ready for a marathon; how do the insights of professionals who work with elite sports men and women to ensure they are fully prepared to do their physical best, on the world stage? Also, what about the teamwork inherent in such activities as the pitstop of a formula one car? Athletes, coaches and a wide number of different experts come into play ensuring a multidisciplinary team converge with essentially the same end in sight as a perioperative prehabilitation team; optimum performance at a crucial time.

Challenges are similar between the two disciplines; how do we foster a culture of learning and teamwork in a high pressure environment where the bottom line carries enormous life changing consequences?

Regular listeners to TopMedTalk may recall the unofficial preamble to this talk, "Prehab Periop World Congress: Gerard Danjoux, Ken Van Someren": https://www.topmedtalk.com/prehab-periop-world-congress-gerard-danjoux-ken-van-someren/

Presented by Ken Van Someren, Director KvS Performance Ltd.

EBPOM 2019 | Financial aspects of prehabilitation Sep 27, 2019

This piece presents the prehabilitation 'business case'; why it's important to care about costs, how outcomes and value based care can help and why money has to be important in healthcare.

How do we convert health benefits and risk management into something which explains the financial bottom line?

Can we really argue that a process which appears, at the point of practice, to take more time, resources and involve a shorter length of stay for patients, is actually cheaper for institutions in the long run and better value for patients?

Is there in fact more than one 'business case' for a proper perioperative prehabilitation clinic at your practice?

The Fit 4 Surgery website (Netherlands) is here: http://fit4surgery.nl/

Presented by Stefan van Rooijen, surgical resident in Maxima Medical Center, The Netherlands, lecturer at the first Health Innovation School (Ministry of Health, Welfare and Sport and Reshape innovation), Surgical resident, Department of Surgery at Maxima Medical Center (ANIOS).

Periop SIG18 | Two sides to the coin: medical administrator; colorectal surgeon Sep 26, 2019

This piece gives an insight into how the insights of an ex-colorectal surgeon can be blended with the understandings of a medical administrator; how can those two roles work together and understand each other more?

There's a useful Perioperative Coach segment which outlines "Stop Bang" here: https://www.topmedtalk.com/periop-coach-3-02-stop-bang-identifying-obstructive-sleep-apnea/

There's a link to the slides here: http://www.anzca.edu.au/documents/03-bruce-waxman_two-sides-to-the-coin.pdf

Presented by Bruce Waxman, Adjunct Associate Professor (Honorary) at Monash University Dept. of Surgery School of Clinical Sciences, Monash Health and Chief Medical Officer, Bass Coast Health, Wonthaggi Hospital, South Gippsland Coast, Victoria.

EBPOM Highlight | Insights from the UK Perioperative Quality Improvement Programme Sep 25, 2019

What is 'knowledge mobilisation'? What's the difference between data used for quality assurance and data used for quality improvement? What's important to patients? Does compettition and publicly reporting data actually help anyone other than those who are already leading in their field? Can league tables lead to a 'culture of blame'? 'We need to spend less time measuring and more time improving'; how do we effectively support practitioners who want to get better?

Presented by Dr Ramani Moonesinghe, Professor of Perioperative Medicine at University College London (UCL).

Do we share an interest in Enhanced Recovery? | The RoundTable Sep 24, 2019

What is the Enhanced Recovery After Surgery (ERAS) Shared Interest Group (SIG)? How does it relate to the advancement of perioperative medicine?

TopMedTalk was at the American Association of Nurse Anaesthetists (AANA) 2018 conference in Boston, check the podcast timeline for more, or click here: https://www.topmedtalk.com/?s=AANA

Desiree Chappell speaks with her guests, Josh Newman Lead CRNA at Passavant Area Hospital, Springfield, Illinois Area and now Chair of the Enhanced Recovery After Surgery (ERAS) Shared Interest Group (SIG) and Randall Moore, DNP, MBA, CRNA and Chief Executive Officer of the AANA.

EBPOM 2019 | Malnutrition and functional capacity Sep 23, 2019

This piece is taken from the free papers presentations given at EBPOM 2019. Malnutrition and functional capacity; what is the effect of multimodal prehabilitation? What can the six minute walk test really show us? Does nutritional status predict preoperative change in a six minute walk test in colorectal cancer patients following a prehabilitation programme?

Presented by Lauren Richer, Director, Nutritional Services, Keyto, Registered Dietician, Greene Family Medicine Clinic and Montreal General Hospital, Montreal, Quebec.

Nasogastric feeding | Sunday Special Sep 22, 2019

How is it the case that some people can lose significant muscle mass while they are being cared for on the Intensive Care Unit (ICU)? What can practitioners do to help avoid this? How do we integrate a dynamic stimulus and react to new research relating to nasogastric feeding?

In this piece you will hear about a randomised controlled pilot study investigating the effect of intermittent versus continuous nasogastric feeding on muscle mass and function in intensive care unit survivors.

Hugh Montgomery presents with his guest, Dr Angela McNelly, clinical researcher at the ISEH and the UCL Centre for Human Health and Performance.

Tim Cook | TopMedTalks to... Sep 21, 2019

NAP (National Audit Project) 6 is the largest ever prospective study of anaphylaxis related to anaesthesia and surgery. Find out the details behind this intriguing study, how long did it take, how does the data impact upon our day to day practice?

There follows a deep dive into the results and recomendations that NAP 6 has produced. Packed with useful information this podcast is one of the stand out pieces of our coverage of the Royal College of Anaesthetists' annual conference in London.

Joff Lacey sits down with his guest Professor Tim Cook, Consultant in Anaesthesia and ICM, Royal United Hospitals, Bath.

Email us: contact@topmedtalk.com

Houman Javedan | TopMedTalks to... Sep 21, 2019

The Silver Tsunami is coming, are you prepared to assess the elderly patient? Mature patients present unique and interesting opportunities to perioperative practitioners. New ways of thinking and different approaches are always necessary.

The British Geriatric Society's "Fit For Frailty" is here: https://www.bgs.org.uk/resources/resource-series/fit-for-frailty

Presented by Desiree Chappell and Monty Mythen with their guest Houman Javedan, MD. Geriatrician at Brigham and Women’s Hospital, assistant program director of the HMS Multi-Campus Fellowship in Geriatric Medicine, and Clinical Director for the Division of Aging in the Department of Medicine.

EBPOM 2019 | Multimodal prehabilitation to prevent postoperative delerium and other complications in elderly patients after elective major abdominal surgery. Sep 20, 2019

Can delirium, the most frequent complication in an elderly patient, be tackled with multimodal prehabilitation? This piece explains how that challenge is being investigated at the moment. It was originally one of the EBPOM 2019 Free Papers.

A link to the paper is here: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6564537/

Presented by Ties Lukas Janssen, General Surgery Resident at Amphia Ziekenhuis.

Periop SIG18 | Management of anti-thrombotics: Fast-track warfarin reversal Sep 19, 2019

This piece gives you information that will empower you when using Warfarin in the perioperative period. How should you sensibly balance bleeding and thrombotic risk? Anti-coagulants are increasing in number, what are the principles behind them which we should learn? An understanding of patient, procedure and type of drug being used is essential, are there other factors that can come into play?

Here is a link to the slides used in this talk: http://www.anzca.edu.au/documents/02-kate-burbury_fast-track-warfarin-reversal.pdf

Presented by Kate Burbury, Associate Professor, Deputy Chief Medical Officer, Peter MacCallum Cancer Centre.

EBPOM 2019 | The INSPIRE trial; reducing post-op pulmonary complications Sep 18, 2019

The effectiveness and cost-effectiveness of INSPIRatory musclE training (IMT) for reducing postoperative pulmonary complications (PPC): a sham-controlled randomised controlled trial (RCT) (INSPIRE). This piece is a concise guide to the method and thinking behind the trial.

Presented by Denny Levett, Professor in Perioperative Medicine and Critical Care at the University of Southampton, Consultant in Perioperative Medicine, Southampton University Hospital NHS Foundation trust (UHS), President, Perioperative Exercise Testing and Training Society (POETTS) and biannual chair of the National Perioperative Cardiopulmonary Exercise Testing course, she's also part of the Fit 4 Surgery research group in Southampton, investigating exercise and nutritional optimisation before major surgery and is clinical CI for the multi-centre INSPIRE trial.

Delaying surgery to adequately prepare? | World Congress 2019 Sep 17, 2019

A quick surprising poll of perioperative practitioners sets the tone for a robust advocation of the responsibility of surgeons and practitioners to do surgery right; as opposed to being inclined to feeling it must be done "right now!". A data driven approach combined with a patient focused attitude are at the centre of the argument. How do these factors combine to produce a business case which all institutions, practitioners and patients can understand?

In terms of time spent, what do we mean when we say "delay"? How do we overcome a patient's attitudes towards healthcare professionals, if they feel there has already been a delay in 'getting treatment'? How can the pathways from diagnosis to recovery be shortened or made more flexible? Can a case manager help this process? Is eight weeks an acceptable waiting time, can we reasonably expect it to be less than that?

Presented by Gerrit Slooter, MD, PhD, Surgical Oncologist, Maxima Medical Centre, The Netherlands.

EBPOM 2019 | Alcohol Matters Sep 16, 2019

The healthcare profession has a mixed history when it comes to messaging around alcohol. Nowadays, from a public health perspective, it is clear that overall it is not helpful for our physiology and well being.

How often do you have alcohol? How many units do you drink? How often do you have a binge? What are the age groups where drinking problems are most apparent? Where is the latest research regarding a perioperative approach to alcohol consumption? How effective is intervention for risky drinkers, should it also be considered for dependent drinkers?

How have studies and evidence been arranged around this topic and where should it lead us? Is there a need for more research?

Presented by Chris Snowden, Consultant Anaesthetist, Freeman Hospital, Newcastle upon Tyne and Senior lecturer at the Institute of Cellular Medicine at Newcastle University, he has recently secured grant funding from the NIAA (RCOA /BJA) to develop prehabilitative training in the elderly surgical patient.

EBPOM Highlight | Academic Health Science Networks - opportunity knocks Sep 15, 2019

Formed five years ago, the Academic Health Science Networks (AHSNs) in England are driving innovation and speeding up the process of implimenting and discovering improvement in institutions. This piece explains how that occured and what we can all learn from it.

Presented by Natasha Curran, pain medicine University College London Hospital (UCLH) and Medical Director at the Health Innovation Network.

Lynn Reede | TopMedTalks to... Sep 14, 2019

How is the AANA facilitating the care of patients? How can you make a patient a 'partner in safety'? How do we coordinate so many disaparate systems of information and care?

Patient records and data ownership is discussed, as is Paul Upton's excellent interview on TopMedTalk regarding "My Preop". The original piece is here: https://www.topmedtalk.com/my-pre-op-empowering-patients-before-surgery/

How do we reach out to patients and inform them about the risks and choices which will be presented to them as part of their surgical pathway? Discussion here moves to the American Association of Retired Persons (AARP) and the incredible work they are doing. For more on the AARP from TopMedTalk go here: https://www.topmedtalk.com/dont-ask-patients-what-is-the-matter-ask-them-what-matters/

Presented by Desiree Chappell and Monty Mythen with their guest Lynn Reede, CRNA and chief clinical officer at the American Association of Nurse Anaesthetists (AANA).

TopMedTalk | How to get people to get things done; The Michigan Project Sep 12, 2019

Learn how to inspire a team to act, create change and get things done. How important are financial incentives, emotional connection and the relative ease of change?

Originally streamed live from the hugely successful EBPOM USA Dallas Master's course.

Presented by Michael Englesbe, Darling Sr. & Cyrenus G. Darling Jr. Professor of Surgery, Michigan.

EBPOM Highlight | Optimising healthcare delivery, panel discussion Sep 11, 2019

This panel discussion tackles, amongst others, the following questions: How can knowledge and health innovation be moved from the theoretical world and turned into practice? How do we overcome ego in the profession? How do efficient systems improve the experience of staff as well as patients? How can perioperative practitioners truly embed ideas into devolved healthcare systems?

Featuring; Anna Batchellor, Anaesthesia and Intensive Care Medicine (ICM), Newcastle upon Tyne; past President of the Intensive Care Society, past Dean of the Faculty of ICM, past member of Council of the Royal College of Anaesthetists; Mark Hamilton, Consultant and Honorary Senior Lecturer in Anaesthesia & Critical Care Medicine, clinical lead for the Perioperative Assessment & Planning Unit, at St. George's Hospital and Medical School, member of the Surgical Outcomes Resource Centre at UCL, Co-Director of Evidence Based Perioperative Medicine (EBPOM), Editor in Chief of Perioperative Medicine and Natasha Curran, pain medicine University College London Hospital (UCLH) and Medical Director at the Health Innovation Network.

EBPOM 2019 | System wide change for prehabilitation Sep 10, 2019

Should prehabilitation be thought of also as "primary prevention" and used to avoid health problems occuring in the first place? If "exercise is real medicine" how do we change the culture so GPs are comfortable prescribing physical activity to patients? How can we get people to exercise more when the political mood is turning against Government interference and the so-called "nanny state"? What is 'the business case' for prehabilitation?

Co-chaired by Mike Grocott and Stefan van Rooijen and featuring: Graciela Martinez-Palli, Consultant in the Department of Anaesthesia and Perioperative Care at Hospital Clinic, Barcelona; Anna Lowe, Programme manager, National Centre for Sport and Exercise Medicine, Lead Allied Health Physical Activity Clinical Champion at Public Health, England; John Moore, Clinical Head of the Division of Anaesthetics, Peri-operative medicine and Critical Care at Manchester University Hospital NHS Foundation Trust; Sarah Ruane, Sport England’s national lead for health, she joined in January 2016 from local government where she oversaw public health, leisure and cultural services.

Enhanced Recovery for obstetrics | Perioperative Coach Sep 09, 2019

What are the results if you apply Enhanced Recovery to obstetrics?

This podcast features Desiree Chappell interviewing Dr Attila Kett, anaesthesiologist and Chairman at St Peter’s University Hospital at New Jersey.

Join in the debate: contact@topmedtalk.com

EBPOM Highlight | Getting it right first time Sep 08, 2019

This piece explains how the "Getting It Right First Time" (GIRFT) project got off the ground. How does it help improve quality of care within the NHS reduce unwarranted variations, bring efficiencies and improve patient outcomes? This piece gives you the detail.

Led by frontline clinicians, who are experts in the areas they review, hear how the project helps to manage services on a daily basis; sharing best practice between trusts, GIRFT identifies changes that help improve and change an institution's procedures and cost savings.

The GIRFT website is here - https://gettingitrightfirsttime.co.uk/

Further listening regarding GIRFT can be found here: https://www.topmedtalk.com/rcoa-13-the-girft-getting-it-right-first-time-project/

Presented by Anna Batchellor, trained in anaesthesia and Intensive Care Medicine (ICM) she works in Newcastle upon Tyne; past President of the Intensive Care Society, past Dean of the Faculty of ICM, past member of Council of the Royal College of Anaesthetists. One of the first formal trainees in ICM in the UK she co-authored the curriculum for training in ICM for the Certificate of Completion of Training. She developed the Advanced Critical Care Practitioner Programme to help us fill the enormous hole appearing in critical care staffing. She tried to retire in June 2016 and managed to spend a year working part time before being hijacked by the Getting It Right First Time (GIRFT) programme.

EBPOM 2019 | "My experience ... of esophageal cancer" Sep 07, 2019

"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 a similar situation and have agreed to be a point of contact for patients and their families, be able to offer reassurance and support at your practice?

Someone your patient can rely on who can honestly say to them; 'Yes, I know exactly what you mean, I know exactly how that feels'.

The Macmillan Cancer Support website is here: https://www.macmillan.org.uk/

Presented by Mo Cottrell, a retired nurse who underwent a 5 week course of Chemoradiotherapy followed by successful surgery for Oesophageal Cancer at Southampton General Hospital in January 2017.

POET 4.10 | Give your patients a warm welcome. Sep 06, 2019

The patient experience can be quite passive and, as a result, people can lose temperature quickly. The consequences can be very negative, this conversation revolves around how you can keep your patients warm. This piece is taken from a longer conversation to be found here: https://www.topmedtalk.com/live-from-the-iseh-part-1/

This edition of TopMedTalk was recorded at The Institute of Sport Exercise and Health (ISEH) live from an Enhanced Recovery After Surgery (ERAS) leadership forum.

The conversation features Professor Monty Mythen and his guest Mark Harper, Consultant Anaesthetist at Brighton and Sussex University Hospitals, with a research interest in the prevention of perioperative hypothermia and the use of cold water adaptation for theraputic purposes.

Periop Medicine SIG 18 | Australia and New Zealand Emergency Laparotomy Audit - Quality Improvement Sep 05, 2019

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-an-update.pdf

Presented by Ben Griffiths, consultant anesthetist at Auckland City Hospital, anaesthetic lead for ANZELA-QI.

POET 4.09 | How to drive perioperative care. Sep 04, 2019

This piece discusses how the contributors are driving better perioperative care in their clinics; the importance of getting patient records in advance; ERAS for obstetrics; challenging opioid use with the multimodal pain management; shared decision making in pain management; the importance of clear communication pathways and patient literacy.

This podcast features Desiree Chappell interviewing; Dr Ellen Flanagan, anaesthesiologist and medical director at the Duke preoperative assessment testing clinic, Dr Attila Kett, anaesthesiologist and Chairman at St Peter's University Hospital at New Jersey and Lynn Reede, CRNA and chief clinical officer at the (AANA) American Association of Nurse Anaesthetists.

EBPOM Highlight | Detecting and managing frailty Sep 04, 2019

Frailty is a common condition which has been topical in geriatric medicine for some time but now it is appearing in the surgical and anaesthetic literature. This talk explores how our understanding and discussion has improved regarding a condition that is still yet to have a clear, universally accepted, definition. How do we build a patient's physical reserve? What is the best way to conceptualise frailty? Are there any universal treatments available?

Presented by Dr Jugdeep Dhesi, Clinical Lead, POPS and Consultant Geriatrician, Guys and St Thomas' NHS Trust.

The malnourished surgery patient | The RoundTable Sep 03, 2019

This piece focuses on the article "The malnourished surgery patient, a silent epidemic in perioperative outcomes?" which you can find here: https://journals.lww.com/co-anesthesiology/Abstract/2019/06000/The_malnourished_surgery_patient__a_silent.23.aspx

The Perioperative Quality Initiative is here: www.poqi.org

Presented by Desiree Chappell with Monty Mythen and their guests Jeroen Molinger, Clinical Medical Exercise Physiologist at Duke University Medical Center, Department of Anesthesiology & ICU and John Whittle, assistant Professor at Duke University Medical Centre.

Length of stay after Major Surgery | Perioperative Coach Sep 02, 2019

In short; Post-Op recovery in less than 3 days with over 90% mobilised on day 1.

This in depth discussion relates to the consensus paper from the Perioperative Quality Initiative, see link below. It focuses on: outcomes, length of stay and DREAMS (Drinking, Eating and Mobilising) within hours after major surgery- all key measures of compliance and success in an Enhanced Recovery Program.

Monty Mythen and Joff Lacey with Mike Grocott presenting with contributions from Dr Julie Thacker, Colorectal Surgeon from Duke University and President of the American Society of Enhanced Recovery and Dr Tim Miller, Anesthesiologist from Duke University.

POQI website is here: http://www.poqi.org

For further CME read the paper in Perioperative Medicine:

https://perioperativemedicinejournal.biomedcentral.com/articles/10.1186/s13741-017-0062-7

Attend our next meeting: http://www.ebpom.org/EBPOM-USA

This piece is taken from a longer discussion here: http://www.topmedtalk.com/aser-ebpom-2017-pod-two-live-from-washington-dc/

EBPOM 2019 | Prehabilitation: how far have we come? Sep 01, 2019

"The father of prehabilitation" reflects on where the discipline is now and where it used to be, from new kid on the block to being touted now as the word of the moment. How has this change come about? Is it the focus value based care? Is it the fact we're becoming more patient focused?

Is it fair to say this is an evidence led focus brought about by more information and understanding regarding long term patient outcomes?

Further discussion includes frailty, engaging patients in their prehabilitation and educating patients. This talk gives a wealth of powerful practical techniques which will help you to continue to provide the sort of high quality healthcare your patients and institutions expect.

This piece gives you a fantastic overview alongside some interesting insights and suggestions as to what the future might hold and where things can be improved.

Presented by Franco Carli, Professor of Anesthesia at McGill University and Associate Professor in the School of Dietetics and Human Nutrition at McGill University, Staff anesthesiologist at the McGill University Health Centre.

Perioperative Care: where next? | EBPOM World Congress 2019 Aug 31, 2019

Prehabilitation is about planned pathways, preparing our patients for a journey which we as practitioners have already travelled. 4.2 million deaths are attributable to surgery each year globally, this presents a huge opportunity to improve the world for those who focus on perioperative surgery and prehabilitation. On the financial side, complications from surgery are proven to put costs up.

It's now widely accepted that perioperative medicine is the future of anaesthesia, how do we help the discipline evolve smoothly as it moves in this direction? The multidisciplinary aspect and the move away from the silo approach to healthcare is important, as is the challenge of the profession expanding out into 'population health'. With this in mind how might training evolve? What opportunities are about to be unlocked as a result of both big data, wearables and genoimcs?

For more information on "Getting it right first time" (GIRFT) go here: https://www.topmedtalk.com/rcoa-13-the-girft-getting-it-right-first-time-project/

Presented by Mike Grocott, Professor of Anaesthesia and Critical Care Medicine, University of Southampton.

TopMedTalk | Enhanced recovery after bariatric surgery Aug 29, 2019

"Enhanced recovery after bariatric 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

If you have any comments or questions you'd like to send to the team email: contact@topmedtalk.com

Presented by David Voellinger, Lead Physician, Novant Health Bariatric Solutions Charlotte, Medical Director, Novant Health Bariatric Center, Chief, Department of General Surgery, Novant Health Presbyterian Medical Center.

Prehabilitation and cancer | EBPOM World Congress 2019 Aug 28, 2019

This piece starts with some words from patients; prehabilitation is "a set of actions that can be taken in advance of treatment to ease your passage through cancer". This vital talk explains how prehabilitation can leave cancer patients feeling personally empowered and ready to live well. Living is one thing, how do we get people to enjoy 'living well'? Further to this how do we do that in such a way that respects patient decisions and life choices? How can we get to a position where exercise, nutrition and psychological support are integral to a cancer diagnosis?

Ideally prehabilitation gets to a point where all patients feel like the ones quoted in this talk; "It's a win win situation [...] do that and you'll be healthier".

Presented by June Davis; June has 22 years of experience working in the NHS as a Dietician, service and professional lead, general manager for a number of service areas within the acute setting and senior project lead for several large scale change projects across London; 10 years experience working as Head of Therapies for large acute Trusts. She is also a Director of Allied Health Solutions, Allied Health Professions Advisor (part time) for Macmillan Cancer Support and a professional advisor to the Care Quality Commission.

Fluids in the 2020's | The RoundTable Aug 27, 2019

This piece gets into the detail regarding one of the big talking points in perioperative medicine over the last year or so; what is the impact of intraoperative hypotension on post operative outcomes?

Further discussion encompases the modern uses of a pulmonary artery catheter.

If you enjoyed hearing Andy Shaw's take on these topics further listening can be found here; https://www.topmedtalk.com/hemodynamic-monitoring-and-the-pulmonary-artery-catheter/

Presented by Desiree Chappell with Monty Mythen, Joff Lacey and their guest Dr Andrew Shaw, Chairman, Department of Anesthesiology and Pain Medicine at The University of Alberta, Edmonton, Alberta and Zone Clinical Department Head for Anesthesia, Alberta Health Services Edmonton Zone. He is also a Fellow of the Royal College of Anaesthetists (UK), the American College of Critical Care Medicine and the Faculty of Intensive Care Medicine (UK).

Urine output | Perioperative Coach Aug 26, 2019

Should we still measure urine output? How useful is permissive oliguria?

Presented by Professor Monty Mythen and Dr Joff Lacey featuring guests Dr Tim Miller from Duke University Medical Centre and John A. Kellum, Tenured Professor, Critical Care Medicine from The University of Pittsburgh.

EBPOM 2019 | Prehabilitation and Perioperative Care, panel discussion Aug 25, 2019

This panel discussion reacts to various questions from the online audience and those in attendance.

Questions include; Is there any good evidence for the use of wearable tech in prehabilitation? How come, if the evidence is almost there, prehabilitation is not yet included in every pathway? In this respect, is change just around the corner? How do we have patients are partners rather than passive participants? What are the benefits of prehabilitation which can be seen in two weeks? How does one go about setting up a streamlined preoperative service? What would be the most important outcome for any prehabilitation trial? In a usually sedintary patient, how do we engage them in exercise training and prehabilitation?

Featuring; Mike Grocott, Professor of Anaesthesia and Critical Care Medicine, University of Southampton, Franco Carli Professor of Anesthesia at McGill University and Associate Professor in the School of Dietetics and Human Nutrition at McGill University, Staff anesthesiologist at the McGill University Health Centre and June Davis; June has 22 years of experience working in the NHS as a Dietitian, service and professional lead, general manager for a number of service areas within the acute setting and senior project lead for several large scale change projects across London; 10 years experience working as Head of Therapies for large acute Trusts. She is also a Director of Allied Health Solutions, Allied Health Professions Advisor (part time) for Macmillan Cancer Support and a professional advisor to the Care Quality Commission.

EBPOM 2019 | EBPOM Prehab trials; WesFit Aug 24, 2019

This piece focuses on the "Wessex Fit-4-Cancer Surgery Trial"; a unique multi-centre, efficacy pragmatic, factorial design, randomised controlled trial, with patient informed development and process evaluation

"You wouldn't run a marathon without preparing," why would you want an operation where you don't get ready for a physically stressful event such as surgery? Prehabilitation is an obvious advantage, gathering the data which proves that is essential to perioperative medicine because it means we can show the advantages clearly to both patients and practitioners as well as looking at ways of making the process more efficient.

For more on this go here: http://wesfit.org.uk/

Presented by Professor Sandy Jack, PhD, Consultant Clinician Scientist in the Anaesthesia and Critical Care Research Unit at University Hospital Southampton NHS Foundation Trust, Southampton and NIHR Southampton Respiratory Biomedical Research Unit and Integrated Physiology and Critical Illness Group, Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Honorary Senior Lecturer at the University of Liverpool, University of Southampton and University College London.

POET 4.08 | If patients come to us anaemic - they just do worse Aug 23, 2019

How important is it to screen patients for anaemia before surgery? Has anaemia fallen off the health care agenda? We begin with a conversation about patients who are anaemic and then turn to why this is sometimes not checked enough. Monty Mythen mentions UK University students appear to suffer from the condition more these days and Lori Heller points out that treating the condition, as part of patient optimisation, is something of a revelation for some, even occasionally removing the need for surgery altogether.

Discussion continues regarding haemoglobin levels and the differentiation between men and women. The importance of discovering the condition early on in the pre-habilitation process is also emphasised. Towards the end of the piece Monty makes some time to speak about the "Iron Woman - Iron Therapy for Female athletes" study instigated by Professor Toby Richards. This piece features Professors Monty Mythen and Mike Grocott with guests Lori Heller, Cardiac Anaestheisologist from US Anaesthesia Partners at the Swedish Medical Center in Seattle, and Mike Scott, Professor in the department of Anesthesiology Virginia Commonwealth University Health System in Richmond USA.

TopMedTalk | Leading a large, multi-state group to achieve excellence Aug 22, 2019

Hear how you can transform your practice through team leadership, courage and a finely tuned awareness of the financial aspects of what you are trying to achieve.

How can growth be tempered to suit the long term vision of a company? Why is teambuilding so crucial to large organisations? Can we determine the direction in which healthcare is evolving overall? Is 'population health in the perioperative space', a widely accepted future direction these days?

Presented by Brian Woods, Anesthesiologist and Vice President at NorthStar Anesthesia.

Periop SIG18 | The Complex Pain Patient in the Perioperative Setting Aug 21, 2019

Why does the complex pain patient need ‘perioperative pain medicine’ to optimize outcomes of surgery? This piece faces the realities behind a perioperative approach which tries to prevent or manage cases of complex regional pain syndrome (CRPS) during surgery and the postoperative period. Should chronic pain be seen as a nervous system disorder? How do we deal with patients who catastrophise their pain? Should we pledge to use a regional analgesia technique wherever possible? Can atypical opioids provide another way?

Lecture slides: http://www.anzca.edu.au/documents/04-stephan-schug_the-complex-pain-patient.pdf

Presented by Stephan A Schug, Anaesthesiology and Pain Medicine, University of Western Australia and Royal Perth Hospital.

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Brought to you by the Perioperative Medicine Special Interest Group (SIG) in association with the Australian and New Zealand Society for Geriatric Medicine and the Internal Medicine Society of Australia and New Zealand at the 7th annual Australasian Symposium of Perioperative Medicine.

The Perioperative Medicine Special Interest Group (SIG) has three aims; improve patient safety and outcomes, share knowledge and collaborate with specialty groups, develop the specialty of perioperative medicine with various craft groups.

For more information follow this link here: http://www.anzca.edu.au/fellows/special-interest-groups/perioperative-medicine

Avoiding the hypotension hazard | The RoundTable Aug 20, 2019

The Hypotension Prediction Index (HPI) Monitor takes 2.6 million features from a single waveform which it then applies to 150 million different wave forms looking for factors which can predict hypotension.

It's the first fully approved foray into predictive analyitics for the world of anaesthesia.

This conversation looks at how it works and how it is being adopted in detail.

Presented by Desiree Chappell with Monty Mythen and Feras Hatib Phd, Director, Research and Development, Algorithms and Signal Processing at Edwards Lifesciences and Dr Simon Davies, Consultant Anaesthetist at York Teaching Hospital NHS Foundation Trust.

Pain Relief in Enhanced Surgical Recovery | Perioperative Coach Aug 19, 2019

This episode of The Perioperative Coach reflects on the pain management discussions being had by the American Society of Enhanced Recovery (ASER) and its members.

For further reading see the articles in Perioperative Medicine Journal:

https://perioperativemedicinejournal.biomedcentral.com/articles/10.1186/s13741-017-0064-5

This conversation taken from a longer piece to be found here: http://www.topmedtalk.com/aser-ebpom-2017-recap-pod-three-live-from-london/

Presented by Monty Mythen with Dr Joff Lacey and Professor Mike Grocott.

Periop SIG18 | Risk prediction tools Aug 18, 2019

How do we accurately calculate the risks to our patients? What are the best tools for the right circumstances? Where can we find data to improve these methods?

Originally titled "50 shades of grey, how (in)accurate are risk prediction scores" the slides from this talk are here: http://www.anzca.edu.au/documents/02-doug-campbell_fifty-shades-of-grey.pdf

The risk calculator is here: https://nzrisk.com/

Presented by Dr Doug Campbell, Anaesthesia Specialist at Auckland City Hospital.

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Brought to you by the Perioperative Medicine Special Interest Group (SIG) in association with the Australian and New Zealand Society for Geriatric Medicine and the Internal Medicine Society of Australia and New Zealand at the 7th annual Australasian Symposium of Perioperative Medicine.

The Perioperative Medicine Special Interest Group (SIG) has three aims; improve patient safety and outcomes, share knowledge and collaborate with specialty groups, develop the specialty of perioperative medicine with various craft groups.

For more information follow this link here: http://www.anzca.edu.au/fellows/special-interest-groups/perioperative-medicine

Tim Miller | TopMedTalks to... Aug 17, 2019

The Perioperative Quality Initiative (POQI) have featured frequently on TopMedTalk, here we discuss their focus on hypotension and blood pressure.

Perioperative Quality Initiative consensus statement on the physiology of arterial blood pressure control in perioperative medicine https://bjanaesthesia.org/article/S0007-0912(19)30047-9/fulltext

Perioperative Quality Initiative consensus statement on preoperative blood pressure, risk and outcomes for elective surgery https://bjanaesthesia.org/article/S0007-0912(19)30057-1/fulltext

Perioperative Quality Initiative consensus statement on intraoperative blood pressure, risk and outcomes for elective surgery https://bjanaesthesia.org/article/S0007-0912(19)30050-9/fulltext

Perioperative Quality Initiative consensus statement on postoperative blood pressure, risk and outcomes for elective surgery https://bjanaesthesia.org/article/S0007-0912(19)30059-5/fulltext

Presented by Monty Mythen and Desiree Chappell with Joff Lacey, registrar in anaesthesia at St George’s Hospital in London, currently undertaking a fellowship in Perioperative Medicine at UCLH as well as being a regular presenter on TopMedTalk and Tim Miller, Associate Professor of Anaesthesiology from Duke University Medical Centre.

POET 4.07 | Has enhanced recovery changed your practice? Aug 16, 2019

This piece discusses the changes enhanched recovery brings, the conversation then moves to narcotics and the opioid epidemic.

Presented by Desiree Chappell, Dr Vijaya Gottumukkala, cardiac anaesthesiologist from MD Anderson and member of the board of directors for the American Society of Enhanced Recovery (ASER) and Dr George Nassif, colorectal surgeon at the Center for Colon & Rectal Surgery in Florida.

Periop SIG 18 | Armed with data to improve perioperative outcomes Aug 15, 2019

This piece is about the application of data, how do we use it and when should we gather it? How important is it to "just get started and find out what the problem is"?

Further reading is available here: https://bjanaesthesia.org/article/S0007-0912(17)33828-X/fulltext

If you're interested in hearing more about the Enhanced Peri-Operative Care for High-risk patients (EPOCH) trial go here: https://www.topmedtalk.com/desirees-roundtable-carol-peden-epoch-qa/

Presented by Professor Carol Peden, Executive Director of the Center for Heath System Innovation and Professor of Anesthesiology at the Keck School of Medicine of the University of Southern California, Fellow of the Institute for Healthcare Improvement (IHI).

Periop SIG18 | Risk prediction and research Aug 14, 2019

This piece features discussion regarding three randomised trials. How can the insights provided by these trials save us money and increase value of care while also improving outcomes?

Preoperative physiotherapy for the prevention of respiratory complications after upper abdominal surgery: pragmatic, double blinded, multicentre randomised controlled trial DOI: https://doi.org/10.1136/bmj.j5916

REstrictive Versus LIbEral Fluid Therapy in Major Abdominal Surgery: RELIEF Study (RELIEF): https://clinicaltrials.gov/ct2/show/NCT01424150

Personalised perioperative care by e-health after intermediate-grade abdominal surgery: a multicentre, single-blind, randomised, placebo-controlled trial: https://www.researchgate.net/publication/325911716_Personalised_perioperative_care_by_e-health_after_intermediate-grade_abdominal_surgery_a_multicentre_single-blind_randomised_placebo-controlled_trial

Presented by David Storey, Head of Anaesthesia, Perioperative and Pain Medicine Unit (APPMU), Melbourne Medical School, University of Melbourne; Director, Melbourne Clinical and Translational Sciences (MCATS) research platform.

Enhanced Recovery | AANA 2019 Aug 13, 2019

"Thank you for taking this meeting beyond these walls" - this piece is the final part of our coverage of The American Association of Nurse Anesthetists (AANA) 2019 Annual Congress in Chicago, Illinois.

Check out the AANA here: https://www.aana.com/

Presented by Desiree Chappell and Monty Mythen with their guest Lynn Reede, Associate Clinical Professor, Northeastern University Nurse Anesthesia Program.

AANA 2019 | Middle Tennessee School of Anesthesia Aug 13, 2019

This piece is part of our coverage of The American Association of Nurse Anesthetists (AANA) 2019 Annual Congress in Chicago, Illinois.

Check out the AANA here: https://www.aana.com/

Middle Tennessee School of Anesthesia's website is here: https://mtsa.edu/

Our guest kindly shares their email with us: bill.johnson@mtsa.edu

Presented by Desiree Chappell and Monty Mythen with their guest, Bill Johnson, DNAP, CRNA, Director, Acute Surgical Pain Management Fellowship at Middle Tennessee School of Anesthesia.

What's life like, Beyond The Mask? | AANA 2019 Aug 13, 2019

This piece is part of our coverage of The American Association of Nurse Anesthetists (AANA) 2019 Annual Congress in Chicago, Illinois.

Check out the AANA here: https://www.aana.com/

The podcast "Beyond The Mask: Innovation & Opportunities For CRNAs" is here: https://beyondthemask.podbean.com/

Presented by Monty Mythen and Desiree Chappell with their guests, Sharon Pearce MSN, CRNA and Jeremy Stanley CFP, AIF; co-presenters of Beyond The Mask: Innovation & Opportunities For CRNAs.

Tackling the pain of the opioid crisis | AANA 2019 Aug 13, 2019

This piece is part of our coverage of The American Association of Nurse Anesthetists (AANA) 2019 Annual Congress in Chicago, Illinois.

Check out the AANA here: https://www.aana.com/

The Pdf our guest mentions "The PAIN MANAGEMENT BEST PRACTICES INTER-AGENCY TASK FORCE REPORT" is here: https://www.hhs.gov/sites/default/files/pain-mgmt-best-practices-draft-final-report-05062019.pdf

The Perioperative Quality Initiative (POQI) is here: http://poqi.org/

Presented by Monty Mythen and Desiree Chappell with their guest, Bruce Schoneboom, PhD, CRNA, FAAN, Associate Dean for Practice, Innovation and Leadership at Johns Hopkins School of Nursing.

Innovators in anesthesia: Anesthesia electronic medical records | AANA 2019 Aug 13, 2019

This piece is part of our coverage of The American Association of Nurse Anesthetists (AANA) 2019 Annual Congress in Chicago, Illinois.

Check out the AANA here: https://www.aana.com/

The Open-Source Anesthesia Electronic Medical Record (OSAEMR) website is here: https://www.osaemr.com/

Presented by Monty Mythen and Desiree Chappell with John T. "Jack" Hitchens, CRNA, BA, ARNP, partner in a CRNA owned and operated Anesthesia Practice, Watchful Care and Dan Simonson, CRNA, MHPA retired as Chief CRNA and managing partner of the Spokane Eye Surgery Center, adjunct faculty at the Washington State University College of Nursing’s Department of Health Policy and Administration.

Daniel Conway and the Surgery School | The RoundTable Aug 13, 2019

Enhanced Recovery After Surgery, (ERAS) is a familiar concept to the typical TopMedTalk listener but what is ERAS+?

How can you target high risk surgery patients with a comprehensive plan for them to help themselves get a better outcome? From managing expectations, to breathing exercises all the way up to significant lifestyle changes such as exercise and smoking cessation.

The ERAS+ website is here: https://www.erasplus.co.uk/

Presented by Joff Lacey with Desiree Chappell with their guest Daniel Conway, Consultant in Anaesthesia and Critical Care, Perioperative Medicine lead, Manchester Biomedical Research Centre.

Mechanically ventilating patients in the operating room | AANA 2019 Aug 12, 2019

This piece is part of our coverage of The American Association of Nurse Anesthetists (AANA) 2019 Annual Congress in Chicago, Illinois.

Check out the AANA here: https://www.aana.com/

Presented by Desiree Chappell and Monty Mythen with their guests Jaclyn Migliarese, BSN, RN, Second-year student, Duke University Nurse Anesthesia Program and Stephan Bodnar, BSN, RN is a second-year student in the Duke University Nurse Anesthesia Program.

Diversity and Inclusion | AANA 2019 Aug 12, 2019

This piece is part of our coverage of The American Association of Nurse Anesthetists (AANA) 2019 Annual Congress in Chicago, Illinois.

Check out the AANA here: https://www.aana.com/

The Diversity CRNA website is here: https://diversitycrna.org/

Presented by Desiree Chappell and Monty Mythen with their guests Debra Diaz, DNP, CRNA, APRN, CDR, AANA Board of Directors, Lena Gould, CRNA, Founder, Diversity in Nurse Anesthesia Mentorship Program, John Bing, Owner, JBing and Assoc Anesthesia Services, AANA Board of Directors.

Simulation in Education | AANA 2019 Aug 12, 2019

This piece is part of our coverage of The American Association of Nurse Anesthetists (AANA) 2019 Annual Congress in Chicago, Illinois.

Check out the AANA here: https://www.aana.com/

Presented by Desiree Chappell with Monty Mythen and their guest Brett Kendon, DNP, CRNA, CHSE, Assistant Clinical Professor, Assistant Program Director, Nurse Anesthesia Program, Northern Kentucky University.

Substance Use Disorder - Peer Support: An Empathetic Information Resource | AANA 2019 Aug 12, 2019

This piece is part of our coverage of The American Association of Nurse Anesthetists (AANA) 2019 Annual Congress in Chicago, Illinois.

Check out the AANA here: https://www.aana.com/

The Peer Assistance section of the AANA’s website is here: www.AANAPeerAssistance.com. Also see www.AANA.com/AboutPeerAssistance for additional facts and information.

Presented by Desiree Chappell and Monty Mythen with their guests, Linda Stone, DNP, CRNA Assistant Program Director at Raleigh School of Nurse Anesthesia and Rodrigo Garcia, CEO Parkdale; APN,MSN, CRNA, MBA.

Emotional Intelligence and Occupational Stress | AANA 2019 Aug 12, 2019

This piece is part of our coverage of The American Association of Nurse Anesthetists (AANA) 2019 Annual Congress in Chicago, Illinois.

Check out the AANA here: https://www.aana.com/

Our guest kindly allowed us to share her email with you: andrea.bittinger@beaumont.org

Presented by Desiree Chappell and Monty Mythen with their guest, Andrea Bittinger, CRNA at William Beaumont Hospital.

The Respiratory Compromise Institute and ERAS | AANA 2019 Aug 12, 2019

Enhanced Recovery continues to be a hot topic in institutions around America, this piece gives us an update regarding its ongoing applicaiton at Vanderbilt University. Prehabilitation contitnues to gather pace in the wake of the Prehabilitation conference held earlier this year.

We also discuss The Respiratory Compromise Institute, which you can read more about here: http://www.respiratorycompromise.org/

This piece is part of our coverage of The American Association of Nurse Anesthetists (AANA) 2019 Annual Congress in Chicago, Illinois.

Check out the AANA here: https://www.aana.com/

Presented by Desiree Chappell and Monty Mythen with their guests, Brent Denworth, Assistant Professor, Director of Advanced Practice & Chief CRNA, Vanderbilt University Medical Center.

Perioperative Nephrology Fluids and the Kidney | Perioperative Coach Aug 12, 2019

Professor John Kellum gives a thumbnail sketch summary of the fluid debate. Presented by Professor Monty Mythen and Dr Joff Lacey with guest John A. Kellum, Tenured Professor, Critical Care Medicine from The University of Pittsburgh. Join in the debate: contact@topmedtalk.com This conversation taken from a longer piece here: http://www.topmedtalk.com/ebpom-2017-pod-one-live-from-london/

A Novel Use of the Erector Spinae Block in the Austere Environment | AANA 2019 Aug 11, 2019

This piece is part of our coverage of The American Association of Nurse Anesthetists (AANA) 2019 Annual Congress in Chicago, Illinois.

Check out the AANA here: https://www.aana.com/

This link leads you to the paper in question: https://www.ncbi.nlm.nih.gov/pubmed/31247096

Presented by Desiree Chappell and Monty Mythen with their guests Robert Fabich, Doctor of Nursing Practice, CRNA, Veteran and Sharrod R. Greene, CRNA, Sentara Anesthesiology Specialists.

Innovators in Anesthesia | AANA 2019 Aug 11, 2019

This piece is part of our coverage of The American Association of Nurse Anesthetists (AANA) 2019 Annual Congress in Chicago, Illinois.

Check out the AANA here: https://www.aana.com/

The Facebook Group "CRNA Inventors and Innovators" mentioned in this piece is here: https://www.facebook.com/groups/2150893568464906/

Presented by Desiree Chappell and Monty Mythen with their guests Diane Miller, Pediatric Devices for Induction of Anesthesia | Product Development | PeDIA, LLC and Jean Snyder, CRNA Inc. Co-owner Goodwin and Snyder Anesthesia Associates, PLLC

Protecting Your Healthcare Practice - Compliance and Enforcement | AANA 2019 Aug 11, 2019

This piece is part of our coverage of The American Association of Nurse Anesthetists (AANA) 2019 Annual Congress in Chicago, Illinois.

Check out the AANA here: https://www.aana.com/

If you would like to contact our guest he has allowed us to post his email here: msilberman@beneschlaw.com

Presented by Desiree Chappell and Monty Mythen with Sol Aronson, a tenured professor at Duke University and Executive Vice Chairman in the Department of Anesthesiology and their guest, Mark Silberman, Partner, Benesch Law Chair, White Collar, Government Investigations, & Regulatory Compliance Vice-Chair, Health Care.

Caring for the transgender patient | AANA 2019 Aug 11, 2019

This piece is part of our coverage of The American Association of Nurse Anesthetists (AANA) 2019 Annual Congress in Chicago, Illinois.

Check out the AANA here: https://www.aana.com/

The NHS's guidelines are here: https://www.nhs.uk/conditions/gender-dysphoria/guidelines/

Presented by Desiree Chappell and Monty Mythen with Jose Castillo, PhD, CRNA Faculty, Texas Wesleyan University, AANA Diversity and Inclusion Committee.

Periop SIG 18 | Perioperative management in specific patient populations, panel discussion Aug 11, 2019

What do we now know about perioperative asprin? More specifically, what is the latest thinking on the results of the PeriOperative ISchemic Evaluation-2 Trial (POISE-2)? How do we educate patients about exercise? How do we support and help patients who have adverse outcomes to surgery? What's the best screening tool for malnutrition?

Moderated by Dr Catherine Gibb, Consultant physician in perioperative care, Monash University and featuring Harry Gibbs, FRACP, FCSANZ, The Alfred, Melbourne, Stephan A Schug, Anaesthesiology and Pain Medicine, University of Western Australia and Royal Perth Hospital, Sunil K. Sahai, MD, FAAP, FACP, Co-Director, The PeriOperative Evaluation & Management Center Section Chief & Professor of Medicine, Section of Consultative Medicine, Department of General Internal Medicine, MD Anderson Cancer Centre and Vasi Naganathan, Academic and Consultant Geriatrician at University of Sydney, Concord Repatriation Hospital, New South Wales, Australia.

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Brought to you by the Perioperative Medicine Special Interest Group (SIG) in association with the Australian and New Zealand Society for Geriatric Medicine and the Internal Medicine Society of Australia and New Zealand at the 7th annual Australasian Symposium of Perioperative Medicine.

The Perioperative Medicine Special Interest Group (SIG) has three aims; improve patient safety and outcomes, share knowledge and collaborate with specialty groups, develop the specialty of perioperative medicine with various craft groups.

For more information follow this link here: http://www.anzca.edu.au/fellows/special-interest-groups/perioperative-medicine

Talks to... | William Wooden Aug 10, 2019

"Our hospital now has twice the capacity it had" cost of care and efficiency are up. Hear how enhanced recovery after surgery (ERAS) and the power of prehabilitation has dramatically shifted institutions towards better outcomes and a higher value of care.

Also in this piece; what is immunonutrition? How does stress alter our immune responses?

The piece mentioned in the podcast can be found here: https://journals.lww.com/annalsofsurgery/Abstract/2018/10000/Impact_of_a_Novel_Preoperative_Patient_centered.13.aspx

Presented by Desiree Chappell and Monty Mythen with their guest William Wooden, Director of Operative Services at Indiana University of Health.

POET 4.06 | Training of Perioperative providers improves care and creates team players Aug 09, 2019

Discussion begins with an explanation of 'Trainees with an Interest in Perioperative Medicine' (TRIPOM), a big hit at the conference this year, then a wider discussion follows which includes thoughts regarding further research and application of the perioperative method as well as where it impacts medicine and care. The importance of a multidisciplinary team based approach is strongly emphasised. The Getting It Right First Time (GIRFT) initiative is also discussed, more on that here: http://topmedtalk.libsyn.com/iseh-highlight-getting-it-right-first-time-girft

Further discussion of TRIPOM is here: https://www.topmedtalk.com/ebpom-2018-10-what-is-tripom/

Presented by Desiree Chappell with her guests; Dr Ramani Moonesinghe, Professor of Perioperative Medicine at University College London (UCL) and Anne-Marie Bougeard perioperative medicine fellow at the Royal College of Anaesthetists (RCoA).

Periop SIG18 | Preoperative complications Aug 08, 2019

How can you make a difference in the preoperative assessment clinic? How do we remain working as a team while respecting everyone's skillset in a multidisciplinary environment?

The value of a good comprehensive preoperative evaluation is clear; how do we ensure that, when this can happen, it does?

How do we best use the 'teachable moment' that prehabilitation for surgery is? Looking at the data is it fair to "try to tell patients, you don't have to stop smoking for good but can't you stop for the next two weeks?"

The Duke Activity Status Index (DASI) can be found here: https://www.mdcalc.com/duke-activity-status-index-dasi

"Can perioperative risk in the frail be managed?", gets referenced frequently in this podcast, if you're curious to have a listen go here; https://www.topmedtalk.com/periop-medicine-sig18-can-perioperative-risk-in-the-frail-be-managed/

Presented by Bobbie Jean Switzer, Professor of Anesthesiology and Director of Perioperative Medicine at Northwestern University in Chicago, Illinois.

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Brought to you by the Perioperative Medicine Special Interest Group (SIG) in association with the Australian and New Zealand Society for Geriatric Medicine and the Internal Medicine Society of Australia and New Zealand at the 7th annual Australasian Symposium of Perioperative Medicine.

The Perioperative Medicine Special Interest Group (SIG) has three aims; improve patient safety and outcomes, share knowledge and collaborate with specialty groups, develop the specialty of perioperative medicine with various craft groups.

For more information follow this link here: http://www.anzca.edu.au/fellows/special-interest-groups/perioperative-medicine

Periop SIG18 | Goal directed therapy to prevent acute kidney injury Aug 07, 2019

How can goal directed therapy be used to prevent acute kidney injury (AKI)? What do we know about AKI? Which members of the surgical team should be involved in AKI detection? Where do we stand on ACE inhibitors (angiotensin converting enzyme inhibitors) and ARBs (angiotensin-receptor blockers)? Where should a perioperative practitioner stand on the choice between restrictive versus liberal fluid therapy?

The slides for this piece are here: http://www.anzca.edu.au/documents/02-vincent-dintini_goal-directed-therapy-to-preven.pdf

Presented by Vincent D'Intini, Senior staff specialist, Nephrologist, Alfred Hospital Melbourne.

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Brought to you by the Perioperative Medicine Special Interest Group (SIG) in association with the Australian and New Zealand Society for Geriatric Medicine and the Internal Medicine Society of Australia and New Zealand at the 7th annual Australasian Symposium of Perioperative Medicine.

The Perioperative Medicine Special Interest Group (SIG) has three aims; improve patient safety and outcomes, share knowledge and collaborate with specialty groups, develop the specialty of perioperative medicine with various craft groups.

For more information follow this link here: http://www.anzca.edu.au/fellows/special-interest-groups/perioperative-medicine

Prehabilitation, the word of the year? | The RoundTable Aug 06, 2019

Is it fair to say that prehabilitation is the new direction for practitioners of Enhanced Recovery After Surgery (ERAS)?

Discussion expands into patient awareness initatives, The Macmillan Cancer Support, Principles and guidance for prehabilitation guide mentioned is here: https://www.macmillan.org.uk/about-us/health-professionals/resources/practical-tools-for-professionals/prehabilitation.html

Age care naturally follows as the roundtable discussion continues. This piece gives a truly pan-national perspective with informed comment from prominent perioperative opinion leaders from The UK, Australia and America. How do those different systems work and what can they each learn from the others?

The journal article mentioned in this piece is here: https://jamanetwork.com/journals/jamasurgery/fullarticle/2732511

Presented by Desiree Chappell with Monty Mythen and Lee A. Fleisher, Professor and Chair of Anesthesiology and Critical Care, University of Pennsylvania and Ross Kerridge, John Hunter Hospital, Newcastle, Australia, often cited as 'the father of Modern Perioperative Medicine'.

Fluid Management | Perioperative Coach Aug 05, 2019

A discussion about fluid management in an enhanced surgical recovery pathway in relation to the guidelines from ASER and the work of The Perioperative Quality Initiative (POQI http://www.poqi.org). Presented by Monty Mythen with his guest Dr Tim Miller, anaesthesiologist at Duke Medical Centre and Vice President of ASER. For more come to our meetings: http://www.ebpom.org/EBPOM-USA

This highlight clip is taken from a longer conversation to be found here: http://www.topmedtalk.com/aser-ebpom-2017-pod-two-live-from-washington-dc/

Periop SIG 18 | Emergency surgery - panel discussion Aug 04, 2019

This is the panel discussion which tackles emergency surgery. Discussion begins with more detail regarding the Enhanced Peri-Operative Care for High-risk patients (EPOCH) trial.

Featuring, Professor Carol Peden, Executive Director of the Center for Heath System Innovation and Professor of Anesthesiology at the Keck School of Medicine of the University of Southern California, Fellow of the Institute for Healthcare Improvement (IHI), Ben Griffiths, consultant anesthetist at Auckland City Hospital, anaesthetic lead for ANZELA-QI and Michael Cox, Professor of Surgery, Nepean Hospital.

Dr Paul Wischmeyer | TopMedTalks to... Aug 03, 2019

Treating patients as people rather than 'jobs to be done' and 'boxes to be ticked' is the focus of this piece. What can Doctors do better when it comes to treating patients? Find out what happened when a perioperative care doctor became a patient.

A fascinating conversation streamed live from Atlanta Georgia during the second day of TopMedTalk's coverage of "EBPOM-USA Masters Course, A Perioperative Care Practicum".

Hosted by Desiree Chappell and Monty Mythen. Featuring Dr Paul Wischmeyer, Professor of Anaesthesiology and Surgery at Duke Anesthesiology and TopMedTalk's Henry Howe, a medical student at Bristol University.

Join us on www.topmedtalk.com and sign up for our email updates and never miss a live streamed conference again.

Periop SIG18 | Minimising risk, panel discussion Aug 02, 2019

What should we think about issues regarding the Perioperative Ischemic Evaluation Study (POISE)? Is it time to treat men and women equally when it comes to haemoglobin levels? What advice should we give to clinicians who are managing change at a hospital? What should our approach to iron be and can interventions make a real difference?

Featuring; Bruce Waxman, Adjunct Associate Professor (Honorary) at Monash University Dept. of Surgery School of Clinical Sciences, Monash Health and Chief Medical Officer, Bass Coast Health, Wonthaggi Hospital, South Gippsland Coast, Victoria, Kate Burbury, Associate Professor, Deputy Chief Medical Officer, Peter MacCallum Cancer Centre and Toby Richards, Academic Professor of Surgery, Vascular Surgeon, University Western Australia.

POET 4.05 | Refusing surgery Aug 02, 2019

Should we refuse surgery to those who won't change? What about pathological issues, such as smoking, should practitioners become more didactic in their approach? How do we effectively communicate risk, both to the patient and the institution you work for?

Professor Monty Mythen presents with Dr Joff Lacey and guests, Professor Sol Aronson, a tenured professor at Duke University and Executive Vice Chairman in the Department of Anesthesiology, and Dr Mike Irwin, Professor and Head, Department of Anaesthesiology, University of Hong Kon.

Join in the debate: contact@topmedtalk.com

Taken from a longer conversation to be found here: http://www.topmedtalk.com/ebpom-2017-pod-two-live-from-london/

Periop SIG18 | Perioperative frailty - panel discussion Aug 01, 2019

This panel discussion provides a vital and thought provoking insight into frailty in a perioperative patient. Further, as perioperative medicine evolves, how do we know enhanced recovery after surgery (ERAS) works? Are there any large randomised controlled trials that prove it?

This piece is moderated by Dr Ming Loh, Staff Specialist Geriatrician and Clinical Lecturer at Westmead Hospital and the University of Sydney, Clinical Lead for the Orthogeriatric Service, Subacute Rehabilitation Ward and Falls Clinic, and features; Ruth E. Hubbard, Professor in Geriatric Medicine at the University of Queensland, Consultant Geriatrician at the Princess Alexandra Hospital and Head of School for PA-Southside Clinical Unit, with Bobbie Jean Sweitzer, Professor of Anesthesiology and Director of Perioperative Medicine at Northwestern University in Chicago, Illinois, and David Storey, Head of Anaesthesia, Perioperative and Pain Medicine Unit (APPMU), Melbourne Medical School, University of Melbourne; Director, Melbourne Clinical and Translational Sciences (MCATS) research platform.

Periop SIG18 | How do we minimise failure to rescue in the post operative period? Jul 31, 2019

How important is it to triage the patient? Which triage tool should we use? How do we determine which of our surgical patients is most at risk? Which procedures carry the highest risks? What should our approach be towards managing patient deterioration? What about when it comes to acute clinical deterioration? What, in terms of research and technology, can we expect in the future to help us?

The slides for this piece are here: http://www.anzca.edu.au/documents/03-imogen-mitchell_how-do-we-minimise-failure.pdf

Presented by Imogen Mitchell, Senior Staff Specialist, ICU, the Canberra Hospital, Dean, ANU Medical School.

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Brought to you by the Perioperative Medicine Special Interest Group (SIG) in association with the Australian and New Zealand Society for Geriatric Medicine and the Internal Medicine Society of Australia and New Zealand at the 7th annual Australasian Symposium of Perioperative Medicine.

The Perioperative Medicine Special Interest Group (SIG) has three aims; improve patient safety and outcomes, share knowledge and collaborate with specialty groups, develop the specialty of perioperative medicine with various craft groups.

For more information follow this link here: http://www.anzca.edu.au/fellows/special-interest-groups/perioperative-medicine

'If compliance goes down - you know you have a problem' | The RoundTable Jul 30, 2019

An entertaining and informative discussion about the implementation process; how do you bring everyone to the table?

Desiree Chappell speaks with Robin Anderson, Enhanced Recovery (ERAS) program coordinator at Duke University, Bethany Sarosiek, Enhanced Recovery After Surgery (ERAS) Development Coordinator at UVA Health System, and Vicki Morton, Director of Clinical and Quality Outcomes at Providence Anesthesiology Associates. All of them are ASER nursing committee members.

‘Money’s tight’; pull together an ER team with limited resources. The key- NURSES! | Perioperative Coach Jul 29, 2019

Implementing better practice and "ERAS 2.0". The ground up approach of a 'council of nurses' sparks some fascinating debate and discussion. Can a roundtable approach sometimes work better than the traditional hierarchical power structure?

Presented by Desiree Chappell with her guests Dr Ruchir Gupta, medical lead for enhanced recovery at Stony Brook University and Joni Brady, Perianesthesia, Pain Management Nursing Consultant Alexandria, Virginia.

Social Media | Sunday Special Jul 28, 2019

This piece is a chance to reflect upon the importance of new media within the sphere of medical education. As the run away success of TopMedTalk and other podcasts in this area shows people are hungry to use the unique potential of this medium. Also - how has social media, video casting and live streaming altered the way conferences are both organised, executed and received?

Finally, our team of experts tackle the eternal question; where to next?

Presented by Joff Lacey with his guests; David Lyness, Doctor in Anaesthetics and Intensive Care Medicine at Belfast Health and Social Care Trust, Segun Olusanyam Specialty Trainee in Intensive Care Medicine, Jamie Strachan, Intensive Care Medicine and Anaesthesia Registrar & Council Member of the Royal College of Anaesthetists and Dr Cian McDermott Consultant in Emergency Medicine at Mater Misericordiae University Hospital.

You can join IFAD for free online: www.fluidacademy.org

Thomas Scheeren | TopMedTalks to... Jul 27, 2019

The Hypotension Prediction Index (HPI), which uses a machine learning algorithm to help predict intraoperative hypotension. Regular listeners to www.topmedtalk.com will be familiar with concerns about perioperative hypotension. For those who have just joined us, or anyone who fancies a quick refresher on this issue, it is covered in detail here: https://www.topmedtalk.com/live-from-boston-asa-2017-the-elephant-in-the-room-intraoperative-hypotension/

Many practitioners believe they can predict hypotension by observing trends in a patient's mean arterial blood pressure but data shows the machine learning artificial intelligence used by HPI delivers significantly better results. This piece was recorded during the first Morpheus Consortium Symposium, for more details on that look here: http://morpheusconsortium.org

Monty Mythen presents with Dr Tim Miller, anesthsiologist from Duke University Medical Centre and Thomas Scheeren, Chair Cardiovascular Dynamics Section at European Society of Intensive Care Medicine - ESICM.

POET 4.04 | Measuring the risk of surgery Jul 26, 2019

What is a 'micromort'? Even more of a worry, what does ten of them mean? How do we measure and communicate risk to patients? Everyday activities all carry inherent risks, how do we put surgery into a context 'everyday people' can more easily understand?

Professor Monty Mythen presents with guests, Professor Sol Aronson, a tenured professor at Duke University and Executive Vice Chairman in the Department of Anesthesiology, and Dr Mike Irwin, Professor and Head, Department of Anaesthesiology, University of Hong Kong.

Join in the debate: contact@topmedtalk.com

Taken from a longer conversation to be found here: http://www.topmedtalk.com/ebpom-2017-pod-two-live-from-london/

Periop Medicine SIG18 | Prehabilitation in the frail Jul 25, 2019

This piece explores some of the talking points and controversies related to dealing with frail patients who are in need of prehabilitation. How do we meet the needs and concerns of elderly patients while delivering a comprehensive standard of perioperative care?

Presented by David Storey, Head of Anaesthesia, Perioperative and Pain Medicine Unit (APPMU), Melbourne Medical School, University of Melbourne; Director, Melbourne Clinical and Translational Sciences (MCATS) research platform.

EBPOM Highlight 2.02 | Post-op critical care: what should we do? Jul 24, 2019

"Post-operative critical care: what should we do?" was 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

Presented by Denny Levett, Professor in Perioperative Medicine and Critical Care at the University of Southampton.

How do you bring perioperative care to your practice? | The RoundTable Jul 23, 2019

What is after ERAS, do we have an 'ERAS of ERAS' - so to speak? This conversation focuses upon bringing about change, managing and sustaining it over time and helping relate it to patient outcomes. Presented by Desiree Chappell with her guest Arman Dagal, Medical Director - Spine COAP at Foundation for Health Care Quality.

Fluid management - the less explored controversies | Perioperative Coach Jul 22, 2019

A conversation about ASER fluid management; NPO; preop drinks and keeping the i.v down.

Monty Mythen is presenting with his guest Dr Scott Brudney, Professor, Departments of Anaesthesiology and Internal Medicine, University of Manitoba, Winnipeg, Canada.

Click here for the American Society for Enhanced Recovery (ASER) and Perioperative Quality Initiative (POQI) joint consensus statement on perioperative fluid management within an enhanced recovery pathway for colorectal surgery: https://perioperativemedicinejournal.biomedcentral.com/articles/10.1186/s13741-016-0049-9

This conversation is taken from a longer piece to be found here: http://www.topmedtalk.com/aser-ebpom-2017-recap-pod-three-live-from-london/

Mike of the antarctic | Sunday Special Jul 21, 2019

Fresh from an expedition to Antarctica, on the National Geographic Explorer, Mike Grocott gives us an update on the "Anaesthesia at the Extreme" conference.

Regular listeners will remember his excellent talk about Xtreme Everest, which you can find here: https://www.topmedtalk.com/10-xtreme-everest-physiology-on-top-of-the-world/

Presented by Desiree Chappell and Monty Mythen with their guest Mike Grocott, Professor of Anaesthesia and Critical Care Medicine, University of Southampton and Dr Jim Down, University College London Hospital.

Carol Peden Dan Sessler | TopMedTalks to... Jul 20, 2019

Lessons learned from the Enhanced Peri-Operative Care for High-risk patients (EPOCH) trial. This conversation focuses upon the challenges of quality improvement programmes; how do we keep track of patients and improve follow up questions after surgery? How do we clearly show Quality Improvement Programmes work for the patient? Further discussion encompasses innovation and utilization in practice.

Presented by Monty Mythen and Desiree Chappell with their guest Carol Peden, Professor of Anesthesiology and Exec. Director of the Center for Health System Innovation, University of Southern California, University of Bath and the Institute for Healthcare Improvement (IHI).

For more on EPOCH look here: https://www.topmedtalk.com/?s=EPOCH

POET 4.03 | Communication uniquely suited to the perioperative domain Jul 19, 2019

Fitness for surgery and an understanding of the realities of risk. How important is it for surgery to take place when balanced against the specific health needs of the patient? How do we encourage patients to alter pathological aspects of their lives in order to minimise the chances of a negative outcome?

Professor Monty Mythen presents with Dr Joff Lacey and guests, Professor Sol Aronson, a tenured professor at Duke University and Executive Vice Chairman in the Department of Anesthesiology, and Dr Mike Irwin, Professor and Head, Department of Anaesthesiology, University of Hong Kong.

Sponsored by EBPOM and Edwards Life Sciences this piece was recorded on day two of EBPOM 2017.

Join in the debate: contact@topmedtalk.com

Taken from a longer conversation to be found here: http://www.topmedtalk.com/ebpom-2017-pod-two-live-from-london/

TopMedTalk | A Masters Programme in Perioperative Medicine Jul 18, 2019

University College London (UCL) offer a fantastic Masters Course in Perioperative Medicine, hear how it works in this podcast.

Also, if you're intrigued, here's the link to the free 4 week course discussed in this podcast:

https://www.ucl.ac.uk/lifelearning/courses/perioperative-medicine

Presented by Desiree Chappell with Sam Bampoe, consultant in Anaesthesia and Perioperative Medicine at University College London NHS Foundation Trust.

EBPOM Highlight 2.01 | Exercise and cancer Jul 17, 2019

This week's conference highlight "Exercise and cancer" was originally streamed live from The Institute of Engineering and Technology (IET) in London during EBPOM 2018 on www.topmedtalk.com

If you'd like to attend an event like this ensure your next click is here: www.ebpom.org/meetings

Presented by Mike Grocott, Professor of Anaesthesia and Critical Care Medicine, University of Southampton.

Don't ask 'what is the matter' ask what matters? | The RoundTable Jul 16, 2019

A powerful discussion about outcomes, patient care and what matters the most.

Presented by Desiree Chappell and Monty Mythen with their guests; Eric J Schneidewind president of the AARP and Kevin Bozic, Chair of Surgery & Perioperative Care at the Dell Medical School.

Getting on the same page | Perioperative Coach Jul 15, 2019

A conversation about enhanced recovery implementation.

Dr Joff Lacey catches up with Mike Scott, Virginia Commonwealth University and Ross Kerridge, John Hunter Hospital, Newcastle, Australia.

The Bigger Picture of Perioperative Medicine | Sunday Special Jul 14, 2019

A transatlantic perspective.

This conversation explores the extended role of the anaesthetist, brought about partly by perioperative care but more widely because of societal changes. Practitioners face a dilemma; how do you best impact value based care, as a specialist, when multidisciplinary approaches are becoming essential?

In the UK, The Royal College of Anaesthetists, are working on this very issue; find out how they are becoming part of conversations regarding public health and modifiable risk factors, as relate to a patient's lifestyle choices and pathology.

The transatlantic perspective is essential here, how do organisations like EBPOM USA advocate these ideas within an American funding model?

No matter which side of the Atlantic you live on there's a very real debate to be had about training students; the job of the anaesthetist has fundamentally altered in recent times. Furthermore, how do those already practising update their skills and stay with the times?

Monty Mythen and Joff Lacey presenting with their guests Liam Brennan, President of the Royal College of Anaesthetists, and Sol Aronson, a tenured professor at Duke University and Executive Vice Chairman in the Department of Anesthesiology.

Dan Sessler | TopMedTalks to... Jul 13, 2019

The Elephant In The Room - intraoperative hypotension. A discussion regarding the exciting results from the first multicentre, randomised controlled trial into targeted intraoperative blood pressure management. This conversation reflects the start of many debates and concern regarding hypotension, a frequent topic here on TopMedTalk. Monty Mythen and Mike Grocott are with Tim Miller, Duke University Medical Centre, speaking with their guest Dr Dan Sessler, Cleveland Clinic.

POET 4.02 | Shared decision making for high risk surgery Jul 12, 2019

POET - The Perioperative Enhancement Team

How can cardiopulmonary exercise testing lead to shared decision making? Hear how aortic aneurysms are dealt with by a world class professional perioperative physician. Learn how that process and its success then spread out into other areas of healthcare within his institution. Do you need to develop a broad knowledge of all surgery and medicine so that you understand what is going on within the different surgical specialities

Presented by Monty Mythen, Joff Lacey and Desiree Chappell with their guest Dr Michael Swart, Consultant in Anaesthesia and Critical Care Medicine at Torbay Hospital and advisor to the UK Department of Health for the Enhanced Recovery Programme.

Periop SIG18 | Early out-of-hospital management for post-op patients Jul 11, 2019

How do we manage the process of early out-of-hospital management sensibly? What does a home-based post operative care system look like? What are the essential elements of transforming your health care system to fit with the latest insights in perioperative practice?

Follow this link to the presentation slides: http://www.anzca.edu.au/documents/01-don-campbell_perioperative-models-of-care.pdf

Presented by Don Campbell, Professor of Medicine at Monash University and Head of General Medicine at Southern Health.

EBPOM Highlight 1.32 | Australian perspective on perioperative medicine Jul 10, 2019

Australia has an interesting history both generally and with perioperative medicine specifically, here the story is told and their current progress is revealed. How do comparisons between various countries help us to understand where improvements can be made? How do the differences between the way in which healthcare is funded impact on patients and providers?

Presented by Ross Kerridge, John Hunter Hospital, Newcastle, Australia, often cited as 'the father of Modern Perioperative Medicine'. --

This piece was originally part of a wider discussion regarding global perspectives on perioperative medicine; it works here as a stand alone talk. Keep an eye on TopMedTalk for the US, UK and global perspectives.

Exercise is real medicine? | The RoundTable Jul 09, 2019

This piece covers; physical medicine and rehabilitation, applying a team approach in care and 'pre and post-habilitation'.

Desiree Chappell presents with Monty Mythen and their guests; Dr Steve Flanagan, Chair of Physical Medicine and Rehabilitation at NYU Langone Brian Stewart, Partner/Clinic Director California Rehabilitation and Sports Therapy and Colleen Walsh, Assistant Professor, Nursing University of Southern Indiana, President, National Association of Orthopaedic Nurses.

Nutrition | Perioperative Coach Jul 08, 2019

"An operation is like a marathon, nobody prepares for that by starving themselves"

Monty Mythen talks to Professor Paul Wischmeyer from the Department of Anesthesiology, Duke University, USA about the e.published American Society of Enhanced Recovery (ASER) and Perioperative Quality Initiative (POQI) joint consensus statement on Nutrition and Screening Therapy within an Surgical Enhanced Program.

Click on this link to access the full paper:

https://journals.lww.com/anesthesia-analgesia/Abstract/publishahead/American_Society_for_Enhanced_Recovery_and.96950.aspx

Furthermore, you can listen to one of Paul's excellent talks here: http://topmedtalk.libsyn.com/website/ebpom-2018-perioperative-nutrition-should-be-a-key-part-of-enhanced-recovery

Is the US spending too much on health care and not enough on health? | Sunday Special Jul 07, 2019

This piece was originally streamed live on www.topmedtalk.com and is taken from the hugely successful "EBPOM-USA: Masters Course, A Perioperative Care Practicum".

Hear the full presentation from Dr Lee A. Fleisher Professor and Chair of Anesthesiology and Critical Care, University of Pennsylvania.

If you like the sound of this and think you and your practice would benefit from attending such a course don't worry, just go to The EBPOM website: https://www.ebpom.org

Zeev Kain | TopMedTalks to... Jul 06, 2019

"Value based care - it’s an interdisciplinary team sport"

Desiree Chappell speaks with Zeev Kain, organiser of the American college of perioperative medicine interdisciplinary conference on orthopaedic value based care.

Find his podcast here: http://drzeevkain.health/podcast/

If you'd like to find out more about the conference follow this link: https://acpm.health/ovbc2019/

Prehab Periop World Congress: Andrew Shaw Jul 05, 2019

Streamed live from the 2019 Prehabilitation World Congress and Annual London Peri-Operative Medicine Congress. This session is sponsored by Edwards Life Sciences.

Presented by Desiree Chappell with Monty Mythen, Joff Lacey and their guest Dr Andrew Shaw, Chairman, Department of Anesthesiology and Pain Medicine at The University of Alberta, Edmonton, Alberta and Zone Clinical Department Head for Anesthesia, Alberta Health Services Edmonton Zone. He is also a Fellow of the Royal College of Anaesthetists (UK), the American College of Critical Care Medicine and the Faculty of Intensive Care Medicine (UK).

POET 4.01 | Perioperative Enhancement Teams Jul 05, 2019

Why do you need a "poet"?

The POET acronym - a truly multidisciplinary Perioperative Enhancement Team; responsible for project managing optimisation programmes.

Monty Mythen speaks with Professor Sol Aronson, a tenured professor at Duke University and Executive Vice Chairman in the Department of Anesthesiology.

This piece is taken from a longer conversation to be found here: http://www.topmedtalk.com/aser-ebpom-2017-recap-pod-three-live-from-london/

Join the debate: contact@topmedtalk.com

Prehab Periop World Congress: Daniel Conway and the surgery school Jul 04, 2019

Streamed live from the 2019 Prehabilitation World Congress and Annual London Peri-Operative Medicine Congress. This session is sponsored by Edwards Life Sciences.

Presented by Joff Lacey with Desiree Chappell with their guest Daniel Conway, Consultant in Anaesthesia and Critical Care, Perioperative Medicine lead, Manchester Biomedical Research Centre.

Prehab Periop World Congress: Feras Hatib, Simon Davies Jul 04, 2019

Streamed live from the 2019 Prehabilitation World Congress and Annual London Peri-Operative Medicine Congress. This session is sponsored by Edwards Life Sciences.

Presented by Monty Mythen with Desiree Chappell and Feras Hatib Phd, Director, Research and Development, Algorithms and Signal Processing at Edwards Lifesciences and Dr Simon Davies, Consultant Anaesthetist at York Teaching Hospital NHS Foundation Trust.

Prehab Periop World Congress: Joff Lacey, Tim Miller Jul 04, 2019

Streamed live from the 2019 Prehabilitation World Congress and Annual London Peri-Operative Medicine Congress.

Presented by Monty Mythen and Desiree Chappell with Joff Lacey, registrar in anaesthesia at St George’s Hospital in London, currently undertaking a fellowship in Perioperative Medicine at UCLH as well as being a regular presenter on TopMedTalk and Tim Miller, Associate Professor of Anaesthesiology from Duke University Medical Centre.

Prehab Periop World Congress: Lee Fleisher, Ross Kerridge Jul 04, 2019

Streamed live from the 2019 Prehabilitation World Congress and Annual London Peri-Operative Medicine Congress.

Presented by Desiree Chappell with Monty Mythen and Lee A. Fleisher Professor and Chair of Anesthesiology and Critical Care, University of Pennsylvania and Ross Kerridge, John Hunter Hospital, Newcastle, Australia, often cited as 'the father of Modern Perioperative Medicine'.

Prehab Periop World Congress: Gerard Danjoux, Ken Van Someren Jul 04, 2019

Streamed live from the 2019 Prehabilitation World Congress and Annual London Peri-Operative Medicine Congress.

Gerard Danjoux, consultant in Anaesthesia and Sleep Medicine at South Tees Hospitals NHS Trust and Ken Van Someren, Director KvS Performance Ltd.

Prehab Periop World Congress: David Walker, Rob Stephens Jul 04, 2019

Streamed live from the 2019 Prehabilitation World Congress and Annual London Peri-Operative Medicine Congress.

Presented by Desiree Chappell and Monty Mythen with their guests David Walker, Professor in Anaesthesia and Critical Care Medicine, University College London Hospitals, Honorary Senior Lecturer UCL and Dr Rob Stephens, Consultant in Anaesthesia, UCLH, Hon Senior Lecturer in Anaesthesia, UCL.

Prehab Periop World Congress: Teodor Stefanov Jul 04, 2019

Streamed live from the 2019 Prehabilitation World Congress and Annual London Peri-Operative Medicine Congress.

Presented by Monty Mythen, Desiree Chappell and Korey Sprigman with their guest Teodor Stefanov, Associate Physician, Anesthesiology Institute at Cleaveland Clinic, Abu Dhabi.

Prehab Periop World Congress: Evan Kharasch Jul 04, 2019

Streamed live from the 2019 Prehabilitation World Congress and Annual London Peri-Operative Medicine Congress. Here we welcome the Editor-in-Chief of 'Anesthesiology', who is also the international visiting lecturer at this year's event.

Presented by Desiree Chappell and Monty Mythen with Korey Sprigman and their guest Evan Kharasch, Professor of Anesthesiology, Vice Chair for Innovation, Director, Academic Entrepreneurship, Duke University School of Medicine.

Prehab Periop World Congress: William Wooden Jul 03, 2019

Streamed live from the 2019 Prehabilitation World Congress and Annual London Peri-Operative Medicine Congress.

If you're interested in hearing shows as they are streamed go to https://www.topmedtalk.com/live-stream/

The piece mentioned in the podcast can be found here: https://journals.lww.com/annalsofsurgery/Abstract/2018/10000/Impact_of_a_Novel_Preoperative_Patient_centered.13.aspx

Presented by Desiree Chappell and Monty Mythen with their guest William Wooden, Director of Operative Services at Indiana University of Health.

Prehab Periop World Congress: Dan Martin and Sandy (Alexander) Jackson Jul 03, 2019

Streamed live from the 2019 Prehabilitation World Congress and Annual London Peri-Operative Medicine Congress.

The survey mentioned on this podcast is here: http://www.periop.co.uk/oxygen/

If you're interested in hearing shows as they are streamed go to https://www.topmedtalk.com/live-stream/

Presented by Monty Mythen with Desiree Chappell and their guests Dan Martin, OBE anaesthetist and intensivist at the Royal Free Hospital and Reader at University College London (UCL) and Sandy (Alexander) Jackson, Academic Clinical Fellow, University of Southampton.

TopMedTalks to... | Feras Hatib Jul 03, 2019

Streamed live from the 2019 Prehabilitation World Congress and Annual London Peri-Operative Medicine Congress. This piece, a break out session held at 'Montague on The Gardens', focuses upon artificial intelligence and was sponsored by Edwards Life Sciences.

Presented by Desiree Chappell and Monty Mythen with their guest, Feras Hatib, Phd, Director, Research and Development, Algorithms and Signal Processing at Edwards Lifesciences.

TopMedTalk | The AI Doctor will see you now... Jul 03, 2019

Streamed live from the 2019 Prehabilitation World Congress and Annual London Peri-Operative Medicine Congress. This piece, a break out session held at 'Montague on The Gardens', focuses upon perioperative blood pressue and artificial intelligence. It was sponsored by Edwards Life Sciences.

Presented by Monty Mythen and Desiree Chappell, this is a short explanation of the technology in practice.

Prehab Periop World Congress: Update from the first day Jul 03, 2019

The TopMedTalk team set out the plan for this week's 2019 Prehabilitation World Congress and Annual London Peri-Operative Medicine Congress. Live from The British Museum the team expand on some of the controversies and talking points coming from EBPOM's most recent event.

Presented by Monty Mythen with Desiree Chappell and Korey Springman.

EBPOM Highlight 1.31 | Changing behaviours of the medical team before surgery Jul 03, 2019

"POETTS 2018 | Changing behaviours of the medical team before surgery" - was 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 Dr Darren Flynn, Practitioner Health Psychologist, Newcastle University.

Insight into ERAS in Saudia Arabia | The RoundTable Jul 02, 2019

This conversation is a fascinating glimpse into the spread of Enhanced Recovery After Surgery (ERAS) in Saudi Arabia.

Desiree Chappell interviews her guests; Fatimah Alsalah, Anesthesiologist at King Fahad Specialist Hospital in Dammam, Deputy head of the transplant anesthesia section, alongside Nicole Greenshields and Douglas Blackwood, Perioperative Medicine Fellows at The University College London (UCL), Department of Anaesthetics.

How do you impliment change? | Perioperative Coach Jul 01, 2019

How do we impliment change in our practice? Is it possible to "set yourself up for success" or should we expect problems? Can you be someone who keeps your chin up when faced with tough challenges?

Presented by Desiree Chappell with co-host Korey Sprigman and their guests, Jamie Harris, CRNA Independent Contractor Tulsa, Oklahoma and Carol Schmidt, CRNA, Michigan.

Fitter Better Sooner | Sunday Special Jun 30, 2019

A large part of the journey towards enhanced recovery, better outcomes and fewer complications, is to do with educating patients. How do we explain to patients that an operation is something which is ideally a collaboration between both practitioner and patient?

The "Fitter, Better, Sooner" toolkit, which this piece focuses on, 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 Royal College of Anaesthetists.

Paul Pomerance | TopMedTalks to... Jun 29, 2019

The American Society of Anesthesiologists (ASA) continues to raise the standards of the medical practice of anesthesiology, as well as keeping a particular focus on improving patient care. This conversation is a chance to catch up with their work.

For more information on the upcoming Anesthesiology 2019, in October (19-23) go here: https://www.asahq.org/annualmeeting

For more on the Patient Safety Movement Foundation go here: https://patientsafetymovement.org/

Finally, the wonderful Linda Mason interview which gets mentioned in this piece is here: https://www.topmedtalk.com/euroanaes2019-linda-mason/

Presented by Desiree Chappell and Monty Mythen with their guest Paul Pomerance, Chief Executive Officer of the American Society Of Anesthesiologists, Worldwide Executive Director at Drug Information Association, Inc.

Judson Williams and Gina McConnell | ERAS Cardiac 2019 Jun 28, 2019

Live from "ERAS cardiac: Center of excellence training conference", an Edwards Life Sciences sponsored conference in North Carolina.

The first article, Enhanced recovery after cardiac surgery program to improve patient outcomes, mentioned in the piece is here:

https://journals.lww.com/nursing/Pages/articleviewer.aspx?year=2018&issue=11000&article=00007&type=Fulltext

The second, One-year results from the first US-based enhanced recovery after cardiac surgery (ERAS Cardiac) program, is here:

https://doi.org/10.1016/j.jtcvs.2018.10.164

Presented by Desiree Chappell with Monty Mythen and Judson Williams, WakeMed cardiovascular surgeon who specializes in treating patients with heart valve disease or structural heart disease, aortic aneurysms, and coronary heart disease, also, Vice President, Board of Directors Enhanced Recovery After Cardiac Surgery (ERACS) and Gina McConnell, BSN, RN, CCRN, WakeMed Cardiothoracic Intensive Care.

Kevin Lobdell | ERAS Cardiac 2019 Jun 28, 2019

Live from "ERAS cardiac: Center of excellence training conference", an Edwards Life Sciences sponsored conference in North Carolina.

The Enhanced Recovery After Cardiac Surgery website is here: https://www.erascardiac.org/

Presented by Desiree Chappell with her guest Kevin Lobdell, Director of Regional CVT Quality, Education, and Research.

Bob Booth | ERAS Cardiac 2019 Jun 28, 2019

Live from "ERAS cardiac: Center of excellence training conference", an Edwards Life Sciences sponsored conference in North Carolina.

Check out the article here: https://jamanetwork.com/journals/jamasurgery/fullarticle/2732511

Find out more about NorthStar here: https://northstaranesthesia.com/

The "Masters of Scale" podcast is here: https://mastersofscale.com/

Presented by Monty Mythen and Desiree Chappell with their guest Bob Booth, Regional Chief Medical Officer, Vice President of Physician Operations at NorthStar Anesthesia, P.A.

Seenu Reddy | ERAS Cardiac 2019 Jun 28, 2019

To the patient: "You're about to run a marathon, you wouldn't do that without training".

The outstanding article referenced in this piece is here:

https://jamanetwork.com/journals/jamasurgery/fullarticle/2732511

The Society of Thoracic Surgeons' website is here: https://www.sts.org/

More about "DRink EAt Mobilise" here: https://www.topmedtalk.com/standardised-outcomes-from-surgery-drink-eat-mobilise-dream/

Live from "ERAS cardiac: Center of excellence training conference", an Edwards Life Sciences sponsored conference in North Carolina.

Presented by Desiree Chappell and Monty Mythen with their guest Seenu Reddy, Surgical Director structural heart program at TriStar.

POET 3.09 | If you need help ask for it Jun 28, 2019

'The Practitioner Health Programme' - why do anaesthetists suffer from mental health problems, what help is there available for them? Learn here how people in that profession are uniquely placed to deal with the inevitable pressures related to healthcare.

Presented by Desiree Chappell and Monty Mythen with their guest Dr Clare Gerada, Medical Director, Physician Health, Practitioner Health Service.

Periop Medicine SIG18 | Can perioperative risk in the frail be managed? Jun 27, 2019

How do you manage frailty? This talk is an honest appraisal of the latest thinking, from a perioperative perspective.

Presented by Bobbie Jean Sweitzer, Professor of Anesthesiology and Director of Perioperative Medicine at Northwestern University in Chicago, Illinois.

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Brought to you by the Perioperative Medicine Special Interest Group (SIG) in association with the Australian and New Zealand Society for Geriatric Medicine and the Internal Medicine Society of Australia and New Zealand at the 7th annual Australasian Symposium of Perioperative Medicine.

The Perioperative Medicine Special Interest Group (SIG) has three aims; improve patient safety and outcomes, share knowledge and collaborate with specialty groups, develop the specialty of perioperative medicine with various craft groups.

For more information follow this link here: http://www.anzca.edu.au/fellows/special-interest-groups/perioperative-medicine

EBPOM Highlight 1.30 | Visiting Professor Plenary Lecturer: "Results of the RELIEF Trial". Jun 26, 2019

"Results of the RELIEF Trial" - 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: https://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 Paul Myles, Head of Alfred Health's and Monash University's Department of Anaesthesia and Perioperative Medicine.

Coordinating an Enhanced Recovery Program | The RoundTable Jun 25, 2019

How important is it to have a dedicated member of your team focused on starting, maintaining and coordinating your enhanced recovery programme?

Does an enhanced recovery programme which comes from the grassroots need support early on in the process? How do you find the right people to support you once the process has begun? Also, how do you explain that these changes will actually reduce workload?

The conversation moves into managing pain, both the reality of pain and the expectations which can, if handled correctly, help to reduce it.

Finally, what are the three key aptitudes that an enhanced recovery coordinator needs?

Presented by Desiree Chappell with Korey Springman, Anesthesiologist and Perioperative Medicine Fellow at Duke University and Vicki Morton, Director of Clinical and Quality Outcomes at Providence Anesthesiology Associates and Courtney Fossen, Manager of Surgical Services at US Anesthesia Partners (USAP).

Understanding delirium among the surgical team | Perioperative Coach Jun 24, 2019

How widespread are misconceptions about delirium within your surgical team? Do you and your colleagues know how to recognise it? If so, how does your definition compare with the actual definition you can find in the Diagnostic and Statistical Manual of Mental Disorders (DSM–5)?

This piece suggests more work needs to be done to accurately diagnose and understand this condition in a clinical environment.

Presented by Robin Schiller and Bridger Bach with their guest Zhaosheng Jin, Queen’s hospital, Barking Havering Redbridge NHS trust, Central London School of Anaesthesia.

Sunday Special | The heart of the debate Jun 23, 2019

What are the hot topics in the cardiac world at the moment? Alongside reflections on this year's annual meeting of 'The Society of Cardiovascular Anesthesiologists' (SCA) this piece tackles; the need for gender balance when composing panels and building a successful event; the need to do what we know and do it well; how quality improvement benefits from simplicity; the need to keep younger practitioners involved and finally the need for a fuller engagement with the multidisciplinary aspect of cardiac care.

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.

TopMedTalks to... Dave O'Conner | Euroanaesthesia 2019 Jun 22, 2019

How do you communicate and spread a passion for fluid management and optimisation to your fellow practitioners? How should you use protocols here? Are there specific tricks we can use to get buy in from our post-anesthesia care unit (PACU)?

Presented by Desiree Chappell with David O’Connor, DNAP, CRN, at Memorial Sloan Kettering (MSK) Cancer Center.

POET 3.08 | Thinking clearly on the brain Jun 21, 2019

What is "The Brain Health Initiative"? Why is it that so many aspects of brain function are so hard to understand? Why is cognitive dysfunction such a difficult topic to discuss? How far away are we from the days when we will have a biomarker that can help us in this area?

Desiree Chappell presents, with her guests; Dr Lee A. Fleisher Professor and Chair of Anesthesiology and Critical Care, University of Pennsylvania and Miles Berger, Neuroanesthesiologist at Duke University Medical Center.

Periop SIG18 | Minimising Risk; anaemia Jun 20, 2019

How should you manage anaemia as part of the perioperative process? Preoperative anaemia has a variable effect on outcomes, how should it be managed? Given the data, should we adopt different tactics for women and men?

This piece gets into the substance of the debate with clear evidence based suggestions which you can incorporate into your practice.

Here is a link to the slides for this presentation:

http://www.anzca.edu.au/documents/01-toby-richards_anaemia-and-risk-modification.pdf

Presented by Toby Richards, Academic Professor of Surgery, Vascular Surgeon, University Western Australia.

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Brought to you by the Perioperative Medicine Special Interest Group (SIG) in association with the Australian and New Zealand Society for Geriatric Medicine and the Internal Medicine Society of Australia and New Zealand at the 7th annual Australasian Symposium of Perioperative Medicine.

The Perioperative Medicine Special Interest Group (SIG) has three aims; improve patient safety and outcomes, share knowledge and collaborate with specialty groups, develop the specialty of perioperative medicine with various craft groups.

For more information follow this link here: http://www.anzca.edu.au/fellows/special-interest-groups/perioperative-medicine

EBPOM Highlight 1.29 | US perspective on perioperative medicine Jun 19, 2019

America is often seen as coming a little late to perioperative practice. However, that's a picture which is now changing for the better, thanks partly to many of the people you have heard here on TopMedTalk.

This piece asks where they are now and where they need to be in the future. Is it true to say that the US system is in the midst of a rapid change? Can consumers of healthcare make reasonable choices regarding value based care? Is the 'fee for service' aspect of America something which a perioperative practice can expect to easily work with?

Presented by Sol Aronson, tenured professor at Duke University and Executive Vice Chairman in the Department of Anesthesiology. --

This piece was originally part of a wider discussion regarding global perspectives on perioperative medicine; it works here as a stand alone talk. Keep an eye on TopMedTalk for the Australian, UK and global perspectives.

Changing the culture around surgical recovery | The RoundTable Jun 18, 2019

What can be learned when it comes to working with a quality improvement program? Do you often run into challenges with the pharmacy? If you want to implement a multi-modal pain management enhanced recovery practice, how can you appeal to the pharmacists and gain buy-in for narcotic alternatives? Additionally m, how far has the message of enhanced recovery reached? Finally, what is the role of the perioperative clinical specialist for an enhanced recovery program?

Presented by Desiree Chappell with her guests Liz Pratt, Director, Enhanced Surgical Recovery & Epic Site Liaison at Barnes-Jewish Hospital and Rachel Wolfe, Clinical Pharmacy Specialist, Perioperative Services & Surgical Critical Care and April Smith, Associate Professor, School of Pharmacy and Health Professions. Both Rachel and April are part of American College of Clinical Pharmacy.

Putting care into intensive care | Perioperative Coach Jun 17, 2019

How is it that a profession which attracts people who care about patients sometimes produces people who seem not to care? This piece discusses "burn out" and the need for all practitioners to keep their focus on the fact that caring for patients is their primary role?

Is the curse of electronic health records, email and digital communication taking up too much time and turning people into "box tickers"?

Presented by Monty Mythen with Paul Wishmeyer, Professor of the Department of Anesthesiology, Duke University.

Blood Pressure | Sunday Special Jun 16, 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 and Sol Aronson, tenured professor at Duke University and Executive Vice Chairman in the Department of Anesthesiology.

Charles Brown | Euroanaesthesia 2019 Jun 15, 2019

"One of the best sessions of the entire conference" was presented by our guest on this piece. In this podcast there's a chance to really discuss perioperative optimisation, with a focus on delirium, in post operative patients. Are we getting to where we need to be or is there more work to be done?

Presented by Desiree Chappell with Sol Aronson and their guest Charles Brown, associate professor of anesthesiology and critical care medicine at the Johns Hopkins University School of Medicine.

POET 3.07 | Perioperative antibiotic stewardship Jun 14, 2019

This passionate talk is a call to action for the peioperative practitioners who are serious about the wider issue of population health. How can the protocols and pathways of your practice be adjusted to seriously contend with the global issue regarding the stewardship of one of medicine's most vital resources?

Presented by Alison Holmes, Professor of Infectious Diseases at Imperial College, Fellow of the Academy of Medical Sciences and an Senior Investigator at the National Institute of Health Research (NIHR).

To hear the fuller version of this talk go here: https://www.topmedtalk.com/ebpom-highlight-1-10-antibiotic-stewardship-in-perioperative-care/

Periop Medicine SIG18 | A Care Chain is only as strong as its weakest link Jun 13, 2019

What is the perioperative chain? What are the opportunities we have to strengthen the links in the chain? Using an evidence based approach this talk gives you a summary of key areas where you can strengthen your practice and bring better patient outcomes alongside reduced cancellations.

Presented by Kerin Fielding, Associate Professor, University of Notre Dame, Australia School of Medicine, Sydney.

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Brought to you by the Perioperative Medicine Special Interest Group (SIG) in association with the Australian and New Zealand Society for Geriatric Medicine and the Internal Medicine Society of Australia and New Zealand at the 7th annual Australasian Symposium of Perioperative Medicine.

The Perioperative Medicine Special Interest Group (SIG) has three aims; improve patient safety and outcomes, share knowledge and collaborate with specialty groups, develop the specialty of perioperative medicine with various craft groups.

For more information follow this link here: http://www.anzca.edu.au/fellows/special-interest-groups/perioperative-medicine

EBPOM Highlight 1.28 | UK perspective on perioperative medicine Jun 12, 2019

The UK could be said to have led the way with perioperative medicine, is that still the case? The theme of change and adaption is key here; this piece asks where is the UK now and where is it going to in the future? How were practitioners in the UK inspired by others around the world to push this movement forward?

Presented by Mike Grocott, Professor of Anaesthesia and critical care at the University of Southampton. --

This piece was originally part of a wider discussion regarding global perspectives on perioperative medicine; it works here as a stand alone talk. Keep an eye on TopMedTalk for the Australian, UK and global perspectives.

Outstanding Outcomes | The RoundTable Jun 11, 2019

This piece, originally streamed live on www.topmedtalk.com features a conversation about the implementation of enhanced recovery protocols and the results practitioners report. The discussion starts with the observation that just implementing the ERAS intraoperative protocols drove outstanding outcomes in practice. The wider discussion focuses on the importance of putting into practice a bigger plan.

Presented by Desiree Chappell with her guests Raul Castillo, Anesthesia Medical Director at the University of Missouri Hospital, Jennifer Clark, Staff Nurse Anesthetist at the University of Missouri Hospital Department of Anesthesiology, and Kay Smith, pain nurse coordinator University of Missouri Hospital.

Pain strategies | Perioperative Coach Jun 10, 2019

This piece looks at the various pain strategies open to a perioperative practitioner. What drugs are best to use, in line with the latest research and a wider understanding of the long term needs of a patient?

The fuller talk is available here: https://www.topmedtalk.com/ebpom-highlight-1-25-pain-management-to-enhance-recovery-after-joint-replacements/

Presented by Dr. Ryan Hanson, Anesthesiologist Brigham and Women's Hospital, Boston, Massachusetts.

Burn out? | Sunday Special Jun 09, 2019

This piece focuses on the question of looking after yourself as a practitioner and interlinking into your team. How important is it to listen to your team? What is "burn out"? How does it express itself in people? What signs should we look for in our friends and colleagues?

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.becomebraveenough.com/

Elena Koepke | TopMedTalks to... Jun 08, 2019

On the last occasion we spoke with our guest she was a Perioperative Medicine Fellow at Duke University; learn now how her experiences have helped change her practice and the edge she has dealing with healthcare. The conference is producing a number of talking points, the Measurement of Exercise Tolerance before Surgery (METS) Trial seems to have shifted opinions, does a genuine 'perioptimist' have a deeper insight into the issues there? Also - does North America really lack the resources, expertise and money to adpot Cardiopulmonary Exercise Testing (CPET)? Presented by Desiree Chappell and Monty Mythen with their guest Dr Elena Koepke, Assistant Professor at Moffitt Cancer Center/USF, Physician Anesthesiologist, Perioperative Medicine Specialist. You can find POETTS here: https://www.poetts.co.uk

Bruce Biccard |Prato 2019 Jun 07, 2019

This piece is the first of TopMedTalk's 'as live' coverage from the 5th Collaborative Clinical Trials in Anaesthesiology Meeting, Prato, Italy. It's your chance to get virtual a place at one of the most influential gatherings of its kind in the world.

Please go to the website mentioned in this piece for more details: https://www.asos.org.za

Presented by Desiree Chappell with Monty Mythen and their guest Bruce Biccard, consultant anaesthetist at the University of Kwazulu-Natal, Director, Perioperative Research Unit, Department of Anaesthetics, Nelson R Mandela School of Medicine.

Ben Creagh-Brown |Prato 2019 Jun 07, 2019

This piece is the first of TopMedTalk's 'as live' coverage from the 5th Collaborative Clinical Trials in Anaesthesiology Meeting, Prato, Italy. It's your chance to get virtual a place at one of the most influential gatherings of its kind in the world.

This piece is a discussion regarding the SQUEEZE Study: A prospective multi-centre international observational study of postoperative vasopressor use.

Presented by Desiree Chappell with Monty Mythen and their guest Ben Creagh-Brown, Clinical Academic Intensivist, Director of Research and Development, Royal Surrey County Hospital NHS Foundation Trust and Co-Chief Investigator of the "Squeeze Study".

Meghan Fall-Lane |Prato 2019 Jun 07, 2019

This piece is the first of TopMedTalk's 'as live' coverage from the 5th Collaborative Clinical Trials in Anaesthesiology Meeting, Prato, Italy. It's your chance to get virtual a place at one of the most influential gatherings of its kind in the world.

Presented by Desiree Chappell with Monty Mythen and their guest Meghan Fall-Lane, Assistant Professor of Anesthesiology and Critical Care at the Perelman School of Medicine; Co-Director of the Penn Center for Perioperative Outcomes Research and Transformation; and Senior Fellow at the Leonard Davis Institute of Health Economics, University of Pennsylvania.

POET 3.06 | Ward monitoring 3.0 Jun 07, 2019

How do new technologies impact the postoperative elements of Enhanced Recovery? Here we discuss "ward monitoring 3.0" and new technologies which are now available, or in the pipeline, to improve outcomes. How do we best use this information and these innovations?

The website mentioned in the podcast is here: https://www.michardconsulting.com/

Presented by Desiree Chappell with Monty Mythen and their guest Frederic Michard of MiCo Consulting.

Paul Myles |Prato 2019 Jun 06, 2019

This piece is the first of TopMedTalk's 'as live' coverage from the 5th Collaborative Clinical Trials in Anaesthesiology Meeting, Prato, Italy. It's your chance to get virtual a place at one of the most influential gatherings of its kind in the world.

Presented by Desiree Chappell with Monty Mythen and their guest Paul Myles, Director, Anaesthesiology and Perioperative Medicine, Alfred Hospital and Monash University.

Toby Richards |Prato 2019 Jun 06, 2019

This piece is the first of TopMedTalk's 'as live' coverage from the 5th Collaborative Clinical Trials in Anaesthesiology Meeting, Prato, Italy. It's your chance to get virtual a place at one of the most influential gatherings of its kind in the world.

Presented by Desiree Chappell with Monty Mythen and their guest Toby Richards, Professor, Anaesthesia Teaching & Research Faculty of Medicine, Nursing and Health Sciences Central Clinical School, Monash University.

Lis Evered |Prato 2019 Jun 06, 2019

Welcome to TopMedTalk's 'as live' coverage from the 5th Collaborative Clinical Trials in Anaesthesiology Meeting, Prato, Italy. It's your chance to get virtual a place at one of the most influential gatherings of its kind in the world.

Presented by Desiree Chappell and Monty Mythen with Lis Evered, neuroscientist and Head of Research in the Department of Anaesthesia and Acute Pain Medicine, St Vincent’s Hospital, Melbourne. She has led an international group to standardise nomenclature for cognitive change associated with anaesthesia and surgery. She is an Editorial Board member of British Journal of Anaesthesia.

Summary of day 1 |Prato 2019 Jun 06, 2019

This piece is the first of TopMedTalk's 'as live' coverage from the 5th Collaborative Clinical Trials in Anaesthesiology Meeting, Prato, Italy. It's your chance to get virtual a place at one of the most influential gatherings of its kind in the world, here you will find a comprehensive summary of day one.

Presented by Desiree Chappell with Monty Mythen.

Periop Medicine SIG18 | Frailty: the elephant in the operating room Jun 06, 2019

"Perioperative shared decision making, does it exist?" - this engaging and provocative talk challenges perioperative practitioners to consider the realities of the life choices being made, sometimes at the bedside.

The book mentioned at the end of the talk is available here: https://www.amazon.com/Letting-Go-plan-good-death-ebook/dp/B0798255H9

Presented by Charlie Corke, Associate Professor, Senior Intensive Care Specialist, Barwon Health.

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Brought to you by the Perioperative Medicine Special Interest Group (SIG) in association with the Australian and New Zealand Society for Geriatric Medicine and the Internal Medicine Society of Australia and New Zealand at the 7th annual Australasian Symposium of Perioperative Medicine.

The Perioperative Medicine Special Interest Group (SIG) has three aims; improve patient safety and outcomes, share knowledge and collaborate with specialty groups, develop the specialty of perioperative medicine with various craft groups.

For more information follow this link here: http://www.anzca.edu.au/fellows/special-interest-groups/perioperative-medicine

EBPOM Highlight 1.27 | Obstetric anaesthesia Jun 05, 2019

"Obstetric anaesthesia" - 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: https://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 Carolyn Johnston, consultant Anaesthetist in St Georges hospital in London and Improvement lead for the National Emergency Laparotomy Network (NELA.org.uk).

Paul Pomerantz | Euroanaesthesia 2019 Jun 04, 2019

TopMedTalk is live from Euroanaesthesia 2019; recognised worldwide as one of the most important and inﬂuential annual congress in anaesthesiology. Over 6000 international delegates alongside more than 100 exhibitors from more than 80 countries, Euroanaesthesia is truly an outstanding international platform. Join Us at the conference in this series of special live podcasts.

Presented by Desiree Chappell and Monty Mythen with their guest Paul Pomerantz, Chief Executive Officer of the American Society Of Anesthesiologists, Worldwide Executive Director at Drug Information Association, Inc.

Dan Longrois | Euroanaesthesia 2019 Jun 04, 2019

TopMedTalk is live from Euroanaesthesia 2019; recognised worldwide as one of the most important and inﬂuential annual congress in anaesthesiology. Over 6000 international delegates alongside more than 100 exhibitors from more than 80 countries, Euroanaesthesia is truly an outstanding international platform. Join Us at the conference in this series of special live podcasts.

Presented by Desiree Chappell and Monty Mythen with their guest Dan Longrois, Professor of Anaesthesia and Intensive Care Medicine, Department of Anaesthesia and Intensive care, Bichat Hospital.

Cancer outcomes drive enhanced recovery | TopMedTalk Jun 04, 2019

"What drove enhanced recovery for us was not the short lengths of stay but the cancer outcomes" - this conversation explains how enhanced recovery gains traction in practice. Even after a relatively short period of application an evidence based approach is hard to refute.

Desiree Chappell presents 'The Roundtable blog'; in this piece she’s in conversation with Dr Michael Scott, Professor of Anesthesiology at Virginia Commonwealth University and Professor at The University of Pennsylvania, Dr Neil Seeley, Chief of Anesthesia for the Cancer Treatment Centres of America and Dr Kevin Watkins, Surgical Oncologist for the Cancer Treatment Centres of America.

Alexandre Joosten | Euroanaesthesia 2019 Jun 04, 2019

TopMedTalk is live from Euroanaesthesia 2019; recognised worldwide as one of the most important and inﬂuential annual congress in anaesthesiology. Over 6000 international delegates alongside more than 100 exhibitors from more than 80 countries, Euroanaesthesia is truly an outstanding international platform. Join Us at the conference in this series of special live podcasts.

Presented by Desiree Chappell and Monty Mythen with their guest Alexandre Joosten, Anesthetist at Hospital Erasme.

Maurizio Cecconi | Euroanaesthesia 2019 Jun 03, 2019

TopMedTalk is live from Euroanaesthesia 2019; recognised worldwide as one of the most important and inﬂuential annual congress in anaesthesiology. Over 6000 international delegates alongside more than 100 exhibitors from more than 80 countries, Euroanaesthesia is truly an outstanding international platform. Join Us at the conference in this series of special live podcasts.

Presented by Desiree Chappell and Monty Mythen with their guest Maurizio Cecconi, Head of the Anaesthesia and Intensive Care Department at Humanitas Research Hospital; President-elect of the European Society of Intensive Care Medicine (ESICM) for 2020-2021, Chair Division of Scientific Affairs at ESICM; Director of the Master in Patient Blood Management at Humanitas University.

Is pain the fifth vital sign"? | Perioperative Coach Jun 03, 2019

What's the current thinking on pain management and the 'opioid crisis'? On reflection were people wrong to emphasise the message that 'pain is the fifth vital sign'? How did 'pain management' instead become 'opioid management'? The UK has had a slightly different ride to the US in this respect, although not without its problems, could that be due to this 'fifth vital sign' message being less popular on the other side of the atlantic? Is it important to manage expectations and emphasise patient comfort rather than a total absence of any pain whatsoever? Presented by Monty Mythen with his guests Mike Grocott, Professor of Anaesthesia and critical care at the University of Southampton and a member of The Morpheus Consortium; Dr. Padma Gulur, anesthesiologist and a Pain Medicine Specialist who sees patients at Davis Ambulatory Surgical Center, Duke Pain Medicine and Duke Perioperative Pain Care; Annemarie Thompson, MD, Director, Residency Program, Professor of Anesthesiology at Duke University School of Medicine.

Michael Pedro | Euroanaesthesia 2019 Jun 03, 2019

TopMedTalk is live from Euroanaesthesia 2019; recognised worldwide as one of the most important and inﬂuential annual congress in anaesthesiology. Over 6000 international delegates alongside more than 100 exhibitors from more than 80 countries, Euroanaesthesia is truly an outstanding international platform. Join Us at the conference in this series of special live podcasts.

The website mentioned in this piece is here: https://www.vyaire.com

Presented by Desiree Chappell and Monty Mythen with their guest Michael Pedro, VP, Medical Director at Vyaire Medical.

Marit Habicher | Euroanaesthesia 2019 Jun 03, 2019

TopMedTalk is live from Euroanaesthesia 2019; recognised worldwide as one of the most important and inﬂuential annual congress in anaesthesiology. Over 6000 international delegates alongside more than 100 exhibitors from more than 80 countries, Euroanaesthesia is truly an outstanding international platform. Join Us at the conference in this series of special live podcasts.

Presented by Desiree Chappell and Monty Mythen with their guest Marit Habicher, Specialist at UKGM Giessen.

Thomas Scheeren | Euroanaesthesia 2019 Jun 02, 2019

TopMedTalk is live from Euroanaesthesia 2019; recognised worldwide as one of the most important and inﬂuential annual congress in anaesthesiology. Over 6000 international delegates alongside more than 100 exhibitors from more than 80 countries, Euroanaesthesia is truly an outstanding international platform. Join Us at the conference in this series of special live podcasts.

Presented by Desiree Chappell and Monty Mythen with their guest Thomas Scheeren, Chair Cardiovascular Dynamics Section at European Society of Intensive Care Medicine (ESICM).

Michelle Chew | Euroanaesthesia 2019 Jun 02, 2019

TopMedTalk is live from Euroanaesthesia 2019; recognised worldwide as one of the most important and inﬂuential annual congress in anaesthesiology. Over 6000 international delegates alongside more than 100 exhibitors from more than 80 countries, Euroanaesthesia is truly an outstanding international platform. Join Us at the conference in this series of special live podcasts.

Presented by Desiree Chappell and Monty Mythen with their guest Michelle Chew, Professor, Senior Consultant, Faculty of Medicine, Linköping University; Associate Professor, Faculty of Health and Medical Sciences, UCPH; Associate Professor, Consultant, Department of Anaestheisa and Intensive Care Medicine, Hallands Sjukhus Halmstad.

Konstantin Balonov | Euroanaesthesia 2019 Jun 02, 2019

TopMedTalk is live from Euroanaesthesia 2019; recognised worldwide as one of the most important and inﬂuential annual congress in anaesthesiology. Over 6000 international delegates alongside more than 100 exhibitors from more than 80 countries, Euroanaesthesia is truly an outstanding international platform. Join Us at the conference in this series of special live podcasts.

Presented by Desiree Chappell and Monty Mythen with their guest Konstantin Balonov, Anesthesiologist; Vice Chair for Perioperative Medicine; Chair, Competency Committee; Assistant Professor, Tufts University School of Medicine.

Sunday Special | "70 Years on: Our NHS" a panel discussion Jun 02, 2019

This is the panel discussion which followed the address at EBPOM 2018 by Professor Sir Bruce Keogh on the eve of the 70th anniversary of the NHS.

Various questions from the audience are considered; where should we be in ten years from now, what are the disruptive forces headed our way?

The panel features; Sir Bruce Keogh, Professor Monty Mythen, University College London, Carol Peden, Professor of Anesthesiology and Exec. Director of the Center for Health System Innovation, University of Southern California, University of Bath and the Institute for Healthcare Improvement (IHI), Professor Sol Aronson, tenured professor at Duke University and Executive Vice Chairman in the Department of Anesthesiology, Mike Grocott, Professor of Anaesthesia and Critical Care Medicine, University of Southampton, NIHR Senior Investigator and Dr Ramani Moonesinghe, Director of the UK National Institute of Academic Anaesthesia Health Services Research Centre.

The full lecture from Sir Bruce Keogh 'Ernest Henry Starling Plenary Lecture 2018 “70 Years on: our NHS”' is available in full here: https://www.topmedtalk.com/ebpom-2018-3-sir-bruce-keogh-the-nhs-at-70/

Frederic Michard | Euroanaesthesia 2019 Jun 01, 2019

TopMedTalk is live from Euroanaesthesia 2019; recognised worldwide as one of the most important and inﬂuential annual congress in anaesthesiology. Over 6000 international delegates alongside more than 100 exhibitors from more than 80 countries, Euroanaesthesia is truly an outstanding international platform. Join Us at the conference in this series of special live podcasts.

The website mentioned in the podcast is here: https://www.michardconsulting.com/

Presented by Desiree Chappell and Monty Mythen with their guest Frederic Michard of MiCo Consulting.

TJ Gan | Euroanaesthesia 2019 Jun 01, 2019

TopMedTalk is live from Euroanaesthesia 2019; recognised worldwide as one of the most important and inﬂuential annual congress in anaesthesiology. Over 6000 international delegates alongside more than 100 exhibitors from more than 80 countries, Euroanaesthesia is truly an outstanding international platform. Join Us at the conference in this series of special live podcasts.

Presented by Desiree Chappell and Monty Mythen with their guest Tong Joo (TJ) Gan, Professor and Chairman at Stoney Brook in New York.

Linda Mason | Euroanaesthesia 2019 Jun 01, 2019

TopMedTalk is live from Euroanaesthesia 2019; recognised worldwide as one of the most important and inﬂuential annual congress in anaesthesiology. Over 6000 international delegates alongside more than 100 exhibitors from more than 80 countries, Euroanaesthesia is truly an outstanding international platform. Join Us at the conference in this series of special live podcasts.

For more information on the American Society of Anesthesiologists (ASA) go here: www.ASAHQ.org

Presented by Desiree Chappell and Monty Mythen with their guest Linda Mason, President of the American Society of Anesthesiologists.

Alexander J Butwick | Euroanaesthesia 2019 Jun 01, 2019

TopMedTalk is live from Euroanaesthesia 2019; recognised worldwide as one of the most important and inﬂuential annual congress in anaesthesiology. Over 6000 international delegates alongside more than 100 exhibitors from more than 80 countries, Euroanaesthesia is truly an outstanding international platform. Join Us at the conference in this series of special live podcasts.

For more info on the Society for Obstetric Anesthesia and Perinatology (SOAP) go to www.soap.org

Presented by Desiree Chappell and Monty Mythen with their guest Alexander J Butwick, Obstetric Anesthesiologist and Researcher in maternal hemorrhage, pain relief in labor, and obstetric epidemiology at Stanford University.

John Koncelik | Euroanaesthesia 2019 Jun 01, 2019

TopMedTalk is live from Euroanaesthesia 2019; recognised worldwide as one of the most important and inﬂuential annual congress in anaesthesiology. Over 6000 international delegates alongside more than 100 exhibitors from more than 80 countries, Euroanaesthesia is truly an outstanding international platform. Join Us at the conference in this series of special live podcasts.

Presented by Desiree Chappell and Monty Mythen with their guest John Koncelik, Facility Medical Director, Florida Gulf to Bay of TeamHealth, Fawcett Memorial Hospital.

EUROANAES2019 - Welcome to the conference! | Euroanaesthesia 2019 Jun 01, 2019

TopMedTalk is live from Euroanaesthesia 2019; recognised worldwide as one of the most important and inﬂuential annual congress in anaesthesiology. Over 6000 international delegates alongside more than 100 exhibitors from more than 80 countries, Euroanaesthesia is truly an outstanding international platform. Join Us at the conference in this series of special live podcasts.

Presented by Monty Mythen and Desiree Chappell.

Frances Chung | TopMedTalks to... Jun 01, 2019

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.

POET 3.05 | Pain control for the perioperative patient May 31, 2019

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 Padma Gulur, Anaesthesia and Executive Vice-Chair at Duke University and Dr Natasha Curran, pain medicine University College London Hospital (UCLH) and Medical Director at the Health Innovation Network.

The fuller version of this conversation is available here: https://www.topmedtalk.com/ebpom-2018-14-the-realities-of-pain-management/

Periop Medicine SIG 18 | Australia and New Zealand Emergency Laparotomy Audit - Quality Improvement May 30, 2019

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-an-update.pdf

Presented by Ben Griffiths, consultant anesthetist at Auckland City Hospital, anaesthetic lead for ANZELA-QI.

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Brought to you by the Perioperative Medicine Special Interest Group (SIG) in association with the Australian and New Zealand Society for Geriatric Medicine and the Internal Medicine Society of Australia and New Zealand at the 7th annual Australasian Symposium of Perioperative Medicine.

The Perioperative Medicine Special Interest Group (SIG) has three aims; improve patient safety and outcomes, share knowledge and collaborate with specialty groups, develop the specialty of perioperative medicine with various craft groups.

For more information follow this link here: http://www.anzca.edu.au/fellows/special-interest-groups/perioperative-medicine

EBPOM Highlight 1.26 | ERAS in Obstetric Surgery May 29, 2019

"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 Clinical and Quality Outcomes at Providence Anesthesiology Associates, University of South Carolina.

What is the Perioperative Medicine Summit? | The RoundTable May 28, 2019

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 Orthopaedic Surgery; Chief, Section of Perioperative and Consultative Medicine; Froedtert and Medical College of Wisconsin and Steven L. Cohn, Professor Emeritus, Director – Medical Consultation Service, Jackson Memorial Hospital University of Miami Miller School of Medicine.

Sedation and the triple low | Perioperative Coach May 27, 2019

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 concentration of volatile anesthesia are said to face an increased risk of adverse outcomes? This piece features Monty Mythen and Desiree Chappell in conversation with Dan Cole, professor of clinical anesthesiology at the David Geffen School of Medicine, University of California, Los Angeles and former president of the American Society of Anesthesiologists (ASA).

Enhanced Recovery After Surgery (ERAS) leadership | Sunday Special May 26, 2019

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 important is it to keep patients warm? Keeping patients and their environments warm is discussed, as is pre-warming, going beyond the standard blankets and patient insulation to include active warming and even patients exercising as a method of warming up. Further to this conversation, how do you measure a patient's temperature?

How do we drive change in our institutions towards enhanced recovery after surgery? The GIRFT (Getting It Right First Time) project is explained. The Health Foundation is also mentioned. The piece also includes patient communication and the question of 'how much is too much?', when administering a dose of morphine. Also, is there a hierarchy on the pathway of enhanced recovery after surgery?

The conversation features Professor Monty Mythen and his two guests; Dr Simeon West, consultant anaethetist at (University College London Hospitals) UCLH who sits on the board at Regional Anaesthesia UK (RAUK) and Mark Harper Consultant Anaesthetist at Brighton and Sussex University Hospitals, with a research interest in the prevention of perioperative hypothermia and the use of cold water adaptation for theraputic purposes. There are also attributed questions from the audience.

Paul Grant | TopMedTalks to... May 25, 2019

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 Glucose on Postoperative Mortality in Noncardiac and Cardiac Surgeries.

https://www.ncbi.nlm.nih.gov/pubmed/29440113

Frailty as a Predictor of Death or New Disability After Surgery: A Prospective Cohort Study.

https://www.ncbi.nlm.nih.gov/pubmed/30048320

Presented by Desiree Chappell and Monty Mythen with their guest Paul Grant, Hospitalist and Director of Perioperative and Consultant Medicine at the University of Michigan.

POET 3.04 | Is paternalism always bad? May 24, 2019

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 contributions from Lee Fleisher, Professor of Anesthesiology and Critical Care, University of Pennsylvania and Sol Aronson, tenured Professor at Duke University, Dr Tim Miller, Duke University and Dr Attilla Kett, St Peter's University Hospital at New Jersey.

Davinder Ramisingh | SCA 2019 May 23, 2019

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.

Anaesthesia 2019 | Fitter, Better, Sooner May 23, 2019

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 Royal College of Anaesthetists.

Periop Medicine SIG18 | Emergency laparotomy May 23, 2019

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 Cox, Professor of Surgery, Nepean Hospital.

Anaesthesia 2019 | Rupert Pearse May 22, 2019

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.

Anaesthesia 2019 | Tim Cook and Paul Wischmeyer May 22, 2019

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 and ICM, Royal United Hospitals, Bath and Paul Wischmeyer, Professor of the Department of Anesthesiology, Duke University.

Anaesthesia 2019 | Paul Wischmeyer May 22, 2019

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 Department of Anesthesiology, Duke University.

EBPOM Highlight 1.25 | Pain Management to Enhance Recovery after joint replacements May 22, 2019

"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.

Anaesthesia 2019 | The Centre for Perioperative Care (CPOC) May 21, 2019

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).

Poster presenters | SCA 2019 May 21, 2019

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.

Anaesthesia 2019 | Live from the conference May 21, 2019

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 Margerrison, TopMedTalk producer.

Michael Eaton | SCA 2019 May 21, 2019

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.

One of the best career decisions I've made | The RoundTable May 21, 2019

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 assistant, New York Presbyterian/Weill Cornell.

Blood pressure | SCA 2019 May 20, 2019

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 and Sol Aronson, tenured professor at Duke University and Executive Vice Chairman in the Department of Anesthesiology.

Are you burned out? | SCA 2019 May 20, 2019

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.becomebraveenough.com/

Anaesthesia 2019 | The Future of Anaesthesia May 20, 2019

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 super computers we imagine doing our work in years to come?

Presented by Joff Lacey with Mike Swart, Consultant in Anaesthesia and Critical Care Medicine at Torbay Hospital and advisor to the UK Department of Health for the Enhanced Recovery Programme.

Developmental neurotoxicity | ASA 2019 May 20, 2019

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, Professor and Chair of Anesthesiology at Weill Cornell Medicine.

It is all about the patient | ASA 2019 May 20, 2019

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.

Perioperative Fluid Management to Enhance Recovery After Surgery | Perioperative Coach May 20, 2019

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:

http://topmedtalk.libsyn.com/asa-2018-san-francisco-exclusive-professor-henrik-kehlet

Social media and the democratisation of education | Sunday Special May 19, 2019

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 their guest Avital O'Glasser, Assistant Professor of Medicine at OHSU, Oregon Health & Science University and member of the communications committee for SPAQI.

If you enjoyed this, carry on listening with this piece here:

Sunday Special | Social Media http://topmedtalk.libsyn.com/sunday-special-social-media

Davinder Ramsingh | TopMedTalks to... May 18, 2019

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, when, why and how you can use this incredible tool. Is it really a piece of bedside assessment equipment which is about to become as ubiquitous as a doctor's thermometer?

It's difficult not to get excited about the ability to take a quick look at a patient's cardiac function, at the bedside, with a handheld piece of kit. Scanning a patient's abdomen, seeing how to apply appropriate measures of care rapidly on the spot, these are just some of the advantages discussed in this piece.

See more here:

Acute Care and Perioperative Ultrasound Workshop Co-sponsored by the Departments of Anesthesiology at Loma Linda and UCLA Medical Centers.

www.pocusededucation.com

Evidence-Based Perioperative Ultrasound Educational Curriculum (created as a free, open-source, platform for point of care ultrasound education)

www.foresightultrasound.com

Professor Monty Mythen is presenting, with his guest, Davinder Ramsingh MD, Director of Research and Perioperative Ultrasound at Loma Linda University Medical Center - Dept. of Anesthesiology.

POET 3.03 | Surgery school May 17, 2019

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-inspiratory-muscle-training

Periop Medicine SIG18 | Advanced Care Planning May 16, 2019

Advanced care planning and shared decision making; what happens when you reach a patient and realise conversations have not been had and systems around them have failed?

Presented by Debra Leung, staff anaesthetist, Peter MacCallum.

EBPOM Highlight 1.24 | The evolution of a community-based Prehabilitation service May 15, 2019

"POETTS 2018 | The evolution of a community-based Prehabilitation service" - 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 Gerard Danjoux, consultant in Anaesthesia and Sleep Medicine at South Tees Hospitals NHS Trust.

Can you bite your upper lip? Assessing patients to reduce post-op respiratory complications | The RoundTable May 14, 2019

Obstructive sleep apnea is important to identify in patients, this piece explains how; use the official STOP BANG website here: http://www.stopbang.ca/osa/screening.php

Opioids and pain management strategy is discussed, alongside reflections on the differences between the healthcare systems of Canada, the UK and America.

Finally, what is "the beard test" and "the upper lip bite test"?

Presented by Desiree Chappell and Monty Mythen with their guests, Frances Chung, Professor, Department of Anesthesiology and Pain Medicine, University of Toronto and Kurt J. Pfeifer, Professor of Medicine, General Internal Medicine, Medical Director, Preoperative Evaluation Clinic, Froedtert and Medical College Eye Institute, Medical College of Wisconsin, Milwaukee, WI.

Psychological optimisation | Perioperative Coach May 13, 2019

Psychological optimisation for surgery; who should have it, what does it mean and how does it work? Further conversation moves into weaning patients off opioids in advance of surgery and cutting their dependency afterwards. Hosted by Desiree Chappell and Vicki Morton with their guest Dr. Padma Gulur, anesthesiologist and a Pain Medicine Specialist who sees patients at Davis Ambulatory Surgical Center, Duke Pain Medicine and Duke Perioperative Pain Care.

Pets as therapy | Sunday Special May 12, 2019

Pets as Therapy are a fantastic charity who have provided a practical theraputic service to various people in assorted contexts, here you can hear them work their magic on the TopMedTalk team. What are the advantages of taking pets into the ward? Can patients benefit from some therapy from our 'hairy friends'? Meet the volunteers and practitioners who have a dogged determination to cheer up our patients. Presented by Desiree Chappell and Monty Mythen with their guests; Hillary Burbage, with Matlock, Pamela Pearl, with Frankie, Suzy Emsden with Alfie the therapy dog and Matthew Robinson, national project co-ordinator for Pets as Therapy.

Angela Bader | TopMedTalks to... May 11, 2019

Does perioperative medicine allow institutions to take a broader view? Population health has been a theme on TopMedTalk, is it a logical extension of the perioperative process? How do we manage specialist care for the elderly and ensure high quality shared decision making? What lies behind the mindset change needed for some to accept surgery is not always the answer? Should we expect medical students to be taught the principles of perioperative medicine? What are some of the unique tensions in the US system that can frustrate the adoption of a truly perioperative practice? Presented by Desiree Chappell and Monty Mythen with their guest Angela Bader, Vice Chair of Perioperative Medicine at Brigham and Women's Hospital.

POET 3.02 | Do you need a breathlessness clinic? May 10, 2019

When it comes to breathlessness how do we better diagnose and apply treatment? How do we overcome the fact that referring to a specialist can sometimes take a patient 'down the wrong route' with a condition that might not be just heart or lung related? Should we take a more perioperative approach to treatment and diagnosis?

"Nick, the patient" asks a few questions and demonstrates the misunderstanding that many sufferers might have; breathlessness is not always connected to your lungs.

"Johnny, the concerned family member" then speaks about his Mother, 84, who has recently experienced breathlessness; she didn't want to complain about it, how can we pick these issues up earlier?

This podcast is presented by Professor Monty Mythen and features contributions from; Ronan Astin, clinical consultant in respiratory medicine at UCL Hospital and finally 'the patients' Nick Margerrison and Johnny Themans.

TopMedTalk Part 2 | TRIPOM May 09, 2019

TopMedTalk live is a gathering of Trainees with an interest in Perioperative Medicine (TRIPOM) alongside TopMedTalk listeners and EBPOM 2018 attendees in the IET London, England.

This conversation is driven by questions from listeners online and attendees in the audience.

What do you do when it comes to 'screening for frailty? Should it be physical frailty or mental frailty? What do we then do with that information? How do we acknowledge the fact that, over the perioperative period, a 'frailty score' will likely change? Is 'the perioperative moment' a moment that can produce lasting long term lifestyle changes? When it comes to prehabilitation, how do we overcome issues regarding patient motivation?

TopMedTalk live was presented by Desiree Chappell and Monty Mythen in front of a live audience with panellists; John Whittle, assistant Professor at Duke University Medical Centre and one of the founders of TRIPOM, Katie Samuel, TRIPOM co-chair and perioperative medicine fellow at UCL Hospitals, Dr Lee A. Fleisher Professor and Chair of Anesthesiology and Critical Care, University of Pennsylvania and Ross Kerridge, John Hunter Hospital, Newcastle, Australia, often cited as 'the father of Modern Perioperative Medicine'.

EBPOM Highlight 1.23 | Psychological Behavioural Change Interventions in Cancer Patients May 08, 2019

"POETTS 2018 | Psychological Behavioural Change Interventions in Cancer Patients" - 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 Chloe Grimmett, behavioural scientist from Southampton University. She works closely alongside the 'Fit for Surgery Team', providing the behavioural intervention which is part of the on-going WesFit prehabilitation trial.

ASER 2019: Jamie Harris and Carol Schmidt | The RoundTable May 07, 2019

"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?

Presented by Desiree Chappell with co-host Korey Sprigman and their guests, Jamie Harris, CRNA, Hillcrest Hospital, Tulsa, Oklahoma and Carol Schmidt, CRNA, Royal Oak, Michigan.

Stop Bang, identifying obstructive sleep apnea | Perioperative Coach May 06, 2019

Obstructive sleep apnea is important to identify in patients, this piece shows you how. Check out the official STOP BANG website here: http://www.stopbang.ca/osa/screening.php Presented by Desiree Chappell and Monty Mythen with their guests, Frances Chung, Professor, Department of Anesthesiology and Pain Medicine, University of Toronto and Kurt J. Pfeifer, Professor of Medicine, General Internal Medicine, Medical Director, Preoperative Evaluation Clinic, Froedtert and Medical College Eye Institute, Medical College of Wisconsin, Milwaukee, WI.

The Perioperative Cognition Workshop - Part 4 | Sunday Special May 05, 2019

This invaluable piece is a chance to attend a workshop which looks at the latest thinking on "perioperative cognition" and 'post-operative cognitive dysfuntion'.

We advise you use this link here to find the PDF of the paper being discussed: https://bjanaesthesia.org/article/S0007-0912(17)54082-9/fulltext

Presented by David Scott, Professor, University of Melbourne, Director, Anaesthesia and Acute Pain Medicine, St Vincent’s Hospital, Melbourne and Lis Evered, Scientific Head of Research, Department of Anaesthesia, St. Vincent's Hospital, Melbourne.

This is Part 4, to find Part 1 follow this link here: https://www.topmedtalk.com/sunday-special-the-perioperative-cognition-workshop-part-1/

Part 2 is here:

https://www.topmedtalk.com/sunday-special-the-perioperative-cognition-workshop-part-2/

Part 3 is here:

https://www.topmedtalk.com/sunday-special-the-perioperative-cognition-workshop-part-3/

Brought to you by the Perioperative Medicine Special Interest Group (SIG) in association with the Australian and New Zealand Society for Geriatric Medicine and the Internal Medicine Society of Australia and New Zealand at the 7th annual Australasian Symposium of Perioperative Medicine.

The Perioperative Medicine Special Interest Group (SIG) has three aims; improve patient safety and outcomes, share knowledge and collaborate with specialty groups, develop the specialty of perioperative medicine with various craft groups.

For more information follow this link here: http://www.anzca.edu.au/fellows/special-interest-groups/perioperative-medicine

The Perioperative Cognition Workshop - Part 3 | Sunday Special May 05, 2019

This invaluable piece is a chance to attend a workshop which looks at the latest thinking on "perioperative cognition" and 'post-operative cognitive dysfuntion'.

We advise you use this link here to find the PDF of the paper being discussed: https://bjanaesthesia.org/article/S0007-0912(17)54082-9/fulltext

Presented by David Scott, Professor, University of Melbourne, Director, Anaesthesia and Acute Pain Medicine, St Vincent’s Hospital, Melbourne and Lis Evered, Scientific Head of Research, Department of Anaesthesia, St. Vincent's Hospital, Melbourne.

This is Part 3, to find Part 1 follow this link here: https://www.topmedtalk.com/sunday-special-the-perioperative-cognition-workshop-part-1/

Part 2 is here:

https://www.topmedtalk.com/sunday-special-the-perioperative-cognition-workshop-part-2/

Part 4 is here:

https://www.topmedtalk.com/sunday-special-the-perioperative-cognition-workshop-part-4/

Brought to you by the Perioperative Medicine Special Interest Group (SIG) in association with the Australian and New Zealand Society for Geriatric Medicine and the Internal Medicine Society of Australia and New Zealand at the 7th annual Australasian Symposium of Perioperative Medicine.

The Perioperative Medicine Special Interest Group (SIG) has three aims; improve patient safety and outcomes, share knowledge and collaborate with specialty groups, develop the specialty of perioperative medicine with various craft groups.

For more information follow this link here: http://www.anzca.edu.au/fellows/special-interest-groups/perioperative-medicine

The Perioperative Cognition Workshop - Part 2 | Sunday Special May 05, 2019

This invaluable piece is a chance to attend a workshop which looks at the latest thinking on "perioperative cognition" and 'post-operative cognitive dysfuntion'.

We advise you use this link here to find the PDF of the paper being discussed: https://bjanaesthesia.org/article/S0007-0912(17)54082-9/fulltext

This is Part 2, to find Part 1 follow this link here: https://www.topmedtalk.com/sunday-special-the-perioperative-cognition-workshop-part-1/

Part 3 is here:

https://www.topmedtalk.com/sunday-special-the-perioperative-cognition-workshop-part-3/

Part 4 is here:

https://www.topmedtalk.com/sunday-special-the-perioperative-cognition-workshop-part-4/

Presented by David Scott, Professor, University of Melbourne, Director, Anaesthesia and Acute Pain Medicine, St Vincent’s Hospital, Melbourne and Lis Evered, Scientific Head of Research, Department of Anaesthesia, St. Vincent's Hospital, Melbourne.

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Brought to you by the Perioperative Medicine Special Interest Group (SIG) in association with the Australian and New Zealand Society for Geriatric Medicine and the Internal Medicine Society of Australia and New Zealand at the 7th annual Australasian Symposium of Perioperative Medicine.

The Perioperative Medicine Special Interest Group (SIG) has three aims; improve patient safety and outcomes, share knowledge and collaborate with specialty groups, develop the specialty of perioperative medicine with various craft groups.

For more information follow this link here: http://www.anzca.edu.au/fellows/special-interest-groups/perioperative-medicine

The Perioperative Cognition Workshop - Part 1 | Sunday Special May 05, 2019

This invaluable piece is a chance to attend a workshop which looks at the latest thinking on "perioperative cognition" and 'post-operative cognitive dysfuntion'.

We advise you use this link here to find the PDF of the paper being discussed: https://bjanaesthesia.org/article/S0007-0912(17)54082-9/fulltext

Presented by David Scott, Professor, University of Melbourne, Director, Anaesthesia and Acute Pain Medicine, St Vincent’s Hospital, Melbourne and Lis Evered, Scientific Head of Research, Department of Anaesthesia, St. Vincent's Hospital, Melbourne.

This is Part 1, to find Part 2 go here:

https://www.topmedtalk.com/sunday-special-the-perioperative-cognition-workshop-part-2/

Part 3 is here:

https://www.topmedtalk.com/sunday-special-the-perioperative-cognition-workshop-part-3/

Part 4 is here:

https://www.topmedtalk.com/sunday-special-the-perioperative-cognition-workshop-part-4/

Brought to you by the Perioperative Medicine Special Interest Group (SIG) in association with the Australian and New Zealand Society for Geriatric Medicine and the Internal Medicine Society of Australia and New Zealand at the 7th annual Australasian Symposium of Perioperative Medicine.

The Perioperative Medicine Special Interest Group (SIG) has three aims; improve patient safety and outcomes, share knowledge and collaborate with specialty groups, develop the specialty of perioperative medicine with various craft groups.

For more information follow this link here: http://www.anzca.edu.au/fellows/special-interest-groups/perioperative-medicine

Mike Grocott | ASER 2019 May 04, 2019

More of our coverage of the American Society of Enhanced Recovery (ASER) annual general meeting. Reflections regarding the rise of Cardiopulmonary Exercise Testing (CPET); a growing field, particularly in the US.

The "Prehabilitation World Congress in association with POETTS & EBPOM" meeting discussed in this podcast is here: https://ebpomusa.org/Prehab-2019

If you are interested in hearing more about the Measurement of Exercise Tolerance before Surgery (METS) trial: https://www.topmedtalk.com/journal-club-1-03-the-mets-trial/

Presented by Desiree Chappell and Monty Mythen with their guest Mike Grocott, Professor of Anaesthesia and critical care at the University of Southampton.

POET 3.01 | Perioperative medicine is population health. May 03, 2019

Perioperative medicine is defined here as: "the practice of patient centred multidisciplinary and integrated medical care of patients from the moment of contemplation of surgery until full recovery". Population health is defined as: "the health outcomes of a group of individuals including the distribution of such outcomes within the group". Do the two compliment each other? Use this concise 15 minute presentation to help build the case for a perioperative care programme at your institution. Presented by Sol Aronson, tenured professor at Duke University and Executive Vice Chairman in the Department of Anesthesiology.

TopMedTalk Part 1 | TRIPOM May 02, 2019

TopMedTalk live is a gathering of Trainees with an interest in Perioperative Medicine (TRIPOM) alongside TopMedTalk listeners and EBPOM 2018 attendees in the IET London, England.

This conversation is driven by questions from listeners online and attendees in the audience. Two pain management experts alongside the TRIPOM representatives and Desiree and Monty respond in detail to some of the key controversies in Perioperative medicine.

Is there an opioid crisis and is it unique to the USA? Is there a problem with opioids and cancer outcomes? How do we educate junior doctors on this topic? What about patients who demand opioids to handle their pain? Should we be looking more closely at where and why Oxycodone specifically is prescribed?

Part two will follow next week.

TopMedTalk live was presented by Monty Mythen and Desiree Chappell in front of a live audience with panellists; John Whittle, assistant Professor at Duke University Medical Centre and one of the founders of TRIPOM, Katie Samuel, TRIPOM co-chair and perioperative medicine fellow at UCL Hospitals, Dr Padma Gulur, Duke University Medical Centre, Dr Natasha Curran, UCL Hospitals.

Join in the debate: contact@topmedtalk.com

EBPOM Highlight 1.22 | Pre-operative Inspiratory Muscle Training May 01, 2019

"POETTS 2018 | Pre-operative Inspiratory Muscle Training" - 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 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.

Carol Peden - EPOCH Q&A | TopMedTalk Apr 30, 2019

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 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 with Desiree Chappell and Carol Peden, Professor of Anesthesiology and Exec. Director of the Center for Health System Innovation, University of Southern California, University of Bath and the Institute for Healthcare Improvement (IHI). Additional contributions from Sol Aronson, tenured professor at Duke University and Executive Vice Chairman in the Department of Anesthesiology as well as TopMedTalk listeners and conference delegates.

Pre-operative anemia, detection and management | Perioperative Coach Apr 29, 2019

Where does anemia fit in the perioperative process? How do we optimise patients who have this condition in such a way as to get them best prepared for surgery? How do we know these procedures are improving outcomes? Presented by Desiree Chappell and Monty Mythen with Mike Grocott and their guest Michael Scott, Professor and Division Director, Critical Care Anaesthesiology - Virginia Commonwealth University.

Preoperative Optimization: Framing up the value proposition | Sunday Special Apr 28, 2019

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 and the fee payer?

This piece is moderated by Sol Aronson, tenured Professor at Duke University, it features a talk from Michael Englesbe, Professor of Surgery, Michigan followed by a panel discussion which also features Dan Engleman, President of the enhanced Recovery after Cardiac surgery society, Baystate Health in Massachusetts, Medical Director, Heart, Vascular & Critical Care Services, Baystate Medical Center and Associate Professor of Surgery University of Massachusetts Medical School-Baystate and Tim Miller, Duke University; further discussion is provided with questions from online listeners and conference delegates posed by Vicki Morton, Doctor of Nursing Practice and Director of Clinical and Quality Outcomes at Providence Anesthesiology Associates.

William Wooden | TopMedTalks to... Apr 27, 2019

Perioperative nutrition is a topic which has fascinates us here on TopMedTalk. Ever evolving and moving forward the questions continue as we explore an area which will only keep growing. Should evidence based arguments be the way we make the case for true investment in this area? Presented by Korey Springman with her guest William Wooden, Director of Operative Services at Indiana University of Health.

Eric J. Zimmerman | ASER 2019 Apr 26, 2019

Our coverage of ASER's annual meeting continues with a piece which focuses on prehabilitation and clinical nutrition, specifically as relates to surgery.

Can the sarcopenic elderly patient build muscle in a reasonable timeframe with the right nutritional support? Are there particular 'magic protiens' we should use? Where does exercise fit into the picture?

The interview regarding nasogastric feeding mentioned in this piece is here: https://www.topmedtalk.com/intensive-care-society-nasogastric-feeding/

Presented by Desiree Chappell and Monty Mythen with their guest Eric J. Zimmerman co-founder and CEO of Enhanced Medical Nutrition.

Tom Poulton | ASER 2019 Apr 26, 2019

Welcome to the first of our exclusive podcasts covering this year's American Society for Enhanced Recovery (ASER) Annual Congress of Enhanced Recovery and Perioperative Medicine. ASER's web presence is here: https://aserhq.org/

This conversation focuses on the big talking points of the meeting so far. The discussion evolves into questions regarding data use and collection before moving into whether or not cancer outcomes are improved by enhanced recovery pathways.

Presented by Desiree Chappell with Monty Mythen and their guest Tom Poulton, Post-CCT Fellow in Onco-anaesthesia at the Peter MacCallum Cancer Centre.

Also, if you're intrigued by our experiments in video our Youtube channel is here: https://www.youtube.com/channel/UC-HYQmeIwcFCYO1hoQ8jShQ

POET 2.10 | Smoking cessation clinics Apr 26, 2019

Could a smoking cessation clinic be the next step in perioperative enhancement at your practice? This piece gives you an introduction to the idea and tackles some of the key elements. Originally streamed live on TopMedTalk further listening is available here: https://www.topmedtalk.com/?s=smoking Presented by James Davis, MD, Director Duke Smoking Cessation Program.

TRIPOM 1.5 | 'Understanding of delirium amongst the surgical team' Apr 25, 2019

This piece focuses on the winning EBPOM USA poster presenter whose team were responsible for the excellent 'Understanding of delirium amongst the surgical team; a multidisciplinary survey'. Go see the poster on the EBPOM website here: https://www.ebpom.org/EBPOM-USA-2019 Presented by Robin Schiller and Bridger Bach with their guest Zhaosheng Jin, Queen’s hospital, Barking Havering Redbridge NHS trust, Central London School of Anaesthesia.

EBPOM Conference Highlight 1.21 | Lessons on EPOCH in the UK Apr 24, 2019

The results of the Enhanced Peri-Operative Care for High-risk patients (EPOCH) trial; where does it put perioperative practice in 2019? What have we learned? 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 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 Carol Peden, Professor of Anesthesiology and Exec. Director of the Center for Health System Innovation, University of Southern California, University of Bath and the Institute for Healthcare Improvement (IHI).

Rick Dutton Q&A Session | TopMedTalk Apr 23, 2019

This standalone piece allows us to explore further some of the issues raised by Saturday's 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 States Anesthesia Partners Baltimore, Maryland Area. Featuring questions and comments from, in this order; Jamie Harris, Tulsa Oklahoma, Tim Miller, Duke University, North Carolina, Sol Aronson, Duke University, Linda Marie Sutton, Duke Univeristy, Tony Senagore, Western Michigan University, Attilla Kett, St Peter's University Hospital at New Jersey, Dan Engleman, Springfield, Massachusetts.

Get off the gurney and exercise! | Perioperative Coach Apr 22, 2019

This piece is about the importance of early mobilisation after surgery; "your first physical therapy session may very well be in the recovery room". Desiree Chappell presents with Monty Mythen and their guests; Dr Steve Flanagan, Chair of Physical Medicine and Rehabilitation at NYU Langone and Colleen Walsh, Assistant Professor, Nursing, University of Southern Indiana, President, National Association of Orthopaedic Nurses.

Hemodynamics - State of the Science | Sunday Special Apr 21, 2019

This piece explores the current thinking on hemodynamics, get ready for a deep dive into the conversation and controversies. Originally streamed live from www.topmedtalk.com as part of our coverage of The EBPOM USA Dallas Master's Course 2019. This panel discussion is chaired by Desiree Chappell, CRNA from Louisville Kentucky and Board Member of ASER. It features Monty Mythen, TopMedTalk Editor In Chief, Smiths Medical Professor of Anaesthesia and Critical Care at University College London, Tim Miller, from Duke University Medical Centre and Dr Simon Davies, Consultant Anaesthetist at York Teaching Hospital NHS Foundation Trust.

Rick Dutton | TopMedTalks to... Apr 20, 2019

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 Master's Course. Presented by Monty Mythen with Rick Dutton, Chief Quality Officer at United States Anesthesia Partners Baltimore, Maryland Area with questions from both conference delegates and online listeners.

POET 2.09 | A centre for geriatric surgery and palliative care Apr 19, 2019

How can your value based care proposition be further enhanced by a centre for geriatric surgey and palliative care? How important is shared decision making to your practice? What are the opportunities for an institution to improve in this area? Presented by Desiree Chappell and Monty Mythen with their guest Angela Bader, Vice Chair of Perioperative Medicine at Brigham and Women's Hospital.

TRIPOM 1.4 | Society for Obstetric Anesthesia and Perinatology (SOAP) Apr 18, 2019

From a leadership perspective should enhanced recovery for obstetrics be "standard of care" across the nation? Interest in this field seems to be growing, how widely accepted is this practice in the US? Finally, what recommendations are there for institutions and practitioners who want to try to apply some of the principles of enhanced recovery after surgery for obstetrics immediately after listening to this podcast? The SOAP website is here: https://soap.org/ Presented by Robin Schiller and Bridger Bach with their guests Mark Zakowski, President of the Society for Obstetric Anesthesia and Perinatology (SOAP) and Chief, Obstetric Anesthesia, Cedars-Sinai Medical Center, Los Angeles and Abhinav Markus, 3rd year medical student, St George's University. Also, for further listening, TopMedTalk speaks in depth to Laurent Bolag here: PART 1 https://www.topmedtalk.com/asa-2018-san-francisco-eras-for-elective-c-section-mom-needs-eras-too-part-1/ PART 2 https://www.topmedtalk.com/asa-2018-san-francisco-eras-for-elective-c-section-mom-needs-eras-too-part-2/

EBPOM Highlight 1.20 | Leading a large, single group towards excellence Apr 17, 2019

"Leading a large, single group towards excellence" - 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

If you have any comments or questions you'd like to send to the team email: contact@topmedtalk.com

Presented by Dr Elizabeth Cherot, Vice President of medical affairs at Axia Women’s Health, followed by a short break out session with Desiree Chappell, Monty Mythen and Sol Aronson alongside questions from the audience online and the delegates at the conference.

We've saved twelve million dollars! | The RoundTable Apr 16, 2019

Discussion begins with a hugely successful Enhanced Recovery program at a large community hospital, continued improvements and service line expansion. Learn about both the advantages and the challenges of a perioperative practice here. Presented by Desiree Chappell and Monty Mythen with their guests Kim Duggan, Perioperative Surgical Home (PSH) - Enhanced Recovery After Surgery (ERAS) Manager, New Hanover Medical Centre and Robin Davis, Clinical Education Specialist II at New Hanover Regional Medical Center.

Haemodynamic monitoring | Perioperative Coach Apr 15, 2019

In critically ill patients where are we with haemodynamic monitoring and management? What is an ideal mean arterial pressure (MAP) during the process? What about chronic hypotensive patients? How do we safely avoid being too dogmatic about guidelines?

Presented by Monty Mythen and Desiree Chappell with their guests Professor Mervyn Singer, Intensive Care Medicine at University College London and Fintan Hughes, Academic Intern at St. James's Hospital Dublin.

Should direct laryngoscopy be consigned to the history books? | Sunday Special Apr 14, 2019

The debate 'Direct laryngoscopes should be consigned to history', was hosted by The Royal College Of Anaesthetists and carried out by our two guests on this piece.

Here we get into the advantages and challenges behind the two techniques; video laryngoscopy and direct laryngoscopy. The conversation explores the fact that these skills are a key part of the job of practitioners, are we "de-skilling" the profession in an overly enthusiastic race toward new technology or are some resisting it simply because it's not what they are used to?

Where do you stand on this fascinating debate? Send us your thoughts on email: contact@topmedtalk.com

Presented by Joff Lacey and Monty Mythen with their two guests; Professor Tim Cook, Consultant in Anaesthesia and ICM, Royal United Hospitals, Bath and Dr William Harrop-Griffiths, St Mary's Hospital, Imperial College Healthcare NHS Trust.

Professor Iain Moppett | TopMedTalks to... Apr 13, 2019

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 privacy concerns with the need for data to be accessible? Can such information be truly anonymised? Discussion moves here to 'Google flu tracker' and its, initially quite good, results.

Finally how do doctors adapt to the new world where they are being told in front of their patients what the right course of action is? Will patients retain trust in the Doctor's decisions?

Taken from day two of our coverage of the Royal College of Anaesthetists' annual conference at The British Museum in London.

Presented by Desiree Chappell, Monty Mythen and Joff Lacey, with their guest Professor Iain Moppett, Professor of Anaesthesia and Perioperative Medicine, University of Nottingham.

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Do you have your ticket to the Dallas Master's Course being organised in March by EBPOM USA yet? Find out more here: https://www.ebpom.org/EBPOM-USA-2019 As a TopMedTalk subscriber you can get a 20% discount for 1 person, or a 50% discount for a team. Just use the promo code "DAL 20" if you're solo or "EDAL 50" if you're coming as a group.

POET 2.08 | The rise and rise of CPET Apr 12, 2019

This piece focuses on the rise of cardiopulmonary exercise testing (CPET) in the wake of the Measurement of Exercise Tolerance before Surgery (METS) Trial, which seems to have shifted opinions, does a genuine 'perioptimist' have a deeper insight into the issues there? Presented by Desiree Chappell and Monty Mythen with their guest Dr Elena Koepke, Assistant Professor at Moffitt Cancer Center/USF, Physician Anesthesiologist, Perioperative Medicine Specialist.

Setting up a perioperative surgical home | TRIPOM Apr 11, 2019

What's the need for a perioperative surgical home? How do issues with aging populations and higher risk patients increase the need to intervene early in their care and treatment? How do you build institutional credibility in this area? How do you approach this area from the point of view of patient need? Crucially, how do you build and inspire a multidisciplinary team around these essential strategic needs? What pitfalls arise in the process, how do you inspire a "volunteer army" to help you distribute the workload and how do you set realistic goals and timelines for the overall workflow? Finally, should all of this become part of the "standard of care"? Presented by Robin Schiller and Bridger Bach with their guest Dennis Bierle, M.D. Internist at the Division of General Internal Medicine, Department of Medicine, Mayo Clinic Rochester.

EBPOM Highlight 1.19 | The Patient Safety Movement Foundation Apr 10, 2019

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 presentation are sourced from the PSMF's YouTube channel, find it here: https://www.youtube.com/channel/UCLLtyscblA8aquiXSSrZ1bA

Their official website is here: https://patientsafetymovement.org/

You can find out more about Mike Ramsay and his work there by listening the "TopMedTalks to..." series, where we discuss healthcare with global thought leaders from around the world: https://www.topmedtalk.com/topmedtalks-to-michael-ramsey/

Presented by Michael Ramsay, Chairman, Department of Anesthesiology and Pain Management, Baylor University Medical Center; President, Baylor Scott & White Research Institute with an introduction from Sol Aronson, Professor Sol Aronson, tenured professor at Duke University and Executive Vice Chairman in the Department of Anesthesiology.

A deeper dive into Enhanced Recovery | The RoundTable Apr 09, 2019

Originally streamed live from the EBPOM USA 2019 conference in Dallas this piece looks into the realities of enhanced recovery. Patient satisfaction and outcomes rise to the top of the priority list as an institution invests in the idea, how long does it take for a clear financial return on the investments required to get it off the ground? How do we get a team motivated to work towards these ideas? Are there any disadvantages to enhanced recovery? How do patients react to it? Also, how does blockchain technology (the innovation behind cryptocurrencies such as Bitcoin) interlock into more practical transfers of patient data? What other innovations are on the horizon? Presented by Desiree Chappell with Monty Mythen and their guest Sabry Ayad, Professor of Anesthesiology, Cleveland Clinic Lerner College of Medicine at Case Western Reserve University

Data and sustainability | Perioperative Coach Apr 08, 2019

"Without data you cannot sustain your programme" - this piece is about understanding the importance of data collection as part of the perioperative process. Quality improvement stems from this, consistent definitions and measures allow you to do the job properly. They also allow you to build the case and put a story to the process which higher management and resource allocation can work with. "If we don't know it's broke we can't fix it" - just as we need to know and recognise success in order to see it grow and develop. Presented by Vicki Morton, Doctor of Nursing Practice and Director of Clinical and Quality Outcomes at Providence Anesthesiology Associates, University of South Carolina.

CPET: Cardio Pulmonary Exercise Testing | Sunday Special Apr 07, 2019

Everything you ever wanted to know about CPET (Cardio Pulmonary Exercise Testing) but were too afraid to ask; this conversation is a fascinating deep dive into the topic with two experts in the field. Discover how widely practiced this technique is across the UK, hear about the advantages people who use it have in terms of outcomes and patient safety. Also, what do institutions then do with the data and how does that increase our understanding of the human body?

Some of the UCL podcasts mentioned in the piece are available here:

Introduction to Cardio Pulmonary Exercise Testing - https://www.youtube.com/watch?v=U_0Gi0gozgU

Cardio Pulmonary Exercise Testing: Setup - https://www.youtube.com/watch?v=qW9KFo0kiMk

Check out their YouTube channel for more: https://www.youtube.com/channel/UC_NlyaSqWQngSCFF1LLHW8w

The POETTS website is here: https://poetts.co.uk/

Finally, our excellent Xtreme Everest podcast archive is here: https://www.topmedtalk.com/category/conferences/xtreme-everest/

Presented by Desiree Chappell with Monty Mythen and their guests Jeroen Molinger, Clinical Medical Exercise Physiologist at Duke University Medical Center, Department of Anesthesiology & ICU and John Whittle, assistant Professor at Duke University Medical Centre.

Clare Gerada | TopMedTalks to... Apr 06, 2019

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.

POET 2.07 | Respect and recognition through teamwork Apr 05, 2019

"If you don't have respect you really can't do anything ... healthcare is a team sport!"

What is a "Respect Officer"? Why is respect so important in perioperative care? What is a "huddle" and should your team include one in your practice?

Presented by Desiree Chappell and Monty Mythen with their guest Amir Jaffer, Chief Medical Officer, New York Presbyterian/ Queens.

EBPOM USA 2019 | TRIPOM Apr 04, 2019

How does enhanced recovery after surgery (ERAS) work for cardiac patients? What lessons have been learned and how have pathways and protocols evolved? How do you get the whole team onboard with such innovations and the multidisciplinary aspect of these notions? Presented by Robin Schiller and Bridger Bach with their guests Dr Mike Grant, Assistant Professor of Anesthesiology and Critical Care Medicine (ACCM) at the Johns Hopkins University School of Medicine.

EBPOM Highlight 1.18 | Emergency laparotomy Collaborative Apr 03, 2019

"Emergency laparotomy Collaborative" - 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 Nial Quiney, Consultant Anaesthetist at Royal Surrey County Hospital and Principal investigator for the Emergency Laparotomy Quality Improvement Care Bundle (ELPQuiC) project and Clinical Lead for the Emergency Laparotomy Collaborative (ELC).

The Global Council on Brain Health | The RoundTable Apr 02, 2019

The American Associaton of Retired People (AARP), an organisation with a membership almost equal to the entire voting population of the United Kingdom, are focusing on brain health, in response to the demands of their members.

Further conversation includes how practitioners both explain the risks of surgery and also calm possible misunderstandings or fears regarding them, as well as wider reflections on 'The Brain Health Initiative'.

Presented by Desiree Chappell with Mike Grocott and their guests Lee Fleisher, Professor of Anesthesiology and Critical Care, University of Pennsylvania and Sarah Lock, Senior Vice President for policy at the American Association of Retired People (AARP) and the director of 'The Global Council on Brain Health'.

The painful truth | Perioperative Coach Apr 01, 2019

Pain is seen by many as the so-called fifth vital sign but is it reasonable to expect us to eliminate it entirely? The long term consequences for medicine and our patients are now manifesting in daily newscasts regarding "the opioid epidemic".

Presented by Monty Mythen with Dr Patrick Shanahan, Anesthesiology Consultants Enterprises, Louisville KY and Mike Grocott, Professor of Anaesthesia and Critical Care Medicine, University of Southampton.

Reflections on EBPOM-USA Dallas Masters Course | Sunday Special Mar 31, 2019

The EBPOM-USA Dallas Masters Course, held between the 22nd - 24th of March 2019, has provided TopMedTalk with a wealth of exciting new material which we will be sharing with you over the next few months. Here you can reflect on the conference or, if you didn't manage to attend, whet your appitite for what is to come. Presented by Desiree Chappell with Monty Mythen, Sol Aronson and Vicki Morton.

John Myburgh | TopMedTalks to... Mar 30, 2019

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 Professor John A Myburgh, Intensive Care Medicine, University of New South Wales; Director of the Division of Critical Care and Trauma at the George Institute for Global Health and Senior Intensive Care Physician at the St George Hospital, Sydney. He holds honorary Professorial appointments at the University of Sydney and Monash University School of Public Health and Preventive Medicine.

POET 2.06 | Prehabilitation and preparation for safer surgery Mar 29, 2019

What's the relationship between Enhanced Recovery after Surgery (ERAS) and Prehabilitation? Should prehabilitation be thought of as a natural part of perioperative enhancement? Should practitioners learn to think of exercise as an anabolic stimulant? Mike Grocott presents with his guests Olle Ljungqvist, Prof. of Surgery, MD, PhD, Surgeon, Örebro University Hospital & Karolinska Institutet, Sweden and Franco Carli, Prof. MD, PhD, Anesthesiologist, McGill University, Canada.

EBPOM USA 2019 | TRIPOM Mar 28, 2019

How has perioperative medicine impacted upon our understanding of obstetrics? Hear how implimenting an ERAS programme in 2016 has benefitted the pioneers who led the way here. Is it something you could impliment in your practice? Presented by Robin Schiller and Bridger Bach with their guests Dr Attila Kett, anaesthesiologist and Chairman at St Peter’s University Hospital at New Jersey and Dr Elizabeth Cherot, Vice President of medical affairs at Axia Women’s Health.

EBPOM Highlight 1.17 | Colloid vs Crystalloid - Goal Directed Therapy Mar 27, 2019

"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 and Critical Care at University College London.

Adverse outcomes and patient optimisation | The RoundTable Mar 26, 2019

Adverse outcomes, we all know they happen but how do we handle them, record them and avoid them in the first place? The discussion then moves to (Patient Recorded Outcome Measures) PROMS.

Patient optimisation is then discussed. Exercise, could it be so effective because it works as an anti inflammatory? A deep dive into the research on that is contained in this conversation.

The RELIEF trial is discussed as the team get into a discussion about what a patient sees as a good outcome. How do we communicate the risks, possible benefits and limitations, of surgery to patients?

The "P.R.E.P." website mentioned is here: https://www.prepwell.co.uk/

Desiree Chappell and Joff Lacey are presenting with their guests Dr Mark Edwards, Consultant in Anaesthesia and Perioperative Medicine at The University Hospital Southampton NHS Foundation Trust and Professor Gerard Danjoux, Consultant in Anaesthesia and Sleep Medicine at South Tees Hospitals NHS Foundation Trust.

Weigh your surgical patients | Perioperative Coach Mar 25, 2019

How important is it to weigh your patients, both before and after surgery? Should this then continue during their stay each day they have an i.v. running?

Presented by Monty Mythen and Henry Howe with their guests Tom Woodcock, an independent consultant in patient safety, medical law and ethics, and Manu Malbrain, Professor at Faculty of Medicine and Pharmacology Vrije University in Brussells.

How should we teach perioperative medicine? | Sunday Special Mar 24, 2019

How do we develop an agreed curriculum that speaks to what perioperative medicine should be? Once that's in place, how should it be overseen? What sort of official endorsements would it need?

Running in parallel to this are the MOOCs - Massive Online Open Courses - that are being developed.

Developing a broad knowledge of the process is distinct from being a perioperative specialist, how do we develop that even further - without developing a schism? These complicated topics are discussed alongside more detail regarding the future of teaching this speciality.

Presented by Monty Mythen and Mike Grocott with their guests; Joel Symmons, Staff Consultant Anaesthetist in the Department of Anaesthesia and Perioperative Medicine at the Alfred Hospital, Perioperative Medicine Short Course Convenor, and a Senior Lecturer in Anaesthesia at Monash University, and Paul Myles, Head of Alfred Health's and Monash University's Department of Anaesthesia and Perioperative Medicine.

Professor Monty Mythen | TopMedTalks To ... Mar 23, 2019

What is TopMedTalk and how did it come about? Why is perioperative medicine such an inspiration to us? Why is our Editor in Chief such an advocate? What is the opioid crisis?

Broadcaster Nick Margerrison speaks with our Editor in Chief about TopMedTalk and perioperative medicine.

We regularly enjoy reading your feedback: contact@topmedtalk.com

POET 2.05 | Rehabilitation as a team sport Mar 22, 2019

Teamwork is an essential part of perioperative care. Here the case is made that we should approach both pre and post habilitation as being akin to playing a team sport.

Presented by Desiree Chappell with her guest Dr Steve Flanagan, Chair of Physical Medicine and Rehabilitation at NYU Langone.

The fuller version of this piece is here: http://topmedtalk.libsyn.com/physical-medicine-in-rehabilitation-applying-a-team-approach-in-care-and-pre-and-post-habilitation

EBPOM Highlight 1.17 | Developing a national quality improvement network Mar 21, 2019

Learn how to develop a national Quality Improvement (QI) network which will increase both communication and knowledge implementation. What are the essential elements of a useful network, how do you build a community within one and solidify it as an essential part of your practice? Presented by Carolyn Johnston, consultant Anaesthetist in St Georges hospital in London.

EBPOM Highlight 1.16 | Postoperative changes in cognition: The role of biomarkers Mar 20, 2019

"Postoperative changes in cognition: The role of biomarkers" - 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.com/meetings

If you have any comments or questions you'd like to send to the team email: contact@topmedtalk.com

Presented by Miles Berger, Neuroanesthesiologist at Duke University Medical Center.

Population health in a 'fee for service' environment | The RoundTable Mar 19, 2019

How do you best work a pre-op clinic? Should they be places where you get your problems documented or where you get your problems 'fixed'? How do you convince your practice to optimise patients for life and not just 90 days? How do we encourage population health? How do we get round the fact that we're still in a 'fee for service world'? What is "PBPM"?

Featuring Desiree Chappell, Monty Mythen, Dr Lee A. Fleisher, Chair of Anesthesiology and Critical Care (University of Pennsylvania) and Vicki Morton DNP and Director of Clinical and Quality Outcomes at Providence Anesthesiology Associates University of South Carolina.

Join in the debate contact@topmedtalk.com

Physiological Principles of Goal Directed Fluid Therapy | Perioperative Coach Mar 18, 2019

This podcast covers the physiological principles of goal directed fluid therapy, fluid responsiveness, the stressed system and the glycocalyx.

Originally streamed live on www.topmedtalk.com

Presented by Dr Joff Lacey with his guest Dr Randall Dull of the University of Illinois, live from the ASA in 2017.

Critical Care Practitioner Podcast | Sunday Special Mar 17, 2019

TopMedTalk catches up with another online media source, The Critical Care Practitioner podcast, organised by our guest who - appropriately enough - is a critical care practitioner. What's it like being a critical care practitioner in the UK at the moment? Originally a lot of nurses moved into the sphere but now paramedics, physiotherapists and many others progress into it. Furthermore what's it like taking your professional passion into the world of podcasting? You can hear the Critical Care Practitioner podcast here. Presented by Desiree Chappell with her guest Jonathan Downham, Critical Care Practitioner and podcaster.

Hugh Montgomery | TopMedTalks to... Mar 16, 2019

Recorded on the first day of the Intensive Care Society's annual conference this conversation starts with some reflections about how conferences have moved into the modern age now with interactivity and new media revitalising the scene in unexpected ways.

Conversation then moves out to some of the big questions: Is the pulmonary artery catheter back? What have been some of the big take aways in nutrition? Why should you feed a cold and starve a fever? More Protein or less?

Finally, ‘humanizing intensive care’ is discussed, do we need more ITU pets?

Presented by Desiree Chappell and Monty Mythen confer on the events of the day with their guest Hugh Montgomery, Intensive Care Society Board Member and, Professor of Cardiovascular Genetics and Critical Care University College London.

POET 2.04 | Shared decision making Mar 15, 2019

Shared decision making is a meeting between experts, on the one hand we have a clinician who understands a diagnosis and a likely prognosis, on the other we have a patient who exclusively understands their values and personal tolerance for risk. Ideally these two perspectives are encouraged to combine into high quality decisions tailored to individual patients. What are the essential elements of this process? Presented by Angela Coulter, a UK based health policy analyst and researcher. Originally streamed live on www.topmedtalk.com the fuller version of this talk "EBPOM 2018| Shared decision making in perioperative care" is here: https://www.topmedtalk.com/ebpom-highlight-1-07-shared-decision-making-in-perioperative-care/

EBPOM Highlight 1.15 | Perioperative nutrition Mar 14, 2019

"Perioperative nutrition" - 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 Paul Wischmeyer, Professor of the Department of Anesthesiology, Duke University.

EBPOM Highlight 1.14 | Does choice of opioid influence health outcomes? Mar 13, 2019

"Does choice of opioid influence health outcomes?" - 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 Padma Gulur, Professor of Anaesthesia and Executive Vice-Chair at Duke University.

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Do you have your ticket to the Dallas Master's Course being organised in March by EBPOM USA yet?

Find out more here: https://www.ebpom.org/EBPOM-USA-2019

As a TopMedTalk subscriber you can get a 20% discount for 1 person, or a 50% discount for a team. Just use the promo code "DAL 20" if you're solo or "EDAL 50" if you're coming as a group.

Do we share an interest in Enhanced Recovery? | The RoundTable Mar 12, 2019

What is the Enhanced Recovery After Surgery (ERAS) Shared Interest Group (SIG)? How does it relate to the advancement of perioperative medicine?

TopMedTalk was at the American Association of Nurse Anaesthetists (AANA) 2018 conference in Boston, check the podcast timeline for more, or click here: https://www.topmedtalk.com/?s=AANA

Desiree Chappell speaks with her guests, Josh Newman Lead CRNA at Passavant Area Hospital, Springfield, Illinois Area and now Chair of the Enhanced Recovery After Surgery (ERAS) Shared Interest Group (SIG) and Randall Moore, DNP, MBA, CRNA and Chief Executive Officer of the AANA.

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Do you have your ticket to the Dallas Master's Course being organised in March by EBPOM USA yet?

Find out more here: https://www.ebpom.org/EBPOM-USA-2019

As a TopMedTalk subscriber you can get a 20% discount for 1 person, or a 50% discount for a team. Just use the promo code "DAL 20" if you're solo or "EDAL 50" if you're coming as a group.

Tackling post operative delirium | Perioperative Coach Mar 11, 2019

How do we address the issue of post operative delirium?

Here you will find fascinating further discussion about cognitive function after surgery. What practical, simple steps can patients and providers take to bridge the gap between new discoveries in this area and risk minimisation?

Featuring Desiree Chappell interviewing her guests, Carol Peden, Professor of Anesthesiology and Executive Director of the Center for Health System Innovation, University of Southern California, University of Bath and the Institute for Healthcare Improvement (IHI) and Lee A. Fleisher Chair of Anesthesiology and Critical Care, University of Pennsylvania.

For more on this topic why not listen to our piece with Henrik Kehlett here: https://www.topmedtalk.com/asa-2018-san-francisco-henrik-kehlet-recovery-is-all-about-inflammation/

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Do you have your ticket to the Dallas Master's Course being organised in March by EBPOM USA yet?

Find out more here: https://www.ebpom.org/EBPOM-USA-2019

As a TopMedTalk subscriber you can get a 20% discount for 1 person, or a 50% discount for a team. Just use the promo code "DAL 20" if you're solo or "EDAL 50" if you're coming as a group.

The POPS clinic at Guy's & St Thomas's | Sunday Special Mar 10, 2019

What is POPS (Proactive care for Older People undergoing Surgery) and how have things gone since this service was introduced to Guy's and St Thomas's back in 2004? How does the team apply the techniques of this programme to the perioperative pathway of a patient? Would a service like this be useful at your practice? Can your institution accommodate a fully comprehensive geriatric assessment and optimisation process?

Furthermore, should a programme like this be rolled out across the UK and could anything similar be considered in the US?

How does having a POPS team facilitate specialist education at the institution? What other opportunities are there for patients and staff as a result of innovations such as this?

Also - what are the drugs that anaesthetists commonly prescribe to patients which people who work on this side of the service aren't so keen on? What are the advantages of being able to safely discharge frail patients who may instead have ended up back in the hospital system?

How do we get undergraduates to learn the skills which simple demographics show are going to become more and more crucial as the trend towards a longer life span continues in the Western world? The Guy's and St Thomas's POPS team offer a fellowship, the final part of this Sunday Special covers both that and the wider issue of getting students and younger practitioners into this growing area of health care.

Desiree Chappell presents, with additional questions thrown in by Monty Mythen, as they speak with their guests; Magda Sbai, specialist registrar at Guy's and St Thomas's, Jason Cross, advanced nurse practitioner and Nursing lead for the POPS team, Claire Gallagher, Deputy clinical nurse specialist, Dr Judith Partridge, consultant geriatricians at Guy's and St Thomas's Hospital in London and Dr Jugdeep Dhesi, Clinical Lead, POPS and Consultant Geriatrician, Guys and St Thomas' NHS Trust.

Dan Cole | TopMedTalks to... Mar 09, 2019

What can practitioners do to preoperatively screen for signs that their patients may have issues with post operative delirium? How do we get patients fit for surgery, particularly with regard to delirium? Can you build up mental resilience in the run up to an operation? Do puzzles and mental activity - such as sudoku or a good crossword - help and is there any evidence of that?

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?

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 concentration of volatile anesthesia are said to face an increased risk of adverse outcomes?

This piece features Monty Mythen and Desiree Chappell in conversation with Dan Cole, professor of clinical anesthesiology at the David Geffen School of Medicine, University of California, Los Angeles and former president of the American Society of Anesthesiologists (ASA).

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Do you have your ticket to the Dallas Master's Course being organised in March by EBPOM USA yet?

Find out more here: https://www.ebpom.org/EBPOM-USA-2019

As a TopMedTalk subscriber you can get a 20% discount for 1 person, or a 50% discount for a team. Just use the promo code "DAL 20" if you're solo or "EDAL 50" if you're coming as a group.

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POET 2.03 | Refusing surgery Mar 08, 2019

Is it unreasonable to give a patient six months to lose weight before, for example, knee surgery? Going even further should we be considering meditation, mindfullness and yoga as part of a pre-habilitation clinic? Hosted by Desiree Chappell and Monty Mythen, recorded at the Interdisciplinary Conference on Orthopedic Value-Based Care, with their guests; Shawna Butler (RN, NBA who works with Singularity University in Exponential Medicine) and Jennifer Brandon (PT, MPT, Hoag Orthopedic Institute in Irvine, California).

JAMA: The ENGAGES Randomized Clinical Trial | Journal Club Mar 07, 2019

The full title of the paper being looked at here is: "Effect of Electroencephalography-Guided Anesthetic Administration on Postoperative Delirium Among Older Adults Undergoing Major Surgery: The ENGAGES Randomized Clinical Trial". The link to the paper is here: https://www.ncbi.nlm.nih.gov/pubmed/30721296 The editorial referenced in the piece is here: https://jamanetwork.com/journals/jama/article-abstract/2724007 Presented by Monty Mythen and Desiree Chappell. -- Do you have your ticket to the Dallas Master's Course being organised in March by EBPOM USA yet?

Find out more here: https://www.ebpom.org/EBPOM-USA-2019

As a TopMedTalk subscriber you can get a 20% discount for 1 person, or a 50% discount for a team. Just use the promo code "DAL 20" if you're solo or "EDAL 50" if you're coming as a group.

EBPOM Highlight 1.13 | PQIP Pain: from individual case to systems management Mar 06, 2019

"PQIP Pain: from individual case to systems management" - originally streamed live from The Institute of Engineering and Technology (IET) in London during EBPOM 2018 on www.topmedtalk.com If you're looking for the talk mentioned here featuring Paul Wishmeyer it is here: https://www.topmedtalk.com/topmedtalks-to-dr-paul-wischmeyer/ 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 Dr Natasha Curran, consultant in anaesthesia and pain management University College London Hospital (UCLH) and Medical Director at the Health Innovations Network, South London.

Geriatric care and the value of teamwork | The RoundTable Mar 05, 2019

How do we best negotiate working in a multidisciplinary team? Generalisations regarding surgeons and anaesthetists only ever work generally, the specifics of each practitioner and their priorities inevitably contrast. How do we keep sight of these broad differences without falling foul of stereotypes?

The conversation evolves; how does the surgical journey fully utilise the team based perioperative approach? With specific focus on geriatric care there is further discussion regarding shared decision making, something which has been part of that discipline for many years.

The debate regarding when a patient becomes geriatric is explored. Is it age which defines that or do symptoms and comorbidities qualify the term?

Recorded on the first day of the Royal College of Anaesthetists' annual conference at The British Museum.

Desiree Chappell and Monty Mythen interview their guests Professor Jenifer Weller, Head of the Centre for Medical and Health Sciences Education, University of Auckland and Dr Jugdeep Dhesi, Clinical Lead, POPS and Consultant Geriatrician, Guys and St Thomas' NHS Trust.

Assessing the risk of delirium | Perioperative Coach Mar 04, 2019

What can practitioners do to preoperatively screen for signs that their patients may have issues with post operative delirium? How do we get patients fit for surgery, particularly as regards delirium? Can you build up mental resilience in the run up to an operation, do suggestions that puzzles and mental activity such as sudoku and a good crossword help have any evidence behind them? This piece features Monty Mythen and Desiree Chappell in conversation with Dan Cole, professor of clinical anesthesiology at the David Geffen School of Medicine, University of California, Los Angeles and former president of the American Society of Anesthesiologists (ASA).

Nasogastric feeding | Sunday Special Mar 03, 2019

How is it the case that some people can lose significant muscle mass while they are being cared for on the Intensive Care Unit (ICU)? What can practitioners do to help avoid this? How do we integrate a dynamic stimulus and react to new research relating to nasogastric feeding? In this piece you will hear about a randomised controlled pilot study investigating the effect of intermittent versus continuous nasogastric feeding on muscle mass and function in intensive care unit survivors. Hugh Montgomery presents with his guest, Dr Angela McNelly, clinical researcher at the ISEH and the UCL Centre for Human Health and Performance.

Mike Swart | TopMedTalks to... Mar 02, 2019

How do you become well known in the NHS for being innovative, particularly in the perioperative area regarding evaluation and communication of risk? How can cardiopulmonary exercise testing lead to shared decision making? Hear how aortic aneurysms are dealt with by a world class professional perioperative physician. Learn how that process and its success then spread out into other areas of healthcare within his institution. Do you need to develop a broad knowledge of all surgery and medicine so that you understand what is going on within the different surgical specialities? Following this discussion is had about the GIRFT (Getting It Right First Time) project. The stated aim is 'to help improve the quality of care within the NHS by reducing unwarranted variations, bringing efficiencies and improving patient outcomes'. This piece gives you the detail from one of the joint clinical leads. Presented by Monty Mythen, Joff Lacey and Desiree Chappell with their guest Dr Michael Swart, Consultant in Anaesthesia and Critical Care Medicine at Torbay Hospital and advisor to the UK Department of Health for the Enhanced Recovery Programme.

POET 2.02 | Overcoming the behaviour gap Mar 01, 2019

The gap between ambition and action is familiar to us all but when it's potentially a matter of life and death how do we overcome it? This piece gives you a sense of both the research which illustrates the 'behaviour gap' in patients who are attempting to make good on their promise to regularly exercise. Presented by Chloe Grimmett, behavioural scientist from Southampton University. She works closely alongside the 'Fit for Surgery Team', providing the behavioural intervention which is part of the on-going WesFit prehabilitation trial. Originally streamed live on www.topmedtalk.com from The Institute of Engineering and Technology (IET) in London during EBPOM 2018 the fuller version of this talk is here: "POETTS 2018 | Psychological Behavioural Change Interventions in Cancer Patients" https://www.topmedtalk.com/poetts-2018-psychological-behavioural-change-interventions-in-cancer-patients/

Various Journals: ACE, ARBs and Asprin | Journal Club Feb 28, 2019

Interesting thoughts on the use of ACE inhibitors and ARBs, alongside considerations regarding asprin. We look at the following papers: Anesthesia and Analgesia: A Systematic Review of Outcomes Associated With Withholding or Continuing Angiotensin-Converting Enzyme Inhibitors and Angiotensin Receptor Blockers Before Noncardiac Surgery. https://www.ncbi.nlm.nih.gov/pubmed/29381513 Anesthesia and Analgesia: A Prospective International Multicentre Cohort Study of Intraoperative Heart Rate and Systolic Blood Pressure and Myocardial Injury After Noncardiac Surgery: Results of the VISION Study

https://journals.lww.com/anesthesia-analgesia/FullText/2018/06000/A_Prospective_International_Multicentre_Cohort.25.aspx

Gynecologic Oncology: Use of paracetamol, low-dose aspirin, or non-aspirin non-steroidal anti-inflammatory drugs and risk of ovarian borderline tumors in Denmark.

https://www.ncbi.nlm.nih.gov/pubmed/30249529

JAMA Surgery: Association of Aspirin With Prevention of Venous Thromboembolism in Patients After Total Knee Arthroplasty Compared With Other Anticoagulants: A Noninferiority Analysis.

https://www.ncbi.nlm.nih.gov/pubmed/30347089

Presented by Desiree Chappell with Monty Mythen and their guests Barbara Slawski, Professor of Medicine and Orthopaedic Surgery; Chief, Section of Perioperative and Consultative Medicine; Froedtert and Medical College of Wisconsin and Steven L. Cohn, Professor Emeritus, Director – Medical Consultation Service, Jackson Memorial Hospital University of Miami Miller School of Medicine.

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Do you have your ticket to the Dallas Master's Course being organised in March by EBPOM USA yet?

Find out more here: https://www.ebpom.org/EBPOM-USA-2019

As a TopMedTalk subscriber you can get a 20% discount for 1 person, or a 50% discount for a team. Just use the promo code "DAL 20" if you're solo or "EDAL 50" if you're coming as a group.

EBPOM Highlight 1.12 | Perioperative nutrition should be a key part of Enhanced Recovery Feb 27, 2019

"Perioperative nutrition should be a key part of Enhanced Recovery" - 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 Paul Wischmeyer, Professor of the Department of Anesthesiology, Duke University.

Treating anemia in the perioperative process | The RoundTable Feb 26, 2019

How does the treatment of anemia fit into the perioperative process? How far should patient optimisation extend to treatment of this condition?

Live from the hugely successful EBPOM USA conference, directly after their presentation Desiree Chappell talks with her guests; Dr Lori Heller, Cardiac Anesthesiologist, Swedish Medical Center, through US anaesthesia partners and acting instructor at the University of Washington, Seattle and Dr Bobbie Jean Sweitzer, Associate Professor and Director of pre-operative medicine at the University of Chicago.

ERAS what's the 'secret sauce'? | Perioperative Coach Feb 25, 2019

This piece starts with the question: Is there a hierarchy amongst the various elements of an enhanced recovery pathway? The conversation that follows tackles some of the essential elements of perioperative care.

This conversation is taken from a longer piece to be found here: https://www.topmedtalk.com/live-from-the-iseh-part-2/

For further expert discussion regarding the Drink, Eat, Mobilise, Sleep (DrEaMS) concept there is another short piece you can find here: https://www.topmedtalk.com/standardised-outcomes-from-surgery-drink-eat-mobilise-dream/

This edition of TopMedTalk was recorded at The Institute of Sport Exercise and Health (ISEH) live from an Enhanced Recovery After Surgery (ERAS) leadership forum.

The conversation features questioner Dr Vishal Patil, Consultant Anaesthetist at Cambridge University Hospitals NHS Foundation Trust, alongside Professor Monty Mythen and his two guests; Dr Simeon West, consultant anaethetist at (University College London Hospitals) UCLH who sits on the board at Regional Anaesthesia UK (RAUK) and Mark Harper Consultant Anaesthetist at Brighton and Sussex University Hospitals, with a research interest in the prevention of perioperative hypothermia and the use of cold water adaptation for thearaputic purposes.

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Do you have your ticket to the Dallas Master's Course being organised in March by EBPOM USA yet?

Find out more here: https://www.ebpom.org/EBPOM-USA-2019

As a TopMedTalk subscriber you can get a 20% discount for 1 person, or a 50% discount for a team. Just use the promo code "DAL 20" if you're solo or "EDAL 50" if you're coming as a group.

Part 2 of TRIPOM USA | Sunday Special Feb 24, 2019

Trainees with an interest in perioperative medicine (TRIPOM) is an ever growing organisation set to continue the global push for perioperative care. This high energy podcast gives you a taste of the enthusiasm people pick up as they learn more about the value of these ideas. Moving more obviously into the perioperative period this piece continues on from last week's talk regarding mitochondrial health where 'healthy ageing' was the focus. The panel now draw the conversation into areas such as nutrition, the impact of frailty on outcomes regarding surgery and patient assessment. How does this gripping research impact upon our work during the perioperative period? Presented by John Whittle, assistant Professor at Duke University Medical Centre and one of the founders of TRIPOM, with a panel including, Mike Grocott, Professor of Anaesthesia and critical care at the University of Southampton, Dr Brant Inman, Urologist at Duke University Medical Center, Dr Amy Pastva, immunologist, physiologist and researcher at Duke University School of Medicine, Dr Paul Wishmeyer, Professor of the Department of Anesthesiology, Duke University. -- Do you have your ticket to the Dallas Master's Course being organised in March by EBPOM USA yet? Find out more here: https://www.ebpom.org/EBPOM-USA-2019 As a TopMedTalk subscriber you can get a 20% discount for 1 person, or a 50% discount for a team. Just use the promo code "DAL 20" if you're solo or "EDAL 50" if you're coming as a group.

Tim Cook | TopMedTalks to... Feb 23, 2019

NAP (National Audit Project) 6 is the largest ever prospective study of anaphylaxis related to anaesthesia and surgery. Find out the details behind this intriguing study, how long did it take, how does the data impact upon our day to day practice?

There follows a deep dive into the results and recomendations that NAP 6 has produced. Packed with useful information this podcast is one of the stand out pieces of our coverage of the Royal College of Anaesthetists' annual conference in London.

Joff Lacey sits down with his guest Professor Tim Cook, Consultant in Anaesthesia and ICM, Royal United Hospitals, Bath.

Email us: contact@topmedtalk.com

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Do you have your ticket to the Dallas Master's Course being organised in March by EBPOM USA yet? Find out more here: https://www.ebpom.org/EBPOM-USA-2019 As a TopMedTalk subscriber you can get a 20% discount for 1 person, or a 50% discount for a team. Just use the promo code "DAL 20" if you're solo or "EDAL 50" if you're coming as a group.

POET 2.01 | The UK's Prepwell initiative Feb 22, 2019

Community based prehabilitation in the UK is being spearheaded by the Prepwell Initiative. Supported by a grant from Sports England this pioneering work is a great example of the way in which a perioperative enhancement team can be formed around your practice.

The "PREP: Preoperative Risk Education Package" website mentioned in this piece is here: https://www.prepwell.co.uk/

Desiree Chappell and Joff Lacey are presenting with their guests Dr Mark Edwards, Consultant in Anaesthesia and Perioperative Medicine at The University Hospital Southampton NHS Foundation Trust and Professor Gerard Danjoux, Consultant in Anaesthesia and Sleep Medicine at South Tees Hospitals NHS Foundation Trust.

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Do you have your ticket to the Dallas Master's Course being organised in March by EBPOM USA yet? Find out more here: https://www.ebpom.org/EBPOM-USA-2019 As a TopMedTalk subscriber you can get a 20% discount for 1 person, or a 50% discount for a team. Just use the promo code "DAL 20" if you're solo or "EDAL 50" if you're coming as a group.

Various articles from; BMJ Open, Journal of Bone Joint Surgery American volume, Diabetes Care, Annals of Surgery | Journal Club Feb 21, 2019

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 Glucose on Postoperative Mortality in Noncardiac and Cardiac Surgeries.

https://www.ncbi.nlm.nih.gov/pubmed/29440113

Frailty as a Predictor of Death or New Disability After Surgery: A Prospective Cohort Study.

https://www.ncbi.nlm.nih.gov/pubmed/30048320

Presented by Desiree Chappell and Monty Mythen with their guest Paul Grant, Hospitalist and Director of Perioperative and Consultant Medicine at the University of Michigan. --

Do you have your ticket to the Dallas Master's Course being organised in March by EBPOM USA yet?

Find out more here: https://www.ebpom.org/EBPOM-USA-2019

As a TopMedTalk subscriber you can get a 20% discount for 1 person, or a 50% discount for a team. Just use the promo code "DAL 20" if you're solo or "EDAL 50" if you're coming as a group.

EBPOM Highlight 1.11 | Hypotension probability in practice Feb 20, 2019

"Hypotension probability in practice" - 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 Mike Spiro, anaesthetic consultant at the Royal Free Hospital and Jez Fabes, Speciality Registrar and Academic Clinical Fellow of Anaesthesia at University College London (UCL) Hospitals.

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Do you have your ticket to the Dallas Master's Course being organised in March by EBPOM USA yet? Find out more here: https://www.ebpom.org/EBPOM-USA-2019 As a TopMedTalk subscriber you can get a 20% discount for 1 person, or a 50% discount for a team. Just use the promo code "DAL 20" if you're solo or "EDAL 50" if you're coming as a group.

The Royal College of Anaesthetists: World Leading Healthcare | The RoundTable Feb 19, 2019

How has the Royal College of Anaethestists (RCoA) evolved over the years and why is perioperative medicine so crucial to its agenda? How has this leadership in perioperative medicine become a force for change and improvement worldwide and what are the common themes that emerge as we take a global perspective on the discipline?

The RCoA's global partnership programme is explained, how can perioperative medicine be part of helping less developed healthcare systems? The considerations are different but the principles remain the same.

The birth of the NHS gave parity of esteem to anaesthetists, the benefits of this are felt by us all in the Western world, could it be argued that this visionary decision might actually help other healthcare systems to evolve more rapidly?

Finally - where is the discipline these days? Leadership and the ability to see the bigger picture are part of it, as is communicating to that wider world with various innovations including this podcast which you, as a listener, are a part of.

Presented by Desiree Chappell and Monty Mythen with their guests Dr Liam Brennan, President of The Royal College of Anaesthetists (RCoA) and Professor Paul Myles, Director, Department of Anaesthesia and Perioperative Medicine, Alfred Hospital and Monash University, Melbourne, Australia.

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Do you have your ticket to the Dallas Master's Course being organised in March by EBPOM USA yet? Find out more here: https://www.ebpom.org/EBPOM-USA-2019 As a TopMedTalk subscriber you can get a 20% discount for 1 person, or a 50% discount for a team. Just use the promo code "DAL 20" if you're solo or "EDAL 50" if you're coming as a group.

Perioperative Medicine Summit 2019 1.12 | Houman Javedan Feb 18, 2019

The Silver Tsunami is coming, are you prepared to assess the elderly patient? Mature patients present unique and interesting opportunities to perioperative practitioners. New ways of thinking and different approaches are always necessary.

The British Geriatric Society's "Fit For Frailty" is here: https://www.bgs.org.uk/resources/resource-series/fit-for-frailty

Presented by Desiree Chappell and Monty Mythen with their guest Houman Javedan, MD. Geriatrician at Brigham and Women’s Hospital, assistant program director of the HMS Multi-Campus Fellowship in Geriatric Medicine, and Clinical Director for the Division of Aging in the Department of Medicine.

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Do you have your ticket to the Dallas Master's Course being organised in March by EBPOM USA yet? Find out more here: https://www.ebpom.org/EBPOM-USA-2019 As a TopMedTalk subscriber you can get a 20% discount for 1 person, or a 50% discount for a team. Just use the promo code "DAL 20" if you're solo or "EDAL 50" if you're coming as a group.

Getting it right first time (GIRFT) | Perioperative Coach Feb 18, 2019

We begin with a question from the audience; 'how do we drive change in our institutions towards enhanced recovery after surgery?' The GIRFT (Getting It Right First Time) project is explained. The Health Foundation is also mentioned.

This edition of TopMedTalk was recorded at The Institute of Sport Exercise and Health (ISEH) live from an Enhanced Recovery After Surgery (ERAS) leadership forum.

The conversation features questioner Paul Hutchings, Consultant Anaesthetist at Norfolk and Norwich University Hospital, alongside Professor Monty Mythen and his two guests; Dr Simeon West, consultant anaethetist at (University College London Hospitals) UCLH who sits on the board at Regional Anaesthesia UK (RAUK) and Mark Harper Consultant Anaesthetist at Brighton and Sussex University Hospitals, with a research interest in the prevention of perioperative hypothermia and the use of cold water adaptation for thearaputic purposes.

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Do you have your ticket to the Dallas Master's Course being organised in March by EBPOM USA yet? Find out more here: https://www.ebpom.org/EBPOM-USA-2019 As a TopMedTalk subscriber you can get a 20% discount for 1 person, or a 50% discount for a team. Just use the promo code "DAL 20" if you're solo or "EDAL 50" if you're coming as a group.

Part 1 of TRIPOM USA | Sunday Special Feb 17, 2019

Trainees with an interest in perioperative medicine (TRIPOM) is an ever growing organisation set to continue the global push for perioperative care. This high energy podcast gives you a taste of the enthusiasm people pick up as they learn more about the value of these ideas. The focus here is on promoting healthy aging across two primary domains: cognitive function and physical ability. Discover how multiple features of aging—including physical and cognitive decline—are strongly associated with the bioenergetic profiles of circulating cells. Could the ability to diagnose mitochondrial health address central challenges in geriatric medicine, such as the need for personalized health care based on an individual’s unique physiology and “biological age”? How does this gripping research impact upon our work during the perioperative period? Co-Presented by Rob Schiller MD, Temple University School of Medicine and Anaeshesia, resident at Duke University and Vice-Chair of TRIPOM USA and Bridger Back MD, University of Utah School of Medicine and Anaesthesia resident at Duke University and Chair of TRIPOM USA. This podcast features a talk from Anthony J. Molina, PhD, Associate Professor, Gerontology and Geriatric Medicine. It also contains a contribution from John Whittle, assistant Professor at Duke University Medical Centre and one of the founders of TRIPOM. -- Do you have your ticket to the Dallas Master's Course being organised in March by EBPOM USA yet? Find out more here: https://www.ebpom.org/EBPOM-USA-2019 As a TopMedTalk subscriber you can get a 20% discount for 1 person, or a 50% discount for a team. Just use the promo code "DAL 20" if you're solo or "EDAL 50" if you're coming as a group.

Perioperative Medicine Summit 2019 1.11 | Perioperative practice Feb 17, 2019

This piece acts as a great summary of some of the big takaways from the conference this year. Discussion about a hugely successful Enhanced Recovery program at a large community hospital, continued improvements and service line expansion. Presented by Desiree Chappell and Monty Mythen with their guests Kim Duggan, Perioperative Surgical Home (PSH) - Enhanced Recovery After Surgery (ERAS) Manager, New Hanover Medical Centre and Robin Davis, Clinical Education Specialist II at New Hanover Regional Medical Center. --

Do you have your ticket to the Dallas Master's Course being organised in March by EBPOM USA yet?

Find out more here: https://www.ebpom.org/EBPOM-USA-2019

As a TopMedTalk subscriber you can get a 20% discount for 1 person, or a 50% discount for a team. Just use the promo code "DAL 20" if you're solo or "EDAL 50" if you're coming as a group.

Perioperative Medicine Summit 2019 1.10 | Master Perioperative Medicine Feb 16, 2019

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 assistant, New York Presbyterian/Weill Cornell.

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Do you have your ticket to the Dallas Master's Course being organised in March by EBPOM USA yet?

Find out more here: https://www.ebpom.org/EBPOM-USA-2019

As a TopMedTalk subscriber you can get a 20% discount for 1 person, or a 50% discount for a team. Just use the promo code "DAL 20" if you're solo or "EDAL 50" if you're coming as a group.

Perioperative Medicine Summit 2019 1.09 | Post op respiratory problems Feb 16, 2019

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. --

Do you have your ticket to the Dallas Master's Course being organised in March by EBPOM USA yet?

Find out more here: https://www.ebpom.org/EBPOM-USA-2019

As a TopMedTalk subscriber you can get a 20% discount for 1 person, or a 50% discount for a team. Just use the promo code "DAL 20" if you're solo or "EDAL 50" if you're coming as a group.

Lynn Reede | TopMedTalks to... Feb 16, 2019

How is the AANA facilitating the care of patients? How can you make a patient a 'partner in safety'? How do we coordinate so many disaparate systems of information and care?

Patient records and data ownership is discussed, as is Paul Upton's excellent interview on TopMedTalk regarding "My Preop". The original piece is here: https://www.topmedtalk.com/my-pre-op-empowering-patients-before-surgery/

How do we reach out to patients and inform them about the risks and choices which will be presented to them as part of their surgical pathway? Discussion here moves to the American Association of Retired Persons (AARP) and the incredible work they are doing. For more on the AARP from TopMedTalk go here: https://www.topmedtalk.com/dont-ask-patients-what-is-the-matter-ask-them-what-matters/

Presented by Desiree Chappell and Monty Mythen with their guest Lynn Reede, CRNA and chief clinical officer at the American Association of Nurse Anaesthetists (AANA).

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Do you have your ticket to the Dallas Master's Course being organised in March by EBPOM USA yet? Find out more here: https://www.ebpom.org/EBPOM-USA-2019 As a TopMedTalk subscriber you can get a 20% discount for 1 person, or a 50% discount for a team. Just use the promo code "DAL 20" if you're solo or "EDAL 50" if you're coming as a group.

Perioperative Medicine Summit 2019 1.08 | Paul Grant Feb 16, 2019

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 Glucose on Postoperative Mortality in Noncardiac and Cardiac Surgeries.

https://www.ncbi.nlm.nih.gov/pubmed/29440113

Frailty as a Predictor of Death or New Disability After Surgery: A Prospective Cohort Study.

https://www.ncbi.nlm.nih.gov/pubmed/30048320

Presented by Desiree Chappell and Monty Mythen with their guest Paul Grant, Hospitalist and Director of Perioperative and Consultant Medicine at the University of Michigan. --

Do you have your ticket to the Dallas Master's Course being organised in March by EBPOM USA yet?

Find out more here: https://www.ebpom.org/EBPOM-USA-2019

As a TopMedTalk subscriber you can get a 20% discount for 1 person, or a 50% discount for a team. Just use the promo code "DAL 20" if you're solo or "EDAL 50" if you're coming as a group.

Perioperative Medicine Summit 2019 1.07 | Elena Koepke Feb 15, 2019

On the last occasion where we spoke with our guest she was a Perioperative Medicine Fellow at Duke University; learn how her experiences have helped change her practice and the edge she now has in dealing with healthcare. The conference is producing a number of talking points, the Measurement of Exercise Tolerance before Surgery (METS) Trial seems to have shifted opinions, does a genuine 'perioptimist' have a deeper insight into the issues there? Also - does North America really lack the resources, expertise and money to adpot Cardiopulmonary Exercise Testing (CPET)? Presented by Desiree Chappell and Monty Mythen with their guest Dr Elena Koepke, Assistant Professor at Moffitt Cancer Center/USF, Physician Anesthesiologist, Perioperative Medicine Specialist. You can find POETTS here: https://www.poetts.co.uk --

Do you have your ticket to the Dallas Master's Course being organised in March by EBPOM USA yet?

Find out more here: https://www.ebpom.org/EBPOM-USA-2019

As a TopMedTalk subscriber you can get a 20% discount for 1 person, or a 50% discount for a team. Just use the promo code "DAL 20" if you're solo or "EDAL 50" if you're coming as a group.

Perioperative Medicine Summit 2019 1.06 | Avital O'Glasser Feb 15, 2019

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 their guest Avital O'Glasser, Assistant Professor of Medicine at OHSU, Oregon Health & Science University and member of the communications committee for SPAQI. --

Do you have your ticket to the Dallas Master's Course being organised in March by EBPOM USA yet?

Find out more here: https://www.ebpom.org/EBPOM-USA-2019

As a TopMedTalk subscriber you can get a 20% discount for 1 person, or a 50% discount for a team. Just use the promo code "DAL 20" if you're solo or "EDAL 50" if you're coming as a group.

Perioperative Medicine Summit 2019 1.05 | Frances Chung and Kurt Pfeifer Feb 15, 2019

Conversation begins with reflections on the conference and the impact of social media, Twitter, Facebook and so forth, on the global perioperative scene before tucking into some of the big stories that are emerging from the conference. Learn more about STOP BANG; Snoring, Tiredness, Observed Apnea, PBP (>140/90) R X or no. How do opioid sensitivity and obstructive sleep apnea effect each other? The opioid crisis, pain as the fifth vital sign and multimodal pain management produce some fascinating discussion, followed by comparisons between healthcare in various territories, Canada, the UK and the US. Finally, what is "the beard test" and "the upper lip bite test"? Check out the official STOP BANG website here: http://www.stopbang.ca Presented by Desiree Chappell and Monty Mythen with their guests, Frances Chung, Professor, Department of Anesthesiology and Pain Medicine, University of Toronto and Kurt J. Pfeifer, Professor of Medicine, General Internal Medicine, Medical Director, Preoperative Evaluation Clinic, Froedtert and Medical College Eye Institute, Medical College of Wisconsin, Milwaukee, WI. -- Do you have your ticket to the Dallas Master's Course being organised in March by EBPOM USA yet? Find out more here: https://www.ebpom.org/EBPOM-USA-2019 As a TopMedTalk subscriber you can get a 20% discount for 1 person, or a 50% discount for a team. Just use the promo code "DAL 20" if you're solo or "EDAL 50" if you're coming as a group.

Perioperative Medicine Summit 2019 1.04 | The big messages so far Feb 15, 2019

What are some of the big take home messages from this conference so far? Lots of material on preoperative assesment, discussion of some of the big trials and papers that have occured in the field and reflections on research into myocardial injury after noncardiac surgery (MINS). This podcast is recorded 'as live' and the team mention interviews which have now been recorded and are available online.

The Steven Cohen and Barbara Slawski conversation is here: https://www.topmedtalk.com/perioperative-medicine-summit-2019-1-01/

The Angela Bader piece is here: https://www.topmedtalk.com/perioperative-medicine-summit-2019-1-03-angela-bader/

And Amir Jaffer is here: https://www.topmedtalk.com/perioperative-medicine-summit-2019-1-02-amir-jaffer/

Presented by Monty Mythen and Desiree Chappell with their guest, a TopMedTalk favourite, Sol Aronson, a tenured professor at Duke University and Executive Vice Chairman in the Department of Anesthesiology. -- Do you have your ticket to the Dallas Master's Course being organised in March by EBPOM USA yet? Find out more here: https://www.ebpom.org/EBPOM-USA-2019 As a TopMedTalk subscriber you can get a 20% discount for 1 person, or a 50% discount for a team. Just use the promo code "DAL 20" if you're solo or "EDAL 50" if you're coming as a group.

Perioperative Medicine Summit 2019 1.03 | Angela Bader Feb 15, 2019

Does perioperative medicine alow institutions to take a broader view? Population health has been a theme on TopMedTalk, is it a logical extension of the perioperative process? How do we manage specialist care for the elderly and ensure high quality shared decision making? What lies behind the mindset change needed for some to accept surgery is not always the answer? Should we expect medical students to be taught the principles of perioperative medicine? What are some of the unique tensions in the US system that can frustrate the adoption of a truly perioperative practice? Presented by Desiree Chappell and Monty Mythen with their guest Angela Bader, Vice Chair of Perioperative Medicine at Brigham and Women's Hospital.

Perioperative Medicine Summit 2019 1.02 | Amir Jaffer Feb 15, 2019

Discussion begins with an overview of the conference and its roots. Special mention is made regarding the Frank Michota Memorial Lecture which takes place on the Friday morning of the conference.

Also on this podcast, what is a "Respect Officer"? Why is respect so important in perioperative care? How does improving 'the culture of safety' also help to improve outcomes? Should we be overly concerned about high cancelation rates for surgery? And what are the advantages of a preoperative risk assessment clinic (PRAC)?

Presented by Desiree Chappell and Monty Mythen with their guest Amir Jaffer, Chief Medical Officer, New York Presbyterian / Queens.

--

Do you have your ticket to the Dallas Master's Course being organised in March by EBPOM USA yet? Find out more here: https://www.ebpom.org/EBPOM-USA-2019 As a TopMedTalk subscriber you can get a 20% discount for 1 person, or a 50% discount for a team. Just use the promo code "DAL 20" if you're solo or "EDAL 50" if you're coming as a group.

Perioperative Medicine Summit 2019 1.01 Feb 14, 2019

The Society for Perioperative Assessment and Quality Improvement (SPAQI) are in Orlando Florida for their 14th annual summit and, of course, we're there to cover it. Find out what you can expect, if you are attending the conference, and what we're going to be bringing you on TopMedTalk, if you couldn't make it this year. 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 Orthopaedic Surgery; Chief, Section of Perioperative and Consultative Medicine; Froedtert and Medical College of Wisconsin and Steven L. Cohn, Professor Emeritus, Director – Medical Consultation Service, Jackson Memorial Hospital University of Miami Miller School of Medicine. -- Do you have your ticket to the Dallas Master's Course being organised in March by EBPOM USA yet? Find out more here: https://www.ebpom.org/EBPOM-USA-2019 As a TopMedTalk subscriber you can get a 20% discount for 1 person, or a 50% discount for a team. Just use the promo code "DAL 20" if you're solo or "EDAL 50" if you're coming as a group.

Brit Journal Anaesthesia: Antiplatelet therapy, bleeding and thrombosis in noncardiac surgery | Journal Club Feb 14, 2019

The full title of today's paper is: Prospective observational cohort study of the association between antiplatelet therapy, bleeding and thrombosis in patients with coronary stents undergoing noncardiac surgery and you can find it here: https://www.ncbi.nlm.nih.gov/pubmed/30686302

Presented by Dr Joff Lacey, registrar in anaesthesia at St George’s Hospital in London, currently undertaking a fellowship in Perioperative Medicine at UCLH.

--

Do you have your ticket to the Dallas Master's Course being organised in March by EBPOM USA yet? Find out more here: https://www.ebpom.org/EBPOM-USA-2019 As a TopMedTalk subscriber you can get a 20% discount for 1 person, or a 50% discount for a team. Just use the promo code "DAL 20" if you're solo or "EDAL 50" if you're coming as a group.

EBPOM Highlight 1.10 | Antibiotic stewardship in perioperative care Feb 13, 2019

"Antibiotic stewardship in perioperative care" - 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 Alison Holmes, Professor of Infectious Diseases at Imperial College, Fellow of the Academy of Medical Sciences and an Senior Investigator at the National Institute of Health Research (NIHR).

--

Do you have your ticket to the Dallas Master's Course being organised in March by EBPOM USA yet? Find out more here: https://www.ebpom.org/EBPOM-USA-2019 As a TopMedTalk subscriber you can get a 20% discount for 1 person, or a 50% discount for a team. Just use the promo code "DAL 20" if you're solo or "EDAL 50" if you're coming as a group.

Opioid reduction | The RoundTable Feb 12, 2019

What's it like in rural America working at a small hospital, 'way out on the frontier'? What best practice initiatives are there to help? How can you implement a process of rapid opioid reduction, more than 70%, in just two years? Presented by Desiree Chappell with her guest Bill Prosser, CRNA Peacehealth Florence Oregon. -- Do you have your ticket to the Dallas Master's Course being organised in March by EBPOM USA yet? Find out more here: https://www.ebpom.org/EBPOM-USA-2019 As a TopMedTalk subscriber you can get a 20% discount for 1 person, or a 50% discount for a team. Just use the promo code "DAL 20" if you're solo or "EDAL 50" if you're coming as a group.

Enhanced Recovery for obstetrics | Perioperative Coach Feb 11, 2019

What are the results if you apply Enhanced Recovery to obstetrics?

This podcast features Desiree Chappell interviewing Dr Attila Kett, anaesthesiologist and Chairman at St Peter’s University Hospital at New Jersey.

Join in the debate: contact@topmedtalk.com

Bill Clinton at the World Patient Safety, Science & Technology Summit | Sunday Special Feb 10, 2019

Global health is something TopMedTalk listeners are naturally passionate about; here you can listen to the keynote address from the 42nd President of The United States, Bill Clinton, to the World Patient Safety, Science & Technology Summit.

273,077 lives have been saved over the last 7 years with over 90,000 of those in just the last year alone. 4,700 hospitals around the world that are part of this effort. 89 technology companies have committed to share data to help develop algorithms and predict dangerous trends. The patient safety movement now has 35 regional chairs leading local networks across 50 countries. This movement is growing rapidly now, PSMF would like to encourage further support.

Their website is here: https://patientsafetymovement.org

Presented by Bill Clinton, 42nd President of The United States and founder of The Clinton Global Initiative. He is introduced by Joe Kiani, Founder, Chairman & CEO of Masimo, Cercacor & the Patient Safety Movement Foundation.

Michael Ramsay | TopMedTalks to... Feb 09, 2019

The Patient Safety Movement Foundation (PSMF) has ambitious targets to limit preventable deaths in healthcare, this piece explains how they intend to reduce them down to zero. They need your help, this is a global movement with an action plan to improve the world in an important but achievable way. Their website is here: https://patientsafetymovement.org/ Monty Mythen and Desiree Chappell speak with their guest Michael Ramsay, Chairman, Department of Anesthesiology and Pain Management, Baylor University Medical Center, and President of Baylor Scott & White Research Institute.

POET 1.10 | Give your patients a warm welcome. Feb 08, 2019

The patient experience can be quite passive and, as a result, people can lose temperature quickly. The consequences can be very negative, this conversation revolves around how you can keep your patients warm. This piece is taken from a longer conversation to be found here: https://www.topmedtalk.com/live-from-the-iseh-part-1/

This edition of TopMedTalk was recorded at The Institute of Sport Exercise and Health (ISEH) live from an Enhanced Recovery After Surgery (ERAS) leadership forum.

The conversation features Professor Monty Mythen and his guest Mark Harper, Consultant Anaesthetist at Brighton and Sussex University Hospitals, with a research interest in the prevention of perioperative hypothermia and the use of cold water adaptation for theraputic purposes.

Perioperative Medicine: Pulmonary artery catheters in cardiac surgery: a retrospective, cohort study | Journal Club Feb 07, 2019

This week on Journal Club we reflect upon the pulmonary artery (PA) catheter.

The following articles were discussed:

JAMA: The effectiveness of right heart catheterization in the initial care of critically ill patients. SUPPORT Investigators:

https://www.ncbi.nlm.nih.gov/pubmed/8782638

BJA: Effect of goal-directed haemodynamic therapy on postoperative complications in low–moderate risk surgical patients: a multicentre randomised controlled trial (FEDORA trial):

https://bjanaesthesia.org/article/S0007-0912(17)54207-5/fulltext

Perioperative Medicine: Pulmonary artery catheter use in adult patients undergoing cardiac surgery: a retrospective, cohort study:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6201566/

Also, this excellent piece with Thomas Scheeren gets a mention, if you've not heard it yet go here:

https://www.topmedtalk.com/talks-to-thomas-scheeren/

Presented by Monty Mythen with Andy Shaw, Chair of the Department of Anesthesiology and Pain Medicine and Zone Clinical Department Head at The University of Alberta, Rupert Pearse, Professor of Intensive Care Medicine at Queen Mary, University of London and Tim Miller, Associate Professor of Anaesthesiology from Duke University Medical Centre.

EBPOM Highlight 1.09 | Rehabilitation post critical care Feb 06, 2019

"Rehabilitation post critical care" - 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 Linda Denehy, Head of the Melbourne School of Health Sciences and Professor of Physiotherapy at The University of Melbourne, Australia.

Let your patients be 'partners in safety' | The RoundTable Feb 05, 2019

How is the AANA facilitating the care of patients? How can you make a patient a 'partner in safety'? How do we coordinate so many disaparate systems of information and care?

Patient records and data ownership is discussed, as is Paul Upton's excellent interview on TopMedTalk regarding "My Preop".

The original piece is here: https://www.topmedtalk.com/my-pre-op-empowering-patients-before-surgery/

How do we reach out to patients and inform them about the risks and choices which will be presented to them as part of their surgical pathway? Discussion here moves to the American Association of Retired Persons (AARP) and the incredible work they are doing.

For more on the AARP from TopMedTalk go here: https://www.topmedtalk.com/dont-ask-patients-what-is-the-matter-ask-them-what-matters/

Presented by Desiree Chappell and Monty Mythen with their guest Lynn Reede, CRNA and chief clinical officer at the American Association of Nurse Anaesthetists (AANA).

Length of stay after Major Surgery | Perioperative Coach Feb 04, 2019

In short; Post-Op recovery in less than 3 days with over 90% mobilised on day 1.

This in depth discussion relates to the consensus paper from the Perioperative Quality Initiative, see link below. It focuses on: outcomes, length of stay and DREAMS (Drinking, Eating and Mobilising) within hours after major surgery- all key measures of compliance and success in an Enhanced Recovery Program.

Monty Mythen and Joff Lacey with Mike Grocott presenting with contributions from Dr Julie Thacker, Colorectal Surgeon from Duke University and President of the American Society of Enhanced Recovery and Dr Tim Miller, Anesthesiologist from Duke University.

POQI website is here: http://www.poqi.org

For further CME read the paper in Perioperative Medicine:

https://perioperativemedicinejournal.biomedcentral.com/articles/10.1186/s13741-017-0062-7

Attend our next meeting: http://www.ebpom.org/EBPOM-USA

This piece is taken from a longer discussion here: http://www.topmedtalk.com/aser-ebpom-2017-pod-two-live-from-washington-dc/

Greater National Advocates | Sunday Special Feb 03, 2019

Please do all you can to help share this a hugely important piece, both for practitioners and patients. Adverse outcomes can be avoided, stories like the one on this podcast are fuel in the engine of those who advocate true perioperative care. If you want to help go to the Greater National Advocates website here: https://www.gnanow.org/ The Patient Safety Movement is here: https://patientsafetymovement.org/

Presented by Desiree Chappell and Monty Mythen with their guests L. Bradley Schwartz, president of Founder and President of Greater National Advocates he has served on the Board of Directors of both the National Association of Healthcare Advocacy Consultants (NAHAC) and the Patient Advocate Certification Board (PACB). Also in the conversation is Joseph Frankel, President, Frankel Design, Inc. - The Art of Brand Development & Promotional Marketing.

Dan Martin, OBE | TopMedTalks to... Feb 02, 2019

Desiree and Monty catch up with Dan Martin, OBE, and speak with him about treating infectious diseases and in particular patients with ebola. Presented by Desiree Chappell and Monty Mythen with their guest Dan Martin, OBE anaesthetist and intensivist at the Royal Free Hospital and Reader at University College London (UCL).

POET 1.09 | How to drive perioperative care. Feb 01, 2019

This piece discusses how the contributors are driving better perioperative care in their clinics; the importance of getting patient records in advance; ERAS for obstetrics; challenging opioid use with the multimodal pain management; shared decision making in pain management; the importance of clear communication pathways and patient literacy.

This podcast features Desiree Chappell interviewing; Dr Ellen Flanagan, anaesthesiologist and medical director at the Duke preoperative assessment testing clinic, Dr Attila Kett, anaesthesiologist and Chairman at St Peter's University Hospital at New Jersey and Lynn Reede, CRNA and chief clinical officer at the (AANA) American Association of Nurse Anaesthetists.

Anesthesiology, New England Journal of Medicine: Triple low alerts | Journal Club Jan 31, 2019

Triple-low Alerts Do Not Reduce Mortality: A Real-time Randomized Trial.

Sessler DI, Turan A, Stapelfeldt WH, Mascha EJ, Yang D, Farag E, Cywinski J, Vlah C, Kopyeva T, Keebler AL, Perilla M, Ramachandran M, Drahuschak S, Kaple K, Kurz A. Anesthesiology. 2019 Jan;130(1):72-82. doi: 10.1097/ALN.0000000000002480.

https://www.ncbi.nlm.nih.gov/pubmed/30312182

Why Money Alone Can't (Always) "Nudge" Physicians: The Role of Behavioral Economics in the Design of Physician Incentives.

Lubarsky DA, French MT, Gitlow HS, Rosen LF, Ullmann SG. Anesthesiology. 2019 Jan;130(1):154-170. doi: 10.1097/ALN.0000000000002373. https://www.ncbi.nlm.nih.gov/pubmed/30074931

Beyond Nudges - When Improving Health Calls for Greater Assertiveness.

Ubel PA, Rosenthal MB. N Engl J Med. 2019 Jan 24;380(4):309-311. doi: 10.1056/NEJMp1806371.

https://www.ncbi.nlm.nih.gov/pubmed/30673544

EBPOM Highlight 1.08 | Post-operative critical care: what should we do? Jan 30, 2019

"Post-operative critical care: what should we do?" - 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 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.

Urine output | Perioperative Coach Jan 28, 2019

Should we still measure urine output? How useful is permissive oliguria?

Presented by Professor Monty Mythen and Dr Joff Lacey featuring guests Dr Tim Miller from Duke University Medical Centre and John A. Kellum, Tenured Professor, Critical Care Medicine from The University of Pittsburgh.

Medical Linguistic Anthropology and Patient Autonomy | Sunday Special Jan 27, 2019

How do the insights of a 'medical linguistic anthropologist' impact upon our understanding of 'shared decision making'? How do patients make decisions about surgery? When, in the perioperative process, do they decide what is best for them?

Does patient autonomy actually even exist?

A bubble bursting conversation with a frequent favourite on TopMedTalk, this podcast is bound to get you thinking!

Presented by Desiree Chappell and Monty Mythen with their guest Dr Lee Fleisher Professor and Chair of Anesthesiology and Critical Care, University of Pennsylvania.

Joe Kiani | TopMedTalks to... Jan 26, 2019

The concern for patient safety naturally flows throughout the healthcare continuum. In our discussion with Masimo Founder, Joe Kiani, we discuss the 'planning for zero’ initiative and how we can realistically reach perfection in this area. The Patient Safety Movement Foundation is an organization dedicated to a goal of ZERO in-hospital preventable deaths by 2020. They request that you and your organization get involved and commit to this goal. Find out more at www.patientsafetymovement.org Presented by Desiree Chappell and Monty Mythen with their guest Joe Kiani, Founder, Chairman & CEO of Masimo, Cercacor & Patient Safety Movement Foundation.

POET 1.08 | If patients come to us anaemic - they just do worse Jan 25, 2019

How important is it to screen patients for anaemia before surgery? Has anaemia fallen off the health care agenda? We begin with a conversation about patients who are anaemic and then turn to why this is sometimes not checked enough. Monty Mythen mentions UK University students appear to suffer from the condition more these days and Lori Heller points out that treating the condition, as part of patient optimisation, is something of a revelation for some, even occasionally removing the need for surgery altogether. Discussion continues regarding haemoglobin levels and the differentiation between men and women. The importance of discovering the condition early on in the pre-habilitation process is also emphasised. Towards the end of the piece Monty makes some time to speak about the "Iron Woman - Iron Therapy for Female athletes" study instigated by Professor Toby Richards. This piece features Professors Monty Mythen and Mike Grocott with guests Lori Heller, Cardiac Anaestheisologist from US Anaesthesia Partners at the Swedish Medical Center in Seattle, and Mike Scott, Professor in the department of Anesthesiology Virginia Commonwealth University Health System in Richmond USA.

Anesthesiology: the Cognitive Effects of Perioperative Pregabalin | Journal Club Jan 24, 2019

Journal Club Express this week focuses upon a piece in Anesthesiology; Cognitive Effects of Perioperative Pregabalin: Secondary Exploratory Analysis of a Randomized Placebo-controlled Study.

Link here: http://anesthesiology.pubs.asahq.org/article.aspx?articleid=2708941

EBPOM Highlight 1.07 | Shared decision making in perioperative care Jan 23, 2019

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 Angela Coulter, a UK based health policy analyst and researcher.

Can Enhanced Recovery work for the critical care patient? | The RoundTable Jan 22, 2019

How do the insights from experience in Enhanced Recovery apply to critical care patients and care postoperative care pathways? We also discuss utilization of advanced monitoring technology for the critically ill patient postoperatively. Presented by Desiree Chappell with her guests Philip Corvo, Chairman of Surgery Stanley J Dudrick Dept of Surgery at Saint Mary's Hospital and Vicki Morton, DNP and Director of Clinical and Quality Outcomes at Providence Anesthesiology Associates University of South Carolina.

Pain Relief in Enhanced Surgical Recovery | Perioperative Coach Jan 21, 2019

This episode of The Perioperative Coach reflects on the pain management discussions being had by the American Society of Enhanced Recovery (ASER) and its members.

For further reading see the articles in Perioperative Medicine Journal:

https://perioperativemedicinejournal.biomedcentral.com/articles/10.1186/s13741-017-0064-5

This conversation taken from a longer piece to be found here: http://www.topmedtalk.com/aser-ebpom-2017-recap-pod-three-live-from-london/

Presented by Monty Mythen with Dr Joff Lacey and Professor Mike Grocott.

Joff Lacey visits the Ether Dome | Sunday Special Jan 20, 2019

Joff and his guests visit the hallowed turf that is the Boston Ether Dome, in the Bulfinch Building, Massachusetts General Hospital. How have times moved on since those early pioneering days when the relatively young profession of Anaesthesia was born? Back then the word wasn't as widely used and the gentlemen in question described their activities as "rendering people insensible using sulphuric ether for the conduct of surgery".

Recorded last year this piece has Dr Joff Lacey paying tribute to the birthplace of Anaesthesia. Joined by Dr Liam Brennan, President of The Royal College of Anaesthetists (RCoA) and Dr Andy Bailey, Addenbrooke's Hospital, Cambridge.

Andrew R Spector | TopMedTalks to... Jan 19, 2019

This podcast concerns sleep apnea as part of pre-operative patient optimisation. How important is it to evaluate patients for sleep disorders before surgery? Are patients with sleep apnea aware of their condition and are they using some form of treatment? What are the health problems associated with sleep disorders? How do you build a financial case for including this in your practice?

A piece originally streamed live from Atlanta Georgia during TopMedTalk's coverage of "EBPOM-USA Masters Course, A Perioperative Care Practicum".

Featuring hosts Desiree Chappell and Vicki Morton interviewing Dr Andrew R. Spector, Neurologist, Sleep Medicine Specialist at Duke Health.

Join us on www.topmedtalk.com sign up for our email updates and never miss a live streamed conference again.

POET 1.07 | Has enhanced recovery changed your practice? Jan 18, 2019

This piece discusses the changes enhanched recovery brings, the conversation then moves to narcotics and the opioid epidemic.

Presented by Desiree Chappell, Dr Vijaya Gottumukkala, cardiac anaesthesiologist from MD Anderson and member of the board of directors for the American Society of Enhanced Recovery (ASER) and Dr George Nassif, colorectal surgeon at the Center for Colon & Rectal Surgery in Florida.

Clinical Anesthesia: effects of anti-inflammatory therapies on postoperative fatigue after major noncardiac surgery | Journal Club Jan 17, 2019

J Clin Anesth. 2018 Dec 29;55:83-91.

doi: 10.1016/j.jclinane.2018.12.038.

[Epub ahead of print]

The effects of dexamethasone, light anesthesia, and tight glucose control on postoperative fatigue and quality of life after major noncardiac surgery: A randomized trial.

Abdelmalak BB, You J, Kurz A, Kot M, Bralliar T, Remzi FH, Sessler D.

https://www.ncbi.nlm.nih.gov/pubmed/30599425

EBPOM Highlight 1.06 | QA, QI and Patient involvement Jan 16, 2019

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 Sarah Hare, of the National Emergency Laparotomy Audit (NELA).

'Remain fluid and keep educating' | The RoundTable Jan 15, 2019

A discussion about the changes enhanched recovery has brought into practices, the conversation then moves to narcotics and the opiode epidemic. Desiree Chappell speaks with Dr Vijaya Gottumukkala, Professor of Anesthesia and Deputy Chair at MD Anderson and Dr George Nassif colorectal surgeon from The Florida Hospital.

Perioperative Nephrology Fluids and the Kidney | Perioperative Coach Jan 14, 2019

Professor John Kellum gives a thumbnail sketch summary of the fluid debate. Presented by Professor Monty Mythen and Dr Joff Lacey with guest John A. Kellum, Tenured Professor, Critical Care Medicine from The University of Pittsburgh. Join in the debate: contact@topmedtalk.com This conversation taken from a longer piece here: http://www.topmedtalk.com/ebpom-2017-pod-one-live-from-london/

Being on the right side of the law | Sunday Special Jan 13, 2019

A discussion about consent, staying on the right side of the law, shared decision making and a 'The Montgomery case' which has defined a Doctor's duty in these sorts of areas.

Presented by Monty Mythen with Desiree Chappell and their guests Hugh Montgomery, and Paul Sankey, Enable Law partner and Clinical Negligence solicitor acting for patients, an accredited expert in his field.

Padma Gulur | TopMedTalks to... Jan 12, 2019

This podcast includes discussion about psychological optimisation for surgery; who should have it, what does it mean and how does it work? Further conversation moves into weaning patients off opioids in advance of surgery and cutting their dependency afterwards. Also, the question of consent to opioids during and after surgery comes up - should we be educating patients more and is it time to look more deeply at the issue of consent? Hosted by Desiree Chappell and Vicki Morton featuring Dr. Padma Gulur, anesthesiologist and a Pain Medicine Specialist who sees patients at Davis Ambulatory Surgical Center, Duke Pain Medicine and Duke Perioperative Pain Care. Join us on www.topmedtalk.com sign up for our email updates and never miss a live streamed conference again.

POET 1.06 | Training of Perioperative providers improves care and creates team players Jan 11, 2019

Discussion begins with an explanation of 'Trainees with an Interest in Perioperative Medicine' (TRIPOM), a big hit at the conference this year, then a wider discussion follows which includes thoughts regarding further research and application of the perioperative method as well as where it impacts medicine and care. The importance of a multidisciplinary team based approach is strongly emphasised. The Getting It Right First Time (GIRFT) initiative is also discussed, more on that here: http://topmedtalk.libsyn.com/iseh-highlight-getting-it-right-first-time-girft Further discussion of TRIPOM is here: https://www.topmedtalk.com/ebpom-2018-10-what-is-tripom/ Presented by Desiree Chappell with her guests; Dr Ramani Moonesinghe, Professor of Perioperative Medicine at University College London (UCL) and Anne-Marie Bougeard perioperative medicine fellow at the Royal College of Anaesthetists (RCoA).

British Journal of Anaesthesia: the use of oxygen | Journal Club Jan 10, 2019

Two articles, which both feature in The British Journal of Anaesthesia (BJA), are dissected in this week's Journal Club. They both discuss oxygen, the two articles are linked to here:

Effectiveness of 80% vs 30–35% fraction of inspired oxygen in patients undergoing surgery: an updated systematic review and meta-analysis:

https://bjanaesthesia.org/article/S0007-0912(18)31346-1/fulltext

Safety of 80% vs 30–35% fraction of inspired oxygen in patients undergoing surgery: a systematic review and meta-analysis:

https://bjanaesthesia.org/article/S0007-0912(18)31351-5/fulltext

Presented by Monty Mythen with Tim Miller, President elect of the American Society of Enhanced Recovery (ASER) and Anaesthsiologist from Duke University Medical Centre and Mike Grocott, Professor of Anaesthesia and critical care at the University of Southampton.

If you would like to contribute to Journal Club please email us on contact@topmedtalk.com

EBPOM Highlight 1.05 | Perioperative Quality Improvement Programme (PQIP) Jan 09, 2019

Originally streamed live from The Institute of Engineering and Technology (IET) in London during EBPOM 2018 on www.topmedtalk.com

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 Dr Ramani Moonesinghe, Professor of Perioperative Medicine at University College London (UCL)

'If compliance goes down - you know you have a problem' | The RoundTable Jan 08, 2019

An entertaining and informative discussion about the implementation process; how do you bring everyone to the table?

Desiree Chappell speaks with Robin Anderson, Enhanced Recovery (ERAS) program coordinator at Duke University, Bethany Sarosiek, Enhanced Recovery After Surgery (ERAS) Development Coordinator at UVA Health System, and Vicki Morton, Director of Clinical and Quality Outcomes at Providence Anesthesiology Associates. All of them are ASER nursing committee members.

Fluid Management | Perioperative Coach Jan 07, 2019

A discussion about fluid management in an enhanced surgical recovery pathway in relation to the guidelines from ASER and the work of The Perioperative Quality Initiative (POQI http://www.poqi.org). Presented by Monty Mythen with his guest Dr Tim Miller, anaesthesiologist at Duke Medical Centre and Vice President of ASER. For more come to our meetings: http://www.ebpom.org/EBPOM-USA This highlight clip is taken from a longer conversation to be found here: http://www.topmedtalk.com/aser-ebpom-2017-pod-two-live-from-washington-dc/

Looking ahead to 2019 | Sunday Special Jan 06, 2019

2019 brings lots of new opportunities for your favourite medical podcast, including the chance to see us at a live event. Maybe you'll join us in real life, or maybe you'll join us online.

This conversation looks forward to 2019, inviting you to become a bigger part of TopMedTalk. We're also extending an invitation to listeners to join us in an episode of TopMedTalk soon, listen to the podcast for more details and email us if you'd be interested in doing a piece with us in your area of specialty: contact@topmedtalk.com

Also in this piece another chance to listen to one of our picks of 2018, from October, Henrik Kehlet, "the Father of Enhanced Recovery": https://www.topmedtalk.com/asa-2018-san-francisco-henrik-kehlet-recovery-is-all-about-inflammation/

Paul Wischmeyer | TopMedTalks to... Jan 05, 2019

Treating patients as people rather than 'jobs to be done' and 'boxes to be ticked' is the focus of this piece. What can Doctors do better when it comes to treating patients? Find out what happened when a perioperative care doctor became a patient.

A fascinating conversation streamed live from Atlanta Georgia during the second day of TopMedTalk's coverage of "EBPOM-USA Masters Course, A Perioperative Care Practicum".

Hosted by Desiree Chappell and Monty Mythen. Featuring Dr Paul Wischmeyer, Professor of Anaesthesiology and Surgery at Duke Anesthesiology and TopMedTalk's Henry Howe, a medical student at Bristol University.

Join us on www.topmedtalk.com and sign up for our email updates and never miss a live streamed conference again.

POET 1.05 | Refusing surgery Jan 04, 2019

Should we refuse surgery to those who won't change? What about pathological issues, such as smoking, should practitioners become more didactic in their approach? How do we effectively communicate risk, both to the patient and the institution you work for?

Professor Monty Mythen presents with Dr Joff Lacey and guests, Professor Sol Aronson, a tenured professor at Duke University and Executive Vice Chairman in the Department of Anesthesiology, and Dr Mike Irwin, Professor and Head, Department of Anaesthesiology, University of Hong Kon.

Join in the debate: contact@topmedtalk.com

Taken from a longer conversation to be found here: http://www.topmedtalk.com/ebpom-2017-pod-two-live-from-london/

Anaesthesia and Analgesia: Subanalysis of the ENIGMA-II Trial | Journal Club Jan 03, 2019

This week's Journal Club takes a piece from Anaesthesia and Analgesia; "Implication of Major Adverse Postoperative Events and Myocardial Injury on Disability and Survival: A Planned Subanalysis of the ENIGMA-II Trial". A link to the article is here: https://www.ncbi.nlm.nih.gov/pubmed/29533264

Presented by Monty Mythen and Desiree Chappell.

EBPOM Highlight 1.04 | Cardiac anaesthesia and anaemia Jan 02, 2019

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 want 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 Andrew Klein, Cardiothoracic Anaesthetist at Royal Papworth Hospital, Cambridge and Editor-in-Chief of Anaesthesia.

How do you bring perioperative care to your practice? | The RoundTable Jan 01, 2019

What is after ERAS, do we have an 'ERAS of ERAS' - so to speak? This conversation focuses upon bringing about change, managing and sustaining it over time and helping relate it to patient outcomes. Desiree Chappell interviews her guest Arman Dagal, Medical Director - Spine COAP at Foundation for Health Care Quality.

‘Money’s tight’; pull together an ER team with limited resources. The key- NURSES! | Perioperative Coach Dec 31, 2018

Implementing better practice and "ERAS 2.0". The ground up approach of a 'council of nurses' sparks some fascinating debate and discussion. Can a roundtable approach sometimes work better than the traditional hierarchical power structure?

Presented by Desiree Chappell with her guests Dr Ruchir Gupta, medical lead for enhanced recovery at Stony Brook University and Joni Brady, Perianesthesia, Pain Management Nursing Consultant Alexandria, Virginia.

Social Media | Sunday Special Dec 30, 2018

This piece is a chance to reflect upon the importance of new media within the sphere of medical education. As the run away success of TopMedTalk and other podcasts in this area shows people are hungry to use the unique potential of this medium. Also - how has social media, video casting and live streaming altered the way conferences are both organised, executed and received?

Finally, our team of experts tackle the eternal question; where to next?

Presented by Joff Lacey with his guests; David Lyness, Doctor in Anaesthetics and Intensive Care Medicine at Belfast Health and Social Care Trust, Segun Olusanyam Specialty Trainee in Intensive Care Medicine, Jamie Strachan, Intensive Care Medicine and Anaesthesia Registrar & Council Member of the Royal College of Anaesthetists and Dr Cian McDermott Consultant in Emergency Medicine at Mater Misericordiae University Hospital.

You can join IFAD for free online: www.fluidacademy.org

Thomas Scheeren | TopMedTalks to... Dec 29, 2018

The Hypotension Prediction Index (HPI), which uses a machine learning algorithm to help predict intraoperative hypotension. Regular listeners to www.topmedtalk.com will be familiar with concerns about perioperative hypotension. For those who have just joined us, or anyone who fancies a quick refresher on this issue, it is covered in detail here: https://www.topmedtalk.com/live-from-boston-asa-2017-the-elephant-in-the-room-intraoperative-hypotension/ Many practitioners believe they can predict hypotension by observing trends in a patient's mean arterial blood pressure but data shows the machine learning artificial intelligence used by HPI delivers significantly better results. This piece was recorded during the first Morpheus Consortium Symposium, for more details on that look here:http://morpheusconsortium.org/ Monty Mythen presents with Dr Tim Miller, anesthsiologist from Duke University Medical Centre and Thomas Scheeren, Chair Cardiovascular Dynamics Section at European Society of Intensive Care Medicine - ESICM.

POET 1.04 | Measuring the risk of surgery Dec 28, 2018

What is a 'micromort'? Even more of a worry, what does ten of them mean? How do we measure and communicate risk to patients? Everyday activities all carry inherent risks, how do we put surgery into a context 'everyday people' can more easily understand?

Professor Monty Mythen presents with guests, Professor Sol Aronson, a tenured professor at Duke University and Executive Vice Chairman in the Department of Anesthesiology, and Dr Mike Irwin, Professor and Head, Department of Anaesthesiology, University of Hong Kong.

Join in the debate: contact@topmedtalk.com

Taken from a longer conversation to be found here: http://www.topmedtalk.com/ebpom-2017-pod-two-live-from-london/

Perioperative Medicine: Albumin and AKl | Journal Club Dec 27, 2018

The piece discussed in this week's Journal Club is called "Acute kidney injury in postoperative shock: is hyperoncotic albumin administration an unrecognized resuscitation risk factor?".

The link is here:

https://perioperativemedicinejournal.biomedcentral.com/track/pdf/10.1186/s13741-018-0110-y

Additional links here:

"Association between albumin administration and survival in cardiac surgery: a retrospective cohort study":

https://www.ncbi.nlm.nih.gov/pubmed/30006911

"Association between Initial Fluid Choice and Subsequent In-hospital Mortality during the Resuscitation of Adults with Septic Shock":

http://anesthesiology.pubs.asahq.org/article.aspx?articleid=2449359

Presented by Monty Mythen with Mike Grocott, Editor in Chief of the Perioperative Medicine Journal, and Professor of Anaesthesia and Critical Care Medicine, University of Southampton.

TopMedTalk Xmas Special Part 3 | Xmas Special 2018 Dec 26, 2018

A three part series covering the year in TopMedTalk.

Here are some links to the pieces discussed:

The Randy Moore piece: https://www.topmedtalk.com/aana-2018-is-there-a-global-shortfall-of-anesthesia-providers/

Here's the piece Monty mentions which celebrated the 60th anniversary of Edwards Life Sciences: https://www.topmedtalk.com/the-hypotension-prediction-index-hpi/

Here's are the pieces with Matthew McEvoy, the second is the Q&A section: https://www.topmedtalk.com/ebpom-usa-chicago-2018-the-opioid-crisis-can-we-kick-the-habit/

https://www.topmedtalk.com/ebpom-usa-chicago-2018-the-opioid-crisis-can-we-kick-the-habit-qa/

The Dingle Conference piece is here, look out for more of these in 2019! https://www.topmedtalk.com/dingle-2018-heart-disease-in-pregnancy/

Myron Yaster's piece is here: https://www.topmedtalk.com/asa-2018-san-francisco-paediatrics-and-opioids-part-2/

The Smith's Medical Symposium piece is here: https://www.topmedtalk.com/asa-2018-san-francisco-smiths-medical-symposium-on-enhanced-recovery-part-1/

The social media piece we mention is here: https://www.topmedtalk.com/topmedtalk-at-ifad-the-growing-popularity-of-new-media-in-medical-education/

Alfie The Therapy Dog is here: https://www.topmedtalk.com/intensive-care-society-alfie-the-therapy-dog/

Happy New Year to all our TopMedTalk listeners and contributors!

Presented by Monty Mythen, Desiree Chappell and Nick Margerrison.

TopMedTalk Xmas Special Part 2 | Xmas Special 2018 Dec 25, 2018

A three part series covering the year in TopMedTalk.

Here are some links to the pieces discussed:

Paul Myles and the RELIEF trial results: https://www.topmedtalk.com/the-relief-trial-results/

And here is the "deep dive" we mention: https://www.topmedtalk.com/the-topmedtalk-top-ten-rcoa-11-the-relief-trial-your-essential-deep-dive-into-the-results-2/

And here are all the RELIEF trial pieces we've done: https://www.topmedtalk.com/?s=RELIEF

Also, make sure you listen to this piece, "RCoA 12 Should direct laryngoscopy be consigned to the history books?": https://www.topmedtalk.com/rcoa-12-should-direct-laryngoscopes-be-consigned-to-the-history-books/

The Stuart Grant piece discussed in this podcast is here: https://www.topmedtalk.com/controversies-in-perioperative-medicine/

The Bruce Keogh speech is here, everyone on the TopMedTalk team cites this as a particularly revealing talk, treat yourself and have a listen: https://www.topmedtalk.com/ebpom-2018-3-sir-bruce-keogh-the-nhs-at-70/

Presented by Monty Mythen, Desiree Chappell and Nick Margerrison.

TopMedTalk Xmas Special Part 1 | Xmas Special 2018 Dec 24, 2018

A three part series covering the year in TopMedTalk.

Here are some links to the pieces discussed:

The conversation with Zeev Kain is here: https://www.topmedtalk.com/zeev-kain-organiser-of-the-american-college-of-perioperative-medicine-interdisciplinary-conference-on-orthopaedic-value-based-care/

The Eric J Schneidewind piece is here:

http://topmedtalk.libsyn.com/the-topmedtalk-top-ten-i-want-to-dance-at-my-daughters-wedding

The first ever Roundtable discussion is here: https://www.topmedtalk.com/the-singularity-university-and-exponential-change/

The piece mentioned, which features Dr Patrick Shannahan, is here: https://www.topmedtalk.com/heated-discussions-exponential-rise-in-babies-born-addicted-to-opiodes/

This link takes you to Sol Aronson's talk: https://www.topmedtalk.com/ebpom-usa-part-1-a-perioperative-practicum-with-professor-sol-aronson/

And the final piece we discuss, featuring Paul Wischmeyer is here: https://www.topmedtalk.com/treating-patients-properly-ebpom-usa/

Presented by Monty Mythen, Desiree Chappell and Nick Margerrison.

Mike of the Antarctic | Sunday Special Dec 23, 2018

Fresh from an expedition to Antarctica, on the National Geographic Explorer, Mike Grocott gives us an update on the "Anaesthesia at the Extreme" conference.

Regular listeners will remember his excellent talk about Xtreme Everest, which you can find here: https://www.topmedtalk.com/10-xtreme-everest-physiology-on-top-of-the-world/

Presented by Desiree Chappell and Monty Mythen with their guest Mike Grocott, Professor of Anaesthesia and Critical Care Medicine, University of Southampton and Dr Jim Down, University College London Hospital.

Carol Peden | TopMedTalks to... Dec 22, 2018

Lessons learned from the Enhanced Peri-Operative Care for High-risk patients (EPOCH) trial. This conversation focuses upon the challenges of quality improvement programmes; how do we keep track of patients and improve follow up questions after surgery? How do we clearly show Quality Improvement Programmes work for the patient? Further discussion encompasses innovation and utilization in practice.

Presented by Monty Mythen and Desiree Chappell with their guest Carol Peden, Professor of Anesthesiology and Exec. Director of the Center for Health System Innovation, University of Southern California, University of Bath and the Institute for Healthcare Improvement (IHI).

For more on EPOCH look here: https://www.topmedtalk.com/?s=EPOCH

POET 1.03 | Communication uniquely suited to the perioperative domain Dec 21, 2018

Fitness for surgery and an understanding of the realities of risk. How important is it for surgery to take place when balanced against the specific health needs of the patient? How do we encourage patients to alter pathological aspects of their lives in order to minimise the chances of a negative outcome?

Professor Monty Mythen presents with Dr Joff Lacey and guests, Professor Sol Aronson, a tenured professor at Duke University and Executive Vice Chairman in the Department of Anesthesiology, and Dr Mike Irwin, Professor and Head, Department of Anaesthesiology, University of Hong Kong.

Sponsored by EBPOM and Edwards Life Sciences this piece was recorded on day two of EBPOM 2017.

Join in the debate: contact@topmedtalk.com

Taken from a longer conversation to be found here: http://www.topmedtalk.com/ebpom-2017-pod-two-live-from-london/

The METS Trial | Journal Club Dec 20, 2018

Here we have a very special edition of Journal Club, in two distinct parts; the The Measurement of Exercise Tolerance before Surgery (METS) trial is discussed here both before and after the results were released into the public domain.

The Measurement of Exercise Tolerance before Surgery (METS) trial has both raised, and answered, complicated questions. How will it change practice? Will it alter the use of the Duke Activity Status Index (DASI) for example? Cardiopulmonary Exercise Testing (CPET) clearly predicts major complications and is more predictive than the comparators. Why is this not clear in the abstract? Why is there an obsession with major cardiac events when they are rare?

The links mentioned in the piece are here:

https://bmjopen.bmj.com/content/6/3/e010359

https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(18)31131-0/fulltext

Presented by Monty Mythen and Desiree Chappell with their guest Professor Mike Grocott of Southampton University and a lead investigator in the METS trial and an author of the paper.

EBPOM Highlight 1.03 | Sprint National Anaesthesia Project, SNAP Dec 19, 2018

"Sprint National Anaesthesia Project, SNAP" was 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 Ramani Moonesinghe, Director of the UK National Institute of Academic Anaesthesia Health Services Research Centre.

Don't ask 'what is the matter' ask what matters? | The RoundTable Dec 18, 2018

Desiree Chappell of The Roundtable blog, with Monty Mythen of TopMedTalk discuss outcomes and patient care, what matters the most?

They are joined by two of the guest speakers from the American College of Perioperative Medicine's 2018 conference; Eric J Schneidewind president of the AARP and Kevin Bozic, Chair of Surgery & Perioperative Care at the Dell Medical School.

Fluid management - the less explored controversies | Perioperative Coach Dec 17, 2018

A conversation about ASER fluid management; NPO; preop drinks and keeping the i.v down.

Monty Mythen is presenting with his guest Dr Scott Brudney, Professor, Departments of Anaesthesiology and Internal Medicine, University of Manitoba, Winnipeg, Canada.

Click here for the American Society for Enhanced Recovery (ASER) and Perioperative Quality Initiative (POQI) joint consensus statement on perioperative fluid management withinan enhanced recovery pathway for colorectal surgery: https://perioperativemedicinejournal.biomedcentral.com/articles/10.1186/s13741-016-0049-9

This conversation is taken from a longer piece to be found here: http://www.topmedtalk.com/aser-ebpom-2017-recap-pod-three-live-from-london/

The Bigger Picture of Perioperative Medicine | Sunday Special Dec 16, 2018

A transatlantic perspective.

This conversation explores the extended role of the anaesthetist, brought about partly by perioperative care but more widely because of societal changes. Practitioners face a dilemma; how do you best impact value based care, as a specialist, when multidisciplinary approaches are becoming essential?

In the UK, The Royal College of Anaesthetists, are working on this very issue; find out how they are becoming part of conversations regarding public health and modifiable risk factors, as relate to a patient's lifestyle choices and pathology.

The transatlantic perspective is essential here, how do organisations like EBPOM USA advocate these ideas within an American funding model?

No matter which side of the Atlantic you live on there's a very real debate to be had about training students; the job of the anaesthetist has fundamentally altered in recent times. Furthermore, how do those already practising update their skills and stay with the times?

Monty Mythen and Joff Lacey presenting with their guests Liam Brennan, President of the Royal College of Anaesthetists, and Sol Aronson, a tenured professor at Duke University and Executive Vice Chairman in the Department of Anesthesiology.

Dan Sessler | TopMedTalks to... Dec 15, 2018

The Elephant In The Room - intraoperative hypotension. A discussion regarding the exciting results from the first multicentre, randomised controlled trial into targeted intraoperative blood pressure management. This conversation reflects the start of many debates and concern regarding hypotension, a frequent topic here on TopMedTalk. Monty Mythen and Mike Grocott are with Tim Miller, Duke University Medical Centre, speaking with their guest Dr Dan Sessler, Cleveland Clinic.

POET 1.02 | Shared decision making for high risk surgery Dec 14, 2018

POET - The Perioperative Enhancement Team

How can cardiopulmonary exercise testing lead to shared decision making? Hear how aortic aneurysms are dealt with by a world class professional perioperative physician. Learn how that process and its success then spread out into other areas of healthcare within his institution. Do you need to develop a broad knowledge of all surgery and medicine so that you understand what is going on within the different surgical specialities

Presented by Monty Mythen, Joff Lacey and Desiree Chappell with their guest Dr Michael Swart, Consultant in Anaesthesia and Critical Care Medicine at Torbay Hospital and advisor to the UK Department of Health for the Enhanced Recovery Programme.

Critical Care Practitioner Podcast | Intensive Care Society Dec 13, 2018

TopMedTalk catches up with another online media source, The Critical Care Practitioner podcast, organised by our guest who - appropriately enough - is a critical care practitioner. What's it like being a critical care practitioner in the UK at the moment? Originally a lot of nurses moved into the sphere but now paramedics, physiotherapists and many others progress into it. Furthermore what's it like taking your professional passion into the world of podcasting? You can hear the Critical Care Practitioner podcast here. Presented by Desiree Chappell with her guest Jonathan Downham, Critical Care Practitioner and podcaster.

The RELIEF Trial; a 'deep dive' into the results | Journal Club Dec 13, 2018

The RELIEF (Restrictive versus liberal fluid therapy in major abdominal surgery) trial has been a huge story for us here at TopMedTalk, recorded on the second day of The Royal Collage of Anaesthetists' annual conference at the British Museum this is the moment the team get to pick over the results in detail. One of the biggest trials ever, it has both raised questions and provided answers. Inevitably there has been a huge debate, this piece puts all the major questions and concerns to the organiser of the trial. Send us your thoughts on The RELIEF trial: contact@topmedtalk.com

Presented by the TopMedTalk team; Professor Monty Mythen, Dr Joff Lacey, Desiree Chappell and Professor Mike Grocott, with their guest Paul Myles, Head of Alfred Health's and Monash University's Department of Anaesthesia and Perioperative Medicine and organiser of the RELIEF trial.

Nasogastric feeding | Intensive Care Society Dec 13, 2018

How is it the case that some people can lose significant muscle mass while they are being cared for on the Intensive Care Unit (ICU)? What can practitioners do to help avoid this? How do we integrate a dynamic stimulus and react to new research relating to nasogastric feeding? In this piece you will hear about a randomised controlled pilot study investigating the effect of intermittent versus continuous nasogastric feeding on muscle mass and function in intensive care unit survivors. Hugh Montgomery presents with his guest, Dr Angela McNelly, clinical researcher at the ISEH and the UCL Centre for Human Health and Performance.

Point of care ultrasound | Intensive Care Society Dec 13, 2018

How essential is training in focused transthoracic echo for adult intensive care? Ultrasound technology has evolved in recent years, some people say handheld devices look set to become as ubiquitous as a doctor's stethoscope. Could the nurse at the bedside get more involved in the process or is it 'protected turf'?

Also, can this technology help patients to become more involved in their treatment and its monitoring?

Presented by Monty Mythen and Desiree Chappell with their guest Marcus Peck, NHS consultant and Chair of Focused Intensive Care Echo (FICE).

Nutrition | Intensive Care Society Dec 13, 2018

This piece starts with a discussion about indirect calorimetry and the challenges associated with it as well as recent improvements in the field. The penn state equation is discussed. Muscle wastage and the need for resistence training, as well as protein feeding is covered. More widely; what does good ICU feeding look like? How can friends and relatives of patients be sure that a loved one is getting good nutritional care? Desiree Chappell and Monty Mythen presenting with their guest Danielle Bear, ICU dietician at Guy's and St Thomas' NHS Foundation Trust.

Mike of the antarctic | Intensive Care Society Dec 13, 2018

Fresh from an expedition to Antarctica, on the National Geographic Explorer, Mike Grocott gives us an update on the "Anaesthesia at the Extreme" conference.

Regular listeners will remember his excellent talk about Xtreme Everest, which you can find here: https://www.topmedtalk.com/10-xtreme-everest-physiology-on-top-of-the-world/

Presented by Desiree Chappell and Monty Mythen with their guest Mike Grocott, Professor of Anaesthesia and Critical Care Medicine, University of Southampton and Dr Jim Down, University College London Hospital.

Alfie the therapy dog | Intensive Care Society Dec 12, 2018

The Pets as Therapy team have been a huge hit at the Intensive Care Society annual conference. How would you incorporate something like this into your practice? There are currently over 6,000 dogs and cats working in healthcare in the UK.

Presented by Desiree Chappell with Monty Mythen and their guests Alfie the therapy dog, Suzy Emsden, volunteer for Pets as Therapy and a pediatric intensivist from the North West, and Matthew Robinson, national project co-ordinator for Pets as Therapy.

Hydration | Intensive Care Society Dec 12, 2018

How do we maintain hydration in a way which is both safe and comfortable for the patients we treat? What about the post-surgical patient who is full of salt and water but tells us they are thirsty? How can we allow patients to hydrate themselves?

Presented by Desiree Chappell with Monty Mythen and their guests Professor Hugh Montgomery, Intensive Care Society Board Member and Professor of Cardiovascular Genetics and Critical Care University College London and Fintan Hughes, Academic Intern at St. James's Hospital Dublin.

Antibiotics, fluid balance and haemodynamic monitoring | Intensive Care Society Dec 12, 2018

Recorded live at the Intensive Care Society This piece is a fascinating discussion regarding the use of antibiotics and fluid balance. The conversation then moves into haemodynamic monitoring and the differences between protocols guidelines and algorythms.

Presented by Monty Mythen and Desiree Chappell with their guests Professor Mervyn Singer, Intensive Care Medicine at University College London and Fintan Hughes, Academic Intern at St. James's Hospital Dublin.

EBPOM Highlight 1.02 | Post-op critical care: what should we do? Dec 12, 2018

"Post-operative critical care: what should we do?" was 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

Presented by Denny Levett, Professor in Perioperative Medicine and Critical Care at the University of Southampton.

Being on the right side of the law | Intensive Care Society Dec 11, 2018

A discussion about consent, staying on the right side of the law, shared decision making and 'The Montgomery case' which has defined a Doctor's duty in these sorts of areas.

Presented by Monty Mythen with Desiree Chappell and their guests Hugh Montgomery, and Paul Sankey, Enable Law partner and Clinical Negligence solicitor acting for patients, an accredited expert in his field.

Pets as Therapy | Intensive Care Society Dec 11, 2018

Pets as Therapy are a fantastic charity who have provided a practical theraputic service to everyone in attendance at the Intensive Care Society annual conference. The TopMedTalk team were determined to catch up with them and have a discussion about how animals can help us all take the woof with the smooth.

Presented by Desiree Chappell with her four special guests, Hillary Burbage, with Matlock and Pamela Pearl, with Frankie.

Exercise is real medicine? | The RoundTable Dec 11, 2018

This piece covers; physical medicine and rehabilitation, applying a team approach in care and 'pre and post-habilitation'.

Desiree Chappell presents with Monty Mythen and their guests; Dr Steve Flanagan, Chair of Physical Medicine and Rehabilitation at NYU Langone Brian Stewart, Partner/Clinic Director California Rehabilitation and Sports Therapy and Colleen Walsh, Assistant Professor, Nursing University of Southern Indiana, President, National Association of Orthopaedic Nurses.

Hugh Montgomery | Intensive Care Society Dec 10, 2018

The first day of the Intensive Care Society's annual conference comes to a close. Heart failure session has ‘standing room only’. Is the pulmonary artery catheter back? What have been some of the big take aways in nutrition? Why should you feed a cold and starve a fever? More Protein or less? Finally, ‘humanizing intensive care’. Do we need more ITU pets? Dogs in particular.

Desiree Chappell and Monty Mythen confer on the events of the day with their guest Hugh Montgomery, Intensive Care Society Board Member and, Professor of Cardiovascular Genetics and Critical Care University College London.

Dan Martin, OBE | Intensive Care Society Dec 10, 2018

Desiree and Monty catch up with Dan Martin, OBE, and speak with him about the Intensive Care Society's annual conference, treating infectious diseases and in particular patients with ebola.

Desiree Chappell and Monty Mythen presenting Dan Martin, OBE anaesthetist and intensivist at the Royal Free Hospital and Reader at University College London (UCL).

State of the art 2018 | Intensive Care Society Dec 10, 2018

Live from The Intensive Care Society, reflections on the opening session of the UK's annual critical care conference. Presented by Desiree Chappell and Monty Mythen.

Find out more www.topmedtalk.com

Join the debate contact@topmedtalk.com

Getting on the same page | Perioperative Coach Dec 10, 2018

A conversation about enhanced recovery implementation.

Dr Joff Lacey catches up with Mike Scott, Virginia Commonwealth University and Ross Kerridge, John Hunter Hospital, Newcastle, Australia.

Is the US spending too much on health care and not enough on health? | Sunday Special Dec 09, 2018

This piece was originally streamed live on www.topmedtalk.com and is taken from the hugely successful "EBPOM-USA: Masters Course, A Perioperative Care Practicum".

Hear the full presentation from Dr Lee A. Fleisher Professor and Chair of Anesthesiology and Critical Care, University of Pennsylvania.

If you like the sound of this and think you and your practice would benefit from attending such a course don't worry, just go to The EBPOM website: https://www.ebpom.org

Zeev Kain | TopMedTalks to ... Dec 08, 2018

"Value based care - it’s an interdisciplinary team sport"

Desiree Chappell speaks with Zeev Kain, organiser of the American college of perioperative medicine interdisciplinary conference on orthopaedic value based care.

Find his podcast here: http://drzeevkain.health/podcast/

If you'd like to find out more about the conference follow this link: https://acpm.health/ovbc2019/

POET 1.01 | Perioperative Enhancement Teams Dec 07, 2018

Why do you need a "poet"?

The POET acronym - a truly multidisciplinary Perioperative Enhancement Team; responsible for project managing optimisation programmes.

Monty Mythen speaks with Professor Sol Aronson, a tenured professor at Duke University and Executive Vice Chairman in the Department of Anesthesiology.

This piece is taken from a longer conversation to be found here: http://www.topmedtalk.com/aser-ebpom-2017-recap-pod-three-live-from-london/

Join the debate: contact@topmedtalk.com

NEJM: Balanced Crystalloids vs Saline | Journal Club Dec 06, 2018

This edition of journal club looks at two articles in the New England Journal of Medicine (NEJM) of circa 30,000 patients studied at Vanderbilt Medical Centre, USA.

One in non-critically ill patients. Click here: http://www.nejm.org/doi/full/10.1056/NEJMoa1711586?query=featured_home

The other in critically ill adult patients: http://www.nejm.org/doi/full/10.1056/NEJMoa1711584?query=featured_home

Accompanied by a very balanced Editorial by Professor John Myburgh. Click here: http://www.nejm.org/doi/full/10.1056/NEJMe1800449?query=recirc_curatedRelated_article

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Featuring Monty Mythen and his guest Andy Shaw, Professor and Chief, Cardiothoracic Anesthesiology at Vanderbilt University Medical Center in Nashville, Tennessee. He is a Fellow of the Royal College of Anaesthetists (UK), a Fellow of the American College of Critical Care Medicine and a Fellow of the Faculty of Intensive Care Medicine (UK).

EBPOM Highlight 1.01 | Exercise and cancer Dec 05, 2018

EBPOM Conference Highlight

This week's conference highlight "Exercise and cancer" was originally streamed live from The Institute of Engineering and Technology (IET) in London during EBPOM 2018 on www.topmedtalk.com

If you'd like to attend an event like this ensure your next click is here: www.ebpom.org/meetings

Presented by Mike Grocott, Professor of Anaesthesia and Critical Care Medicine, University of Southampton.

Insight into ERAS in Saudia Arabia | The RoundTable Dec 04, 2018

This conversation is a fascinating glimpse into the spread of Enhanced Recovery After Surgery (ERAS) in Saudi Arabia.

Desiree Chappell interviews her guests; Fatimah Alsalah, Anesthesiologist at King Fahad Specialist Hospital in Dammam, Deputy head of the transplant anesthesia section, alongside Nicole Greenshields and Douglas Blackwood, Perioperative Medicine Fellows at The University College London (UCL), Department of Anaesthetics.

Nutrition | Perioperative Coach Dec 03, 2018

"An operation is like a marathon, nobody prepares for that by starving themselves"

Monty Mythen talks to Professor Paul Wischmeyer from the Department of Anesthesiology, Duke University, USA about the e.published American Society of Enhanced Recovery (ASER) and Perioperative Quality Initiative (POQI) joint consensus statement on Nutrition and Screening Therapy within an Surgical Enhanced Program.

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Click on this link to access the full paper:

https://journals.lww.com/anesthesia-analgesia/Abstract/publishahead/American_Society_for_Enhanced_Recovery_and.96950.aspx

Furthermore, you can listen to one of Paul's excellent talks here: http://topmedtalk.libsyn.com/website/ebpom-2018-perioperative-nutrition-should-be-a-key-part-of-enhanced-recovery

Breathlessness should be investigated irrespective of age | TopMedTalk Dec 02, 2018

When it comes to breathlessness how do we better diagnose and apply treatment? How do we overcome the fact that referring to a specialist can sometimes take a patient 'down the wrong route' with a condition that might not be just heart or lung related?

Ronan Astin, clinical consultant in respiratory medicine at UCL Hospital, explains his more holistic approach to treatment and diagnosis.

"Nick the patient" asks a few questions and demonstrates the misunderstanding that many sufferers might have; breathlessness is not always connected to your lungs.

"Johnny the patient" then speaks about his Mother, 84, who has recently experienced breathlessness; she didn't want to complain about it, how can we pick these issues up earlier?

Dan Martin, anaesthetist at The Royal Free Hospital, speaks about his processes including the cardiopulmonary exercise testing they use. Testing patients, during a session on an exercise bike, reveals physiological and pathological causes but furthermore it can reveal the psychological issues which may be behind the problem.

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This podcast is presented by Professor Monty Mythen and features contributions from; Ronan Astin, clinical consultant in respiratory medicine at UCL Hospital; Dan Martin, anaesthetist at the Royal Free Hospital and finally 'the patients' Nick Margerrison and Johnny Themans.

Montezuma's revenge Dec 01, 2018

A quick refresher on some of the hot topics from ASER 2017, including the messy issue of bowel prep and the prickly topic of opiates.

A couple of highlights from Professor Monty Mythen and Dr Joff Lacey's live coverage of ASER 2017 for TopMedTalk featuring Dr Julie Thacker, President of American Society of Enhanced Recovery and Desiree Chappell a CRNA in Louisville, Kentucky and board member of EBPOM USA.

What do you value? | TopMedTalk Nov 30, 2018

A round table discussion hosted by Desiree Chappell and featuring Monty Mythen, recorded at the Interdisciplinary Conference on Orthopedic Value-Based Care.

This is the fourth segment of the conversation between Desiree, Monty and their two guests; Shawna Butler (RN, NBA who works with Singularity University in Exponential Medicine) and Jennifer Brandon (PT, MPT, Hoag Orthopedic Institute in Irvine, California).

Here Monty speaks, from a transatlantic perspective, about the need in value based care to know your outcomes.

Fluid Matters - 'Goal Directed Fluid Therapy' | TopMedTalk Nov 29, 2018

This is another excerpt from "Controversies in perioperative medicine"; "The Great Fluid Debate". A fascinating piece containing Dr Tim Miller's enthusiastic advocation of goal directed fluid therapy and then the subsequent debate that follows.

It ends up moving into the subject of 'enhanced recovery after cardiothoracic surgery' and what lessons we can learn from excessive hemofiltration during on bypass surgery.

Chaired by Professor Monty Mythen and featuring a presentation by Dr Tim Miller, anaesthsiologist from Duke University Medical Centre and followed by a debate featuring members of the audience and the panel; Professor Mike Grocott, Professor of Anaesthesia and critical care at the University of Southampton; Professor Paul Wischmeyer from the Department of Anesthesiology, Duke University and Professor Stuart Grant, MB ChB, FRCA Director, Medical Student Education, Duke University School of medicine.

Join in the debate! Email us your thoughts for inclusion in a future podcast: contact@topmedtalk.com

Fluid Matters - The nil by mouth (NPO) debate | TopMedTalk Nov 28, 2018

This piece is taken from "The Great Fluid Debate", it's about changes in practice that have been implemented both in the UK and at various medical centres in the US. Hear how and why the old 'nil by mouth' or ‘NPO’ policy has changed in many instances.

From water to carbohydrate drinks, to black coffee, the thinking has changed in many institutions but part of the battle is in educating patients and their well meaning friends and relatives.

These pieces have been released to coincide with IFAD, the 7th International Fluid Academy Day. Make sure you subscribe to TopMedTalk to ensure you hear some of the pieces we recorded there.

Chaired by Professor Monty Mythen and featuring; Dr Tim Miller, anesthsiologist from Duke University Medical Centre; Professor Mike Grocott, Professor of Anaesthesia and Critical Care at the University of Southampton; Professors Paul Wischmeyer and Stuart Grant, from the Department of Anesthesiology, Duke University and featuring questions from the audience.

Join in the debate: contact@topmedtalk.com

Fluid Matters - 'The Great American Fluid Debate' | TopMedTalks Nov 27, 2018

This is an excerpt from 'The Great American Fluid Debate' which was hosted at Duke University Medical Centre's "Controversies in Perioperative Medicine" conference of this year.

These pieces have been released to coincide with IFAD, the 7th International Fluid Academy Day. Make sure you subscribe to TopMedTalk to ensure you hear some of the pieces we recorded there.

The two pieces Monty mentions in the podcast, featuring Paul Myles, are found here:

"THE RESULTS"

https://www.topmedtalk.com/the-relief-trial-results/

"YOUR ESSENTIAL DEEP DIVE"

https://www.topmedtalk.com/rcoa-11-the-relief-trial-your-essential-deep-dive-into-the-results/

And you can find the other piece here:

"JOURNAL CLUB; BALANCED VERSUS SALINE"

https://www.topmedtalk.com/journal-club-saline-solution/

Presented by Monty Mythen featuring; Mike Grocott, Professor of Anaesthesia and critical care at the University of Southampton; Professor Paul Wischmeyer from the Department of Anesthesiology, Duke University; Professor Stuart Grant, MB ChB, FRCA Director, Medical Student Education, Duke University School of medicine and Tim Miller, anaesthsiologist from Duke University Medical Centre.

Fluid Matters - Fluid Responsiveness and venous capacitance | POQI Nov 26, 2018

This conversation reflects a discussion at the Perioperative Quality Inititative (POQI). It originally ran under the title, "Intervascular volume and fluid responsiveness" but, as this conversation explains, it was renamed "Fluid Responsiveness and venous capacitance".

With a genuinely multidisciplinary approach on display here this piece gives you a glimpse at the inner workings of the POQI process. How does macro circulation interlock with micro circulation and cellular function? How do people on the ground measure stroke volumes? What do you do when passive leg raising is not appropriate? How do we address hypovolemia? How do you define fluid responsiveness at the bedside?

Presented by Desiree Chappell and Mike Grocott with their guests David Kaufman Associate Professor, Director, Medical Intensive Care Unit at NYU School of Medicine, NYU-Langone Medical Center and Dr Greg Martin Director, Research Network, GaCTSA; Director, Predictive Health Institute; Research Director, Emory Critical Care Center.

Unlocking the Secrets of the Mighty Mitochondria | Xtreme Everest Nov 25, 2018

This special four part series explores the fascinating story of Xtreme Everest – the ground-breaking, research programme that has pursued a novel approach to scientific exploration. Over the last decade, this innovative team has performed large scale studies at high altitude to mimic some of the effects of critical illness. The objective is for their findings to be brought “from the mountainside to the bedside” so that the care for our sickest patients may be improved.

In this podcast, Andrew Murray, discusses the findings from his studies on Everest in which he has investigated novel mechanisms that control mitochondrial function under hypoxic conditions. It is hoped that his discoveries will facilitate major breakthroughs in tailoring medical interventions to improve the outcome of critical care patients.

Presented by Joff Lacey with his guest; Andrew Murray a reader in metabolic physiology at the University of Cambridge. Since 2005, Andrew has been a member of the Xtreme Everest research group, studying mitochondrial function in cardiac and skeletal muscle at high altitude.

Fluid Matters - Total body water and electrolytes | POQI Nov 24, 2018

These pieces have been released to coincide with IFAD, the 7th International Fluid Academy Day. Make sure you subscribe to TopMedTalk to ensure you hear some of the pieces we recorded there.

Coming from this summer's Peroperative Quality Initiative (POQI) hosted at Washington Duke University in Durham this podcast is presented by Monty Mythen and Henry Howe with their guests Tom Woodcock, an independent consultant in patient safety, medical law and ethics, and Manu Malbrain, Professor at Faculty of Medicine and Pharmacology Vrije University in Brussells.

The website mentioned in this piece is here: https://www.fluidacademy.org/

The growing popularity of new media in medical education | IFAD Nov 23, 2018

This piece is a chance to reflect upon the importance of new media within the sphere of medical education. As the run away success of TopMedTalk and other podcasts in this area shows people are hungry to use the unique potential of this medium. Also - how has social media, video casting and live streaming altered the way conferences are both organised, executed and received?

Finally, our team of experts tackle the eternal question; where to next?

Presented by Joff Lacey with his guests; David Lyness, Doctor in Anaesthetics and Intensive Care Medicine at Belfast Health and Social Care Trust, Segun Olusanyam Specialty Trainee in Intensive Care Medicine, Jamie Strachan, Intensive Care Medicine and Anaesthesia Registrar & Council Member of the Royal College of Anaesthetists and Dr Cian McDermott Consultant in Emergency Medicine at Mater Misericordiae University Hospital.

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Streamed live from the International Fluid Academy Day (IFAD) in Amsterdam on www.topmedtalk.com

You can also join in with IFAD for free online https://www.fluidacademy.org/

Discussing The Paradigm Shift in Fluid Therapy | IFAD Nov 23, 2018

This podcast is an exclusive discussion regarding the second session at The International Fluid Academy Day (IFAD) in Amsterdam.

This in depth discussion is a reaction to the session at IFAD and contains insights into the following topics; 'Everything you need to know about fluid therapy', results from some of the most recent trials and 'How to set-up a fluid guideline'.

The team also reflect a little more on the first session.

Presented by Joff Lacey with Monty Mythen and Henry Howe.

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Streamed live from the International Fluid Academy Day (IFAD) in Amsterdam on www.topmedtalk.com

You can also join in with IFAD for free online https://www.fluidacademy.org/

TopMedTalk at IFAD | Understanding Fluid Physiology Nov 23, 2018

Download this podcast for an exclusive discussion regarding the first session at The International Fluid Academy Day (IFAD) on Friday morning in Amsterdam.

This in depth discussion is a reaction to the first session at IFAD and contains insights into the following topics; 'Everything you need to know about fluid physiology'; 'From Frank-Starling to Guyton-Hall'; 'Understanding edema formation' and 'Where does the albumin go?'.

Presented by Joff Lacey with Monty Mythen and Henry Howe.

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Streamed live from the International Fluid Academy Day (IFAD) in Amsterdam on www.topmedtalk.com

You can also join in with IFAD for free online https://www.fluidacademy.org/

Fluid Matters - Definite definitions, fluid physiology | POQI Nov 23, 2018

This conversation was recorded on the morning of the second day of the Perioperative Quality Initiative (POQI) meeting hosted at Washington Duke University in Durham.

These pieces have been released to coincide with IFAD, the 7th International Fluid Academy Day. Make sure you subscribe to TopMedTalk to ensure you hear some of the pieces we recorded there.

Presented by Desiree Chappell with Professor Monty Mythen, Henry Howe and their guest Tim Miller, anaesthsiologist from Duke University Medical Centre and organiser of the POQI meeting.

Have you joined the International Fluid Academy yet? Nov 23, 2018

Live from the International Fluid Academy Day (IFAD) in Amsterdam; the team explain how you can join in for free online https://www.fluidacademy.org/ and give us a bit of the history of the conference along with some of the discussion points you can expect to hear.

Presented by Joff Lacey with Henry Howe, Monty Mythen and their guest Manu Malbrain, Professor at the Faculty of Medicine and Pharmacology Vrije University in Brussells and organiser of the conference.

Part 3 of 3 - No elective surgery if hematocrit is less than 36! How can you get started? | EBPOM USA - Atlanta Nov 22, 2018

The full version of this talk "Standing up a Preoperative Anemia Clinic" was given during the EBPOM-USA Masters Course which was live streamed on www.topmedtalk.com from Atlanta.

The rationalization; data, outcomes, economics; The practical realities; screening, workflow and workforce, financials and tracking; all of this is contained within this three part series.

Presented by Dr Lori Heller, Cardiac Anesthesiologist, Swedish Medical Center, through US anaesthesia partners and acting instructor at the University of Washington, Seattle.

Part 2 of 3 - Treating pre-op anemia with i.v. iron is safe and effective | EBPOM USA - Atlanta Nov 21, 2018

The full version of this talk "Standing up a Preoperative Anemia Clinic" was given during the EBPOM-USA Masters Course which was live streamed on www.topmedtalk.com from Atlanta.

The rationalization; data, outcomes, economics; The practical realities; screening, workflow and workforce, financials and tracking; all of this is contained within this three part series.

Presented by Dr Lori Heller, Cardiac Anesthesiologist, Swedish Medical Center, through US anaesthesia partners and acting instructor at the University of Washington, Seattle.

Part 1 of 3 - Preoperative anemia is a risk factor for poor outcomes | EBPOM USA - Atlanta Nov 20, 2018

The full version of this talk "Standing up a Preoperative Anemia Clinic" was given during the EBPOM-USA Masters Course which was live streamed on www.topmedtalk.com from Atlanta.

The rationalization; data, outcomes, economics; The practical realities; screening, workflow and workforce, financials and tracking; all of this is contained within this three part series.

Presented by Dr Lori Heller, Cardiac Anesthesiologist, Swedish Medical Center, through US anaesthesia partners and acting instructor at the University of Washington, Seattle.

Part 3 of 3: Smoking kills more than all addictive substances combined - plus car accidents | EBPOM USA - Atlanta Nov 19, 2018

Standing up a Preoperative Smoking Cessation Program Moderator: The rationalization; data, outcomes, economics; The practical realities; screening, workflow and workforce, financials and tracking

Presented by James Davis, MD, Director Duke Smoking Cessation Program

This is taken from the hugely successful "EBPOM-USA: Masters Course, A Perioperative Care Practicum" which took place in Atlanta earlier this year.

Hypoxia and the Brain | Xtreme Everest Nov 18, 2018

This special four part series explores the fascinating story of Xtreme Everest – the ground-breaking, research programme that has pursued a novel approach to scientific exploration. Over the last decade, this innovative team has performed large scale studies at high altitude to mimic some of the effects of critical illness. The objective is for their findings to be brought “from the mountainside to the bedside” so that the care for our sickest patients may be improved.

In this podcast, Chris Imray, describes the physiological changes within the brain when exposed to the hypoxic conditions of high altitude and how our understanding of this may change the management of patients.

Presented by Joff Lacey with his guest Chris Imray, a Consultant Vascular Surgeon at University Hospitals Coventry and Warwickshire NHS Trust and a Professor at Warwick Medical School. Chris is a passionate climber and has long been involved in altitude research. He was the deputy climbing leader for the 2007 Xtreme Everest expedition and was part of the summit team.

Part 2 of 3: Smoking kills more than all addictive substances combined - plus car accidents | EBPOM USA - Atlanta Nov 17, 2018

Standing up a Preoperative Smoking Cessation Program Moderator: The rationalization; data, outcomes, economics; The practical realities; screening, workflow and workforce, financials and tracking

This is taken from the hugely successful "EBPOM-USA: Masters Course, A Perioperative Care Practicum" which took place in Atlanta earlier this year.

Presented by James Davis, MD, Director Duke Smoking Cessation Program

Part 1 of 3: Smoking kills more than all addictive substances combined - plus car accidents | EBPOM USA - Atlanta Nov 16, 2018

Standing up a Preoperative Smoking Cessation Program Moderator: The rationalization; data, outcomes, economics; The practical realities; screening, workflow and workforce, financials and tracking

This is taken from the hugely successful "EBPOM-USA: Masters Course, A Perioperative Care Practicum" which took place in Atlanta earlier this year.

Presented by James Davis, MD, Director Duke Smoking Cessation Program.

Part 2 of 2: Obstructive sleep apnea- Snoring is boring and can seriously damage your health | EBPOM USA - Atlanta 2018 Nov 15, 2018

Standing up an Obstructive Sleep Apnea (OSA) Clinic.

The rationalization; data, outcomes, economics; The practical realities; screening, workflow and workforce, financials and tracking.

This is taken from the hugely successful "EBPOM-USA: Masters Course, A Perioperative Care Practicum" which took place in Atlanta earlier this year.

Presented by Andrew Spector Assistant Professor of Neurology at Duke University Medical Center in Durham, NC USA

Part 1 of 2: Obstructive sleep apnea- Snoring is boring and can seriously damage your health | EBPOM USA - Atlanta 2018 Nov 14, 2018

Standing up an Obstructive Sleep Apnea (OSA) Clinic.

The rationalization; data, outcomes, economics; The practical realities; screening, workflow and workforce, financials and tracking.

This is taken from the hugely successful "EBPOM-USA: Masters Course, A Perioperative Care Practicum" which took place in Atlanta earlier this year.

Presented by Andrew Spector Assistant Professor of Neurology at Duke University Medical Center in Durham, NC USA

Heart disease in pregnancy | EBPOM Ireland 2018 Nov 13, 2018

This talk covers heart disease in pregnancy and was taken from the "20th Current Controversies in Anaesthesia & Peri-Operative Medicine" conference which took place in Dingle, Ireland in October 2018.

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).

Point of care ultrasound, POCUS | ASA 2018 Nov 12, 2018

What is "Point of care ultrasound" or POCUS? What is the usefulness of ultrasound? Have the boundaries of this application been reached yet? How do you get started with point of care ultrasound? The websites mentioned in this piece are: https://www.foresightultrasound.com/ and www.POCUSEducation.com

Monty Mythen and Desiree Chappell with Mike Grocott and their guest Davinder Ramsingh, M.D. Associate Professor of Anesthesiology, Loma Linda University.

The Significance of the Microcirculation | Xtreme Everest Nov 11, 2018

This special four part series explores the fascinating story of Xtreme Everest – the ground-breaking, research programme that has pursued a novel approach to scientific exploration. Over the last decade, this innovative team has performed large scale studies at high altitude to mimic some of the effects of critical illness. The objective is for their findings to be brought “from the mountainside to the bedside” so that the care for our sickest patients may be improved.

In this podcast, Dan Martin, explains the fascinating discoveries that his team have made about the microcirculation and how it may adapt to the challenge of hypoxia. Alterations to the microcirculation may be instrumental in the body’s ability to cope under hypoxic conditions and could be become a target for interventions in critical illness.

Dan Martin is a reader in perioperative and critical care medicine at UCL and consultant in critical care at the Royal Free Hospital in London. He was the research lead for Xtreme Everest in 2007 and expedition lead in 2013.

Enhanced Recovery v2.0 | ASA 2018 Nov 10, 2018

Where are we with the journey from Enhanced Recovery (ER) to Perioperative Medicine? Is it fair to characterise the latter as "Enhanced Recovery v2.0"? Mike Grocott explains how the Royal College of Anaesthetists (RCoA) have set up a plan for "perioperative care" going forward. Does this terminology, "perioperative care" help? Also - news about the "international board of perioperative medicine", how are the challenges of the global ambition for this movement being met?

Monty Mythen and Desiree Chappell with Mike Grocott.

Paediatrics and opioids Part 2 | ASA 2018 Nov 09, 2018

How important is 'expectation management' in pediatrics? What could the usefulness of cannabis be as a way of reducing reliance on opioids? Is research in this area growing?

Desiree Chappell and Mike Grocott interview their guest Myron Yaster, Children's Hospital Colorado.

Paediatrics and opioids. Part 1 | ASA 2018 Nov 08, 2018

Recognising and treating pain in children has gone through significant change over the years, this is a trend that looks set to continue. With a focus upon Enhanced Recovery (ER), what are the pathways for the pediatric patient? Should we be looking more at opioid reduction rather than opioid avoidance? How large a part of the problem is the dispensation of opioids and the "bystander risk" - where they go unused but are kept in a drugs cabinet at home, posing a risk to curious teenagers? How much of an issue are opioids and their negative consequences in pediatrics? How should one dispose of opioids?

Desiree Chappell and Mike Grocott interview their guest Myron Yaster, Children's Hospital Colorado.

ERAS for elective C-Section- Mom needs ERAS too Part 2 | ASA 2018 Nov 07, 2018

The conversation from part 1 continues with questions such as; what specific anaesthesia protocols do you use? Is there room in this context to consider a drug diversion programme? Is phenylephrine a good choice for these procedures?

There is also a special mention for The Society for Obstetric Anesthesia and Perinatology (SOAP) - you can find their website here: https://soap.org/

Desiree Chappell and Monty Mythen interview their guest Laurent Bollag, M.D., is UW Medicine's chief of Obstetric Anesthesia and a UW associate professor or Anesthesiology and Pain Medicine.

ERAS for elective C-Section- Mom needs ERAS too Part 1 | ASA 2018 Nov 06, 2018

The conversation begins with some thoughts on Enhanced Recovery (ER) for the obstetric patient. Further discussion covers the "transatlantic" differences between the US, UK and the wider EU. Where does pain management fit into the ceasarian section (c-section) debate? What are the advantages of a drug diversion programme in that respect? The issue of fluid management in the operating room is discussed. What is Evidence Based Obstetric Anaesthesia? Desiree Chappell and Monty Mythen interview their guest Laurent Bollag, M.D., is UW Medicine's chief of Obstetric Anesthesia and a UW associate professor or Anesthesiology and Pain Medicine.

Roundtable: Enhanced Recovery After Surgery | EBPOM USA - Chicago 2018 Nov 05, 2018

This roundtable discussion digs deep into the question of Enhanced Recovery After Surgery (ERAS), how do you obtain buy in and sustainability and what can we learn from the experiences of advocates at the University of Pittsburgh Medical Center (UPMC).

Presented by Desiree Chappell with her guests Dr Jennifer Holder-Murray, Vice Chair of Quality Integration, Assistant Professor of Surgery, Division of Colon & Rectal Surgery, University of Pittsburgh Medical Center (UPMC) and Dr Stephen Esper, Assistant Professor and Director of Perioperative Services, University of Pittsburgh Medical Center (UPMC) Department of Anesthesiology and Perioperative Medicine.

The Problem with Hypoxia – the inception of Xtreme Everest | Xtreme Everest Nov 04, 2018

This special four part series explores the fascinating story of Xtreme Everest – the ground-breaking, research programme that has pursued a novel approach to scientific exploration. Over the last decade, this innovative team has performed large scale studies at high altitude to mimic some of the effects of critical illness. The objective is for their findings to be brought “from the mountainside to the bedside” so that the care for our sickest patients may be improved.

In this podcast, Denny Levett explains the complex and unpredictable nature of hypoxia, its prevalence in critical care and why there was the scientific demand to head to the world’s highest mountain in search of answers to this clinical challenge.

Presented by Joff Lacey with his guest Denny Levett, a consultant in perioperative medicine and critical care at Southampton University Hospital and deputy research leader for the Xtreme Everest expedition in 2007.

Promo - Joff Lacey's Xtreme Everest Extra, out every Sunday! | Xtreme Everest Nov 04, 2018

This piece is a quick reminder that we have launched a new series on TopMedTalk "Xtreme Everest Extra". It's in four parts and we're going to be releasing them every Sunday from now on.

The link to the first episode is here: https://www.topmedtalk.com/xtreme-everest-extra-the-problem-with-hypoxia-the-inception-of-xtreme-everest/

This series is intended for a broad audience, the more in depth pieces we did earlier in the year are to be found here: https://www.topmedtalk.com/?s=Xtreme+Everest+%7C

Smith's Medical Symposium on Enhanced Recovery – Part 6 | ASA 2018 Nov 03, 2018

Recorded before a live audience and streamed on www.topmedtalk.com

The conversation from part 5 continues. More on Caesarian Section plus: should we implement Enhanced Recovery After Surgery (ERAS) training into undergraduate and post-graduate training? Is ERAS similar to perioperative surgical home (PSH)? As new data emerges about ERAS how often will pathways and protocols be changed? What is the future for ERAS?

Desiree Chappell interviews her guest Dr Elizabeth Cherot, Vice President of medical affairs at Axia Women’s Health, with contributions from Monty Mythen, TopMedTalk Editor in Chief and Smiths Medical Professor of Anaesthesia and Critical Care at University College London.

Go to www.topmedtalk.com and download our full back catalogue now.

Smith's Medical Symposium on Enhanced Recovery – Part 5 | ASA 2018 Nov 02, 2018

Recorded before a live audience and streamed on www.topmedtalk.com

The conversation from part 4 continues, the subject is, Enhanced Recovery After Surgery for obstetrics and cesarian sections (c-section). Questions include: How can ERAS co-habitate with the "baby friendly initiative"? The USA is 16th in the world with OB outcomes can ERAS help with that? As we are trying to impliment ERAS for c-section we are encountering some social issues such as screening neo-nates before they go home and arranging a car seat before they go home? What was the reaction of hospital administation leaders when they realised your plans would reduce length of stay? Do you do ERAS for 'complicated' patients? ERAS generally seems to reduce length of stay; what major/minor procedure specific complications can we tell our patients have also been reduced? What is the mechanism by which a carbohydrate load is supposed to work, what are the essential elements of that load? What do you think about the role of exparel vs bupivacaine?

Desiree Chappell interviews her guest Dr Elizabeth Cherot, Vice President of medical affairs at Axia Women’s Health, with contributions from Monty Mythen, TopMedTalk Editor in Chief and Smiths Medical Professor of Anaesthesia and Critical Care at University College London.

Go to www.topmedtalk.com and download our full back catalogue now.

Smith's Medical Symposium on Enhanced Recovery part 4 | ASA 2018 Nov 01, 2018

Recorded before a live audience and streamed on www.topmedtalk.com The subject is, Enhanced Recovery After Surgery for obstetrics and Caesarean sections (c-section). Questions include: What's the standard length of stay for an elective Caesarean section (C-section) being done with Enhanced Recovery After Surgery (ERAS) protocols? Do Mums want to go home in a day? Don't C-section practitioners already follow ERAS protocols? What is the role of tap blocks in C-section? What is your hospital's protocol for ERAS for Mums? Desiree Chappell interviews her guest Dr Elizabeth Cherot, Vice President of medical affairs at Axia Women’s Health, with contributions from Monty Mythen, TopMedTalk Editor in Chief and Smiths Medical Professor of Anaesthesia and Critical Care at University College London. Go to www.topmedtalk.com and download our full back catalogue now.

Smith's Medical Symposium on Enhanced Recovery part 3 | ASA 2018 Oct 31, 2018

Recorded before a live audience this piece continues the question and answer session from parts one and two.

Epidurals versus plane blocks, what do you choose and why? Is there a potential for decrease in fasting times for clear fluids to further enhance recovery? Where can Enhanced Recovery (ER) protocol templates be found on line? How do we know which parts of Enhanced Recovery work and which parts are less important? Is local anesthesia the secret to avoiding post-operative delerium?

Desiree Chappell continues her conversation with her guest Vincent W. S. Chan, Professor Anesthesia at The University of Toronto with contributions from Monty Mythen, TopMedTalk Editor in Chief and Smiths Medical Professor of Anaesthesia and Critical Care at University College London.

Go to www.topmedtalk.com and download our full back catalogue now.

Smith's Medical Symposium on Enhanced Recovery part 2 | ASA 2018 Oct 30, 2018

What is the balance of risks and benefits related to regional anaesthesia? Does the short term use of opioids really contribute to the opioid crisis? What are the benefits of "opioid sparing" when held against "opioid free"? When it comes to regional anaesthesia, what kind of benefits should we expect beyond pain control and opioid sparing? Desiree Chappell interviews her guest Vincent W. S. Chan, Professor Anesthesia at The University of Toronto with contributions from Monty Mythen, TopMedTalk Editor in Chief and Smiths Medical Professor of Anaesthesia and Critical Care at University College London. Go to www.topmedtalk.com and download our full back catalogue now.

Smith's Medical Symposium on Enhanced Recovery part 1 | ASA 2018 Oct 29, 2018

Recorded before a live audience this Q&A session was recorded at the annual meeting of the American Society of Anesthesiologists (ASA) at a specially hosted dinner where both those in attendance and the online audience could submit questions. This discussion is about Enhanced Recovery (ER) and lowering tolerance of poor outcomes after surgery. How do we know practitioners are actually using the principles of Enhanced Recovery After Surgery (ERAS)? Put simply, they should be Drinking, Eating, Mobilising and Sleeping (DREAMS). What are the key elements of an ERAS program? This piece features Desiree Chappell in conversation with Monty Mythen. Go to www.topmedtalk.com and download our full back catalogue now.

Frailty and the perioperative patient - enhancing recovery | ASA 2018 Oct 28, 2018

Where is perioperative medicine as a specialty in the US? How do frail patients benefit from the perioperative process? Age and physical fitness are important factors when deciding if you're going to put a patient through major surgery, how do these factors allow us to differentiate between those who are likely to have a poor outcome? How common is cardiopulmonary exercise testing (CPET) in the US?

Presented by Desiree Chappell and Monty Mythen with their guest Bobbie Jean Sweitzer, Director of Perioperative Medicine at Northwestern.

Considerations for the obstetric patient; ERAS for C-section | ASA 2018 Oct 27, 2018

Obstetrics might seem the natural place for Enhanced Recovery After Surgery (ERAS). Which components of Enhanced Recovery apply the most to a procedure such as a Caesarian section (C-section)? Differences between obstetrics in the UK and the US are discussed. The addictive qualities of oxycodone are discussed in detail. This leads to a discussion about what tablets patients should be leaving the hospital with. Presented by Monty Mythen and Desiree Chappell with their guest Brendan Carvalho, Professor of Anesthesiology, Perioperative and Pain Medicine at Stanford University Medical Center.

Regional anaesthesia associated with improved cancer survival – new data | ASA 2018 Oct 26, 2018

This piece is a deep dive into regional anaesthesia for Enhancing Recovery. Hear how paravertebral nerve blocks can be used in breast cancer surgery, how does this effect long term outcomes for patients? There is then further discussion regarding regional anaesthesia for Ambulatory Surgery.

There is also a long form discussion of electromyographic (EMG) objective monitoring on a neuromuscular blockade. How can this help reduce and discover potential poor outcomes?

Further questions from the online audience are addressed such as "can you send knee surgery patients home on the day of surgery, how do you manage pain?"

Presented by Desiree Chappell and Monty Mythen with their guest Professor Stuart Grant, MB ChB, FRCA Director, Medical Student Education, Duke University School of medicine.

Improving outcomes for the perioperative patient | ASA 2018 Oct 25, 2018

Enhanced Recovery After Surgery (ERAS) is the focus for the TopMedTalk team at this year's ASA. This piece features discussion regarding; what to do about pre-operative frailty, smoking cessation, patient-centric care and how to manage pre and post operative expectations.

How do we ensure the conversations we have before surgery both reflect the needs of the patient and the realities of an operation? Moving beyond that how do we use patient reported outcomes to improve the process overall?

We also have contributions from the audience; "What role does the General Practitioner have in promoting smoking cessation, is the pre-operative clinic too late to get the ball rolling?" and "Is perioperative medicine to be understood as a generic provider / management system or as a specific branch of practice?"

Desiree Chappell and Monty Mythen speak with their guest Dr Angela Edwards, Head of Perioperative Medicine at Wake Forest University School of Medicine.

Optimising the perioperative patient | ASA 2018 Oct 24, 2018

This piece is about optimizing the perioperative patient for Enhanced Recovery (ER). Hear from one of the pioneers of ER for laparoscopic colorectal surgery in the UK, over 15 years ago he was sending patients home in less than 24 hours having had laparoscopic right hemicolectomys!

This is the story of one of the roots of Enhanced Recovery adoption in the NHS. We also cover issues such as, the importance of pre-operative nutrition, gabapentinoids and, in a similar vein, low dose ketamine. Do such treatments require a frailty adjustment and what is the bigger picture as regards delirium?

Questions are taken from the audience; what is the value of lidocaine infusions? How does opioid minimisation fit into this picture? How practical are alternating dosages when it comes to analgesics in the US healthcare system?

Finally, there is an indepth discussion about anemia in the perioperative process.

Presented by Desiree Chappell and Monty Mythen with their guest Michael Scott, Professor and Division Director, Critical Care Anesthesiology- Virginia Commonwealth University

The practical applications of innovation | ASA 2018 Oct 23, 2018

How do new technologies impact the postoperative elements of Enhanced Recovery? We discuss ward monitoring 3.0 and the technology available, or in the pipeline, to improve outcomes. How do we best use this information and these innovations?

There is also a refreshing conversation about Artificial Intelligence (AI) alongside discussion about "bed sensors" and "facial recognition". Some dementia units are using new technology to monitor patient movement both in and out of their beds, how does this tie into the issue of early mobilisation? Furthermore - what will the consequences be when facial recognition and monitoring is ubiquitous within institutions?

The website mentioned in the podcast is here: https://www.michardconsulting.com/

Presented by Desiree Chappell with Monty Mythen and their guest Frederic Michard of MiCo Consulting.

Teaching Anaesthesia to Medical Students | ASA 2018 Oct 22, 2018

This fascinating conversation revolves around the experience and need for good teachers in the field of Anaesthesia. How do we encourage professionals and students to pursue this vital and rewarding discipline? Dr Joff Lacey presents with his guest Dr Rob Stephens, Consultant in Anaesthesia, UCLH, Hon Senior Lecturer in Anaesthesia, UCL.

Perioperative Fluid Management to Enhance Recovery After Surgery | ASA 2018 Oct 21, 2018

This conversation focuses on perioperative fluid management as part of Enhanced Recovery After Surgery (ERAS). Firstly, the team addresses the online poll - Is Enhanced Recovery (ER) the standard of care where you practice? They then move into a wider discussion about the key elements of ER alongside the main topic of perioperative fluid management.

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.

For more on the RELIEF trial: https://www.topmedtalk.com/?s=RELIEF

Massive study of quality shows no benefit; why? | ASA 2018 Oct 20, 2018

Lessons learned from the Enhanced Peri-Operative Care for High-risk patients (EPOCH) trial. This conversation focuses upon the challenges of quality improvement programmes; how do we keep track of patients and improve follow up questions after surgery? How do we clearly show Quality Improvement Programmes work for the patient? Further discussion encompasses innovation and utilization in practice.

Presented by Monty Mythen and Desiree Chappell with their guest Carole Peden, Professor of Anesthesiology and Exec. Director of the Center for Health System Innovation, University of Southern California, University of Bath and the Institute for Healthcare Improvement (IHI).

For more on EPOCH look here: https://www.topmedtalk.com/?s=EPOCH

Building a sustainable ERAS programme | ASA 2018 Oct 19, 2018

This fascinating in-depth conversation about Enhanced Recovery After Surgery, facilitated by questions both from our worldwide online audience and people who were attending the American Society of Anesthesiologists (ASA) conference in San Francisco this year.

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 Vijaya Gottumukkala, Professor of Anesthesia and Deputy Chair at MD Anderson.

Fluid - Matters; Part 2 Total body water and electrolytes | TopMedTalk Highlight Oct 19, 2018

In no particular order we're playing some of the content that listeners have voted for with their downloads. This episode is one of the top ten most downloaded podcasts we've done so far.

This discussion focuses on the perioperative quality initiative's (POQI) intense focus this year on total body water and electrolytes. How often should we weigh patients to monitor water balance? What can we learn from a real understanding of the circulation of interstitial fluid and lymphatics? What is the role of diuretics for the perioperative practitioner? Also, haemodilution, what should you do if you have a patient with a positive post operative fluid balance and a low haemoglobin? Finally, how do we deal with Sodium balance and Chloride?

Coming from this summer's POQI hosted at Duke University in North Carolina, USA this podcast is presented by Monty Mythen and Henry Howe with their guests Tom Woodcock, an independent consultant in patient safety, medical law and ethics, and Manu Malbrain, Professor at the Faculty of Medicine and Pharmacology Vrije University in Brussells.

The website mentioned in this piece is here: https://www.fluidacademy.org/

ERAS working with existing resources | ASA 2018 Oct 18, 2018

Despite the fact that a return on investment is a given after 12 months why is it that resources are not available for those of us pushing for Enhanced Recovery After Surgery (ERAS)? How do we convert the conversation down from pure financial terms into a lexicon that institutions can understand?

The 'Council of Nurses' idea advocated in this piece is explored further in a previous podcast on TopMedTalk to be found here: https://www.topmedtalk.com/a-council-of-nurses/

Join the team on the first day of the ASA in San Francisco. Originally streamed live on http://www.topmedtalk.com from the Smith's Medical Booth in the exhibition hall of the conference.

Presented by Monty Mythen and Desiree Chappell with their guest Dr Ruchir Gupta, medical lead for enhanced recovery at Stony Brook University.

RCoA 11 - The RELIEF Trial; your essential 'deep dive' into the results | TopMedTalk Highlight Oct 18, 2018

This series is a chance for new listeners to jump on board and for established listeners to catch up with some of our favourite podcasts so far, as voted for by our listeners: "RCoA 11 - The RELIEF Trial; your essential 'deep dive' into the results." The RELIEF (Restrictive versus liberal fluid therapy in major abdominal surgery) trial has been a huge story for us here at TopMedTalk, recorded on the second day of The Royal Collage of Anaesthetists' annual conference at the British Museum this is the moment the team get to pick over the results in detail. One of the biggest trials ever, it has both raised questions and provided answers. Inevitably there has been a huge debate, this piece puts all the major questions and concerns to the organiser of the trial. Send us your thoughts on The RELIEF trial: contact@topmedtalk.com

Presented by the TopMedTalk team; Professor Monty Mythen, Dr Joff Lacey, Desiree Chappell and Professor Mike Grocott, with their guest Paul Myles, Head of Alfred Health's and Monash University's Department of Anaesthesia and Perioperative Medicine and organiser of the RELIEF trial.

Welcome to The ASA | ASA 2018 Oct 17, 2018

Join the team on the first day of the ASA in San Francisco. Originally streamed live on http://www.topmedtalk.com from the Smith's Medical Booth in the exhibition hall of the conference.

Presented by Monty Mythen, Desiree Chappell, Mike Grocott and Joff Lacey.

I want to dance at my daughter's wedding | TopMedTalk Highlight Oct 17, 2018

This series is a chance for new listeners to jump on board and for established listeners to catch up with some of our favourite podcasts so far.

"I want to dance at my daughter's wedding"

What are the goals of healthcare providers, how do we measure success and why does value based care matter? Insight from The American Association of Retired People puts the focus in this conversation upon the patient. How do they measure value? What do they want and why?

This piece features Desiree Chappell with two of the guest speakers from the American College of Perioperative Medicine's 2018 conference; Eric J Schneidewind president of the AARP and Kevin Bozic, Chair of Surgery & Perioperative Care at the Dell Medical School.

It's a clip taken from a longer conversation which you can listen to in full here: https://www.topmedtalk.com/the-beauty-of-shared-decision-making/

The Roundtable on NELA and shared decision making | TopMedTalk Highlight Oct 16, 2018

This series is a chance for new listeners to jump on board and for established listeners to catch up with some of our favourite podcasts so far. "EBPOM 2018 - 4 | The Roundtable on NELA and shared decision making" What is the standard of care given to patients who are getting an 'emergency laparotomy'? How do you use national data on a local level? Also in this conversation; teaching patients, learning from patients, shared decision making and bringing together the preferences of the patient and practitioner. There is also reaction to the keynote speaker, Sir Bruce Keogh, who's full speech is available as a podcast here: https://www.topmedtalk.com/ebpom-2018-3-sir-bruce-keogh-the-nhs-at-70/

Presented by Desiree Chappell this roundtable discussion involves her two guests; Angela Coulter, a UK based health policy analyist and researcher, and Sarah Hare of the National Emergency Laparotomy Audit (NELA).

The Global Council on Brain Health | ASA 2018 Oct 15, 2018

This fascinating piece is essential listening from the ASA 2018. Originally streamed live on www.topmedtalk.com during our live coverage of the conference in San Francisco.

Hear how the American Associaton of Retired People (AARP), an organisation with a membership almost equal to the entire voting population of the United Kingdom, are to focusing on brain health, in response to the demands of their members.

Further conversation includes how practitioners both explain the risks of surgery and also calm possible misunderstandings or fears regarding them, as well as wider reflections on 'The Brain Health Initiative'.

Presented by Desiree Chappell with Mike Grocott and their guests Lee Fleisher, Professor of Anesthesiology and Critical Care, University of Pennsylvania and Sarah Lock, Senior Vice President for policy at the American Association of Retired People (AARP) and the director of 'The Global Council on Brain Health'.

The Brain Health Initiative | TopMedTalk Highlight Oct 15, 2018

We're playing TopMedTalk's Top Ten during the month of October, in no particular order. It's an opportunity for new and established listeners to catch up with the most popular podcasts over the past year.

Here you will find a fascinating discussion about cognitive function after surgery and a wider conversation about the 'brain health initiative'. What practical, simple steps can patients and providers take to bridge the gap between new discoveries in the arena of brain health and risk minimisation?

Featuring Desiree Chappell interviewing her guests, Carol Peden, Professor of Anesthesiology and Executive Director of the Center for Health System Innovation, University of Southern California, University of Bath and the Institute for Healthcare Improvement (IHI) and Lee A. Fleisher Chair of Anesthesiology and Critical Care, University of Pennsylvania.

Join us on www.topmedtalk.com and sign up for our email updates and never miss a live streamed conference again.

Also - you can find Slido here: http://www.slido.com/ - the 'event code' you require is #tmtasa18

Henrik Kehlet: Recovery is all about inflammation! | ASA 2018 Oct 14, 2018

On the morning of the first day of the 2018, annual conference, of the American Society of Anesthesiologists (ASA) Monty Mythen and Desiree Chappell were lucky enough to get an exclusive interview with Professor Henrik Kehlet.

Henrik Kehlet is a gastrointestinal surgeon and former professor of surgery, Copenhagen University, and now professor of perioperative therapy and Head of Section of Surgical Pathophysiology, Rigshospitalet, Copenhagen University.

He has published more than 650 articles within perioperative pathophysiology, pain relief and surgical outcome summarized into the concept of 'fast-track surgery', which also includes a focus on perioperative fluid management.

TopMedTalk is live at the ASA 2018 in San Francisco, this piece was originally streamed live on the website: www.topmedtalk.com

Go there now to find out how you can be a bigger part of TopMedTalk, not only can you listen to the conference but also you can contribute questions to our programmes here:

http://www.slido.com/ - the 'event code' you require is #tmtasa18

Direct laryngoscopes should be consigned to history? | TopMedTalk Highlight Oct 14, 2018

We're playing TopMedTalk's Top Ten during the month of October, in no particular order. It's an opportunity for new and established listeners to catch up with the most popular podcasts over the past year.

The debate 'Direct laryngoscopes should be consigned to history' was hosted by The Royal College Of Anaesthetists and carried out by our two guests on this piece. TopMedTalk sat down to have our own mini-debate during the conference.

Presented by Joff Lacey and Monty Mythen with their two guests; Professor Tim Cook, Consultant in Anaesthesia and ICM, Royal United Hospitals, Bath and Dr William Harrop-Griffiths, St Mary's Hospital, Imperial College Healthcare NHS Trust.

Join us on www.topmedtalk.com and sign up for our email updates and never miss a live streamed conference again.

Also - you can find Slido here: http://www.slido.com/ - the 'event code' you require is #tmtasa18

EBPOM USA - CHICAGO 2018 | Frailty assessment, why and how? Part 2 | EBPOM USA - Chicago 2018 Oct 13, 2018

In this, the second of a two part piece, the issue of frailty is assessed as a diagnosis. The realities of treating, often elderly people, who suffer from it are examined and discussed.

Originally streamed live on www.topmedtalk.com the talk was part of EBPOM 2018 in Chicago.

Presented by Dr Bobbie Jean Sweitzer, Associate Professor and Director of pre-operative medicine at the University of Chicago.

Treating Patients Properly | TopMedTalk Top Ten Oct 13, 2018

We're playing TopMedTalk's Top Ten during the month of October, in no particular order. It's an opportunity for new and established listeners to catch up with the most popular podcasts over the past year.

Today's piece is called "Treating Patients Properly" and was recorded at EBPOM USA, Atlanta.

Treating patients as people rather than 'jobs to be done' and 'boxes to be ticked' is the focus of this piece. What can Doctors do better when it comes to treating patients? Find out what happened when a perioperative care doctor became a patient. A fascinating conversation, streamed live from Atlanta Georgia during the second day of TopMedTalk's coverage of "EBPOM-USA Masters Course, A Perioperative Care Practicum".

Hosted by Desiree Chappell and Monty Mythen. Featuring Dr Paul Wischmeyer, Professor of Anaesthesiology and Surgery at Duke Anesthesiology and TopMedTalk's Henry Howe, a medical student at Bristol University.

Join us on www.topmedtalk.com and sign up for our email updates and never miss a live streamed conference again.

Also - you can find Slido here: http://www.slido.com/ - the 'event code' you require is #tmtasa18

Frailty assessment, why and how? Part 1 | EBPOM USA - Chicago 2018 Oct 12, 2018

In this two part piece the issue of frailty is assessed as a diagnosis. The realities of treating, often elderly people, who suffer from it are examined and discussed.

Originally streamed live on www.topmedtalk.com the talk was part of EBPOM 2018 in Chicago.

Presented by Dr Bobbie Jean Sweitzer, Associate Professor and Director of pre-operative medicine at the University of Chicago.

The FEDORA Trial | TopMedTalk Top Ten Oct 12, 2018

We're playing TopMedTalk’s top ten during the month of October, in no particular order. It's an opportunity for new and established listeners to catch up with the most popular podcasts of the past year.

This piece was originally presented during the Third Annual Quality Improvement Leadership Forum, 2018, at the Union League Club in Philidelphia.

The trial looked at the effect of goal-directed haemodynamic therapy on postoperative complications in low–moderate risk surgical patients: a multicentre randomised controlled trial (FEDORA trial).

Randomised Controlled Multicentre trial; n=420; GDHT vs Control

Conclusions:

"Oesophageal Doppler monitor-guided GDHT reduced postoperative complications and hospital length of stay in low–moderate risk patients undergoing intermediate risk surgery, with no difference in mortality at 180 days."

Click here for full text.

http://bjanaesthesia.org/article/S0007-0912(17)54207-5/fulltext

--

Also - you can find Slido here: http://www.slido.com/ - the 'event code' you require is #tmtasa18

EBPOM USA | Roundtable; Big data and predictive analytics | EBPOM USA - Chicago 2018 Oct 11, 2018

How do hospitals and institutions best use their assets in a world of big data where we can deploy predictive analytics and the new metrics they make available to us? Currently we tend to use the clumsy metrics of averages when there now exists the possibility to use more high fidelity predictive patterns adapted to the unique flow of users and situations. Learn how constraint based optimisation and forecasting has allowed for an exponential rise in the effectiveness of our already existing resources.

Desiree Chappell and her guests Sanjeev Agrawal, President & CMO at LeanTaaS, ex Google, Aloqa and Collegefeed and Mike Grocott, Anaesthesia and Critical Care Medicine, University of Southampton.

Patients are the experts in being patients | TopMedTalk Top Ten Oct 11, 2018

In no particular order we're playing some of the content that listeners have voted for with their downloads. This episode is one of the top ten most downloaded podcasts we've done so far.

"Patients are the experts in being patients"

The penultimate part of the first round table discussion hosted by Desiree Chappell and featuring Monty Mythen; recorded on February the 9th, the opening night of the Interdisciplinary Conference on Orthopedic Value-Based Care.

This is the final segment of a fascinating 'round table discussion' between Desiree, Monty and their two guests; Shawna Butler (RN, NBA who works with Singularity University in Exponential Medicine) and Jennifer Brandon (PT, MPT, Hoag Orthopedic Institute in Irvine, California).

Here Shawna speaks about “innovation as a team sport”.

The Opioid crisis, can we kick the habit? - Q&A | EBPOM USA - Chicago 2018 Oct 10, 2018

Recorded at the recent Evidence Based Perioperative Medicine (EBPOM) USA conference this is the question and answer session which followed the talk "The Opioid crisis, can we kick the habit?". Along with various questions from the audience, both at the conference and listening live online, Desiree Chappell presents an entertaining conversation with Matthew McEvoy. Presented by Desiree Chappell with Matthew McEvoy, Vice-Chair for Educational Affairs and Professor of Anesthesiology at Vanderbilt University Medical Center.

Sir Bruce Keogh The NHS at 70 | TopMedTalk Top Ten Oct 10, 2018

In no particular order we're playing some of the content that listeners have voted for with their downloads. This episode is one of the top ten most downloaded podcasts we've done so far.

The NHS, a national institution beloved by the people of the United Kingdom is 70 years old. EBPOM celebrated this fact with a talk that gets right to the heart of why this institution is so special and also how it can move forward in the brave new world we find ourselves in now.

This piece was streamed live, from the IET at EBPOM 2018, on www.topmedtalk.com

Sir Bruce Keogh KBE, FRCS, FRCP, is a giant in the world of UK healthcare. A British surgeon and physician who specialises in cardiac surgery he was, until this year, Medical Director of the National Health Service in England and National Medical Director of the NHS Commissioning Board (NHS England).

Go check out the website: www.topmedtalk.com

The Opioid crisis, can we kick the habit? | EBPOM USA - Chicago 2018 Oct 09, 2018

Recorded at the recent Evidence Based Perioperative Medicine (EBPOM) USA conference this piece, in less than 10 minutes, lays out the case for kicking the opioid habit, specifically in America. Use this to help build the case for reducing the use of opioids at your institution.

Presented by Matthew McEvoy, Vice-Chair for Educational Affairs and Professor of Anesthesiology at Vanderbilt University Medical Center

Fluid - Matters; Part 2 Total body water and electrolytes | TopMedTalk Top Ten Oct 09, 2018

In no particular order we're playing some of the content that listeners have voted for with their downloads. This episode is one of the top ten most downloaded podcasts we've done so far.

This discussion focuses on the perioperative quality initiative's (POQI) intense focus this year on total body water and electrolytes. How often should we weigh patients to monitor water balance? What can we learn from a real understanding of the circulation of interstitial fluid and lymphatics? What is the role of diuretics for the perioperative practitioner? Also, haemodilution, what should you do if you have a patient with a positive post operative fluid balance and a low haemoglobin? Finally, how do we deal with Sodium balance and Chloride?

Coming from this summer's POQI hosted at Duke University in North Carolina, USA this podcast is presented by Monty Mythen and Henry Howe with their guests Tom Woodcock, an independent consultant in patient safety, medical law and ethics, and Manu Malbrain, Professor at the Faculty of Medicine and Pharmacology Vrije University in Brussells.

The website mentioned in this piece is here: https://www.fluidacademy.org/

Wrong surgery or wrong patient? - Q&A | EBPOM USA - Chicago 2018 Oct 08, 2018

Recorded at the recent Evidence Based Perioperative Medicine (EBPOM) USA conference this piece is the question and answer session which followed Mike Grocott's talk; "Wrong surgery or wrong patient?". Various questions from the audience follow after a short conversation between Mike and our Editor in Chief Monty Mythen. Presented by Monty Mythen with his guest Mike Grocott, Professor of Anaesthesia and Critical Care Medicine, University of Southampton.

RCoA 11 - The RELIEF Trial; your essential 'deep dive' into the results | TopMedTalk Top Ten Oct 08, 2018

This series is a chance for new listeners to jump on board and for established listeners to catch up with some of our favourite podcasts so far, as voted for by our listeners: "RCoA 11 - The RELIEF Trial; your essential 'deep dive' into the results." The RELIEF (Restrictive versus liberal fluid therapy in major abdominal surgery) trial has been a huge story for us here at TopMedTalk, recorded on the second day of The Royal Collage of Anaesthetists' annual conference at the British Museum this is the moment the team get to pick over the results in detail. One of the biggest trials ever, it has both raised questions and provided answers. Inevitably there has been a huge debate, this piece puts all the major questions and concerns to the organiser of the trial. Send us your thoughts on The RELIEF trial: contact@topmedtalk.com

Presented by the TopMedTalk team; Professor Monty Mythen, Dr Joff Lacey, Desiree Chappell and Professor Mike Grocott, with their guest Paul Myles, Head of Alfred Health's and Monash University's Department of Anaesthesia and Perioperative Medicine and organiser of the RELIEF trial.

Wrong surgery or wrong patient? | EBPOM USA - Chicago 2018 Oct 07, 2018

Recorded at the recent Evidence Based Perioperative Medicine (EBPOM) USA conference this piece, in less than 15 minutes, lays out the case for shared decision making so you can avoid carrying out surgery which is not right for either the surgeon or patient. Use this to help build the case for shared decision making at your institution by demonstrating that it hits the 'triple aim for populations' by simultaneously delivering a better patient experience, health care and cost.

Presented by Mike Grocott, Professor of Anaesthesia and Critical Care Medicine, University of Southampton.

I want to dance at my daughter's wedding | TopMedTalk Top Ten Oct 07, 2018

This series is a chance for new listeners to jump on board and for established listeners to catch up with some of our favourite podcasts so far.

"I want to dance at my daughter's wedding"

What are the goals of healthcare providers, how do we measure success and why does value based care matter? Insight from The American Association of Retired People puts the focus in this conversation upon the patient. How do they measure value? What do they want and why?

This piece features Desiree Chappell with two of the guest speakers from the American College of Perioperative Medicine's 2018 conference; Eric J Schneidewind president of the AARP and Kevin Bozic, Chair of Surgery & Perioperative Care at the Dell Medical School.

It's a clip taken from a longer conversation which you can listen to in full here: https://www.topmedtalk.com/the-beauty-of-shared-decision-making/

ACOs are the only hope for affordable health care - Q&A | EBPOM USA - Chicago 2018 Oct 06, 2018

Recorded at the recent Evidence Based Perioperative Medicine (EBPOM) USA conference this piece is the question and answer session which followed Lee Fleisher's talk; "ACOs are the only hope for affordable health care". Various questions from the audience follow a short conversation between Lee and our lead presenter Desiree Chappell. Presented by Desiree Chappell with her guest Lee A. Fleisher, Professor of Anesthesiology and Critical Care and Senior Fellow, Leonard Davis Institute of Health Economics, University of Pennsylvania.

The Roundtable on NELA and shared decision making | TopMedTalk Top Ten Oct 06, 2018

This series is a chance for new listeners to jump on board and for established listeners to catch up with some of our favourite podcasts so far. "EBPOM 2018 - 4 | The Roundtable on NELA and shared decision making" What is the standard of care given to patients who are getting an 'emergency laparotomy'? How do you use national data on a local level? Also in this conversation; teaching patients, learning from patients, shared decision making and bringing together the preferences of the patient and practitioner. There is also reaction to the keynote speaker, Sir Bruce Keogh, who's full speech is available as a podcast here: https://www.topmedtalk.com/ebpom-2018-3-sir-bruce-keogh-the-nhs-at-70/

Presented by Desiree Chappell this roundtable discussion involves her two guests; Angela Coulter, a UK based health policy analyist and researcher, and Sarah Hare of the National Emergency Laparotomy Audit (NELA).

ACOs are the only hope for affordable health care | EBPOM USA - Chicago 2018 Oct 05, 2018

Recorded at the recent Evidence Based Perioperative Medicine (EBPOM) USA conference this piece, in approximately 15 minutes, lays out the case for Accountable Care Organizations (ACOs) as the only hope for affordable health care.

Presented by Lee A. Fleisher, Professor of Anesthesiology and Critical Care and Senior Fellow, Leonard Davis Institute of Health Economics, University of Pennsylvania.

The Brain Health Initiative | TopMedTalk Top Ten Oct 05, 2018

In no particular order we're playing some of the content that listeners have voted for with their downloads. This episode is one of the top ten most downloaded podcasts we've done so far. Here you will find a fascinating discussion about cognitive function after surgery and a wider conversation about the 'brain health initiative'. What practical, simple steps can patients and providers take to bridge the gap between new discoveries in the arena of brain health and risk minimisation?

Featuring Desiree Chappell interviewing her guests, Carol Peden, Professor of Anesthesiology and Executive Director of the Center for Health System Innovation, University of Southern California, University of Bath and the Institute for Healthcare Improvement (IHI) and Lee A. Fleisher Chair of Anesthesiology and Critical Care, University of Pennsylvania.

Perioperative medicine is population health - Q&A | EBPOM USA - Chicago 2018 Oct 04, 2018

Recorded at the recent Evidence Based Perioperative Medicine (EBPOM) USA conference this is the question and answer session which followed Sol Aronson's talk; "Perioperative medicine is population health". Various questions from the audience follow after a short conversation between Sol and our, Editor in Chief, Monty Mythen.

Presented by Monty Mythen with Sol Aronson, tenured professor at Duke University and Executive Vice Chairman in the Department of Anesthesiology

Direct laryngoscopes should be consigned to history? | TopMedTalk Top Ten Oct 04, 2018

This episode is one of the top ten most downloaded podcasts we've done so far.

The debate 'Direct laryngoscopes should be consigned to history' was hosted by The Royal College Of Anaesthetists and carried out by our two guests on this piece. TopMedTalk sat down to have our own mini-debate during the conference.

Presented by Joff Lacey and Monty Mythen with their two guests; Professor Tim Cook, Consultant in Anaesthesia and ICM, Royal United Hospitals, Bath and Dr William Harrop-Griffiths, St Mary's Hospital, Imperial College Healthcare NHS Trust.

Perioperative medicine is population health | EBPOM USA - Chicago 2018 Oct 03, 2018

Recorded at the recent Evidence Based Perioperative Medicine (EBPOM) USA conference this piece, in just 15 minutes, lays out the argument that the practice of perioperative medicine clearly walks hand in hand with the wider issue of population health management. Use this to help build the case for a perioperative care programme at your institution.

Presented by Sol Aronson, tenured professor at Duke University and Executive Vice Chairman in the Department of Anesthesiology.

Xtreme Everest Promo Part 2 | Xtreme Everest Oct 02, 2018

These clips are taken from the hugely successful 'The Xtreme Everest Symposium' organised by the Department of Anesthesiology, Duke University, USA.

To hear all of the Xtreme Everest podcasts, in full, for free, follow this link here: https://www.topmedtalk.com/?s=xtreme+

The contributors, in order, are; Chris Imray, Kay Mitchell, David McLeod, Richard Moon and Mike Grocott.

Xtreme Everest Promo Part 1 | Xtreme Everest Oct 01, 2018

These clips are taken from the hugely successful 'The Xtreme Everest Symposium' organised by the Department of Anesthesiology, Duke University, USA.

To hear all of the Xtreme Everest podcasts, in full, for free, follow this link here: https://www.topmedtalk.com/?s=xtreme+

The contributors, in order, are; Mike Grocott, Denny Levett, Monty Mythen, Daniel Martin and Andrew Murray.

The Hypotension Prediction Index (HPI) Sep 30, 2018

Live from Edwards Life Sciences in Irvine, South California, on their 60th anniversary. This conversation adds more detail to the picture emerging of the hypotension prediction index (HPI).

Monty Mythen interviews his guests Thomas Scheeren, Professor of Anesthesiology, University Medical Center, Groningen and Chair Cardiovascular Dynamics Section at European Society of Intensive Care Medicine - ESICM with Bart Geerts, Consultant Anaesthetist, Amsterdam UMC and Maxime Cannesson Professor of Anesthesiology & Vice Chair for Perioperative Medicine at UCLA Health.

Hemodynamic monitoring and the pulmonary artery catheter | Edwards Lifesciences at 60 Sep 30, 2018

On the occasion of the 60th anniversary of Edwards Life Sciences, Monty Mythen presents a discussion about hemodynamic monitoring and the pulmonary artery catheter, from their headquarters in Irvine, South California.

Presented by Monty Mythen with Andy Shaw, Professor and Chair, Department of Anesthesiology and Pain Management, Rupert Pearse, Professor of Intensive Care Medicine at Queen Mary, University of London and Tim Miller, Associate Professor of Anaesthesiology from Duke University Medical Centre.

Roundtable, treating anemia in the perioperative process | EBPOM USA - Chicago 2018 Sep 30, 2018

How does the treatment of anemia fit into the perioperative process? How far should patient optimisation extend to treatment of this condition?

Live from the hugely successful EBPOM USA conference, directly after their presentation Desiree Chappell talks with her guests; Dr Lori Heller, Cardiac Anesthesiologist, Swedish Medical Center, through US anaesthesia partners and acting instructor at the University of Washington, Seattle and Dr Bobbie Jean Sweitzer, Associate Professor and Director of pre-operative medicine at the University of Chicago.

The Perioperative Care Practicum EBPOM USA : taster session - part 2 | EBPOM USA - Atlanta 2018 Sep 29, 2018

EXCLUSIVE: TopMed talk is coming live from the 'Chicago Masters Course - A Perioperative Care Practicum'. Go to the website now and listen live to the world's most cutting edge thinkers and pioneers in the world of perioperative medicine and care right now: http://www.topmedtalk.com/

This piece is a collection of highlights from the last 'Perioperative Care Practicum' recorded at EBPOM USA conference in Atlanta Georgia earlier this year.

The fuller talks, from which these highlights are take can be found on the TopMed talk website:

Part 4 https://www.topmedtalk.com/ebpom-usa-part-4-a-perioperative-practicum-with-desiree-chappell/

Part 5 https://www.topmedtalk.com/ebpom-usa-part-5-a-perioperative-practicum-with-tj-gan/

Part 6 https://www.topmedtalk.com/ebpom-usa-part-6-a-perioperative-practicum-with-dr-tim-miller/

Make sure you join us live on www.topmedtalk.com and while you're there remember to sign up for our mailing list so you can always be a part of our broadcasts!

Featuring Desiree Chappell, Certified Registered Nurse Anesthetist (CRNA) and board member of The American Society of Enhanced Recovery (ASER), Tong Joo (TJ) Gan, Professor and Chairman at Stoney Brook in New York and the immediate past President of the American Society of Enhanced Recovery (ASER), Dr Tim Miller, anaesthsiologist from Duke University Medical Centre.

The Perioperative Care Practicum EBPOM USA : taster session - part 1 | EBPOM USA - Atlanta 2018 Sep 28, 2018

EXCLUSIVE: TopMed talk is coming live from the 'Chicago Masters Course - A Perioperative Care Practicum'. Go to the website now and listen live to the world's most cutting edge thinkers and pioneers in the world of perioperative medicine and care: http://www.topmedtalk.com/

This piece is a collection of highlights from the last 'Perioperative Care Practicum' recorded at the EBPOM USA conference in Atlanta Georgia earlier this year.

The fuller talks are available on the TopMed talk website:

Part 1: https://www.topmedtalk.com/ebpom-usa-part-1-a-perioperative-practicum-with-professor-sol-aronson/

Part 2: https://www.topmedtalk.com/ebpom-usa-part-2-a-perioperative-practicum-with-professor-monty-mythen/

Part 3: https://www.topmedtalk.com/ebpom-usa-part-3-a-perioperative-practicum-with-dr-lee-a-fleisher/

Make sure you join us to hear it live www.topmedtalk.com and while you're there remember to sign up for our mailing list so you can always be a part of our live broadcasts!

Featuring Professor Sol Aronson, tenured professor at Duke University and Executive Vice Chairman in the Department of Anesthesiology, Professor Monty Mythen Smiths Medical Professor of Anaesthesia and Critical Care at University College London and Professor Lee A. Fleisher, Anesthesiology and Critical Care, University of Pennsylvania.

Roundtable Highlight - Optimum optimisation? | EBPOM USA - Atlanta 2018 Sep 27, 2018

"It's one thing to optimise them to get them through surgery, it's another (...) to optimise them period!" - Dr Fleisher begins the conversation as the team circle round the tricky issue of patient optimisation in the 'fee for service' world. Many hospitals don't want to reduce surgery, can the bottom line be shifted closer toward the greater good of 'public health'? Dr Fleisher explains that 'per beneficiary per month' (PBPM) is one possible route. The conversation evolves from there.

What are your thoughts? We are always keen to tap into the collective knowledge of our global audience, join the debate and send the team an email: contact@topmedtalk.com

Recorded on the first day of the 'EBPOM USA - Masters Course' this podcast features Desiree Chappell, Monty Mythen, Dr Lee A. Fleisher Chair of Anesthesiology and Critical Care (University of Pennsylvania) and Vicki Morton DNP and Director of Clinical and Quality Outcomes at Providence Anesthesiology Associates University of South Carolina.

This piece is taken from a longer conversation to be found here: https://www.topmedtalk.com/dealing-with-policy-and-value-based-care-the-roundtable-blog/

Roundtable Highlight - The Maryland 'Funding Experiment' | EBPOM USA - Atlanta 2018 Sep 26, 2018

In this piece the team talk about possibly one of the most interesting funding experiments in the US; The Maryland global budgeting experiment. January 2014, after months of negotiations between Maryland and federal authorities, global budgeting went statewide. It was voluntary for hospitals, but within six months every hospital in the state had signed up. Four years on and it is a fascinating case study in how healthcare can be funded in such a way as to essentially incentivise public health measures within the American system, something that was previously seen as a perennial problem.

Recorded on the first day of the 'EBPOM USA - Masters Course' this podcast features Desiree Chappell, Monty Mythen, Dr Lee A. Fleisher Chair of Anesthesiology and Critical Care (University of Pennsylvania) and Vicki Morton DNP and Director of Clinical and Quality Outcomes at Providence Anesthesiology Associates University of South Carolina.

This piece is taken from a longer conversation to be found here: https://www.topmedtalk.com/dealing-with-policy-and-value-based-care-the-roundtable-blog/

Joff Lacey visits the Ether Dome in Boston | ASA 2017 Sep 25, 2018

Joff and his guests visit the hallowed turf that is the Boston Ether Dome, in the Bulfinch Building, Massachusetts General Hospital. How have times moved on since those early pioneering days when the relatively young profession of Anaesthesia was born? Back then the word wasn't as widely used and the gentlemen in question described their activities as "rendering people insensible using sulphuric ether for the conduct of surgery".

Remember - if you've not yet subscribed to our mailing list you're only getting half of the TopMed talk experience, go to our website now: www.topmedtalk.com

Recorded last year this piece has Dr Joff Lacey paying tribute to the birthplace of Anaesthesia. Joined by Dr Liam Brennan, President of The Royal College of Anaesthetists (RCoA) and Dr Andy Bailey, Addenbrooke's Hospital, Cambridge.

EXCLUSIVE interview with the incoming President of the AANA | AANA 2018 Sep 24, 2018

TopMedTalk is at the American Association of Nurse Anaesthetists (AANA) 2018 in Boston. After an incredible year for the organisation and we were delighted to be able to get some time with the association's incoming President.

Desiree Chappell speaks with her guest Garry Brydges, DNP, MSN, MBA,CRNA, ACNP-BC, Chief Nurse Anesthetist at UT MD Anderson Cancer Center-Department of Anesthesiology and Perioperative Medicine and incoming President of the AANA.

EXCLUSIVE interview with the outgoing President of the AANA | AANA 2018 Sep 24, 2018

TopMedTalk is at the American Association of Nurse Anaesthetists (AANA) 2018 conference in Boston. It has been an incredible year for the organisation and we were delighted to be able to get some time with the association's current outgoing President. Here Desiree Chappell sits down with her guest Dr Bruce Weiner, Adjunct Faculty at the University of South Florida, Clinician at Envision Healthcare and President of the AANA.

Introducing the Enhanced Recorvery After Surgery (ERAS) Shared Interest Group (SIG) | AANA 2018 Sep 24, 2018

Desiree Chappell and her guests discuss the Enhanced Recorvery After Surgery (ERAS) Shared Interest Group (SIG). TopMedTalk is at the American Association of Nurse Anaesthetists (AANA) 2018 conference in Boston and will be sharing podcasts from the meeting with you over the next several days. Desiree Chappell speaks with her guests, Josh Newman Lead CRNA at Passavant Area Hospital, Springfield, Illinois Area and now Chair of the Enhanced Recovery After Surgery (ERAS) Shared Interest Group (SIG) and Randall Moore, DNP, MBA, CRNA and Chief Executive Officer of the AANA

Any answers? Part 4: Quality assurance and quality improvement | EBPOM World Congress 2018 Sep 24, 2018

The Enhanced Perioperative Care for High-risk patients (EPOCH) trial results, as revealed at EBPOM 2018, show no change in mortality rates either on a 90 day or 180 day scale. What does this mean as regards the drive towards quality improvement in perioperative healthcare? For more on this we highly recommend you listen to these two podcasts here: The Epoch Trial Results: https://www.topmedtalk.com/ebpom-2018-8-the-epoch-trial-results/ The Dawn of a new EPOCH: https://www.topmedtalk.com/ebpom-2018-9-the-dawn-of-a-new-epoch/ Further light at the end of the tunnel is found in this piece about The Emergency Laparotomy Collaborative (ELC) which Monty mentions during the podcast: https://www.topmedtalk.com/ebpom-2018-emergency-lapartoomy-collaborative/ Presented by Monty Mythen and Desiree Chappell with contributions from Rupert Pearse, Professor of Intensive Care Medicine at Queen Mary, University of London, Nial Quiney, Consultant Anaesthetist at Royal Surrey County Hospital and Principal investigator for the Emergency Laparotomy Quality Improvement Care Bundle (ELPQuiC) project and Clinical Lead for the Emergency Laparotomy Collaborative (ELC), Carole Peden, Professor of Anesthesiology and Executive Director of the Center for Health System Innovation, University of Southern California, University of Bath and the Institute for Healthcare Improvement (IHI), Ramani Moonesinghe, Director of the UK National Institute of Academic Anaesthesia Health Services Research Centre. This special programme was originally streamed live on www.topmedtalk.com - if you missed it you're obviously not yet signed up to our newsletter! Remedy the situation, for free, now by either going to the website www.topmedtalk.com or following this link to sign up directly: https://www.topmedtalk.com/sign-up/

Any answers? Part 3: The Big Trials | EBPOM World Congress 2018 Sep 23, 2018

Here Monty and Desiree present part of Professor Paul Myles's EBPOM 2018 presentation regarding the RELIEF trial, a massive part of the perioperative calendar this year. What are the consequences of this trial for the practice of Enhanced Recovery After Surgery (ERAS)? Also hear more about the follow up trial which will be looking at Acute Kidney Injury (AKI). This then leads to discussion of the OPTIMISE II trial.

Discussion then leads into the FEDORA trial and the IMPRESS trial with a clip of Monty's talk from EBPOM 2018.

Presented by Monty Mythen and Desiree Chappell with contributions from Professor Paul Myles Head of Alfred Health's and Monash University's Department of Anaesthesia and Perioperative Medicine and Professor Rupert Pearse, Intensive Care Medicine at Queen Mary, University of London.

This special programme was originally streamed live on www.topmedtalk.com - if you missed it you're obviously not yet signed up to our newsletter. Go to the website or follow this link: https://www.topmedtalk.com/sign-up/

Is there a global shortfall of anesthesia providers? | AANA 2018 Sep 22, 2018

Is there a global shortfall of anesthesia providers? How do we widen the number of people in the profession, both nationally and internationally?

TopMedTalk is at the AANA 2018 conference in Boston and will be sharing podcasts from the meeting with you over the next several days.

In this piece Desiree Chappell and Monty Mythen talk with Josh Newman, CRNA and Randy Moore, CRNA and CEO of the American association of Nurse Anesthetists.

The Hypotension Prediction Index (HPI) | TopMedTalk Sep 22, 2018

The Hypotension Prediction Index (HPI), which uses a machine learning algorithm to help predict intraoperative hypotension. Regular listeners to www.topmedtalk.com will be familiar with concerns about perioperative hypotension. For those who have just joined us, or anyone who fancies a quick refresher on this issue, it is covered in detail here: https://www.topmedtalk.com/live-from-boston-asa-2017-the-elephant-in-the-room-intraoperative-hypotension/ Many practitioners believe they can predict hypotension by observing trends in a patient's mean arterial blood pressure but data shows the machine learning artificial intelligence used by HPI delivers significantly better results. This piece was recorded during the first Morpheus Consortium Symposium, for more details on that look here: http://morpheusconsortium.org/ Monty Mythen presents with Dr Tim Miller, anesthsiologist from Duke University Medical Centre and Thomas Scheeren, Chair Cardiovascular Dynamics Section at European Society of Intensive Care Medicine - ESICM.

Any answers? Part 2: Should we let the machines help? | EBPOM World Congress 2018 Sep 21, 2018

Artificial intelligence; everyone's talking about it and everyone is doing it, or so they say. What's the reality behind these technologies? This discussion delves deep into that future with a discussion about the exciting new developments in the Hypotension Probability Index (HPI) which uses an automated closed loop technology that helps to predict intraoperative hypotension.

This piece is presented by Monty Mythen and Desiree Chappell with contributions from; Sir Bruce Keogh KBE, FRCS, FRCP, British surgeon and physician who specialises in cardiac surgery he was, until this year, Medical Director of the National Health Service in England and National Medical Director of the NHS Commissioning Board (NHS England); Ramani Moonesinghe, Director of the UK National Institute of Academic Anaesthesia Health Services Research Centre; Mike Spiro, anaesthetic consultant at the Royal Free Hospital and also a question from one of the EBPOM Q&A sessions.

This special programme was originally streamed live on www.topmedtalk.com - if you missed it you're obviously not yet signed up to our newsletter. Go to the website or follow this link: https://www.topmedtalk.com/sign-up/

Any answers? Part 1: Colloid vs Crystalloid | EBPOM World Congress 2018 Sep 20, 2018

This special programme was originally streamed live on www.topmedtalk.com - if you missed it you're obviously not yet signed up to our newsletter. Go to the website or follow this link: https://www.topmedtalk.com/sign-up/

Co-presented by Monty Mythen and Desiree Chappell with contributions from Dr Tim Miller, Anaesthesiologist from Duke University Medical Centre, Mark Edwards, Consultant in Anaesthesia and Perioperative Medicine at The University Hospital Southampton NHS Foundation Trust and Paul Myles, Head of Alfred Health's and Monash University's Department of Anaesthesia and Perioperative Medicine.

Physiological Principles of Goal Directed Fluid Therapy | ASA 2017 Sep 19, 2018

This podcast covers the physiological principles of goal directed fluid therapy, fluid responsiveness, the stressed system and the glycocalyx.

Originally streamed live on www.topmedtalk.com and available here in a slightly longer format: https://www.topmedtalk.com/live-from-boston-asa-2017-physiological-principles-of-goal-directed-fluid-therapy/

Dr Joff Lacey interviews his guest Dr Randall Dull of the University of Illinois, live from the ASA in 2017.

POET – a truly multidisciplinary Perioperative Enhancement Team | EBPOM World Congress 2017 Sep 18, 2018

The POET acronym – a truly multidisciplinary Perioperative Enhancement Team; responsible for project managing optimisation programmes.

Monty Mythen speaks with Professor Sol Aronson, tenured professor at Duke University and Executive Vice Chairman in the Department of Anesthesiology.

This piece is taken from a longer conversation to be found here: https://www.topmedtalk.com/aser-ebpom-2017-recap-pod-three-live-from-london/

Hot topic: Outcomes after colorectal surgery | POQI Sep 17, 2018

This piece is a discussion, originally held last year on www.topmedtalk.com, about outcomes after colorectal surgery. Drinking, Eating, Mobilising and Sleep (DREAMS) within hours of major surgery are key process and outcome measures. The conversation is in relation to the concensus paper which was published by the Perioperative Quality Initiative www.poqi.org and is available for you to read here:

https://perioperativemedicinejournal.biomedcentral.com/articles/10.1186/s13741-017-0062-7

Presented by Monty Mythen and Joff Lacey with contributions from Dr Julie Thacker, Colorectal Surgeon form Duke and President of the American Society of Enhanced Recovery, Dr Tim Miller, Anesthesiologist from Duke and Professor Mike Grocott, Anaesthesia and Critical Care Medicine, University of Southampton.

Looking to the future - Bruce Keogh Sep 16, 2018

The NHS, a national institution beloved by the people of the United Kingdom, is 70 years old. EBPOM celebrated this fact with a talk that asked how this institution can move forward. This short clip is taken from a longer piece which you can find here: https://www.topmedtalk.com/ebpom-2018-3-sir-bruce-keogh-the-nhs-at-70/ This piece was streamed live, from the IET at EBPOM 2018, on www.topmedtalk.com Sir Bruce Keogh KBE, FRCS, FRCP, is a giant in the world of UK healthcare. A British surgeon and physician who specialises in cardiac surgery he was, until this year, Medical Director of the National Health Service in England and National Medical Director of the NHS Commissioning Board (NHS England).

"Can we change?" - Sir Bruce Keogh | EBPOM World Congress 2018 Sep 15, 2018

The NHS, a national institution beloved by the people of the United Kingdom, is 70 years old. EBPOM celebrated this fact with a talk that gets right to the heart of why this institution is so special and also how it can move forward in the brave new world which we now ourselves in.

This short clip is taken from a longer piece which you can find here: https://www.topmedtalk.com/ebpom-2018-3-sir-bruce-keogh-the-nhs-at-70/

This piece was streamed live, from the IET at EBPOM 2018, on www.topmedtalk.com

Sir Bruce Keogh KBE, FRCS, FRCP, is a giant in the world of UK healthcare. A British surgeon and physician who specialises in cardiac surgery he was, until this year, Medical Director of the National Health Service in England and National Medical Director of the NHS Commissioning Board (NHS England).

POETTS 2018 - CPET for Risk Stratification in Major Urological Surgery | EBPOM World Congress 2018 Sep 14, 2018

"POETTS 2018 | CPET for Risk Stratification in Major Urological Surgery" - 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 James Prentis, Consultant Anaesthetist, Freeman Hospital, Newcastle-upon-Tyne.

POETTS 2018 - The Measurement of Exercise Tolerance before Surgery (METS) Study: early results | EBPOM World Congress 2018 Sep 13, 2018

"POETTS 2018 | The Measurement of Exercise Tolerance before Surgery (METS) Study: early results" - 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 Mike Grocott, Professor of Anaesthesia and Critical Care Medicine, University of Southampton.

POETTS 2018 - CPET and Shared Decision Making | EBPOM World Congress 2018 Sep 12, 2018

"POETTS 2018 | CPET and Shared Decision Making" - 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 Dr Helen Anderson, a Consultant Anaesthetist and Peri-operative Physician at Derriford Hospital, Plymouth, and currently the lead for Pre-operative Assessment and CPET.

POETTS 2018 - Activity Monitors and CPET variables | EBPOM World Congress 2018 Sep 11, 2018

"POETTS 2018 | Activity Monitors and CPET variables" - 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 John Griffiths, a consultant in anaesthetics and intensive care medicine at Oxford University Hospitals NHS Foundation Trust.

POETTS 2018 - Surgery School and i-cough | EBPOM World Congress 2018 Sep 10, 2018

"POETTS 2018 | Pre-operative Inspiratory Muscle Training" - 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 John Moore, Adult Critical Care Clinical Director and Consultant Critical Care & Anaesthesia at Manchester.

POETTS 2018 - Pre-operative Inspiratory Muscle Training | EBPOM World Congress 2018 Sep 09, 2018

"POETTS 2018 | Pre-operative Inspiratory Muscle Training" - 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 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.

POETTS 2018 - Changing behaviours of the medical team before surgery | EBPOM World Congress 2018 Sep 08, 2018

"POETTS 2018 | Changing behaviours of the medical team before surgery" - 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 Dr Darren Flynn, Practitioner Health Psychologist, Newcastle University.

POETTS 2018 - The evolution of a community-based Prehabilitation service | EBPOM World Congress 2018 Sep 07, 2018

"POETTS 2018 | The evolution of a community-based Prehabilitation service" - 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 Gerard Danjoux, consultant in Anaesthesia and Sleep Medicine at South Tees Hospitals NHS Trust.

POETTS 2018 - Psychological Behavioural Change Interventions in Cancer Patients | EBPOM World Congress 2018 Sep 06, 2018

"POETTS 2018 | Psychological Behavioural Change Interventions in Cancer Patients" - 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 Chloe Grimmett, behavioural scientist from Southampton University. She works closely alongside the 'Fit for Surgery Team', providing the behavioural intervention which is part of the on-going WesFit prehabilitation trial.

EBPOM 2018 - 10 | What is TRIPOM? Sep 05, 2018

Trainees with an Interest in Perioperative Medicine (TRIPOM) is an exciting new collaborative designed to enhance and channel the enthusiasm of its members through various free open access online resources. The aim is to help give trainees a voice in the field of perioperative medicine.

Their website is here: www.tripom.org

Joff Lacey presenting, with his guests; John Whittle, assistant Professor at Duke University Medical Centre and one of the founders of TRIPOM and Sam Bampoe, one of the founders of TRPIPOM and a consultant in Anaesthesia and Perioperative Medicine at University College London NHS Foundation Trust.

Join in the debate: contact@topmedtalk.com

EBPOM 2018 - 14 | The realities of pain management Sep 04, 2018

What is pain control for a perioperative patient? What is the 'subacute period' and do you incorporate it into your practice? How do we keep patients 'opioid free' once they leave our care? Furthermore - is the curriculum for medical professionals changing in light of the 'opioid epidemic'?

The tide is undoubtedly turning, the conversation covers lots of good news related to a rising awareness of a very serious problem which includes a need to educate the public.

Desiree Chappell and Vicki Morton presenting, with their guests; Professor Padma Gulur, Anaesthesia and Executive Vice-Chair at Duke University and Dr Natasha Curran, pain medicine University College London Hospital (UCLH) and Medical Director at the Health Innovation Network.

PQIP Pain: from individual case to systems management | EBPOM World Congress 2018 Sep 03, 2018

"PQIP Pain: from individual case to systems management" - 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 Dr Natasha Curran, consultant in anaesthesia and pain management University College London Hospital (UCLH) and Medical Director at the Health Innovations Network, South London.

Does choice of opioid influence health outcomes? | EBPOM World Congress 2018 Sep 02, 2018

"Does choice of opioid influence health outcomes?" - 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 Padma Gulur, Professor of Anaesthesia and Executive Vice-Chair at Duke University.

Perioperative nutrition | EBPOM World Congress 2018 Sep 01, 2018

"Perioperative nutrition" - 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 Paul Wischmeyer, Professor of the Department of Anesthesiology, Duke University.

Enhanced recovery case study with Q&A | EBPOM World Congress 2018 Aug 31, 2018

"Case study with Q & A" - 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

This piece followed on from this presentation here: https://www.topmedtalk.com/ebpom-2018-perioperative-nutrition-should-be-a-key-part-of-enhanced-recovery/

Perioperative nutrition should be a key part of Enhanced Recovery | EBPOM World Congress 2018 Aug 30, 2018

"Perioperative nutrition should be a key part of Enhanced Recovery" - 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 Paul Wischmeyer, Professor of the Department of Anesthesiology, Duke University.

Hypotension probability in practice | EBPOM World Congress 2018 Aug 29, 2018

"Hypotension probability in practice" - 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 Mike Spiro, anaesthetic consultant at the Royal Free Hospital and Jez Fabes, Speciality Registrar and Academic Clinical Fellow of Anaesthesia at University College London (UCL) Hospitals.

AI - Can hypotension be predicted before it happens? | EBPOM World Congress 2018 Aug 28, 2018

"Hypotension: Cause and effect" - 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 our Editor In Chief, Monty Mythen, Smiths Medical Professor of Anaesthesia and Critical Care at University College London.

SNAP (Sprint National Anaesthesia Project) | EBPOM World Congress 2018 Aug 27, 2018

"SNAP (Sprint National Anaesthesia Project)" - 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 Ramani Moonesinghe, Director of the UK National Institute of Academic Anaesthesia Health Services Research Centre.

Rehabilitation post critical care | EBPOM World Congress 2018 Aug 26, 2018

"Rehabilitation post critical care" - 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 Linda Denehy, Head of the Melbourne School of Health Sciences and Professor of Physiotherapy at The University of Melbourne, Australia.

Post-operative critical care: what should we do? | EBPOM World Congress 2018 Aug 25, 2018

"Post-operative critical care: what should we do?" - 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 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.

EBPOM 2018 - 4 | The Roundtable on NELA and shared decision making Aug 24, 2018

What is the standard of care given to patients who are getting an 'emergency laparotomy'? How do you use national data on a local level?

Also in this conversation; teaching patients, learning from patients, shared decision making and bringing together the preferences of the patient and practitioner.

There is also reaction to yesterday's keynote speaker, Sir Bruce Keogh, who's full speech is available as a podcast here: https://www.topmedtalk.com/ebpom-2018-3-sir-bruce-keogh-the-nhs-at-70/

Presented by Desiree Chappell this roundtable discussion involves her two guests; Angela Coulter, a UK based health policy analyist and researcher, and Sarah Hare of the National Emergency Laparotomy Audit (NELA).

Antibiotic stewardship in perioperative care | EBPOM World Congress 2018 Aug 23, 2018

"Antibiotic stewardship in perioperative care" - 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 Alison Holmes, Professor of Infectious Diseases at Imperial College, Fellow of the Academy of Medical Sciences and an Senior Investigator at the National Institute of Health Research (NIHR).

Shared decision making in perioperative care | EBPOM World Congress 2018 Aug 22, 2018

"Shared decision making in perioperative care" - 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 Angela Coulter, a UK based health policy analyst and researcher

QA, QI and Patient involvement | EBPOM World Congress 2018 Aug 21, 2018

"QA, QI and Patient involvement" - 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 Sarah Hare, of the National Emergency Laparotomy Audit (NELA).

EBPOM 2018 - 13 | 20 years of EBPOM Aug 20, 2018

Discussion begins with an explanation of 'Trainees with an Interest in Perioperative Medicine' (TRIPOM), a big hit at the conference this year, then a wider discussion follows which includes thoughts regarding further research and application of the perioperative method as well as where it impacts medicine and care. The importance of a multidisciplinary team based approach is strongly emphasised.

The Getting It Right First Time (GIRFT) initiative is also discussed, more on that here:

http://topmedtalk.libsyn.com/iseh-highlight-getting-it-right-first-time-girft

Further discussion of TRIPOM is here:

https://www.topmedtalk.com/ebpom-2018-10-what-is-tripom/

Presented by Desiree Chappell with her guests; Dr Ramani Moonesinghe, Professor of Perioperative Medicine at University College London (UCL) and Anne-Marie Bougeard perioperative medicine fellow at the Royal College of Anaesthetists (RCoA).

EBPOM 2018 - 7 | "70 Years on: Our NHS" panel discussion Aug 19, 2018

This is the panel discussion which followed the address at EBPOM 2018 by Professor Sir Bruce Keogh on the eve of the 70th anniversary of the NHS.

Various questions from the audience are considered; where should we be in ten years from now, what are the disruptive forces headed our way?

The panel features; Sir Bruce Keogh, Professor Monty Mythen, University College London, Carole Peden, Professor of Anesthesiology and Exec. Director of the Center for Health System Innovation, University of Southern California, University of Bath and the Institute for Healthcare Improvement (IHI), Professor Sol Aronson, tenured professor at Duke University and Executive Vice Chairman in the Department of Anesthesiology, Mike Grocott, Professor of Anaesthesia and Critical Care Medicine, University of Southampton, NIHR Senior Investigator and Dr Ramani Moonesinghe, Director of the UK National Institute of Academic Anaesthesia Health Services Research Centre.

The full lecture from Sir Bruce Keogh 'Ernest Henry Starling Plenary Lecture 2018 “70 Years on: our NHS”' is available in full here: https://www.topmedtalk.com/ebpom-2018-3-sir-bruce-keogh-the-nhs-at-70/

EBPOM 2018 - 3 | Sir Bruce Keogh The NHS at 70 Aug 18, 2018

The NHS, a national institution beloved by the people of the United Kingdom is 70 years old. EBPOM celebrated this fact with a talk that gets right to the heart of why this institution is so special and also how it can move forward in the brave new world we find ourselves in now.

This piece was streamed live, from the IET at EBPOM 2018, on www.topmedtalk.com

Sir Bruce Keogh KBE, FRCS, FRCP, is a giant in the world of UK healthcare. A British surgeon and physician who specialises in cardiac surgery he was, until this year, Medical Director of the National Health Service in England and National Medical Director of the NHS Commissioning Board (NHS England).

Perioperative medicine is Population Health Management | EBPOM World Congress 2018 Aug 17, 2018

"Perioperative medicine is Population Health Management" - 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 Sol Aronson, tenured professor at Duke University and Executive Vice Chairman in the Department of Anesthesiology

Fluid therapy in emergency surgery | EBPOM World Congress 2018 Aug 16, 2018

"Fluid therapy in emergency surgery" - 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 Mark Edwards, Consultant in Anaesthesia and Perioperative Medicine at The University Hospital Southampton NHS Foundation Trust.

EBPOM 2018| Emergency laparotomy Collaborative Aug 15, 2018

"Emergency laparotomy Collaborative" - 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 Nial Quiney, Consultant Anaesthetist at Royal Surrey County Hospital and Principal investigator for the Emergency Laparotomy Quality Improvement Care Bundle (ELPQuiC) project and Clinical Lead for the Emergency Laparotomy Collaborative (ELC).

EBPOM 2018| Driving value in perioperative care: The Michigan experience Aug 14, 2018

"Driving value in perioperative care: The Michigan experience" - 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 Michael Englesbe, Darling Sr. & Cyrenus G. Darling Jr. Professor of Surgery, Michigan.

EBPOM 2018| Colloid vs Crystalloid - Goal Directed Therapy Aug 13, 2018

"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 and Critical Care at University College London.

EBPOM 2018| Perioperative Haemodynamic Management Aug 12, 2018

"Perioperative Haemodynamic Management" - 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 and Critical Care at University College London.

EBPOM 2018 - 11 | A US perspective on the NHS and 'The Brain Health initiative' Aug 11, 2018

After 70 years the NHS still continues to promote debate around the world, here you get expert analysis of the deeper realities of a taxpayer funded national health service.

Also - what is "The Brain Health Initiative"? Why is it that so many aspects of brain function are so hard to understand? Why is cognitive dysfunction such a difficult topic to discuss? How far away are we from the days when we will have a biomarker that can help us in this area?

Desiree Chappell presents, with her guests; Dr Lee A. Fleisher Professor and Chair of Anesthesiology and Critical Care, University of Pennsylvania and Miles Berger, Neuroanesthesiologist at Duke University Medical Center.

Join in the debate: contact@topmedtalk.com

EBPOM 2018| Postoperative changes in cognition: The role of biomarkers Aug 10, 2018

"Postoperative changes in cognition: The role of biomarkers" - 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 Miles Berger, Neuroanesthesiologist at Duke University Medical Center.

EBPOM 2018| Obstetric anaesthesia Aug 09, 2018

"Obstetric anaesthesia" - 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 Carolyn Johnston, consultant Anaesthetist in St Georges hospital in London and Improvement lead for the National Emergency Laparotomy Network (NELA.org.uk).

EBPOM 2018| Cardiac anaesthesia and anaemia Aug 08, 2018

"Cardiac anaesthesia and anaemia" - 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 Andrew Klein, Cardiothoracic Anaesthetist at Royal Papworth Hospital, Cambridge and Editor-in-Chief of Anaesthesia.

EBPOM 2018 - 9 | The dawn of a new EPOCH? Aug 07, 2018

How can we redeploy critical care thinking and perioperative care pathways at scale for the high risk surgical patient? What is the Enhanced Perioperative Care after high-risk Surgery (EPOCH trial)? How has it altered the way people think about their practice? Will there be an EPOCH-2?

Presented by Desiree Chappell, Joff Lacey and Mike Grocott with their guest; Professor Rupert Pearse, Professor of Intensive Care Medicine at Queen Mary, University of London.

Join in the debate: contact@topmedtalk.com

EBPOM 2018| Visiting Professor Plenary Lecturer: "Results of the RELIEF Trial" Aug 06, 2018

"Results of the RELIEF Trial" - 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 Paul Myles, Head of Alfred Health's and Monash University's Department of Anaesthesia and Perioperative Medicine.

EBPOM 2018 - 8 | The EPOCH trial results Aug 05, 2018

The highly anticipated results of the Enhanced Peri-Operative Care for High-risk patients (EPOCH) trial, presented for the first time at EBPOM 2018. Were these results as expected? Can we make large scale quality improvement programmes work? Does this trial put 'the big questions' to bed?

This piece is introduced by Monty Mythen and presented by Professor Rupert Pearse, Professor of Intensive Care Medicine at Queen Mary, University of London and Carol Peden, Professor of Anesthesiology and Exec. Director of the Center for Health System Innovation, University of Southern California, University of Bath and the Institute for Healthcare Improvement (IHI).

Join in the debate: contact@topmedtalk.com

EBPOM 2018| Exercise and cancer Aug 04, 2018

"Exercise and cancer" - 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 Mike Grocott, Professor of Anaesthesia and Critical Care Medicine, University of Southampton.

EBPOM 2018| Perioperative Quality Improvement Programme (PQIP) Aug 03, 2018

"Perioperative Quality Improvement Programme (PQIP)" - 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 Dr Ramani Moonesinghe, Professor of Perioperative Medicine at University College London (UCL)

EBPOM 2018| Perioperative brain health initiative: A population health safety initiative Aug 02, 2018

"Perioperative brain health initiative: A population health safety initiative" - one of the lectures which www.topmedtalk.com streamed live from The Institute of Engineering and Technology (IET) in London during EBPOM 2018.

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 Dr Lee A. Fleisher Professor and Chair of Anesthesiology and Critical Care, University of Pennsylvania

EBPOM USA Part 6| Practical realities; How and why Fluid management matters Aug 01, 2018

This is the sixth presentation - originally streamed live on www.topmedtalk.com - taken from the hugely successful "EBPOM-USA: Masters Course, A Perioperative Care Practicum".

Hear the full presentation from Dr Tim Miller, anaesthsiologist from Duke University Medical Centre.

If you like the sound of this and think you and your practice would benefit from attending such a course don't worry, just go to The EBPOM website: https://www.ebpom.org/EBPOM-USA-2018

EBPOM USA Part 5| Practical realities; How and why multimodal Analgesia matters Jul 31, 2018

This is the fifth presentation - originally streamed live on www.topmedtalk.com - taken from the hugely successful "EBPOM-USA: Masters Course, A Perioperative Care Practicum".

Hear the full presentation from Tong Joo (TJ) Gan, Professor and Chairman at Stoney Brook in New York and the immediate past President of the American Society of Enhanced Recovery (ASER).

If you like the sound of this and think you and your practice would benefit from attending such a course don't worry, just go to The EBPOM website: https://www.ebpom.org/EBPOM-USA-2018

EBPOM USA Part 4| Enhanced Recovery - State of the Art Jul 30, 2018

This is the fourth presentation - originally streamed live on www.topmedtalk.com - taken from the hugely successful "EBPOM-USA: Masters Course, A Perioperative Care Practicum".

Hear the full presentation from Desiree Chappell, Certified Registered Nurse Anesthetist (CRNA) and board member of The American Society of Enhanced Recovery (ASER).

If you like the sound of this and think you and your practice would benefit from attending such a course don't worry, just go to The EBPOM website: https://www.ebpom.org/EBPOM-USA-2018

10 Xtreme Everest | Physiology on Top of the World. Jul 29, 2018

Presented by, Mike Grocott, recorded live at 'The Xtreme Everest Symposium' organised by the Department of Anesthesiology, Duke University, USA.

09 Xtreme Everest | Therapeutic Hyperoxia: Medicine Under Pressure. Jul 28, 2018

Presented by, Richard Moon, recorded live at 'The Xtreme Everest Symposium' organised by the Department of Anesthesiology, Duke University, USA.

This series also includes:

TOMORROW:

Morpheus Consortium Distinguished Lecture: Xtreme Everest: Physiology on Top of the World. Mike Grocott

08 Xtreme Everest | A Slightly Different Path to Everest: The Pyramid Lab 2012 & 2016 Jul 28, 2018

Presented by, David McLeod, recorded live at 'The Xtreme Everest Symposium' organised by the Department of Anesthesiology, Duke University, USA.

--

This series also includes:

OUT LATER TODAY:

Therapeutic Hyperoxia: Medicine Under Pressure. Richard Moon

SUNDAY

Morpheus Consortium Distinguished Lecture: Xtreme Everest: Physiology on Top of the World. Mike Grocott

Epigenetics of Hypoxia | Xtreme Everest Jul 27, 2018

Presented by, Kay Mitchell, recorded live at 'The Xtreme Everest Symposium' organised by the Department of Anesthesiology, Duke University, USA.

This series also includes:

OUT LATER TODAY:

SATURDAY:

A Slightly Different Path to Everest: The Pyramid Lab 2012 & 2016, David MacLeod

Therapeutic Hyperoxia: Medicine Under Pressure. Richard Moon

SUNDAY

Morpheus Consortium Distinguished Lecture: Xtreme Everest: Physiology on Top of the World. Mike Grocott

06 Xtreme Everest | Oxygen and the Brain. Jul 27, 2018

Presented by, Chris Imray, recorded live at 'The Xtreme Everest Symposium' organised by the Department of Anesthesiology, Duke University, USA.

This series also includes:

OUT LATER TODAY:

The Epigenetics of Hypoxia. Kay Mitchell

SATURDAY:

A Slightly Different Path to Everest: The Pyramid Lab 2012 & 2016, David MacLeod

Therapeutic Hyperoxia: Medicine Under Pressure. Richard Moon

SUNDAY

Morpheus Consortium Distinguished Lecture: Xtreme Everest: Physiology on Top of the World. Mike Grocott

05 Xtreme Everest | Oxygen Therapy: The Yin and Yang of Our Favorite Drug. Jul 26, 2018

Presented by, Monty Mythen., recorded live at 'The Xtreme Everest Symposium' organised by the Department of Anesthesiology, Duke University, USA.

Oxygen Therapy: The Yin and Yang of Our Favorite Drug. Monty Mythen.

FRIDAY:

Oxygen and the Brain. Chris Imray

The Epigenetics of Hypoxia. Kay Mitchell

SATURDAY:

A Slightly Different Path to Everest: The Pyramid Lab 2012 & 2016, David MacLeod

Therapeutic Hyperoxia: Medicine Under Pressure. Richard Moon

SUNDAY

Morpheus Consortium Distinguished Lecture: Xtreme Everest: Physiology on Top of the World. Mike Grocott

04 Xtreme Everest | Metabolic Adaptation to Hypoxia. Jul 26, 2018

Presented by, Andrew Murray, recorded live at 'The Xtreme Everest Symposium' organised by the Department of Anesthesiology, Duke University, USA.

This series also includes:

OUT LATER TODAY:

Oxygen Therapy: The Yin and Yang of Our Favorite Drug. Monty Mythen.

FRIDAY:

Oxygen and the Brain. Chris Imray

The Epigenetics of Hypoxia. Kay Mitchell

SATURDAY:

A Slightly Different Path to Everest: The Pyramid Lab 2012 & 2016, David MacLeod

Therapeutic Hyperoxia: Medicine Under Pressure. Richard Moon

SUNDAY:

Morpheus Consortium Distinguished Lecture: Xtreme Everest: Physiology on Top of the World. Mike Grocott

03 Xtreme Everest | Cardiovascular Adaptation to Hypoxia. Jul 25, 2018

Presented by, Daniel Martin, recorded live at 'The Xtreme Everest Symposium' organised by the Department of Anesthesiology, Duke University, USA.

This series also includes:

THURSDAY:

Metabolic Adaptation to Hypoxia. Andrew Murray

Oxygen Therapy: The Yin and Yang of Our Favorite Drug. Monty Mythen.

FRIDAY:

Oxygen and the Brain. Chris Imray

The Epigenetics of Hypoxia. Kay Mitchell

SATURDAY:

A Slightly Different Path to Everest: The Pyramid Lab 2012 & 2016, David MacLeod

Therapeutic Hyperoxia: Medicine Under Pressure. Richard Moon

SUNDAY

Morpheus Consortium Distinguished Lecture: Xtreme Everest: Physiology on Top of the World. Mike Grocott

02 Xtreme Everest | What Happens to Healthy Humans in Hypoxia? Jul 24, 2018

Presented by, Denny Levett, recorded live at 'The Xtreme Everest Symposium' organised by the Department of Anesthesiology, Duke University, USA.

--

What Happens to Healthy Humans in Hypoxia? Denny Levett.

This series also includes:

WEDNESDAY:

Cardiovascular Adaptation to Hypoxia. Daniel Martin

THURSDAY:

Metabolic Adaptation to Hypoxia. Andrew Murray

Oxygen Therapy: The Yin and Yang of Our Favorite Drug. Monty Mythen.

FRIDAY:

Oxygen and the Brain. Chris Imray

The Epigenetics of Hypoxia. Kay Mitchell

SATURDAY:

A Slightly Different Path to Everest: The Pyramid Lab 2012 & 2016, David MacLeod

Therapeutic Hyperoxia: Medicine Under Pressure. Richard Moon

SUNDAY

Morpheus Consortium Distinguished Lecture: Xtreme Everest: Physiology on Top of the World. Mike Grocott

01 Xtreme Everest | Critical Care - Can we Learn from Environmental Physiology? Jul 23, 2018

Presented by, Professor Mike Grocott, recorded live at 'The Xtreme Everest Symposium' organised by the Department of Anesthesiology, Duke University, USA.

--

Human Tolerance of Hypoxia: Going to Extremes to Understand Critical Illness.

This series also includes:

TUESDAY:

What Happens to Healthy Humans in Hypoxia? Denny Levett

WEDNESDAY:

Cardiovascular Adaptation to Hypoxia. Daniel Martin

THURSDAY:

Metabolic Adaptation to Hypoxia. Andrew Murray

Oxygen Therapy: The Yin and Yang of Our Favorite Drug. Monty Mythen.

FRIDAY:

Oxygen and the Brain. Chris Imray

The Epigenetics of Hypoxia. Kay Mitchell

SATURDAY:

A Slightly Different Path to Everest: The Pyramid Lab 2012 & 2016, David MacLeod

Therapeutic Hyperoxia: Medicine Under Pressure. Richard Moon

SUNDAY

Morpheus Consortium Distinguished Lecture: Xtreme Everest: Physiology on Top of the World. Mike Grocott

POPS Part 4| Education, education, education. Jul 22, 2018

The Guy's and St Thomas's POPS team offer a fellowship, here the discussion covers both that and the wider issue of getting students and younger practitioners into this growing area of health care. How do we get undergraduates to learn the skills which simple demographics show are going to become more and more crucial as the trend towards a longer life span continues in the Western world?

Monty Mythen and Desiree Chappell continue their conversation with Dr Jugdeep Dhesi, Clinical Lead, POPS and Consultant Geriatrician, Guy's and St Thomas' NHS Trust.

POPS Part 3| The Frailty Unit Jul 22, 2018

The Frailty Unit is part of the service offered by the Proactive care for Older People undergoing Surgery (POPS) team at Guy's and St Thomas's Hospital. Could something like this work outside of the context of the UK's National Health Service? What are the advantages of being able to safely discharge frail patients who may instead have ended up back in the hospital system?

Monty Mythen and Desiree Chappell continue their conversation with Dr Jugdeep Dhesi, Clinical Lead, POPS and Consultant Geriatrician, Guy's and St Thomas' NHS Trust.

POPS Part 2| POPS - meet more of the team from Guy's and St Thomas's Jul 21, 2018

In part two of this series we continue looking at the POPS (Proactive care for Older People undergoing Surgery) team at Guy's and St Thomas's Hospital. How does having a POPS team facilitate specialist education at the institution? What other opportunities are there for patients and staff as a result of innovations such as this?

Finally - what are the drugs that anaesthetists commonly prescribe to patients which people who work on this side of the service aren't so keen on?

Desiree Chappell presents, with additional questions thrown in by Monty Mythen, as they speak with their guests; Magda Sbai, specialist registrar at Guy's and St Thomas's, Jason Cross, advanced nurse practitioner and Nursing lead for the POPS team, Claire Gallagher, Deputy clinical nurse specialist and Dr Jugdeep Dhesi, Clinical Lead, POPS and Consultant Geriatrician, Guys and St Thomas' NHS Trust.

POPS Part 1| TopMed talk at Guy's and St Thomas's Hospital in Central London Jul 21, 2018

What is POPS (Proactive care for Older People undergoing Surgery) and how have things gone since this service was introduced to Guy's and St Thomas's back in 2004? How do the team apply the techniques of this programme to the perioperative pathway of a patient? Would a service like this be useful at your practice? Can your institution accommodate a fully comprehensive geriatric assessment and optimisation process?

Furthermore, should a programme like this be rolled out across the UK and could anything similar be considered in the US?

Desiree Chappell, joined by Monty Mythen, as they speak with their guests; Dr Jugdeep Dhesi and Dr Judith Partridge, consultant geriatricians at Guy's and St Thomas's Hospital in London.

The Great World Fluid Debate: John Myburgh Jul 20, 2018

Here we feature a central figure in the ongoing Great World Fluid debate. He was sadly unable to attend EBPOM 2018 but we still 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 Professor John A Myburgh, Intensive Care Medicine, University of New South Wales; Director of the Division of Critical Care and Trauma at the George Institute for Global Health and Senior Intensive Care Physician at the St George Hospital, Sydney.

He holds honorary Professorial appointments at the University of Sydney and Monash University School of Public Health and Preventive Medicine.

The Measurement of Exercise Tolerance before Surgery (METS) trial. CPET predicts major complications. Jul 19, 2018

The Measurement of Exercise Tolerance before Surgery (METS) trial has both raised, and answered, complicated questions. In the immediate wake of EBPOM 2018, this conversation explores some of the deeper issues and big take home moments from the trial. How will it change practice? Will it alter the use of the Duke Activity Status Index (DASI) for example? Cardiopulmonary Exercise Testing (CPET) clearly predicts major complications and is more predictive than the comparators. Why is this not clear in the abstract? Why is there an obsession with major cardiac events when they are rare?

Presented by Monty Mythen and Desiree Chappell with their guest Professor Mike Grocott of Southampton University and a lead investigator in the METS trial and an author of the paper.

EBPOM 2018 - 12 | The importance of CPET and NELA Jul 16, 2018

What are the benefits of Cardio Pulmonary Exercise Testing (CPET) in cancer patients? What is the evidence that suggests prehabilitation changes outcomes? Furthermore, what is the National Emergency Laparotomy Audit (NELA) and what are its benefits?

Presented by Joff Lacey and Desiree Chappell with their guests; Carolyn Johnston, consultant Anaesthetist in St Georges hospital in London and Improvement lead for the National Emergency Laparotomy Network (NELA.org.uk) and Malcolm West, National Institute for Health Research (NIHR) funded clinical lecturer in surgery and honorary colorectal surgical specialist registrar at the University of Southampton, United Kingdom.

Join in the debate: contact@topmedtalk.com

The Second Annual Prehabilitation World Congress - Part 2 Jul 13, 2018

Key messages and big takeaways from a hugely successful meeting, The Second Annual Prehabilitation World Congress, held in Eindhoven, The Netherlands. What was the 'dare to dream' section? How is the business case for prehabilitation being made?

Also - listen out for details of the third World Congress and discover how you can get involved.

Mike Grocott presents with his guests; Sandy Jack, MD, PhD, Senior Researcher, Southampton University Hospital, United Kingdom, Gerrit Slooter, MD, PhD, Surgical Oncologist, Maxima Medical Center, The Netherlands and Gerard Danjoux, Prof, MD, PhD, Consultant Anaesthetist, South Tees Hospitals NHS Hospital, United Kingdom.

Join in the debate: contact@topmedtalk.com

The Second Annual Prehabilitation World Congress - Part 1 Jul 12, 2018

What's the relationship between Enhanced Recovery after Surgery (ERAS) and Prehabilitation? How are randomised trials showing outcome data in a positive way?

Furthermore, according to some of the keynote speakers, what were the highlights and big headlines at this important gathering?

Mike Grocott presents with his guests Olle Ljungqvist, Prof. of Surgery, MD, PhD, Surgeon, Örebro University Hospital & Karolinska Institutet, Sweden and Franco Carli, Prof. MD, PhD, Anesthesiologist, McGill University, Canada.

Join in the debate: contact@topmedtalk.com

Prehabilitation and rehabilitation; the importance of movement Jul 11, 2018

What is pre-habilitation and how important is early mobilisation to perioperative post-operative rehabilitation?

Desiree Chappell presents with her guests Dr Steve Flanagan, Chair of Physical Medicine and Rehabilitation at NYU Langone and Colleen Walsh, Assistant Professor, Nursing University of Southern Indiana, President, National Association of Orthopaedic Nurses.

This piece taken from a longer conversation to be heard here: https://www.topmedtalk.com/rehabilitation-exercise-is-real-medicine/

I want to dance at my daughter's wedding. Jul 10, 2018

What are the goals of healthcare providers, how do we measure success and why does value based care matter? Insight from The American Association of Retired People puts the focus in this conversation upon the patient. How do they measure value? What do they want and why?

This piece features Desiree Chappell with two of the guest speakers from the American College of Perioperative Medicine's 2018 conference; Eric J Schneidewind president of the AARP and Kevin Bozic, Chair of Surgery & Perioperative Care at the Dell Medical School.

It's a clip taken from a longer conversation which you can listen to in full here: https://www.topmedtalk.com/the-beauty-of-shared-decision-making/

ISEH Highlight: Kill or cure? Cold water adaption therapy. Jul 08, 2018

Cold water adaptation for theraputic purposes. How can you gain the benefits of this unusual but increasingly popular activity? Open water swimming is discussed, how long you need to do it and what the benefits are. It's suggested that it might work because it is an anti-inflammatory. There's even the suggestion it can help with issues such as chrohn's disease.

This piece is taken from a longer conversation to be found here: https://www.topmedtalk.com/live-from-the-iseh-part-1/

This edition of TopMedTalk was recorded at The Institute of Sport Exercise and Health (ISEH) live from an Enhanced Recovery After Surgery (ERAS) leadership forum.

The conversation features Professor Monty Mythen and his guest Mark Harper Consultant Anaesthetist at Brighton and Sussex University Hospitals, with a research interest in the prevention of perioperative hypothermia and the use of cold water adaptation for theraputic purposes.

EBPOM 2018 - 6 | TRIPOM at TopMedTalk live pt2 Jul 07, 2018

TopMedTalk live is a gathering of Trainees with an interest in Perioperative Medicine (TRIPOM) alongside TopMedTalk listeners and EBPOM 2018 attendees in the IET London, England.

This conversation is driven by questions from listeners online and attendees in the audience.

What do you do when it comes to 'screening for frailty? Should it be physical frailty or mental frailty? What do we then do with that information? How do we acknowledge the fact that, over the perioperative period, a 'frailty score' will likely change? Is 'the perioperative moment' a moment that can produce lasting long term lifestyle changes? When it comes to prehabilitation, how do we overcome issues regarding patient motivation?

TopMedTalk live was presented by Desiree Chappell and Monty Mythen in front of a live audience with panellists; John Whittle, assistant Professor at Duke University Medical Centre and one of the founders of TRIPOM, Katie Samuel, TRIPOM co-chair and perioperative medicine fellow at UCL Hospitals, Dr Lee A. Fleisher Professor and Chair of Anesthesiology and Critical Care, University of Pennsylvania and Ross Kerridge, John Hunter Hospital, Newcastle, Australia, often cited as 'the father of Modern Perioperative Medicine'.

Join in the debate: contact@topmedtalk.com

EBPOM 2018 - 5 | TRIPOM at TopMedTalk live pt1 Jul 06, 2018

TopMedTalk live is a gathering of Trainees with an interest in Perioperative Medicine (TRIPOM) alongside TopMedTalk listeners and EBPOM 2018 attendees in the IET London, England.

This conversation is driven by questions from listeners online and attendees in the audience. Two pain management experts alongside the TRIPOM representatives and Desiree and Monty respond in detail to some of the key controversies in Perioperative medicine.

Is there an opioid crisis and is it unique to the USA? Is there a problem with opioids and cancer outcomes? How do we educate junior doctors on this topic? What about patients who demand opioids to handle their pain? Should we be looking more closely at where and why Oxycodone specifically is prescribed?

TopMedTalk live was presented by Monty Mythen and Desiree Chappell in front of a live audience with panellists; John Whittle, assistant Professor at Duke University Medical Centre and one of the founders of TRIPOM, Katie Samuel, TRIPOM co-chair and perioperative medicine fellow at UCL Hospitals, Dr Padma Gulur, Duke University Medical Centre, Dr Natasha Curran, UCL Hospitals.

Join in the debate: contact@topmedtalk.com

EBPOM 2018 -2 | Join us on the topmedtalk.com live stream now! Jul 04, 2018

Back in London for EBPOM 2018!

This piece features a quick rundown of some of the things you can expect to hear from www.TopMedTalk.com on our live streaming page. As always highlights of that will feature in the main podcast but, while the conference is on, we're streaming it live.

TO LISTEN CLICK ON THIS LINK HERE:

https://playall.sharp-stream.com/topmedtalk.mp3?autoplay=true

This edition of TopMedTalk is presented by Desiree Chappell, Joff Lacey and Vicki Morton.

Join in the debate: contact@topmedtalk.com

EBPOM USA Part 3| A Perioperative Practicum with Dr Lee A. Fleisher Jul 02, 2018

This is the third presentation - originally streamed live on www.topmedtalk.com - taken from the hugely successful "EBPOM-USA: Masters Course, A Perioperative Care Practicum".

Hear the full presentation from Dr Lee A. Fleisher Professor and Chair of Anesthesiology and Critical Care, University of Pennsylvania.

If you like the sound of this and think you and your practice would benefit from attending such a course don't worry, just go to The EBPOM website: https://www.ebpom.org/EBPOM-USA-2018

EBPOM USA Part 2| A Perioperative Practicum with Professor Monty Mythen Jul 01, 2018

This is the second presentation - originally streamed live on www.topmedtalk.com - taken from the hugely successful "EBPOM-USA: Masters Course, A Perioperative Care Practicum".

Hear the full presentation from our Editor In Chief, Professor Monty Mythen, Smiths Medical Professor of Anaesthesia and Critical Care at University College London.

If you like the sound of this and think you and your practice would benefit from attending such a course don't worry, just go to The EBPOM website: https://www.ebpom.org/EBPOM-USA-2018

EBPOM USA Part 1| A Perioperative Practicum with Professor Sol Aronson Jun 30, 2018

This is the opening address and first presentation - originally streamed live on www.topmedtalk.com - taken from the hugely successful "EBPOM-USA: Masters Course, A Perioperative Care Practicum".

Hear the full presentation from Professor Sol Aronson, a tenured professor at Duke University and Executive Vice Chairman in the Department of Anesthesiology.

If you like the sound of this and think you and your practice would benefit from attending such a course don't worry, just go to The EBPOM website: EBPOM-USA Chicago Masters Course A Perioperative Care Practicum

ISEH Highlight: How do you measure a patient's temperature? Jun 29, 2018

How and where do you measure a patient's temperature? This is a detailed answer to a frequently asked question, various methods are discussed.

This piece is taken from a longer conversation to be found here: https://www.topmedtalk.com/live-from-the-iseh-part-1/

This edition of TopMedTalk was recorded at The Institute of Sport Exercise and Health (ISEH) live from an Enhanced Recovery After Surgery (ERAS) leadership forum.

The conversation features Professor Monty Mythen and his two guests; Dr Simeon West, consultant anaethetist at (University College London Hospitals) UCLH who sits on the board at Regional Anaesthesia UK (RAUK) and Mark Harper Consultant Anaesthetist at Brighton and Sussex University Hospitals, with a research interest in the prevention of perioperative hypothermia and the use of cold water adaptation for theraputic purposes. There are also questions from the audience.

Fluid - Matters | Part 6 'Goal Directed Fluid Therapy' Jun 28, 2018

This is another excerpt from "Controversies in perioperative medicine"; "The Great Fluid Debate". A fascinating piece containing Dr Tim Miller's enthusiastic advocation of goal directed fluid therapy and then the subsequent debate that follows.

It ends up moving into the subject of 'enhanced recovery after cardiothoracic surgery' and what lessons we can learn from excessive hemofiltration during on bypass surgery.

Chaired by Professor Monty Mythen and featuring a presentation by Dr Tim Miller, anaesthsiologist from Duke University Medical Centre and followed by a debate featuring members of the audience and the panel; Professor Mike Grocott, Professor of Anaesthesia and critical care at the University of Southampton; Professor Paul Wischmeyer from the Department of Anesthesiology, Duke University and Professor Stuart Grant, MB ChB, FRCA Director, Medical Student Education, Duke University School of medicine.

Join in the debate! Email us your thoughts for inclusion in a future podcast: contact@topmedtalk.com

Journal Club Express: Intraoperative hyperoxia and surgical site infections Jun 27, 2018

Effect of intraoperative hyperoxia on the incidence of surgical site infections: a meta-analysis

B. Cohen, Y.N. Schacham, K. Ruetzler, S. Ahuja, D. Yang, E.J. Mascha, A.B. Barclay, M.H. Hung, D.I.

BACKGROUND Whether supplemental intraoperative oxygen reduces surgical site infections remains unclear. Recent recommendations from the World Health Organization and Center for Disease Control to routinely use high inspired oxygen concentrations to reduce infection risk have been widely criticized. We therefore performed a meta-analysis to evaluate the influence of inspired oxygen on infection risk, including a recent large trial.

METHODS A systematic literature search was performed. Primary analysis included all eligible trials. Sensitivity analyses distinguished studies of colorectal and non-colorectal surgeries, and excluded studies with high risk of bias. Another post-hoc sensitivity analysis excluded studies from one author that appear questionable.

RESULTS The primary analysis included 26 trials (N=14,710). The RR [95%CI] for wound infection was 0.81 [0.70, 0.94] in the high vs. low inspired oxygen groups. The effect remained significant in colorectal patients (N=10,469), 0.79 [0.66, 0.96], but not in other patients (N=4,241), 0.86 [0.69, 1.09]. When restricting the analysis to studies with low risk of bias, either by strict inclusion criteria (N=5,047) or by researchers’ judgment (N=12,547), no significant benefit remained: 0.84 [0.67, 1.06] and 0.89 [0.76, 1.05], respectively.

CONCLUSIONS When considering all available data, intraoperative hyperoxia reduced wound infection incidence. However, no significant benefit remained when analysis was restricted to objective- or investigator-identified low-bias studies, although those analyses were not as well-powered. Meta-analysis of the most reliable studies does not suggest that supplemental oxygen substantively reduces wound infection risk, but more research is needed to fully answer this question.

DOI: https://doi.org/10.1016/j.bja.2018.02.027

Fluid - Matters | Part 5 the nil by mouth (NPO) debate Jun 26, 2018

Fluid Matters - the ‘nil by mouth’ or ‘NPO’ debate

This piece is taken from "The Great Fluid Debate", it's about changes in practice that have been implimented both in the UK and at various medical centres in the US. Hear how and why the old 'nil by mouth' or ‘NPO’ policy has changed in many instances.

From water to carbohydrate drinks, to black coffee, the thinking has changed in many institutions but part of the battle is in educating patients and their well meaning friends and relatives.

Chaired by Professor Monty Mythen and featuring; Dr Tim Miller, anesthsiologist from Duke University Medical Centre; Professor Mike Grocott, Professor of Anaesthesia and Critical Care at the University of Southampton; Professors Paul Wischmeyer and Stuart Grant, from the Department of Anesthesiology, Duke University and featuring questions from the audience.

Join in the debate: contact@topmedtalk.com

RCoA Conference Highlight: Global views on Perioperative Medicine - real concerns - prisms or schisms? Jun 25, 2018

How do we develop a way to teach perioperative medicine and once that's in place, how should it be overseen? What sort of official endorsement might it need?

Developing a broad knowledge of the process is distinct from being a specialist, how do we develop that further - without developing a schism? This complicated topic is discussed alongside more detail regarding the future for this area.

Presented by Monty Mythen and Mike Grocott with their guests; Joel Symmons, Staff Consultant Anaesthetist in the Department of Anaesthesia and Perioperative Medicine at the Alfred Hospital, Perioperative Medicine Short Course Convenor, and a Senior Lecturer in Anaesthesia at Monash University, and Paul Myles, Head of Alfred Health's and Monash University's Department of Anaesthesia and Perioperative Medicine.

This piece is taken from a longer podcast which you can hear here: https://www.topmedtalk.com/rcoh-14-how-should-we-teach-perioperative-medicine/

ISEH Highlight: ERAS what's the 'secret sauce'? Jun 24, 2018

This piece starts with the question: Is there a hierarchy amongst the various elements of an enhanced recovery pathway? The conversation that follows tackles some of the essential elements of perioperative care.

This conversation is taken from a longer piece to be found here: https://www.topmedtalk.com/live-from-the-iseh-part-2/

For further expert discussion regarding the Drink, Eat, Mobilise, Sleep (DrEaMS) concept there is another short piece you can find here: https://www.topmedtalk.com/standardised-outcomes-from-surgery-drink-eat-mobilise-dream/

This edition of TopMedTalk was recorded at The Institute of Sport Exercise and Health (ISEH) live from an Enhanced Recovery After Surgery (ERAS) leadership forum.

The conversation features questioner Dr Vishal Patil, Consultant Anaesthetist at Cambridge University Hospitals NHS Foundation Trust, alongside Professor Monty Mythen and his two guests; Dr Simeon West, consultant anaethetist at (University College London Hospitals) UCLH who sits on the board at Regional Anaesthesia UK (RAUK) and Mark Harper Consultant Anaesthetist at Brighton and Sussex University Hospitals, with a research interest in the prevention of perioperative hypothermia and the use of cold water adaptation for thearaputic purposes.

Fluid - Matters | Part 4 'The Great American Fluid Debate' Jun 23, 2018

This is an excerpt from 'The Great American Fluid Debate' which was hosted at Duke University Medical Centre's "Controversies in Perioperative Medicine" conference of this year. The debate is framed as "restrictive versus liberal" but, as you'll hear, those terms are questioned by panel members. How do the results of 'The Relief Trial' figure in this debate? Is the pendulum of progress swinging too far - from overly liberal to too restrictive? What can the research and detailed data around these questions tell us?

The two pieces Monty mentions in the podcast, featuring Paul Myles, are found here:

"THE RESULTS"

https://www.topmedtalk.com/the-relief-trial-results/

"YOUR ESSENTIAL DEEP DIVE"

https://www.topmedtalk.com/rcoa-11-the-relief-trial-your-essential-deep-dive-into-the-results/

And you can find the other piece here:

"JOURNAL CLUB; BALANCED VERSUS SALINE"

https://www.topmedtalk.com/journal-club-saline-solution/

Presented by Monty Mythen featuring; Mike Grocott, Professor of Anaesthesia and critical care at the University of Southampton; Professor Paul Wischmeyer from the Department of Anesthesiology, Duke University; Professor Stuart Grant, MB ChB, FRCA Director, Medical Student Education, Duke University School of medicine and Tim Miller, anaesthsiologist from Duke University Medical Centre.

Send us your feedback: contact@topmedtalk.com

Controversies in perioperative medicine; "is pain the fifth vital sign"? Jun 22, 2018

What is 'the morpheus consortium'? What's the current thinking on pain management and the 'opioid crisis'? On reflection were people wrong to emphasise the message that 'pain is the fifth vital sign'? How did 'pain management' instead become 'opioid management'?

The UK has had a slightly different ride to the US in this respect, although not without its problems, could that be due to this 'fifth vital sign' message being less popular on the other side of the atlantic? Is it important to manage expectations and emphasise patient comfort rather than a total absence of any pain whatsoever?

Also here, there's a fascinating discussion of anemia and sex discrimination within its treatment. What is a normal level of hemoglobin in a patient and should this vary depending upon gender?

Presented by Monty Mythen with his guests Mike Grocott, Professor of Anaesthesia and critical care at the University of Southampton and a member of The Morpheus Consortium; Dr. Padma Gulur, anesthesiologist and a Pain Medicine Specialist who sees patients at Davis Ambulatory Surgical Center, Duke Pain Medicine and Duke Perioperative Pain Care; Annemarie Thompson, MD, Director, Residency Program, Professor of Anesthesiology at Duke University School of Medicine.

Controversies in perioperative medicine Jun 21, 2018

Monty sits down with one of the co-organisers of this year's meeting in Orlando and discusses this year's annual conference, "Controversies in perioperative medicine". The discussion encompasses pain relief, opioids, the increased use of ultrasound and the use of particular blocks during abdominal surgery. As ultrasound improves how is perioperative medicine changing? What are the challenges presented by larger patients? What are the potential problems with an ultrasound guided tap block? Presented by Professor Monty Mythen with his guest Professor Stuart Grant, MB ChB, FRCADirector, Medical Student Education, Duke University School of medicine. Join the debate and email us at contact@topmedtalk.com

Fluid Matters | Part 3 Fluid Responsiveness and venous capacitance Jun 20, 2018

This conversation reflects a discussion had at the Perioperative Quality Inititative (POQI). It originally ran under the title, "Intervascular volume and fluid responsiveness" but, as this conversation explains, it was renamed "Fluid Responsiveness and venous capacitance".

With a genuinely multidisciplinary approach on display here this piece gives you a glimpse at the inner workings of the POQI process. How does macro circulation interlock with micro circulation and cellular function? How do people on the ground measure stroke volumes? What do you do when passive leg raising is not appropriate? How do we address hypovolemia? How do you define fluid responsiveness at the bedside?

Presented by Desiree Chappell and Mike Grocott with their guests David Kaufman Associate Professor, Director, Medical Intensive Care Unit at NYU School of Medicine, NYU-Langone Medical Center and Dr Greg Martin Director, Research Network, GaCTSA; Director, Predictive Health Institute; Research Director, Emory Critical Care Center.

Fluid - Matters | Part 2 Total body water and electrolytes Jun 19, 2018

This discussion focuses on the perioperative quality initiative's intense focus this year on total body water and electrolights. How often should we weigh patients to monitor water balance? What can we learn from a real understanding of the circulation of interstitial fluid and lymphatics? What is the role of diuretics for the perioperative practitioner? Also, haemodilution, what should you do if you have a patient with a positive post operative fluid balance and a low haemoglobin? Finally, how do we deal with sodium balance and Chloride?

Coming from this summer's Peroperative Quality Initiative (POQI) hosted at Washington Duke University in Durham this podcast is presented by Monty Mythen and Henry Howe with their guests Tom Woodcock, an independent consultant in patient safety, medical law and ethics, and Manu Malbrain, Professor at Faculty of Medicine and Pharmacology Vrije University in Brussells.

The website mentioned in this piece is here: https://www.fluidacademy.org/

You can email the team via contact@topmedtalk.com

Enhanced recovery for cesarean section patients Jun 18, 2018

How does perioperative care relate to obstetrics? Who does it benefit, the patient, the hospital or both? How does it help to engage pregnant patients through the perioperative process? Furthermore, does the issue of addiction arise in this area?

Coming from this summer's Peroperative Quality Initiative (POQI), hosted at Washington Duke University in Durham, this podcast features Monty Mythen and Desiree Chappell interviewing their guests Dr Attila Kett, anaesthesiologist and Chairman at St Peter’s University Hospital at New Jersey and Dr. Elizabeth Cherot Medical Doctor/Managing Partner at Brunswick Hills Obstetrics and Gynecology. The team are also joined by Professor Sol Aronson, a tenured professor at Duke University and Executive Vice Chairman in the Department of Anesthesiology.

Fluid - Matters|Part 1 Definite definitions, fluid physiology Jun 17, 2018

Names, titles and definitions were sliced, diced and discussed at the Perioperative Quality Initiative (POQI). This conversation, recorded on the morning of the second day of the meeting and featuring some of the participants, reflects that.

"Stress volumes" and "Pre-load" are a couple of examples given in this piece. Everyone involved knew what these words described but once discussions got into detail it became clear multiple definitions were at play. Part of the point of an initiative like POQI is to bring terms like this, used by different people in different ways, to a concensus. This conversation explores some of the dillemmas which emerged as a result.

'Starling pressures' are discussed as is the role of lymph in the fluid balance of our patient's bodies. Furthermore the topic of fluid responsiveness comes up as does passive leg raising. Also, how does the fact that a patient's blood pressure can be normal, even if they've lost upto 25% of blood volume, impact on our understanding of these things?

Finally, how does this relate to the practitioners at the bedside? How do we translate these debates into practical advice which will make a real difference to patients, this piece goes some way towards answering those questions.

Send us your thoughts and contribute ot the debate: contact@topmedtalk.com

Coming from this summer's Peroperative Quality Initiative (POQI) hosted at Washington Duke University in Durham this podcast is presented by Desiree Chappell with Professor Monty Mythen, Henry Howe and their guest Tim Miller, anaesthsiologist from Duke University Medical Centre and organiser of the POQI meeting.

ISEH Highlight: Getting it right first time (GIRFT) Jun 16, 2018

We begin with a question from the audience; 'how do we drive change in our institutions towards enhanced recovery after surgery?'

The GIRFT (Getting It Right First Time) project is explained. The Health Foundation is also mentioned.

This conversation is taken from a longer piece to be found here: https://www.topmedtalk.com/live-from-the-iseh-part-2/

This edition of TopMedTalk was recorded at The Institute of Sport Exercise and Health (ISEH) live from an Enhanced Recovery After Surgery (ERAS) leadership forum.

The conversation features questioner Paul Hutchings, Consultant Anaesthetist at Norfolk and Norwich University Hospital, alongside Professor Monty Mythen and his two guests; Dr Simeon West, consultant anaethetist at (University College London Hospitals) UCLH who sits on the board at Regional Anaesthesia UK (RAUK) and Mark Harper Consultant Anaesthetist at Brighton and Sussex University Hospitals, with a research interest in the prevention of perioperative hypothermia and the use of cold water adaptation for thearaputic purposes.

Journal Club Express - multimodal pain management Jun 15, 2018

Association of Multimodal Pain Management Strategies with Perioperative Outcomes and Resource Utilization: A Population-based Study.

Memtsoudis SG1, Poeran J, Zubizarreta N, Cozowicz C, Mörwald EE, Mariano ER, Mazumdar M.

BACKGROUND: Multimodal analgesia is increasingly considered routine practice in joint arthroplasties, but supportive large-scale data are scarce. The authors aimed to determine how the number and type of analgesic modes is associated with reduced opioid prescription, complications, and resource utilization.

METHODS: Total hip/knee arthroplasties (N = 512,393 and N = 1,028,069, respectively) from the Premier Perspective database (2006 to 2016) were included. Analgesic modes considered were opioids, peripheral nerve blocks, acetaminophen, steroids, gabapentin/pregabalin, nonsteroidal antiinflammatory drugs, cyclooxygenase-2 inhibitors, or ketamine. Groups were categorized into "opioids only" and 1, 2, or more than 2 additional modes. Multilevel models measured associations between multimodal analgesia and opioid prescription, cost/length of hospitalization, and opioid-related adverse effects. Odds ratios or percent change and 95% CIs are reported.

RESULTS: Overall, 85.6% (N = 1,318,165) of patients received multimodal analgesia. In multivariable models, additions of analgesic modes were associated with stepwise positive effects: total hip arthroplasty patients receiving more than 2 modes (compared to "opioids only") experienced 19% fewer respiratory (odds ratio, 0.81; 95% CI, 0.70 to 0.94; unadjusted 1.0% [N = 1,513] vs. 2.0% [N = 1,546]), 26% fewer gastrointestinal (odds ratio, 0.74; 95% CI, 0.65 to 0.84; unadjusted 1.5% [N = 2,234] vs. 2.5% [N = 1,984]) complications, up to a -18.5% decrease in opioid prescription (95% CI, -19.7% to -17.2%; 205 vs. 300 overall median oral morphine equivalents), and a -12.1% decrease (95% CI, -12.8% to -11.5%; 2 vs. 3 median days) in length of stay (all P < 0.05). Total knee arthroplasty analyses showed similar patterns. Nonsteroidal antiinflammatory drugs and cyclooxygenase-2 inhibitors seemed to be the most effective modalities used.

CONCLUSIONS: While the optimal multimodal regimen is still not known, the authors' findings encourage the combined use of multiple modalities in perioperative analgesic protocols.

DOI: 10.1097/ALN.0000000000002132

RCoA Conference Highlight: Do we still care about direct laryngoscopy? Jun 14, 2018

The debate 'Direct laryngoscopes should be consigned to history' was hosted by The Royal College Of Anaesthetists and carried out by the two guests on this piece.

The conversation explores the fact that this skill is a key part of the job of practitioners, are we "de-skilling" the profession in an overly enthusiastic race toward new technology, or are some resisting it simply because it's not what they are used to?

This piece is taken from a longer conversation, to be found here: https://www.topmedtalk.com/rcoa-12-should-direct-laryngoscopes-be-consigned-to-the-history-books/

Where do you stand on the debate? Send us your thoughts: contact@topmedtalk.com

Presented by Joff Lacey and Monty Mythen with their two guests; Professor Tim Cook, Consultant in Anaesthesia and ICM, Royal United Hospitals, Bath and Dr William Harrop-Griffiths, St Mary's Hospital, Imperial College Healthcare NHS Trust.

ISEH Highlight: Give your patients a warm welcome. Jun 13, 2018

The patient experience can be quite passive and, as a result, people can lose temperature quickly. The consequences can be very negative, this conversation revolves around how you can keep your patients warm.

This piece is taken from a longer conversation to be found here: https://www.topmedtalk.com/live-from-the-iseh-part-1/

This edition of TopMedTalk was recorded at The Institute of Sport Exercise and Health (ISEH) live from an Enhanced Recovery After Surgery (ERAS) leadership forum.

The conversation features Professor Monty Mythen and his guest Mark Harper, Consultant Anaesthetist at Brighton and Sussex University Hospitals, with a research interest in the prevention of perioperative hypothermia and the use of cold water adaptation for theraputic purposes.

'Anesthesia and Analgesia' go big on POQI Jun 12, 2018

This piece focuses on the latest print issue of 'Anesthesia and Analgesia' which is saturated with coverage of the Perioperative Quality Initiative (POQI), the most recent meeting of which was sponsored by the American Society of Enhanced Recovery (ASER).

This conversation acts as an update on where some of the latest thinking is as regards perioperative medicine. It includes a deep dive into gastrointestinal tract dysfunction and allows you to find out the best "whey" to an enhanced recovery alongside information about nutrition screening.

There's also a look at the perioperative medicine calendar, with details on how you can meet Monty and the team at one of the many events we're covering over the next few months.

Monty Mythen is interviewing Dr Tim Miller from Duke University Medical Centre.

Send us your thoughts: contact@topmedtalk

Web links:

- The ASER open source articles mentioned in the piece can be found on the POQI website.

- Also in this piece there is news about, The Morpheus Consortium, there's more information here: http://morpheusconsortium.org

- And finally, the website Dr Tim Miller mentions, is here: https://anesthesiology.duke.edu

Good noises for ultrasound. Jun 11, 2018

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, when, why and how you can use this incredible tool. Is it really a piece of bedside assessment equipment which is about to become as ubiquitous as a doctor's thermometer?

It's difficult not to get excited about the ability to take a quick look at a patient's cardiac function, at the bedside, with a handheld piece of kit. Scanning a patient's abdomen, seeing how to apply appropriate measures of care rapidly on the spot, these are just some of the advantages discussed in this piece.

See more here:

Acute Care and Perioperative Ultrasound Workshop Co-sponsored by the Departments of Anesthesiology at Loma Linda and UCLA Medical Centers.

www.pocuseducation.com

Evidence-Based Perioperative Ultrasound Educational Curriculum (created as a free, open-source, platform for point of care ultrasound education)

www.foresightultrasound.com

Professor Monty Mythen is presenting, with his guest, Davinder Ramsingh MD, Director of Research and Perioperative Ultrasound at Loma Linda University Medical Center - Dept. of Anesthesiology.

An interview with Professor Monty Mythen, our Editor in Chief Jun 10, 2018

What is TopMedTalk and how did it come about? Why is perioperative medicine such an inspiration to us? Why is our Editor in Chief such an advocate? What is the opioid crisis?

Broadcaster Nick Margerrison speaks with our Editor in Chief about TopMedTalk and perioperative medicine.

We regularly enjoy reading your feedback: contact@topmedtalk.com

RCoA Conference Highlight: It's time to get it right, first time Jun 09, 2018

The GIRFT (Getting It Right First Time) project. The stated aim is 'to help improve the quality of care within the NHS by reducing unwarranted variations, bringing efficiencies and improving patient outcomes'. This piece gives you the detail from one of the joint clinical leads. This piece is taken from a longer piece to be found here: https://www.topmedtalk.com/rcoa-13-the-girft-getting-it-right-first-time-project/ Also, if you'd like to hear more about The GIRFT (Getting It Right First Time) project, there's another podcast where we speak about it here: https://www.topmedtalk.com/live-from-the-iseh-part-2/ Presented by Monty Mythen, Joff Lacey and Desiree Chappell with their guest Dr Michael Swart, Consultant in Anaesthesia and Critical Care Medicine at Torbay Hospital and advisor to the UK Department of Health for the Enhanced Recovery Programme.

Journal Club Express: ICU Nurse-Led Communication, shorter stay and better ratings? Jun 08, 2018

A Randomized Trial of a Family-Support Intervention in Intensive Care Units

Douglas B. White et al. for the PARTNER Investigators

Surrogate decision makers (e.g. family and friends) for incapacitated, critically ill patients can understandably find it very difficult to make decisions related to goals of care.

Having to make such decisions can cause them psychological distress and may lead to treatment that is not exactly what the patient might have chosen if they could speak for themselves.

In this trial the investigators conducted a stepped-wedge, cluster-randomized trial involving patients with a high risk of death and their surrogates (folks speaking for them) in five intensive care units (ICUs).

They compared what they term “a multicomponent family-support intervention delivered by the interprofessional ICU team” with usual care.

A total of 1420 patients were enrolled in the trial.

Results

The family-support intervention delivered by the interprofessional ICU team did not significantly reduce the burden of psychological symptoms for the surrogates.

However their ratings of the quality of communication and the patient- and family - centered care were better. Furthermore - the length of stay in the intensive care unit was shorter.

Compelling, in favour of this team approach, but the authors suggest we shouldn’t 'dive straight in'; rather that a large replication trial may be conducted, in multiple geographic regions, to establish the findings further.

Thus recognising different health systems have potentially different attitudes and practices regarding care for patients with advanced critical illness.

We will be delving into this excellent paper at greater length in an upcoming journal club.

Link to paper:

The New England Journal of Medicine:

https://www.nejm.org/doi/full/10.1056/NEJMoa1802637

Link to the accompanying editorial by Daniela Lamas, Nurse-Led Communication in the Intensive Care Unit:

https://www.nejm.org/doi/full/10.1056/NEJMe1804576

RCoA Conference Highlight: When do you become geriatric? Jun 07, 2018

Geriatricians naturally fit into the perioperative sphere. Shared decision making is an obvious aspect of this, as is preoperative assessment and the consideration of the risks and benefits of surgery.

Also in this piece; when do you become geriatric?

This piece is taken from a longer conversation to be found here: https://www.topmedtalk.com/rcoa-06-geriatric-care-and-the-value-of-teamwork/

Desiree Chappell and Monty Mythen interview their guest Dr Jugdeep Dhesi, Clinical Lead, POPS and Consultant Geriatrician, Guys and St Thomas’ NHS Trust.

Join in the debate: contact@topmedtalk.com

RCoA Conference Highlight: Perioperative medicine for the world Jun 06, 2018

How can perioperative medicine be part of helping less developed healthcare systems? The considerations are different but the principles remain the same. The birth of the NHS gave parity of esteem to anaesthetists, the benefits of this are felt by us all in the Western world, could it be argued that this visionary decision might actually help other healthcare systems to evolve more rapidly?

This piece is taken from a longer conversation to be found here: https://www.topmedtalk.com/rcoa-04-the-royal-college-of-anaesthetists-world-leading-healthcare/

Presented by Monty Mythen with their guests Dr Liam Brennan, President of The Royal College of Anaesthetists (RCoA) and Professor Paul Myles, Director, Department of Anaesthesia and Perioperative Medicine, Alfred Hospital and Monash University, Melbourne, Australia.

Join the debate: contact@topmedtalk.com

RCoA Conference Highlight: Big data privacy concerns are legitimate Jun 05, 2018

Big data is a complicated topic and here you will find a discussion about the need to balance the rights of the individual against an obligation to explore and unlock the treasures it offers for wider society.

How do we hammer home the fact that responsibly recording data is part of a practitioner's duty of care?

Taken from day two of our coverage of the Royal College of Anaesthetists' annual conference at The British Museum in London. Presented by Desiree Chappell and Joff Lacey, with their guest Professor Iain Moppett, Professor of Anaesthesia and Perioperative Medicine, University of Nottingham.

This piece is taken from a longer conversation to be found here: https://www.topmedtalk.com/rcoa-07-big-data-ai-and-the-changing-face-of-medicine/

RCoA Conference Highlight: Need help? Ask for it. Jun 04, 2018

The pressures of being an anaesthetist are difficult to discuss for some, this conversation might be the start of that for you or a colleague. The message is clear; practitioners are human and they must ask for help if they need it.

This piece is taken from a longer piece to be found here: https://www.topmedtalk.com/rcoa-05-if-youre-struggling-seek-help/

Presented by Desiree Chappell and Monty Mythen with their guest Dr Clare Gerada, Medical Director, Physician Health, Practitioner Health Service.

Share your thoughts with us: contact@topmedtalk.com

RCoA Conference Highlight: Antibiotics - when is the right time? Jun 03, 2018

NAP (National Audit Project) 6 is the largest ever prospective study of anaphylaxis related to anaesthesia and surgery. This conversation deals with the question; when is the best time to administer antibiotics?

This piece is taken from a longer conversation to be found here: https://www.topmedtalk.com/rcoa-8-nap6-perioperative-anaphylaxis/

Joff Lacey presents with his guest Professor Tim Cook, Consultant in Anaesthesia and ICM, Royal United Hospitals, Bath.

Join in the conversation: contact@topmedtalk.com

What next for TopMedTalk? Jun 02, 2018

TopMedTalk set itself a target of over 10,000 downloads in the first year. Much to everyone's delight and surprise, we've smashed that target already!

This piece is a chance to hear how you can become a bigger part of what we are doing here; it could be as simple as you connecting with us online, sharing some of our content on your social media feed, emailing us your feedback (contact@topmedtalk.com), or even coming to one of the many meetings we're scheduled to attend: www.ebpom.org/meetings

It's also a sincere thanks to everyone who has taken one or more of these steps, we could not have managed to have the success we've had without you.

Featuring on this podcast are some of the main TopMedTalk team members; Monty Mythen, Desiree Chappell, Nick Margerrison and Henry Howe.

RCoA Highlight: Who leads the way in perioperative medicine ? Jun 02, 2018

The NHS has helped to put the UK into a leading position in perioperative medicine, elsewhere there have been pioneers and innovators pushing it forward. How has this leadership in perioperative medicine become a force for change and improvement worldwide and what are the common themes that emerge as we take a global perspective on the discipline?

This piece is taken from a longer conversation to be found here: https://www.topmedtalk.com/rcoa-04-the-royal-college-of-anaesthetists-world-leading-healthcare/

Presented by Monty Mythen with their guests Dr Liam Brennan, President of The Royal College of Anaesthetists (RCoA) and Professor Paul Myles, Director, Department of Anaesthesia and Perioperative Medicine, Alfred Hospital and Monash University, Melbourne, Australia.

Join the debate: contact@topmedtalk.com

Vital information about nutrition and screening therapy Jun 01, 2018

In this piece Monty Mythen speaks to Professor Paul Wischmeyer from the Department of Anesthesiology, Duke University, about the recently published American Society of Enhanced Recovery (ASER) and Perioperative Quality Initiative (POQI) joint consensus statement on Nutrition and Screening Therapy within an Surgical Enhanced Program, which has just been print published.

The link to it is here: https://journals.lww.com/anesthesia-analgesia/pages/currenttoc.aspx Join the debate: contact@topmedtalk.com

RCoA Highlight: Inflammatory claims about exercise May 31, 2018

A highlights RCoA’s Anaesthesia 2018

A fascinating conversation about the anti-inflammatory effects of exercise. The theory is floated that this could be part of the reason why exercise as a form a prehabilitation might be so effective as part of an enhanced recovery pathway.

This is part of a longer piece which you can enjoy in full here:

https://www.topmedtalk.com/rcoa-03-adverse-outcomes-and-patient-optimisation/

Featuring Joff Lacey speaking to Dr Mark Edwards, Consultant in Anaesthesia and Perioperative Medicine at The University Hospital Southampton NHS Foundation Trust and Professor Gerard Danjoux, Consultant in Anaesthesia and Sleep Medicine at South Tees Hospitals NHS Foundation Trust.

Join the debate: contact@topmedtalk.com

Journal Club Express 30/05/18 May 30, 2018

Effect of Use of a Bougie vs Endotracheal Tube and Stylet on First-Attempt Intubation Success Among Patients With Difficult Airways Undergoing Emergency Intubation

Brian E. Driver, MD1; Matthew E. Prekker, MD1,2; Lauren R. Klein, MD1; et al

Key Points

Question

In patients admitted to the emergency department with difficult airway characteristics undergoing orotracheal intubation with a Macintosh laryngoscope blade, does a bougie facilitate higher first-attempt intubation success than an endotracheal tube + stylet?

Findings

In this randomized clinical trial that included 757 adults, bougie use resulted in significantly higher first-attempt intubation success than an endotracheal tube + stylet (96% vs 82%) for those with a difficult airway characteristic.

Meaning

Although bougie use led to a higher likelihood of first-attempt intubation success, further research is needed to assess generalizability to other institutions and settings.

DOI: 10.1001/jama.2018.6496

RCoA 14 - How should we teach perioperative medicine? May 29, 2018

How do we develop an agreed curriculum that speaks to what perioperative medicine should be? Once that's in place, how should it be overseen? What sort of official endorsements would it need?

Running in parallel to this are the MOOCs - Massive Online Open Courses - that are being developed.

Developing a broad knowledge of the process is distinct from being a perioperative specialist, how do we develop that even further - without developing a schism? These complicated topics are discussed alongside more detail regarding the future of teaching this speciality.

Presented by Monty Mythen and Mike Grocott with their guests; Joel Symmons, Staff Consultant Anaesthetist in the Department of Anaesthesia and Perioperative Medicine at the Alfred Hospital, Perioperative Medicine Short Course Convenor, and a Senior Lecturer in Anaesthesia at Monash University, and Paul Myles, Head of Alfred Health's and Monash University's Department of Anaesthesia and Perioperative Medicine.

Morphine doses - how high is too high? Live from the ISEH (Part 2) May 28, 2018

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.

We begin with a question from the audience; how do we drive change in our institutions towards enhanced recovery after surgery? The GIRFT (Getting It Right First Time) project is explained. The Health Foundation is also mentioned. The piece also includes patient communication and the question of 'how much is too much?', when administering a dose of morphine. Also, is there a hierarchy on the pathway of enhanced recovery after surgery?

The conversation features Professor Monty Mythen and his two guests; Dr Simeon West, consultant anaethetist at (University College London Hospitals) UCLH who sits on the board at Regional Anaesthesia UK (RAUK) and Mark Harper Consultant Anaesthetist at Brighton and Sussex University Hospitals, with a research interest in the prevention of perioperative hypothermia and the use of cold water adaptation for theraputic purposes. There are also questions from the audience.

This piece is part two of a two part series.

Cold, kill or cure? Live from the ISEH (Part 1) May 27, 2018

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 important is it to keep patients warm? Keeping patients and their environments warm is discussed, as is pre-warming, going beyond the standard blankets and patient insulation to include active warming and even patients exercising as a method of warming up. Further to this conversation, how do you measure a patient's temperature?

The conversation features Professor Monty Mythen and his two guests; Dr Simeon West, consultant anaethetist at (University College London Hospitals) UCLH who sits on the board at Regional Anaesthesia UK (RAUK) and Mark Harper Consultant Anaesthetist at Brighton and Sussex University Hospitals, with a research interest in the prevention of perioperative hypothermia and the use of cold water adaptation for theraputic purposes. There are also questions from the audience.

This piece is part one of a two part series.

RCoA 13 - The GIRFT (Getting It Right First Time) Project May 26, 2018

How do you become well known in the NHS for being innovative, particularly in the perioperative area regarding evaluation and communication of risk? How can cardiopulmonary exercise testing lead to shared decision making? Hear how aortic aneurysms are dealt with by a world class professional perioperative physician. Learn how that process and its success then spread out into other areas of healthcare within his institution. Do you need to develop a broad knowledge of all surgery and medicine so that you understand what is going on within the different surgical specialities? Following this discussion is had about the GIRFT (Getting It Right First Time) project. The stated aim is 'to help improve the quality of care within the NHS by reducing unwarranted variations, bringing efficiencies and improving patient outcomes'. This piece gives you the detail from one of the joint clinical leads. Presented by Monty Mythen, Joff Lacey and Desiree Chappell with their guest Dr Michael Swart, Consultant in Anaesthesia and Critical Care Medicine at Torbay Hospital and advisor to the UK Department of Health for the Enhanced Recovery Programme.

RCoA 12 - Should direct laryngoscopy be consigned to the history books? May 25, 2018

The debate 'Direct laryngoscopes should be consigned to history', hosted by The Royal College Of Anaesthetists and carried out by our two guests on this piece.

Here we get into the advantages and challenges behind the two techniques; video laryngoscopy and direct laryngoscopy. The conversation explores the fact that these skills are a key part of the job of practitioners, are we "de-skilling" the profession in an overly enthusiastic race toward new technology or are some resisting it simply because it's not what they are used to?

Where do you stand on this fascinating debate? Send us your thoughts on email: contact@topmedtalk.com

Presented by Joff Lacey and Monty Mythen with their two guests; Professor Tim Cook, Consultant in Anaesthesia and ICM, Royal United Hospitals, Bath and Dr William Harrop-Griffiths, St Mary's Hospital, Imperial College Healthcare NHS Trust.

RCoA 11 - The RELIEF Trial; your essential 'deep dive' into the results. May 24, 2018

The RELIEF (Restrictive versus liberal fluid therapy in major abdominal surgery) trial has been a huge story for us here at TopMedTalk, recorded on the second day of The Royal Collage of Anaesthetists' annual conference at the British Museum this is the moment the team get to pick over the results in detail.

One of the biggest trials ever, it has both raised questions and provided answers. Inevitably there has been a huge debate, this piece puts all the major questions and concerns to the organiser of the trial.

Send us your thoughts on The RELIEF trial: contact@topmedtalk.com

Presented by the TopMedTalk team; Professor Monty Mythen, Dr Joff Lacey, Desiree Chappell and Professor Mike Grocott, with their guest Paul Myles, Head of Alfred Health's and Monash University's Department of Anaesthesia and Perioperative Medicine and organiser of the RELIEF trial.

RCoA 10 - The Royal College of Anaesthetists, leading the debate. May 23, 2018

How does The Royal College of Anaesthetists' move forward from here? A stunning conference with internationally renowned speakers from all around the world, the perioperative process continues to grow and the NHS is leading the world in healthcare. This conversation gets into some of the issues this momentum can now be focused on.

How has the conversation moved forward, how has the RCoA contributed to this and where should we be looking to now?

Recorded towards the end of the first day of the Royal College of Anaesthetists' annual conference Monty Mythen, Desiree Chappell and Mike Grocott interview their guest Russell Ampofo, Director of Education, Training and Examinations for The Royal College of Anaesthetists.

RCoA 09 - What is the Lifelong Learning platform? May 23, 2018

The Royal College of Anaesthetists' Lifelong Learning platform will replace the e-Portfolio and include a logbook functionality. It's expected to go live in August 2018. Find out the details here.

This piece was recorded as part of TopMedTalk's coverage of the RCoA's annual conference at The British Museum in 2018. Joff Lacey presents, with his guests Esma Doganguzel and Lina Fazlanie, from the Royal College of Anaesthetists' Lifelong Learning team.

Email us your feedback: contact@topmedtalk.com

RCoA 08 - NAP6: Perioperative Anaphylaxis May 23, 2018

NAP (National Audit Project) 6 is the largest ever prospective study of anaphylaxis related to anaesthesia and surgery. Find out the details behind this intriguing study, how long did it take, how does the data impact upon our day to day practice?

There follows a deep dive into the results and recomendations that NAP 6 has produced. Packed with useful information this podcast is one of the stand out pieces of our coverage of the Royal College of Anaesthetists' annual conference in London.

Joff Lacey presents with his guest Professor Tim Cook, Consultant in Anaesthesia and ICM, Royal United Hospitals, Bath.

Email us: contact@topmedtalk.com

RCoA 07 - Big data, AI and the changing face of medicine May 23, 2018

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 privacy concerns with the need for data to be accessible? Can such information be truly anonymised? Discussion moves here to 'Google flu tracker' and its, initially quite good, results.

Finally how do doctors adapt to the new world where they are being told in front of their patients what the right course of action is? Will patients retain trust in the Doctor's decisions?

Taken from day two of our coverage of the Royal College of Anaesthetists' annual conference at The British Museum in London. Presented by Desiree Chappell, Monty Mythen and Joff Lacey, with their guest Professor Iain Moppett, Professor of Anaesthesia and Perioperative Medicine, University of Nottingham.

RCoA 06 - Geriatric care and the value of teamwork May 23, 2018

How do we best negotiate working in a multidisciplinary team? Generalisations regarding surgeons and anaesthetists only ever work generally, the specifics of each practitioner and their priorities inevitably contrast. How do we keep sight of these broad differences without falling foul of stereotypes?

The conversation evolves; how does the surgical journey fully utilise the team based perioperative approach? With specific focus on geriatric care there is further discussion regarding shared decision making, something which has been part of that discipline for many years.

The debate regarding when a patient becomes geriatric is explored. Is it age which defines that or do symptoms and comorbidities qualify the term?

Recorded on the first day of the Royal College of Anaesthetists' annual conference at The British Museum. Desiree Chappell and Monty Mythen interview their guests Professor Jenifer Weller, Head of the Centre for Medical and Health Sciences Education, University of Auckland and Dr Jugdeep Dhesi, Clinical Lead, POPS and Consultant Geriatrician, Guys and St Thomas' NHS Trust.

Join the debate: contact@topmedtalk.com

RCoA 05 - 'If you're struggling ... seek help' May 23, 2018

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.

Share your thoughts with us: contact@topmedtalk.com

RCoA 04 - The Royal College of Anaesthetists, world leading healthcare May 22, 2018

How has the Royal College of Anaethestists (RCoA) evolved over the years and why is perioperative medicine so crucial to its agenda? How has this leadership in perioperative medicine become a force for change and improvement worldwide and what are the common themes that emerge as we take a global perspective on the discipline?

The RCoA's global partnership programme is explained, how can perioperative medicine be part of helping less developed healthcare systems? The considerations are different but the principles remain the same.

The birth of the NHS gave parity of esteem to anaesthetists, the benefits of this are felt by us all in the Western world, could it be argued that this visionary decision might actually help other healthcare systems to evolve more rapidly?

Finally - where is the discipline these days? Leadership and the ability to see the bigger picture are part of it, as is communicating to that wider world with various innovations including this podcast which you, as a listener, are a part of.

Presented by Desiree Chappell and Monty Mythen with their guests Dr Liam Brennan, President of The Royal College of Anaesthetists (RCoA) and Professor Paul Myles, Director, Department of Anaesthesia and Perioperative Medicine, Alfred Hospital and Monash University, Melbourne, Australia.

Join the debate: contact@topmedtalk.com

RCoA 03 - Adverse outcomes and patient optimisation May 22, 2018

Adverse outcomes, we all know they happen but how do we handle them, record them and avoid them in the first place? The discussion then moves to (Patient Recorded Outcome Measures) PROMS.

Patient optimisation is then discussed. Exercise, could it be so effective because it works as an anti inflammatory? A deep dive into the research on that is contained in this conversation.

The RELIEF trial is discussed as the team get into a discussion about what a patient sees as a good outcome. How do we communicate the risks, possible benefits and limitations, of surgery to patients?

Also in this piece, find out about a fascinating community-based multimodal prehabilitation service.

Desiree Chappell and Joff Lacey are presenting with their guests Dr Mark Edwards, Consultant in Anaesthesia and Perioperative Medicine at The University Hospital Southampton NHS Foundation Trust and Professor Gerard Danjoux, Consultant in Anaesthesia and Sleep Medicine at South Tees Hospitals NHS Foundation Trust.

Join in the debate: contact@topmedtalk.com

RCoA 02 - Outcomes, universal healthcare and the goals of the RCoA May 22, 2018

Recorded live at The British Museum in London this piece contains a lot of discussion about the NHS; how does it rank in terms of outcomes? What does the offer of universal healthcare mean in terms of that? How does it compare to the way things are done in America and around the world?

The team then discuss the shared goals and huge crossoever which exists between perioperative practitioners and The Royal College of Anaesthetists. Particular focus is given to the challenge of public health overall.

Presented by Desiree Chappell with Monty Mythen and Joff Lacey after the first session, on the first day, of the annual meeting of the Royal College of Anaesthetists.

Join in the debate: contact@topmedtalk.com

RCoA 01 - Live from the annual meeting of The Royal College of Anaesthetists May 22, 2018

TopMedTalk is covering the flagship meeting of the Royal College of Anaesthetists from the British Museum, London.

In this piece, discussion is had about the importance of perioperative medicine leading to conversation about the naming of the conference and differences between terminology; are you an 'anaesthetist' or an 'anaesthesiologist'?

The contributors emphasise the global perspective as well as telling you some of the things you should be looking forward to as our coverage progresses over the next few days.

Send us your thoughts: contact@topmedtalk.com

Presented by Monty Mythen, Joff Lacey and Desiree Chappell with their guest Mike Grocott, Professor of anasthesia and critical care at the University of Southampton and one of the co-organisers of the meeting.

Why practice value based care? May 20, 2018

What motivates an institution to adopt a value based care programme? How do readmission rates react to optimisation? How do you work care coordination into a successful practice?

This piece was originally part of our coverage of 'The American College of perioperative medicine interdisciplinary conference on value based care for orthopedics'.

Desiree Chappell speaks with Allan Beck Chief Executive Officer of the Baylor Orthopedic and Spine Hospital at Arlington.

This is taken from a longer conversation which you can find here: http://www.topmedtalk.com/barriers-and-successes-in-value-based-care/

What is SNAP-2? May 19, 2018

This piece explains the 2nd Sprint National Anaesthesia Project: Epidemiology of Critical Care provision after Surgery (SNAP-2: EpiCCS) SNAP-2: EpiCCS aims to describe the epidemiology of perioperative risk, outcome, critical care referral and admission after inpatient surgery in the UK. It will also examine whether planned postoperative critical care admission is effective as an intervention to reduce postoperative morbidity. http://www.niaa-hsrc.org.uk/SNAP-2-EpiCCS Presented by Monty Mythen with his guest Dr Ramani Moonesinghe, Director of the UK National Institute of Academic Anaesthesia Health Services Research Centre. This taken from a longer conversation here: http://www.topmedtalk.com/aser-ebpom-2017-recap-pod-three-live-from-london/ Join in the discussion: contact@topmedtalk.com

Curb your fluid? May 18, 2018

Goal directed fluid therapy and enhanced surgical recovery, are there still some battles not yet won? How do you get anaesthetists to curb their fluid? How do you cure the random element of fluid therapy? Dr Joff Lacey interviews his guest Dr Randall Dull, University of Illinois, live from the ASA 2017. This piece taken from a longer conversation, "Physiological Principles of Goal Directed Fluid Therapy": http://www.topmedtalk.com/live-from-boston-asa-2017-physiological-principles-of-goal-directed-fluid-therapy-fluid-responsiveness-the-stressed-system-and-the-glycocalyx/ Join in the debate: contact@topmedtalk.com

Journal Club Express 17/05/18 May 17, 2018

Association between intraoperative opioid administration and 30-day readmission: a pre-specified analysis of registry data from a healthcare network in New England

High intraoperative opioid dose is a modifiable anaesthetic factor that varies in the practice of individual anaesthetists and affects postoperative outcomes. Conservative standards for intraoperative opioid dosing may reduce the risk of postoperative readmission, particularly in ambulatory surgery.

https://doi.org/10.1016/j.bja.2017.12.044

Journal Club Express 21/05/18 May 16, 2018

Anaesthesia, surgery, and life-threatening allergic reactions: management and outcomes in the 6th National Audit Project (NAP6)

N.J.N. Harper et al.

Anaphylaxis, a life threatening allergic reaction, is thankfully rare but a very serious complication in the perioperative period, around the time of surgery. The 6th National Audit Project of the Royal College of Anaesthetists (NAP6) collected and reviewed 266 reports of serious anaphylaxis from all UK NHS hospitals over 1 yr.

RESULTS?

The good news is senior anaesthetists resuscitated all patients.

The rest is a mixed bag; Immediate management was judged to be ‘good’ in 46% but ‘poor’ in 15%, recognition of anaphylaxis was prompt in 97% and treatment was prompt in 83% of cases.

Epinephrine (ADRENALINE) was administered i.v. in 76%, i.m. in 14%, both in 6%, and not at all in 11% of cases.

A catecholamine infusion was administered in half of cases.

Cardiac arrests (40 cases; 15%) were promptly treated but cardiac compressions were omitted in half of patients with unrecordable BP.

The surgical procedure was abandoned in most cases.

Very sadly, Ten (3.8%) patents died from anaphylaxis, mostly elderly with cardiovascular disease. Fluid administration was deemed inadequate in 19% of cases. Adverse sequelae, psychological, cognitive, or physical, were reported in one-third of cases.

THE BOTTOM LINE:

The authors suggest management of perioperative anaphylaxis could be improved, especially with respect to administration of epinephrine, cardiac compressions, and i.v. fluid.

https://bjanaesthesia.org/article/S0007-0912(18)30321-0/fulltext

The Xtreme Everest Oxygen Research Consortium | Xtreme Everest May 16, 2018

The Xtreme Everest project has won numerous awards and received both local, national and international media coverage. Here we have a discussion with some of the key players about oxygen and the Xtreme Everest team's research studies into human adaptation to hypoxia. How can the human body adapt to extreme conditions, we assume it will inevitably cause damage but this is not always the case. How do people who have inherited a tolerance for low levels of oxygen manage?

Professor Monty Mythen, Joff Lacey and Mike Grocott, head of The Xtreme Everest Oxygen Research Consortium; are joined by Dr Dan Martin OBE an anaesthetist and critical care doctor from The Royal Free Hospital in London, a consultant in Intensive Care and an Everest summiteer.

The documentary mentioned in this piece is here: https://www.youtube.com/watch?v=ecCJ8sMVeiU

This taken from a longer piece here: http://www.topmedtalk.com/live-from-boston-asa-2017-life-at-the-extremes-trials-on-everest-adapting-to-hypoxia/

And the Xtreme Everest website is here: http://www.xtreme-everest.co.uk/

Do you need a poet to do surgery? May 15, 2018

ASER 2017 and the POET acronym - a truly multidisciplinary Perioperative Enhancement Team; responsible for project managing optimisation programmes.

Monty Mythen speaks with Professor Sol Aronson, a tenured professor at Duke University and Executive Vice Chairman in the Department of Anesthesiology.

This piece is taken from a longer conversation to be found here: http://www.topmedtalk.com/aser-ebpom-2017-recap-pod-three-live-from-london/

Join the debate: contact@topmedtalk.com

Also - why not put a bit of poetry into your practice - check out the POETTS CPET (Course Cardiopulmonary Exercise Testing For Pre-operative Assessment Course) here: https://ebpom.org/18th-POETTS-CPET-Course

Elderly patients and post operative delirium May 14, 2018

A discussion about the importance of screening and risk mitigation regarding cognitive dysfunction and delirium in the perioperative period, with particular focus on elderly patients.

Monty Mythen and Mike Grocott are joined by their guests Dr Liam Brennan, President of the Royal College of Anaesthetists, and Dr Fay Gilder, Addenbrooke’s, Cambridge.

This piece taken from a longer piece to be found here: http://www.topmedtalk.com/live-from-boston-asa-2017-perioperative-delirium-2/

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Want to hear more of this sort of discussion? Listen out for Dr Jugdeep Dehsi, and other experts, live from ‘Anaesthesia 2018’ the Royal College of Anaesthetists annual meeting at the British Museum (May 22nd - 23rd) with the TopMedTalk team.

Subscribe FREE at www.TopMedTalk.com

Standardised Outcomes from Surgery. Drink, Eat, Mobilise, Sleep (DrEaMS) May 13, 2018

Dr Ramani Moonesinghe on Standardised Outcomes from Major Surgery.

Dr Joff Lacey and Professor Monty Mythen talk to Dr Ramani Moonesinghe, Director of the Heath Services Research Centre at the Royal College of Anaesthetists and a lead author of the Perioperative Quality Initiative (POQI http://www.poqi.org) guidelines on outcomes from surgery.

Simple objective measures such as Drinking, Eating and Mobilising, Sleep (DrEaMS).

For further reading see this article in Perioperative Medicine: https://perioperativemedicinejournal.biomedcentral.com/articles/10.1186/s13741-017-0062-7

Attend our next meeting: http://www.ebpom.org/EBPOM-USA

This piece is taken from a longer conversation here: http://www.topmedtalk.com/aser-ebpom-2017-recap-pod-three-live-from-london/

Measuring risk in surgery; what is a micromort? May 12, 2018

What is a 'micromort'? Even more of a worry, what does ten of them mean? How do we measure and communicate risk to patients? Everyday activities all carry inherent risks, how do we put surgery into a context 'everyday people' can more easily understand?

Recorded on day two of EBPOM 2017; Professor Monty Mythen presents with guests, Professor Sol Aronson, a tenured professor at Duke University and Executive Vice Chairman in the Department of Anesthesiology, and Dr Mike Irwin, Professor and Head, Department of Anaesthesiology, University of Hong Kong.

Taken from a longer conversation to be found here: http://www.topmedtalk.com/ebpom-2017-pod-two-live-from-london/

The RELIEF trial results May 11, 2018

Monty Mythen presents the results of the RELIEF (Restrictive versus liberal fluid therapy in major abdominal surgery) trial. Does it answer the questions you hoped? Does this trial put to bed the questions about liberal vs restricted fluid therapy or is it a debate that's set to run and run? Can a trial ever be truly definitive? Send us your thoughts: contact@topmedtalk.com

Hear Monty Mythen discuss the first thoughts of Paul Myles, Head of Alfred Health's and Monash University's Department of Anaesthesia and Perioperative Medicine, organiser of the trial. Here is the link to the New England Journal of Medicine article which Monty mentions in the piece:

https://www.nejm.org/doi/full/10.1056/NEJMoa1801601?query=RP

Perioperative nephrology and renal injury biomarkers May 11, 2018

In this piece find out how renal injury biomarkers can offer practitioners and patients hope.

Presented by Professor Monty Mythen and Dr Joff Lacey featuring guests John A. Kellum, Tenured Professor, Critical Care Medicine from The University of Pittsburgh and Dr Tim Miller from Duke University Medical Centre.

Join in the debate: contact@topmedtalk.com

This piece taken from a longer conversation to be found here: http://www.topmedtalk.com/ebpom-2017-pod-one-live-from-london/

Sleep disorders from the perioperative perspective? May 09, 2018

Where should sleep apnea be on the perioperative surgeon's priority list? A fascinating introduction to the topic, sleep disorders affect every area of life but in the perioperative sphere it brings significantly higher risks of complications following surgery. How important is it that such conditions are picked up during pre-operative optimisation? Furthermore, why do the evaluation at all - if no action at all is taken as a result?

A piece originally streamed live from Atlanta Georgia during TopMedTalk's coverage of "EBPOM-USA Masters Course, A Perioperative Care Practicum".

Featuring hosts Desiree Chappell and Vicki Morton interviewing Dr Andrew R. Spector, Neurologist, Sleep Medicine Specialist at Duke Health. This piece originally featured here in a longer form: http://www.topmedtalk.com/sleep-disorders-in-surgical-patients-ebpom-usa/

Join us on www.topmedtalk.com sign up for our email updates and never miss a live streamed conference again.

Remember; the Relief Trial results will be here tomorrow, the 10th of May 2018, with Monty Mythen coming to you from Sydney Australia.

The evolving role of the anaesthetist May 08, 2018

A conversation that is now even more relevant, the changing role of the anaesthetist. Matters such as population health, lifestyle choices and a wider sense of social responsibility are discussed as Monty asks his contributors, 'is this really what you signed up for'?

Presented by Monty Mythen and Joff Lacey with guests, Sol Aronson, a tenured professor at Duke University and Executive Vice Chairman in the Department of Anesthesiology and Liam Brennan President of The Royal College of Anaesthetists and consultant anaesthetist with a paediatric interest at Cambridge University Hospitals.

This piece is taken from a longer conversation to be found here: http://www.topmedtalk.com/live-from-boston-asa-2017-the-bigger-picture-of-perioperative-medicine-the-uk-and-usa-perspective/

The RELIEF Trial - are you ready? May 05, 2018

Standby for the results of The RELIEF Trial; coming soon on TopMedTalk, Professor Monty Mythen will be presenting an exclusive programme here covering the results of the trial and discussing its impact.

The REstrictive Versus LIbEral Fluid Therapy in Major Abdominal Surgery: RELIEF trial, will it answer the questions we hoped? Will this trial put to bed the questions about liberal restricted fluid therapy or is it a debate that's set to run and run? Can a trial ever be truly definitive?

This piece is taken from a longer piece to be found here: http://www.topmedtalk.com/live-from-boston-asa-2017-the-releif-trial/

A council of nurses May 04, 2018

This piece begins with the question, what does Enhanced Recovery mean to you?

Here we go for a ground up approach via a 'council of nurses'. Can a 'roundtable' sometimes work better than the traditional hierarchical power structure?

Desiree Chappell interviews Dr Ruchir Gupta medical lead for enhanced recovery at Stony Brook University.

Taken from a longer conversation to be found here: http://www.topmedtalk.com/what-does-enhanced-recovery-mean-to-you/

Join the debate and tell us your story: contact@topmedtalk.com

Success means our insurance provider reduced our reimbursements? May 03, 2018

How do we bend cost curve to our advantage? How do we assert the irreducible minimum? Is it possible to spend less money and get better outcomes? Is it possible to get people to realise that not 'doing something' is sometimes the right decision? How do 'bundle payments' work in relation to overall health?

Featuring Desiree Chappell, Monty Mythen, Dr Lee A. Fleisher Chair of Anesthesiology and Critical Care (University of Pennsylvania) and Vicki Morton DNP and Director of Clinical and Quality Outcomes at Providence Anesthesiology Associates University of South Carolina.

Join the debate www.topmedtalk.com

METS trial - exercise tolerance and surgery outcomes. May 02, 2018

METS trial - exercise tolerance and surgery outcomes.

The results of the METS trial were presented at the International Anaesthesia Research Society meeting in Chicago.

Measurement of Exercise Tolerance before Surgery (METS) study: a protocol for an international multicentre prospective cohort study of cardiopulmonary exercise testing prior to major non-cardiac surgery (http://bmjopen.bmj.com/content/6/3/e010359).

The trial design is discussed and excitement shared about the potential impact of the results. The study of over 1,400 people involves participants in Canada, the UK, Australia and New Zealand. The full paper is under review at a major journal and following publication will be discussed in full on a future edition of TopMed talk.

Monty Mythen and Professor Mike Grocott presenting from Chicago at the IARS's poster session.

PLEASE NOTE: The results of the trial are not included in this piece.

Join the debate: contact@topmedtalk.com

Find out about EBPOM's live events: https://ebpom.org/Meetings

Opioid addiction can happen to anyone. May 01, 2018

Opioid addiction can happen to anyone, even world leading Professors like Dr Paul Wischmeyer. Listen to Paul's story and then spread this important message to colleagues, patients and friends; there is help available, the first and most important step is to ask for it.

Hosted by Desiree Chappell and Monty Mythen. Featuring Dr Paul Wischmeyer, Professor of Anaesthesiology and Surgery at Duke Anesthesiology and TopMedTalk's Henry Howe, a medical student at Bristol University.

Join us on www.topmedtalk.com sign up for our email updates and never miss a live streamed conference again.

This piece is taken from a longer conversation to be found here: http://www.topmedtalk.com/treating-patients-properly-ebpom-usa/

ERAS for Obstetrics? Apr 30, 2018

Dr Attilla Kett explains how he applies Enhanced Recovery after Surgery to obstetrics.

This podcast features Desiree Chappell interviewing Dr Attila Kett, anaesthesiologist and Chairman at St Peter’s University Hospital at New Jersey.

Join in the debate: contact@topmedtalk.com

Want to come see us live in London? http://www.ebpom.org/

Journal Club Express 27/04/18 Apr 27, 2018

Steroids in cardiac surgery: a systematic review and meta-analysis

BJA April 2018, Volume 120, Pages 657-667.

See full article here: https://www.ncbi.nlm.nih.gov/pubmed/29576107

Join in the debate: contact@topmedtalk.com

Don't forget to come and meet the TopMedTalk team at one of the EBPOM events, details on the forthcoming London meeting can be found here: https://ebpom.org/EBPOM2018

How do we encourage population health in a 'fee for service' environment? Apr 26, 2018

The first conference highlight from EBPOM USA 2018: How do you best work a pre-op clinic? Should they be places where you get your problems documented or where you get your problems 'fixed'? How do you convince your practice to optimise patients for life and not just 90 days? How do we encourage population health? How do we get round the fact that we're still in a 'fee for service world'? What is "PBPM"?

Featuring Desiree Chappell, Monty Mythen, Dr Lee A. Fleisher Chair of Anesthesiology and Critical Care (University of Pennsylvania) and Vicki Morton DNP and Director of Clinical and Quality Outcomes at Providence Anesthesiology Associates University of South Carolina.

Join in the debate contact@topmedtalk.com

If patients come to us anaemic - they just do worse EBPOM USA Apr 26, 2018

How important is it to screen patients for anaemia before surgery? Has anaemia fallen off the health care agenda?

We begin with a conversation about patients who are anaemic and then turn to why this is sometimes not checked enough. Monty Mythen mentions UK University students appear to suffer from the condition more these days and Lori Heller points out that treating the condition, as part of patient optimisation, is something of a revelation for some, even occasionally removing the need for surgery altogether.

Discussion continues regarding haemoglobin levels and the differentiation between men and women. The importance of discovering the condition early on in the pre-habilitation process is also emphasised. Towards the end of the piece Monty makes some time to speak about the "Iron Woman - Iron Therapy for Female athletes" study instigated by Professor Toby Richards.

This piece was originally streamed live from EBPOM USA and features Professors Monty Mythen and Mike Grocott with guests Lori Heller, Cardiac Anaestheisologist from US Anaesthesia Partners at the Swedish Medical Center in Seattle, and Mike Scott, Professor in the department of Anesthesiology Virginia Commonwealth University Health System in Richmond USA.

Join in the conversation with feedback via contact@topmedtalk.com

Treating patients properly, EBPOM USA Apr 25, 2018

Treating patients as people rather than 'jobs to be done' and 'boxes to be ticked' is the focus of this piece. What can Doctors do better when it comes to treating patients? Find out what happened when a perioperative care doctor became a patient.

A fascinating conversation streamed live from Atlanta Georgia during the second day of TopMedTalk's coverage of "EBPOM-USA Masters Course, A Perioperative Care Practicum".

Hosted by Desiree Chappell and Monty Mythen. Featuring Dr Paul Wischmeyer, Professor of Anaesthesiology and Surgery at Duke Anesthesiology and TopMedTalk's Henry Howe, a medical student at Bristol University.

Join us on www.topmedtalk.com and sign up for our email updates and never miss a live streamed conference again.

EBPOM USA: How are you driving perioperative care? Apr 24, 2018

This piece discusses how the contributors are driving better perioperative care in their clinics; the importance of getting patient records in advance; ERAS for obstetrics; challenging opioid use with the multimodal pain management; shared decision making in pain management; the importance of clear communication pathways and patient literacy.

This podcast features Desiree Chappell interviewing; Dr Ellen Flanagan, anaesthesiologist and medical director at the Duke preoperative assessment testing clinic, Dr Attila Kett, anaesthesiologist and Chairman at St Peter's University Hospital at New Jersey and Lynn Reede, CRNA and chief clinical officer at the (AANA) American Association of Nurse Anaesthetists.

Add to the discussion contact@topmedtalk.com

This is a not to miss experience EBPOM USA Apr 23, 2018

Marc Koch President & CEO of Somnia Inc reviews the conference with Desiree Chappell. What should you expect at an EBPOM meeting? How useful is the practical advice given? How important is the networking side of an event like this?

Hosted by Desiree Chappell.

Join us on www.topmedtalk.com sign up for our email updates and never miss a live streamed conference again.

Why are you short of breath? Apr 21, 2018

When it comes to breathlessness how do we better diagnose and apply treatment earlier? How do we overcome the fact that referring to a specialist can sometimes take a patient 'down the wrong route' with a condition that might not be just heart or lung related?

Ronan Astin, clinical consultant in respiratory medicine at UCL Hospital, explains his more holistic approach to treatment and diagnosis.

"Nick the patient" asks a few questions and demonstrates the misunderstanding that many sufferers might have; breathlessness is not of course always connected to your lungs.

"Johnny the patient" then speaks about his Mother, 84, who has recently experienced breathlessness, she didn't want to complain about it, how can we pick these issues up earlier?

Dan Martin, anaesthetist at The Royal Free Hospital, speaks about his processes including the cardiopulmonary exercise testing they use. Testing patients, during a session on an exercise bike, reveals physiological and pathological causes but furthermore it can reveal the psychological issues which may be behind the problem.

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This podcast is presented by Professor Monty Mythen and features contributions from; Ronan Astin, clinical consultant in respiratory medicine at UCL Hospital; Dan Martin, anaesthetist at the Royal Free Hospital and finally 'the patients' Nick Margerrison and Johnny Themans.

Journal Club Express - Postoperative delirium in total knee and hip arthroplasty patients Apr 20, 2018

Professor Monty Mythen presents Journal Club Express.

Postoperative delirium in total knee and hip arthroplasty patients: a study of perioperative modifiable risk factors

DOI: 10.1016/j.bja.2017.12.046

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S. M. Weinstein et al. Br J Anaesth 2018; 120(5): 999-1008

This is an American single center retrospective study with 41,766 patients undergoing hip and knee arthroplasties over a seven year period. They showed that 22.1% patients developed post operative delirium according to the ICD 9 definition of delirium. Delirium occurs more in patients with multiple co-morbidities, older age, higher baseline creatinine, lower haemoglobins and longer patients stays.

They looked at the type of anaesthetic as well as the use of opioids, ketamine and benzodiazepines. They found the rates of delirium were higher in the knee arthroplasty group compared with the hip arthroplasty group.

Those that received a neuroaxial block had a lower rate of delirium; Spinal: OR 0.55 (CI 0.37-0.83), Epidural: OR 0.59 (CI 0.38-0.93), CSE: OR0.56 (CI 0.40-0.80). There was a high risk with the use of postoperative benzodiazepines (OR 2.47 CI 2.04-2.97) and ketamine infusion ()R 10.59 CI 5.26-19.91) as well as intraoperative ketamine (OR 1.27 CI 1.01-1.59) and opioids (OR 10.59 CI 5.26-19.91).

Sleep disorders in surgical patients, EBPOM USA Apr 20, 2018

This podcast concerns sleep apnea as part of pre-operative patient optimisation. How important is it to evaluate patients for sleep disorders before surgery? Are patients with sleep apnea aware of their condition and are they using some form of treatment? What are the health problems associated with sleep disorders? How do you build a financial case for including this in your practice?

A piece originally streamed live from Atlanta Georgia during TopMedTalk's coverage of "EBPOM-USA Masters Course, A Perioperative Care Practicum".

Featuring hosts Desiree Chappell and Vicki Morton interviewing Dr Andrew R. Spector, Neurologist, Sleep Medicine Specialist at Duke Health.

Join us on www.topmedtalk.com sign up for our email updates and never miss a live streamed conference again.

Psychological optimisation, EBPOM USA Apr 20, 2018

Originally streamed live from Atlanta Georgia during TopMedTalk's coverage of "EBPOM-USA Masters Course, A Perioperative Care Practicum" this podcast includes discussion about psychological optimisation for surgery; who should have it, what does it mean and how does it work? Further conversation moves into weaning patients off opioids in advance of surgery and cutting their dependency afterwards. Also, the question of consent to opioids during and after surgery comes up - should we be educating patients more and is it time to look more deeply at the issue of consent?

Hosted by Desiree Chappell and Vicki Morton featuring Dr. Padma Gulur, anesthesiologist and a Pain Medicine Specialist who sees patients at Davis Ambulatory Surgical Center, Duke Pain Medicine and Duke Perioperative Pain Care.

Join us on www.topmedtalk.com sign up for our email updates and never miss a live streamed conference again.

The importance of what you eat and what you do, EBPOM USA Apr 18, 2018

The importance of exercise, weight and perioperative nutrition. Which is worse, being fat or not being fit? Malnutrition, a silent epidemic? How useful are protein shakes? Are supervised exercise sessions cost effective?

Finally the team discuss the importance of starting these conversations with children, optimising nutrition and exercise for them will enhance their lives forever.

Hosted by Monty Mythen and Mike Grocott with their guests; Dr Denny Levett, consultant in Perioperative Medicine and Critical Care at Southampton University Hospital NHS Foundation trust, and Dr Paul Wischmeyer Professor of Anaesthesiology and Surgery at Duke Anesthesiology.

Journal Club The FEDORA trial Apr 15, 2018

Professor Monty Mythen's full presentation regarding 'the FEDORA trial'.

This piece was originally presented during the Third Annual Quality Improvement Leadership Forum, 2018, at the Union League Club in Philidelphia.

The trial looked at the effect of goal-directed haemodynamic therapy on postoperative complications in low–moderate risk surgical patients: a multicentre randomised controlled trial (FEDORA trial).

Randomised Controlled Multicentre trial; n=420; GDHT vs Control

Conclusions:

"Oesophageal Doppler monitor-guided GDHT reduced postoperative complications and hospital length of stay in low–moderate risk patients undergoing intermediate risk surgery, with no difference in mortality at 180 days."

Click here for full text.

http://bjanaesthesia.org/article/S0007-0912(17)54207-5/fulltext

If you are using this article to earn your CPD points please now, having listened, click here:

http://pmp.ocbmedia.com/podcasts/journal-club-the-fedora-trial/

Day 3 EBPOM USA with Monty Mythen and Desiree Chappell Apr 15, 2018

Join Desiree and Monty as they reflect on the EBPOM USA weekend so far and look ahead to what remains.

Also - a reminder that you still have chance to hear the conference presentations live from the www.topmedtalk.com website. Go there now to get details, it's free and has proven to be incredibly popular around the world!

Dealing with policy and value based care, The Roundtable Blog Apr 14, 2018

A fascinating discussion and debate regarding the central dichotomy inherent in periperative medicine. No stone is left unturned as the team get their teeth into the subject tackling the always tricky subject of profit and patient optimisation.

Recorded on the first day of the conference this piece is a real stand out moment for TopMedTalk, make sure you both listen in and provide us with your thoughts contact@topmedtalk.com

Featuring Desiree Chappell, Monty Mythen, Dr Lee A. Fleisher Chair of Anesthesiology and Critical Care (University of Pennsylvania) and Vicki Morton DNP and Director of Clinical and Quality Outcomes at Providence Anesthesiology Associates University of South Carolina.

Remember, TopMedTalk are live streaming the conference for free, exclusively for listeners to the podcast. Go now to www.topmedtalk.com

TopMed talk live from EBPOM USA Apr 14, 2018

Originally streamed live from the EBPOM USA conference. Desiree Chappell, Monty Mythen, Dr Tim Miller (anaestheseologist at Duke University) and Dr Angela Edwards (head of perioperative medicine at Wake Forest University School of Medicine) discuss some of the presentations and their personal highlights.

Join in the conversation, email us at contact@topmedtalk.com

The Roundtable blog live from EBPOM USA Apr 14, 2018

A fascinating conversation, streamed live from EBPOM-USA on the second day of the conference.

Reflections on the conference alongside insightful discussions about how the contributors have each been attracted to perioperative medicine. Also, the perennial debate about patient care and profits, are the two factors in conflict?

Featuring Desiree Chappell host of The Roundtable Blog, Dr Brian Woods anesthesiologist and Vice President at NorthStar Anesthesia, Irving Ye Regional Chief medical officer for NorthStar Anesthesia and Elena Koepke Perioperative Medicine Fellow at Duke University.

www.topmedtalk.com

EBPOM USA - Reflections on day 1 Apr 14, 2018

Find out what the big stories and talking points were on day one of the highly anticipated "EBPOM-USA Masters Course, A Perioperative Care Practicum".

Recorded on the morning of day two; Monty Mythen, Desiree Chappell and Mike Grocott reflect on the first day of the conference.

Remember, if you would like to hear the presentations live from EBPOM-USA you can "tune in" through our website to the live stream www.topmedtalk.com

Featuring live podcasts alongside the audio from the full schedule of the conference. It's free but you must catch it live as it happens!

Get your free live stream pass now! Apr 13, 2018

ATLANTA conference alert!

Mike Grocott and Sol Aronson do a special podcast to alert TopMedTalk listeners to an exciting offer; EBPOM-USA Perioperative Care Practicum "The How to Guide" for evaluation, management and implementation - is to be streamed live, for free, from this year's conference.

Presentations will be available to you from our website as they happen, go there now and make sure you take advantage of this unique chance to be at one of the most important events in the global perioperative calendar.

Set your watch to Eastern Standard Time to catch the speakers live!

Click here: https://www.topmedtalk.com/live-stream/

Or go to www.topmedtalk.com and find the live stream section of the website.

Go there, go now, it's live, as it happens!

TOPMEDTALK NEWS Apr 13, 2018

Stories include the call to reclassify cancers, dangerous cannabis substitute causes bleeding from the eyes and a chilli chomping champion gets more than he bargined for.

For comment and story suggestions email us contact@topmedtalk.com

JOURNAL CLUB SPECIAL Apr 11, 2018

Journal club special's featured article is today from "Anesthesia & Analgesia" April 2018 - Volume 126 - Number 4 https://journals.lww.com/anesthesia-analgesia/pages/default.aspx The excerpt in this piece comes from an earlier TopMed talk here: https://www.topmedtalk.com/live-from-boston-asa-2017-anaesthesia-and-global-health-an-expert-view/ Remember you can join the TopMed talk team live at one of our conferences - we're in Atlanta later this week for the first Perioperative Care Practicum - go to www.ebpom.org for details.

Looking forward to EBPOM-USA Apr 11, 2018

Editor in Chief of TopMed Talk, Monty Mythen and Desiree Chappell, host of the Roundtable blog, talk about the upcoming "EBPOM-USA Masters Course - A Perioperative Care Practicum".

More details about the event here:

https://www.ebpom.org/EBPOM-USA2-2018

Also - for details of how you can sign up to our live stream for free go to www.topmedtalk.com

And, if you are attending the course and would like to meet the TopMed talk team, email us contact@topmedtalk.com

JOURNAL CLUB XPRESS 10th April 2018 Apr 10, 2018

Should continuous rather than single-injection interscalene block be routinely offered for major shoulder surgery? A meta-analysis of the analgesic and side-effects profiles.

Br J Anaesth. 2018 Apr;120(4):679-692.

See full article here: https://doi.org/10.1016/j.bja.2017.11.104

Consent and anaesthetics. Apr 09, 2018

Dr Carol Peden and Dr Lee A. Fleisher join Desiree Chappell in a discussion, taken from The Roundtable blog, which here concerns consent and anaesthetics.

The original longer piece you can find here:

https://www.topmedtalk.com/2-9-the-brain-health-initiative/

Are we aiming for opioid-lite? Apr 06, 2018

The opioid crisis is a big concern for the Western World. Should we be aiming for opioid-lite, or trying to get rid of them entirely?

Monty Mythen speaks with Carol Peden, Lee Fleisher and Andrea Kurz, live at the Third Annual Quality Improvement Leadership Forum, 2018.

This clip is a shorter version of a longer conversation to be found here: https://www.topmedtalk.com/how-is-perioperative-medicine-taking-control-in-2018-and-beyond/

Patient monitoring Apr 06, 2018

Dr Joff Lacey grabs a quick chat with Matt McEvoy from Vanderbilt University, speaking about patient monitoring, after a presentation at ASER 2018.

This, from a larger piece, found here:

https://www.topmedtalk.com/monitoring-patients-in-the-post-operative-period/

TOPMEDTALK WEEKLY NEWS Apr 05, 2018

Stories include the UK obesity crisis, nightmare bacteria in the US and The Duke Of Edinburgh has an operation on his hip.

For comment and story suggestions email us contact@topmedtalk.com

ERAS and cancer outcomes Apr 04, 2018

What drives enhanced recovery for you and how does it change outcomes?

Desiree Chappell presents 'The Roundtable blog'; in this clip she’s in conversation with Dr Neil Seeley Chief of anesthesia for Cancer Treatment Centres of America and Dr Michael Scott Professor of Anesthesiology at Virginia Commonwealth University and Professor at The University of Pennsylvania.

This clip is part of a longer conversation which you can find here: https://www.topmedtalk.com/2-6-enhanced-recovery-for-liver-resection-patients/

POQI does review what we are doing Apr 03, 2018

Julie Thacker discusses where we're at with enhanced recovery and POQI.

This clip, presented by Desiree Chappell at ASER 2018, is part of a longer piece which can be found here: http://www.topmedtalk.com/what-is-asers-vision-for-2018/

Has ERAS developed an energy of its own? Mar 30, 2018

Dr George Nassif explains to Desiree Chappell of The Roundtable blog how Enhanced Recovery After Surgery has grown into a movement which has had far reaching and occasionally unexpected consequences.

The domino effect which starts with enhanced recovery, moves to better patient outcomes and then tackling one of the biggest narcotics epidemics the US has ever seen.

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The fuller version of this piece is here: http://www.topmedtalk.com/how-has-enhanced-recovery-changed-your-practice/

ERAS: Implementation and the importance of regular meetings Mar 29, 2018

Vicki Morton and Bethany Sarosiek get into a conversation about the importance of regular meetings following the process of ERAS adoption and then its essential maintenance.

How have you managed the adoption process at your institution? Email us contact@topmedtalk.co.uk

The fuller version of this conversation is here: https://www.topmedtalk.com/using-a-team-approach-to-care/

Enhanced Recovery - is there anyone still in the wilderness? Mar 29, 2018

Has enhanced recovery reached the mass adoption point or are there still medical institutions which do not know about it? Is it now at a point where the process is just going to run organically? In this podcast the team assess where we are at as the dissemination process appears to be working.

Do you agree that we might in fact be at the tipping point right now?

Email us with your thoughts contact@topmedtalk.com

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Join Desiree Chappell, Monty Mythen, Tim Miller and Stefan Holubar, recorded live at this year's ASER 2018.

The fuller version of this podcast is here: https://www.topmedtalk.com/ready-for-aser-2017/

Should pain relief mean you will feel no pain? Mar 28, 2018

Pain is seen by many as the so-called fifth vital sign but is it reasonable to expect us to eliminate it entirely? The long term consequences for medicine and our patients are now manifesting in daily newscasts regarding "the opioid epidemic".

Patrick Shanahan and Mike Grocott discuss the crisis with Monty Mythen. It's a battle which ASER / ERAS and EBPOM are all helping to fight.

The fuller version of this discussion is here: https://www.topmedtalk.com/the-opiate-crisis-topmedtalk-live-from-aser-2018/

Journal club; balanced versus saline Mar 27, 2018

This edition of journal club looks at two articles in March 1st NEJM of circa 30,000 patients studied at Vanderbilt Medical Centre, USA

One in non-critically ill patients. Click here: http://www.nejm.org/doi/full/10.1056/NEJMoa1711586?query=featured_home

The other in critically ill adult patients: http://www.nejm.org/doi/full/10.1056/NEJMoa1711584?query=featured_home

Accompanied by a very balanced Editorial by Professor John Myburgh. Click here: http://www.nejm.org/doi/full/10.1056/NEJMe1800449?query=recirc_curatedRelated_article

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Listen to Monty Mythen and our guest Andy Shaw discuss the above.

Andy Shaw is Professor and Chief, Cardiothoracic Anesthesiology at Vanderbilt University Medical Center in Nashville, Tennessee. He is a Fellow of the Royal College of Anaesthetists (UK), a Fellow of the American College of Critical Care Medicine and a Fellow of the Faculty of Intensive Care Medicine (UK).

Techno Talk: My PreOp Mar 26, 2018

On this episode Dr Paul Upton explains My Preop. For more information go to: www.ultramed.co Broadcaster Nick Margerrison presents Techno Talk; joined by Professor Monty Mythen, editor in Chief of TopMedTalk and Pete Paterson, a sports psychology master.

2.9 The Brain Health initiative Mar 26, 2018

Carol Peden and Lee A. Fleisher join Desiree Chappell for a fascinating discussion about cognitive function after surgery and a wider conversation about the 'brain health initiative'.

What practical simple steps can patients and providers take to bridge the gap between new discoveries in this area and risk minimisation?

How is perioperative medicine taking control in 2018 and beyond? Mar 24, 2018

An intense and fascinating conversation which acts as a swift update for those interested in where perioperative medicine is currently at and what its ambitions for the future should be. Where are we in the process? Put yourself at the forefront of the debate by listening to this piece.

Featuring Carol Peden, Lee Fleisher and Andrea Kurz, live at the Third Annual Quality Improvement Leadership Forum, 2018.

2.7 What does enhanced recovery mean to you? Mar 19, 2018

Ruchir Gupta and Joni Brady sit at the Roundtable with Desiree Chappell to discuss implimenting better practices and "ERAS 2.0".

The ground up approach via a 'council of nurses' sparks some fascinating debate and discussion. Can a roundtable approach sometimes work better than the traditional hierarchical power structure?

Looking back over ASER 2018 Mar 18, 2018

Joff Lacey, Monty Mythen, Mike Grocott and Desiree Chappell look back at a successful and, at points very passionate, ASER 2018. What are we now looking forward to? How did the discussions around leadership pan out? What about the blood pressure sessions?

Was this, as the team suggest, a "maturing" of the movement?

What are your reflections on ASER 2018? Get it touch email contact@topmedtalk.com

How do you bring perioperative care to your practice? Mar 18, 2018

Arman Dagal and Desiree Chappell discuss bringing about change, managing and sustaining it over time and helping relate it to patient outcomes.

What is after ERAS, do we have an 'ERAS of ERAS' - so to speak?

How do you promote ERAS both inside and outside your facility? Mar 18, 2018

Kara Douglas and Joni Brady speak about the advantages of enhanced recovery and what practicioners can do to promote it.

Educating both the wider community and the patients themselves are an important part of the discussion.

Monitoring patients in the post operative period Mar 17, 2018

Joff Lacey catches up with Matt McEvoy after a lively debate about monitoring patients in the post operative period.

One of the big moments of ASER 2018 - make sure you hear this.

2.8 Critical care patients and enhanced recovery Mar 17, 2018

Desiree Chappell, Philip Corvo and Vicki Morton discuss critical care patients and enhanced recovery pathways. How do the insights of ERAS apply to these situations?

ERAS Implementation Mar 16, 2018

Joff Lacey catches up with Mike Scott (Virginia Commonwealth University) and Ross Kerridge (John Hunter Hospital, Newcastle, Australia) in the exhibit hall of ASER 2018 for a quick chat on enhanced recovery implementation.

2.6 Enhanced recovery for liver resection patients Mar 16, 2018

Michael Scott, Neil Seeley, Kevin Watkins and Desiree Chappell discuss enhanced recovery pathways, specifically regarding liver sections and other complex operations.

2.5 How ERAS introperative protocols drive outstanding outcomes Mar 16, 2018

Raul Castillo, Jennifer Clark and Kay Smith join Desiree Chappell to discuss their experiences of enhanced recovery.

They discuss how just imprementing the ERAS intraoperative protocols drove outstanding outcomes in their practice. They then get into a wider discussion about the importance of putting into practice the bigger plan.

Using a team approach to care Mar 16, 2018

An entertaining and informative discussion about the implementation process, how do you bring everyone to the table?

Desiree Chappell speaks with Robin Anderson, Bethany Sarosiek and Vicki Morton, ASER nursing committee members.

Heated discussions - exponential rise in babies born addicted to opiodes Mar 16, 2018

Joff Lacey, Monty Mythen and Patrick Shanahan get stuck into an informative discussion about yesterday's 'heated' and controversial debate regarding the opiode crisis.

Joff Lacey reports he heard one clinician say "over 25% of total knee replacements are still on opiodes 6 months after their operation".

Patrick Shanahan pleads with the public "don't connect discomfort with a need for a narcotic to take care of it, there are many other avenues to take care of pain; that message is not out there enough!"

Monty Mythen and the team agree it's important not to "demonise narcotics" but all agree these discussions are essential.

How has enhanced recovery changed your practice? Mar 15, 2018

Desiree Chappell, Dr Vijaya Gottumukkala and Dr George Nassif discuss the changes enhanched recovery has brought into their world, the conversation then moves to narcotics and the opiode epidemic.

What is ASER's vision for 2018 Mar 15, 2018

The Roundtable Blog on TopMedTalk, live from ASER 2018.

Dr Julie Thacker takes some time with Desiree Chappell to discuss ASER's vision for this year.

Meet the TopMedTalk team for ASER 2018 Mar 15, 2018

Monty Mythen, Joff Lacey and Mike Grocott chat with Desiree Chappell about the plan for the TopMedTalk team at ASER 2018.

Joff Lacey will be out and about with his roving mic getting on the spot interviews with attendees, gathering late breaking news as it happens.

Mike Grocott will be doing Journal Club, a deep dive into some of thre big papers of the last 12 months or so.

And finally, Desiree Chappell, will be returning to her popular Round Table Blog podcasts; bringing people from diverse backgrounds to the conversation so they can explain how they apply the perioperative process to their work.

The Opiate crisis - TOPMEDTALK live from ASER 2018 Mar 15, 2018

Monty Mythen, Joff Lacey and Mike Grocott look ahead to this years conference and look back over the meeting last year in Washington.

The team discuss the association between low blood pressure and outcomes and the first interventional trial related to that.

They are then joined by Dr Patrick Shanahan who discusses, amongst other things, the issues related to opiode and narcotic use which can be reduced by the perioperative process.

"My Pre-op". Empowering patients before surgery. Mar 14, 2018

Techno Talk Broadcaster Nick Margerrison presents Techno Talk; joined by Professor Monty Mythen, editor in Chief of TopMedTalk and Pete Paterson, a sports psychology master. On this episode Dr Paul Upton explains My Preop. For more information go to: www.ultramed.co

Are you ready for ASER 2018? Mar 14, 2018

Desiree Chappell, Monty Mythen, Tim Miller and Stefan Holubar discuss some of the big issues at ASER 2018.

The team discuss whether or not we're at the point of mass adoption for enhanced surgical recovery? Where next with post operative opitate prescriptions? And finally what to expect this year from ASER 2018.

Optimal analgesia within an enhanced recovery pathway Mar 13, 2018

Mike Grocott, Joff Lacey, Monty Mythen and Julie Thacker react to the American Society for Enhanced Recovery (ASER) and Perioperative Quality Initiative (POQI) joint consensus statement on optimal analgesia within an enhanced recovery pathway for colorectal surgery.

What is "optimal analgesia" and how rapidly should a patient "return to normal"?

The links to the papers are here:

Part 1:

https://perioperativemedicinejournal.biomedcentral.com/articles/10.1186/s13741-017-0064-5

Part 2:

https://perioperativemedicinejournal.biomedcentral.com/articles/10.1186/s13741-017-0063-6

Journal Club Xpress: After non-cardiac surgery myocardial injury is common and dangerous. Mar 12, 2018

Myocardial Injury after Noncardiac Surgery: A Large, International, Prospective Cohort Study Establishing DiagnosticCriteria, Characteristics, Predictors, and 30-day Outcomes

TheVascular events In noncardiac Surgery patIents cOhort evaluatioN (VISION)Writing Group, on behalf of The Vascular events In noncardiac Surgery patIentscOhort evaluatioN (VISION) Investigators. Anesthesiology 03 2014,Vol.120, 564-578.

International,prospective cohort study of 15,065 patients > 45 yr, having noncardiac surgery.

TroponinT was measured first 3 postoperative days. Diagnosticcriterion for MINS was a peak troponin T level of 0.03 ng/ml or greater judgeddue to myocardial ischemia.

MINSwas an independent predictor of 30-day mortality (adjusted hazard ratio, 3.87;95% CI, 2.96–5.08) and had the highest population-attributable risk (34.0%, 95%CI, 26.6–41.5) of the perioperative complications.

1,200 patients (8.0%) suffered MINS, and over half (58.2%) of these patients would nothave fulfilled the universal definition of myocardial infarction. Fewer than one in five (15.8%) patients with MINS experienced an ischemic symptom.

Among adults undergoing noncardiacsurgery, MINS is common and associated with substantial mortality.

For original paper click here:

http://anesthesiology.pubs.asahq.org/article.aspx?articleid=1917890

Journal Club: Multi-centre trial in BJA: Goal Directed Therapy improves outcomes Mar 10, 2018

Effect of goal-directed haemodynamic therapy on postoperative complications in low–moderate risk surgical patients: a multicentre randomised controlled trial (FEDORA trial)

Randomised Controlled Multicentre trial; n=420; GDHT vs Control

Conclusions:

"Oesophageal Doppler monitor-guided GDHT reduced postoperative complications and hospital length of stay in low–moderate risk patients undergoing intermediate risk surgery, with no difference in mortality at 180 days."

Click here for full text.

http://bjanaesthesia.org/article/S0007-0912(17)54207-5/fulltext

Dr Tim Miller and Dr Julie Thacker Mar 10, 2018

Dr Tim Miller, Anesthesiologist from Duke talks about opiods "we're definately opening our eyes in The States". Also, Dr Julie Thacker, President of the American Society of Enhanced Recovery features with her thoughts on colorectal surgery.

Bowel Prep and Opiates Mar 08, 2018

A quick refresher on some of the hot topics from ASER 2017, including the messy issue of bowel prep and the prickly topic of opiates.

A couple of highlights from Professor Monty Mythen and Dr Joff Lacey's live coverage of ASER 2017 for TopMedTalk featuring Dr Julie Thacker, President of American Society of Enhanced Recovery and Desiree Chappell a CRNA in Louisville, Kentucky and board member of EBPOM USA.

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15th - 17th March 2018 ASER/EBPOM 2018 Annual Congress of Enhanced Recovery and Perioperative Medicine, register here: http://aserhq.org/2018-annual-congress/

Is rehabilitation a team sport? Mar 07, 2018

Dr Steve Flanagan - Chair of Physical Medicine and Rehabilitation at NYU Langone.

Taken from the Roundtable discussions hosted by Desiree Chappell live from the American College of Perioperative Medicine's Interdisciplinary Conference on Orthopedic Value-Based Care.

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The fuller version of this piece is here: http://topmedtalk.libsyn.com/physical-medicine-in-rehabilitation-applying-a-team-approach-in-care-and-pre-and-post-habilitation

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Also - don't forget: 15th - 17th March 2018 ASER/EBPOM 2018 Annual Congress of Enhanced Recovery and Perioperative Medicine, register here: http://aserhq.org/2018-annual-congress/

Journal Club Xpress: > 100K patient study of Spinal vs GA for fractured neck of femur Mar 06, 2018

Association of Hospital-level Neuraxial Anesthesia Use for Hip Fracture Surgery with Outcomes: A Population-based Cohort Study

McIsaac D et al. Anesthesiology 3 2018, Vol.128, 480-491

A population-based cohort study using linked administrative data in Ontario, Canada. 107,317 hip fracture patients > 65 yr of age from 2002 to 2014.

Hip fracture surgery patients at hospitals that use more than 20 to 25% neuraxial anesthesia have improved survival independent of patient-level anesthesia type and other confounders. The underlying causal mechanism for this association requires a prospective study to guide improvements in perioperative care and outcomes of hip fracture patients.

For original paper click here:

http://anesthesiology.pubs.asahq.org/article.aspx?articleid=2657156

Sol Aronson and Monty Mythen speak about the forthcoming EBPOM USA meeting, April 13-15th. Mar 06, 2018

Sol Aronson and Monty Mythen speak about the forthcoming EBPOM 2018 annual conference in Atlanta.

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For more details on the upcoming Perioperative Practicum, Atlanta, April 13-15 2018 click here:

https://www.ebpom.org/EBPOM-USA2-2018

Journal Club Express Mar 05, 2018

2 articles in March 1st NEJM of circa 30,000 patients studied at Vanderbilt Medical Centre, USA

One in non-critically ill patients. Click here: http://www.nejm.org/doi/full/10.1056/NEJMoa1711586?query=featured_home

The other in critically ill adult patients: http://www.nejm.org/doi/full/10.1056/NEJMoa1711584?query=featured_home

Accompanied by a very balanced Editorial by Professor John Myburgh. Click here: http://www.nejm.org/doi/full/10.1056/NEJMe1800449?query=recirc_curatedRelated_article

Join "Journal Club" live at an upcoming EBPOM meeting: https://www.ebpom.org/EBPOM-USA?newsid=1015

Are you screening surgical patients adequately for malnutrition? Mar 01, 2018

Monty Mythen talks to Professor Paul Wischmeyer from the Department of Anesthesiology, Duke University, USA about the recently e.published American Society of Enhanced Recovery (ASER) and Perioperative Quality Initiative (POQI) joint consensus statement on Nutrition and Screening Therapy within an Surgical Enhanced Program.

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Click on this link to access the full paper:

https://journals.lww.com/anesthesia-analgesia/Abstract/publishahead/American_Society_for_Enhanced_Recovery_and.96950.aspx

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Come and meet Professor Wischmeyer and learn how to set up a highly cost effective nutrition pathway for surgical patients at the upcoming Perioperative Practicum, Atlanta, April 13-15 2018. Click here for details:

https://www.ebpom.org/EBPOM-USA2-2018

The beauty of shared decision making? Feb 27, 2018

A short digest of the longer chat from Desiree Chappell's "Round Table Blog", hosted at the American College of Perioperative Medicine's Interdisciplinary Conference on Orthopedic Value-Based Care.

Here Kevin Bozic, Chair of Surgery & Perioperative Care at the Dell Medical School and Professor Monty Mythen, London, UK discuss aspects of perioperative care with insightful additional comments from Eric Schneidewind, President of the AARP.

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The fuller version of this is here: https://www.topmedtalk.com/articles/don-t-ask-patients-what-is-the-matter-ask-them-what-matters

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Also - don't forget: 15th - 17th March 2018 ASER/EBPOM 2018 Annual Congress of Enhanced Recovery and Perioperative Medicine, register here: http://aserhq.org/2018-annual-congress/

Lifesaving news; big data delivers shocking information regarding intraoperative blood pressure - Dan Sessler at the ASA 2017 Feb 22, 2018

A stunning moment from last year's conference, captured exclusively on TopMedTalk; Monty Mythen and Mike Grocott are joined by Dr Dan Sessler (Cleveland Clinic) and Dr Tim Miller (Duke University Medical Centre) exciting results from the first multicentre, randomised controlled trial into targeted intraoperative blood pressure management.

Don't forget: 15th - 17th March 2018 ASER/EBPOM 2018 Annual Congress of Enhanced Recovery and Perioperative Medicine, register here: http://aserhq.org/2018-annual-congress/

"A seminal moment in anaesthesia" - Julian Gore-Booth ASA 2017 Feb 21, 2018

Julian Gore-Booth, Chief Executive Officer at The World Federation of Societies of Anaesthesiologists, in an exclusive interview for TopMedTalk at last year's ASA.

Here he reveals why we are at 'a seminal moment in anaesthesiology'.

For the fuller interview look for "Live from Boston ASA 2017 - Anaesthesia and Global Health - an expert view" direct link here: http://topmedtalk.libsyn.com/monty-boston-pod-12

The singularity university and exponential change Feb 20, 2018

The first round table discussion hosted by Desiree Chappell and featuring Monty Mythen, recorded on February the 9th, the first night of the Interdisciplinary Conference on Orthopedic Value-Based Care. This is the first segment of a fascinating 'round table discussion' between Desiree, Monty and their two guests; Shawna Butler (RN, NBA who works with Singularity University in Exponential Medicine) and Jennifer Brandon (PT, MPT, Hoag Orthopedic Institute in Irvine, California). Firstly we hear about Shawna and her work, at Singularity University; specifically she speaks about the pace of exponential change, as compared with linear progress. -- Don't forget: 15th - 17th March 2018 ASER/EBPOM 2018 Annual Congress of Enhanced Recovery and Perioperative Medicine, register here: http://aserhq.org/2018-annual-congress/

Pre-operative and post-operative rehabilitation Feb 20, 2018

The first round table discussion hosted by Desiree Chappell and featuring Monty Mythen, recorded on February the 9th, the first night of the Interdisciplinary Conference on Orthopedic Value-Based Care. This is the second segment of a fascinating 'round table discussion' between Desiree, Monty and their two guests; Shawna Butler (RN, NBA who works with Singularity University in Exponential Medicine) and Jennifer Brandon (PT, MPT, Hoag Orthopedic Institute in Irvine, California). Here Jennifer speaks to the group about pre-operative and post-operative rehabilitation; followed by a discussion about engaging older patients with technology. -- Don't forget: 15th - 17th March 2018 ASER/EBPOM 2018 Annual Congress of Enhanced Recovery and Perioperative Medicine, register here: http://aserhq.org/2018-annual-congress/

Using new technology with elderly patients Feb 20, 2018

The first round table discussion hosted by Desiree Chappell and featuring Monty Mythen; recorded on February the 9th, the opening night of the Interdisciplinary Conference on Orthopedic Value-Based Care. Desiree, Monty and their two guests; Shawna Butler (RN, NBA who works with Singularity University in Exponential Medicine) and Jennifer Brandon (PT, MPT, Hoag Orthopedic Institute in Irvine, California) continue a discussion about using new technology with elderly patients.

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Don't forget: 15th - 17th March 2018 ASER/EBPOM 2018 Annual Congress of Enhanced Recovery and Perioperative Medicine, register here: http://aserhq.org/2018-annual-congress/

Knowing your outcomes Feb 20, 2018

The first round table discussion hosted by Desiree Chappell and featuring Monty Mythen, recorded on February the 9th, the first night of the Interdisciplinary Conference on Orthopedic Value-Based Care. This is the fourth segment of the conversation between Desiree, Monty and their two guests; Shawna Butler (RN, NBA who works with Singularity University in Exponential Medicine) and Jennifer Brandon (PT, MPT, Hoag Orthopedic Institute in Irvine, California). Here Monty speaks, from a transatlantic perspective, about the need in value based care to know your outcomes.

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Don't forget: 15th - 17th March 2018 ASER/EBPOM 2018 Annual Congress of Enhanced Recovery and Perioperative Medicine, register here: http://aserhq.org/2018-annual-congress/

The magic of value based care Feb 20, 2018

The first round table discussion hosted by Desiree Chappell and featuring Monty Mythen; recorded on February the 9th, the opening night of the Interdisciplinary Conference on Orthopedic Value-Based Care.

This is the fifth segment of a fascinating 'round table discussion' between Desiree, Monty and their two guests; Shawna Butler (RN, NBA who works with Singularity University in Exponential Medicine) and Jennifer Brandon (PT, MPT, Hoag Orthopedic Institute in Irvine, California).

Here Jennifer speaks about engaging the multidisciplinary team and explains how social workers can become involved earlier in the process, this is added to by Shawna.

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Don't forget: 15th - 17th March 2018 ASER/EBPOM 2018 Annual Congress of Enhanced Recovery and Perioperative Medicine, register here: http://aserhq.org/2018-annual-congress/

Patients are the experts in being patients Feb 20, 2018

The penultimate part of the first round table discussion hosted by Desiree Chappell and featuring Monty Mythen; recorded on February the 9th, the opening night of the Interdisciplinary Conference on Orthopedic Value-Based Care.

This is the final segment of a fascinating 'round table discussion' between Desiree, Monty and their two guests; Shawna Butler (RN, NBA who works with Singularity University in Exponential Medicine) and Jennifer Brandon (PT, MPT, Hoag Orthopedic Institute in Irvine, California).

Here Shawna speaks about “innovation as a team sport”.

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Don't forget: 15th - 17th March 2018 ASER/EBPOM 2018 Annual Congress of Enhanced Recovery and Perioperative Medicine, register here: http://aserhq.org/2018-annual-congress/

Perioperative care and the multidisciplinary approach Feb 20, 2018

The final part of the first round table discussion hosted by Desiree Chappell and featuring Monty Mythen; recorded on February the 9th, the opening night of the Interdisciplinary Conference on Orthopedic Value-Based Care.

Join Desiree, Monty and their two guests; Shawna Butler (RN, NBA who works with Singularity University in Exponential Medicine) and Jennifer Brandon (PT, MPT, Hoag Orthopedic Institute in Irvine, California) as they discuss perioperative care and the multi-disciplinary approach. An example of it in practice is given, the fact it means anaesthesiologists can be involved in knowing what works and how things are going.

The conversation then concludes with the question “who are the main stakeholders”?

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Don't forget: 15th - 17th March 2018 ASER/EBPOM 2018 Annual Congress of Enhanced Recovery and Perioperative Medicine, register here: http://aserhq.org/2018-annual-congress/

Zeev Kain | TopMedTalks to ... Feb 12, 2018

Desiree Chappell speaks with Zeev Kain, organiser of the American college of perioperative medicine interdisciplinary conference on orthopaedic value based care.

Find his podcast here: http://drzeevkain.health/podcast/

The future of value based care. Feb 11, 2018

Monty Mythen and Desiree Chappell of The Roundtable blog speak with Jan Vest, C.E.O of Signature Medical Group and Josh Luke, America's leading health-care futurist and writer of "EX-Acute, a former hospital CEO tells all on what's wrong with American healthcare".

Barriers and successes in value based care Feb 11, 2018

Desiree Chappell from The Round Table blog speaks with Dr. Jay Pond and Allan Beck Chief Executive Officer of the Baylor Orthopedic and Spine Hospital at Arlington.

Value based care at the Baylor Orthopedic and Spine Hospital, Arlington. Feb 11, 2018

Desiree Chappell catches up with John Boudreaux and Phillip Gallegos from the Baylor Orthopedic and Spine Hospital, Arlington. They discuss improving patient outcomes and their approach to value based care.

Utilization of pre-op management and pre-habilitation. Feb 11, 2018

Desiree Chappelle of The Round Table perioperative care blog and our very own Monty Mythen are joined by Linda Russell.

Linda is a national expert in the area of perioperative Management of Orthopedic Patients. Over the past 5 years she created a division responsible for the preoperative assessment and postoperative care of approximately 16,000 patients who have Orthopedic surgery and are admitted to the famed HSS.

Rehabilitation: exercise is real medicine Feb 10, 2018

Steve Flanagan, Brian Stewart and Colleen Walsh join Desiree Chappelle and Monty Mythen on TopMedTalk in association with The Round Table Perioperative Care Blog.

The team discuss physical medicine and rehabilitation, applying a team approach in care and 'pre and post-habilitation'.

Don't ask patients 'what is the matter' ask them what matters? Feb 10, 2018

Desiree Chappell of The Roundtable blog, with Monty Mythen of TopMedTalk discuss outcomes and patient care, what matters the most?

They are joined by two of the guest speakers from the American College of Perioperative Medicine's 2018 conference; Eric J Schneidewind and Kevin Bozic.

Should you have to lose weight before you get a new knee? Feb 10, 2018

Should you have to lose weight before you get a new knee.

A short sampler from Desiree's round table discussion with TopMedTalk.

Today at value based orthopedic care 2018 Feb 09, 2018

Professor Monty Mythen and the TopMedTalk team have just arrived in Southern California to join Desiree Chappell for the American College of Perioperative Medicine's Interdisciplinary Conference on Orthopedic Value-Based Care (visit here: https://www.transcend.health).

TopMedTalk partners with The Round Table (visit here: http://www.enhancedrecoveryblog.org) to deliver quality guest interviews and discussions between researchers and practicioners of perioperative medicine with a focus on Enhanced Recovery.

Should more surgery be postponed the USA to better prepare patients? Jan 08, 2018

Bowel prep for ERAS? President of ASER live from Washington DC meeting 2017. Jan 08, 2018

Bowel prep has moved on and become “less harmful”, patient satisfaction is now part of the process, it wasn’t always previously. How is surgical site infection balanced with patient comfort? Sponsored by EBPOM and EDWARDS life sciences. This is a piece from the first ever pilot episode of TopMedTalk; Monty couldn’t make it to ASER that year so worked with some friends to pick up on the big stories, Dr Joff Lacey here speaks with their guest Dr Julie Thacker, the then president elect at ASER about bowel prep.

Post-operative Frailty. Fay Gilder Live from American Society of Anesthesiology, Boston 2017 (1min 24 sec) Jan 08, 2018

Presidential visit to the Ether Dome at Massachusett's General Hospital in Boston Nov 05, 2017

Joff Lacey joins Dr Liam Brennan (President, Royal College of Anaesthestists) and Dr Andy Bailey (Addenbrooke's Hospital, Cambridge) on a trip to the birthplace of anaesthesia - the Ether Dome.

Live from Boston ASA 2017 - The RELIEF Trial Oct 23, 2017

The REstrictive Versus LIbEral Fluid Therapy in Major Abdominal Surgery: RELIEF Study (RELIEF) is discussed.

How much IV fluid should be used? Will a more restrictive approach be useful? The trial design is discussed, pre-trial surveying, how they went about setting it up and what protocols they followed.

Will this trial put to bed the questions about liberal restricted fluid therapy? Can a trial ever be truly definitive?

Presented by Monty Mythen, Mike Grocott and Joff Lacey, joined by their guest Professor Paul Myles (The Alfred, Melbourne).

This article mentioned in BMJ Open is found here: http://bmjopen.bmj.com/content/7/3/e015358

Live from Boston ASA 2017 - Life at The Extremes - trials on Everest & adapting to hypoxia Oct 23, 2017

A discussion about oxygen and the Xtreme Everest research studies into human adaptation to hypoxia. How does the human body adapt to extreme conditions, we assume it will inevitably cause damage but this is not always the case. How do people who have inherited a tolerance for low levels of oxygen manage?

Monty Mythen, Mike Grocott and Joff Lacey are joined by special guest Dr Dan Martin OBE Consultant in Intensive Care and Everest summiteer.

Live from Boston ASA 2017 - Anaesthesia and Global Health - an expert view Oct 23, 2017

Podcast 12: Guest presenter Dr Liam Brennan (President of the Royal College of Anaesthetists) is joined by Dr Gonzalo Barreiro (President of the World Federation of Societies of Anaesthesiologists, WFSA), Julian Gore-Booth (CEO of WFSA) and Dr Paul Clyburn (President of the Association of Anaesthetists of Great Britain and Ireland) to discuss the unmet global need for safe and accessible anaesthesia.

Live from Boston ASA 2017 - Perioperative Delirium Oct 22, 2017

A discussion about the importance of screening and risk mitigation regarding cognitive dysfunction and delirium in the perioperative period.

Monty Mythen and Mike Grocott are joined by their guests Dr Liam Brennan, President of the Royal College of Anaesthetists, and Dr Fay Gilder, Addenbrooke’s, Cambridge.

Join the debate: contact@topmedtalk.com

Live from Boston ASA 2017 - Goal Directed Fluid Therapy - Increased Risk of Kidney Injury? Oct 22, 2017

Podcast 10: Monty Mythen, Mike Grocott and Joff Lacey talk to Dr Tim Miller (Duke University Medical Centre) about a recent study investigating the impact of GDFT on postoperative acute kidney injury in the colorectal patient.

Live from Boston ASA 2017 - Physiological Principles of Goal Directed Fluid Therapy - fluid responsiveness, the stressed system and the glycocalyx Oct 22, 2017

Joff Lacey talks to Dr Randall Dull (University of Illinois) to pick apart the physiological principles of intraoperative fluid resuscitation and the need to rethink our approach.

Live from Boston ASA 2017 - Enhanced Recovery and Protocolised Care in Cardiac Surgery Oct 22, 2017

Podcast 8: Joff Lacey is joined by Dr Davinder Ramsingh (Loma Linda University) to discuss the application of ERAS in the cardiac surgical patient.

Live from Boston ASA 2017 - The Elephant In The Room - intraoperative hypotension Oct 22, 2017

A discussion regarding the exciting results from the first multicentre, randomised controlled trial into targeted intraoperative blood pressure management.

Monty Mythen and Mike Grocott are joined by their guests Dr Dan Sessler, Cleveland Clinic, and Dr Tim Miller, Duke University Medical Centre.

Live from Boston ASA 2017 - Intraoperative Goal Directed Fluid Therapy - where do we stand? Oct 22, 2017

This podcast focuses on the changing role of goal directed fluid therapy in enhanced recovery programmes. There is discussion around the Perioperative Quality Initiative guidelines, assessment of risk and how this relates specifically to laparoscopic surgery.

Updates on relevant trials and the importance of risk stratifying patients to ensure goal directed fluid therapy is used on those that stand to really benefit.

Presented by Monty Mythen, Mike Grocott and Joff Lacey, who are joined by Dr Tim Miller, Duke University Medical Centre, and Professor Mike Scott, Virginia Commonwealth University.

Live from Boston ASA 2017 - The Bigger Picture of Perioperative Medicine - the UK and USA perspective Oct 21, 2017

This conversation explores the extended role of the anaesthetist, brought about partly by perioperative care but more widely because of societal changes. Practitioners face a dilemma; how do you best impact value based care, as a specialist, when multidisciplinary approaches are becoming essential?

In the UK, The Royal College of Anaesthetists, are working on this very issue; find out how they are becoming part of conversations regarding public health and modifiable risk factors, as relate to a patient's lifestyle choices and pathology.

The transatlantic perspective is essential here, how do organisations like EBPOM USA advocate these ideas within an American funding model?

No matter which side of the Atlantic you live on there's a very real debate to be had about training students; the job of the anaesthetist has fundamentally altered in recent times. Furthermore, how do those already practising update their skills and stay with the times?

Monty Mythen and Joff Lacey presenting with their guests Liam Brennan, President of the Royal College of Anaesthetists, and Sol Aronson, a tenured professor at Duke University and Executive Vice Chairman in the Department of Anesthesiology.

Live from Boston ASA 2017 - Perioperative Medicine in USA Oct 21, 2017

Anaesthesiology has reached a moment of great change, the discipline is evolving rapidly. With change comes opportunity, this conversation explores the transitional situation experts, practitioners and students find themselves in, how can you best fit into the new world? Renumeration is one changing factor but so is the idea that prevention is a clear goal for people who would like to avoid being seen as patients.

The transatlantic side of this debate is useful as a paradigm to think about where things might go but there are further elements which are outside of that picture; the evolution of AI and technology means concepts such as patient optimisation and 'the new economy of healthcare' may take on unpredictable forms in the future. How does a world of limited resources and increased technological capacity fit into the perioperative movement?

'Evidence Based Perioperative Medicine USA' is discussed alongside the intention to get beyond advocacy and into practical realities. How do we apply all these ideas?

Presented by Monty Mythen, Mike Grocott and Joff Lacey; joined by their guest Sol Aronson, a tenured professor at Duke University and Executive Vice Chairman in the Department of Anesthesiology.

Podcast 3: Live from Boston ASA 2017 – Perioperative Medicine and the Perioperative Surgical Home – are we talking the same language? Oct 21, 2017

Discussion about the challenge of delivering patient-centred, value-driven healthcare.

Value based care is discussed, value for the patient is emphasised and discussion is had about how much people trust hospitals and doctors. The difference between the perception of healthcare institutions and practitioners in UK and the US is debated.

Perioperative medicine, perioperative surgical home, enhanced recovery after surgery (ERAS); the terms differ but are they all really the same thing?

Does value based care mean we have to ask our patients what they value? Shared decision making and an awareness of where an individual's priorities lie is becoming an essential part of the picture now.

How does this dovetail into the questions regarding multiple morbidities and pathological health concerns? Prehabilitation may mean modifiable risk factors brought on by lifestyle need to be addressed as part of patient optimisation.

How does this work in a fee for service environment? The answers vary but if there's a significant saving for a hospital can it be funded by the institution itself?

Professor Monty Mythen, Professor Mike Grocott and Dr Joff Lacey presenting with their guest Prof Zeev Kain, Chancellor's Professor of Anaesthesia at University of California at Irvine and President of the American College of Perioperative Medicine.

Podcast 2: Live from Boston ASA 2017 - The big challenge of big trials Oct 21, 2017

The challenges facing the anaesthesia community as the need for big trials looms large. Why does it take so long for the anaesthesia community to adopt new techniques? Goal directed fluid therapy, as an example, seems to work but involves a cultural change and huge trials before it can be adopted.

The Optimisation of Peri-operative Cardiovascular Management to Improve Surgical Outcome II (OPTIMISE II) trial is discussed in detail, as is the FLO-ELA (FLuid Optimisation in Emergency LAparotomy) trial.

Could it be that because fluid therapy involves a cultural change within the anaesthesia community there is a difficulty for some to accept the evidence as it is?

Finally Monty asks, as regards big trials, "blood pressure, shouldn't there be more of a focus on that?".

Presenting live from Boston ASA; Professor Monty Mythen, Professor Mike Grocott and Dr Joff Lacey.

Join the debate: contact@topmedtalk.com

Podcast 1: Live from Boston ASA 2017 - Anaesthesia and the Perioperative Medicine movement Oct 21, 2017

The largest gathering of anaesthesiologists in the world; feel as if you're there with the TopMedTalk team at ASA 2017.

This discussion covers the birth of anaesthesia, in Boston, and its adoption around the world. The contrast between demonstration and adoption in the 1800's and in the modern world is questioned, are we too cautious in adopting new ideas these days? Also - what has been the impact upon surgery, do patients now have unrealistic expectations as regards pain management as a result of it?

And finally, is perioperative medicine a natural evolution of this history?

Professor Monty Mythen, Professor Mike Grocott and Dr Joff Lacey recorded this piece live in Boston at the ASA 2017.

Join the debate contact@topmedtalk.com

Anesthesiology 2017 intro Oct 17, 2017

TopMedTalk ASA 2017 mission statement.

The start of our live coverage from Boston.

Urine output | TopMedTalk General Sep 04, 2017

Should we still measure urine output? How useful is permissive oliguria?

Presented by Professor Monty Mythen and Dr Joff Lacey featuring guests Dr Tim Miller from Duke University Medical Centre and John A. Kellum, Tenured Professor, Critical Care Medicine from The University of Pittsburgh. Join in the debate: contact@topmedtalk.com

This taken from a longer conversation on the subject of perioperative nephrology to be found here: http://www.topmedtalk.com/ebpom-2017-pod-one-live-from-london/

Renal Injury Biomarkers Sep 04, 2017

How do cell cycle arrest biomarkers offer hope?

Presented by Professor Monty Mythen and Dr Joff Lacey featuring guests John A. Kellum, Tenured Professor, Critical Care Medicine from The University of Pittsburgh and Dr Tim Miller from Duke University Medical Centre. Join in the debate: contact@topmedtalk.com This piece taken from a longer conversation to be found here: http://www.topmedtalk.com/ebpom-2017-pod-one-live-from-london/

Perioperative Nephrology Fluids and the Kidney Sep 04, 2017

Professor John Kellum gives a thumbnail sketch summary of the fluid debate.

Presented by Professor Monty Mythen and Dr Joff Lacey with guest John A. Kellum, Tenured Professor, Critical Care Medicine from The University of Pittsburgh. Join in the debate: contact@topmedtalk.com This conversation taken from a longer piece here: http://www.topmedtalk.com/ebpom-2017-pod-one-live-from-london/

Intraoperative Hypotension Sep 04, 2017

Reactions to one of the big take away points of EBPOM 2017, intraoperative hypotension lower than 65 mmHg appears to show a close correlation to terrible, sometimes fatal, outcomes.

Presented by Professor Monty Mythen and Dr Joff Lacey featuring guests Dr Tim Miller from Duke University Medical Centre and John A. Kellum, Tenured Professor, Critical Care Medicine from The University of Pittsburgh. Join in the debate: contact@topmedtalk.com This piece taken from a longer conversation to be found here: http://www.topmedtalk.com/aser-ebpom-2017-pod-two-live-from-washington-dc/

Risk of Surgery Sep 04, 2017

What is a 'micromort'? Even more of a worry, what does ten of them mean? How do we measure and communicate risk to patients? Everyday activities all carry inherent risks, how do we put surgery into a context 'everyday people' can more easily understand?

Recorded on day two of EBPOM 2017; Professor Monty Mythen presents with guests, Professor Sol Aronson, a tenured professor at Duke University and Executive Vice Chairman in the Department of Anesthesiology, and Dr Mike Irwin, Professor and Head, Department of Anaesthesiology, University of Hong Kong.

Sponsored by EBPOM and Edwards Life Sciences.

Join in the debate: contact@topmedtalk.com

Taken from a longer conversation to be found here: http://www.topmedtalk.com/ebpom-2017-pod-two-live-from-london/

Refusing Surgery | EBPOM World Congress 2017 Sep 04, 2017

Should we refuse surgery to those who won't change? What about pathological issues, such as smoking, should practitioners become more didactic in their approach? How do we effectively communicate risk, both to the patient and the institution you work for?

Recorded on day two of EBPOM 2017; Professor Monty Mythen presents with Dr Joff Lacey and guests, Professor Sol Aronson, a tenured professor at Duke University and Executive Vice Chairman in the Department of Anesthesiology, and Dr Mike Irwin, Professor and Head, Department of Anaesthesiology, University of Hong Kong.

Sponsored by EBPOM and Edwards Life Sciences.

Join in the debate: contact@topmedtalk.com

Taken from a longer conversation to be found here: http://www.topmedtalk.com/ebpom-2017-pod-two-live-from-london/

Fitness for surgery | EBPOM World Congress 2017 Sep 04, 2017

Fitness for surgery and an understanding of the realities of risk. How important is it for surgery to take place when balanced against the specific health of the patient? How do we encourage patients to alter pathological aspects of their lives in order to minimise the chances of a negative outcome?

Recorded on day two of EBPOM 2017; Professor Monty Mythen presents with Dr Joff Lacey and guests, Professor Sol Aronson, a tenured professor at Duke University and Executive Vice Chairman in the Department of Anesthesiology, and Dr Mike Irwin, Professor and Head, Department of Anaesthesiology, University of Hong Kong.

Sponsored by EBPOM and Edwards Life Sciences.

Join in the debate: contact@topmedtalk.com

Taken from a longer conversation to be found here: http://www.topmedtalk.com/ebpom-2017-pod-two-live-from-london/

Perioperative Enhancement Teams | ASER 2017 Aug 30, 2017

ASER 2017 and the POET acronym - a truly multidisciplinary Perioperative Enhancement Team; responsible for project managing optimisation programmes.

Monty Mythen speaks with Professor Sol Aronson, a tenured professor at Duke University and Executive Vice Chairman in the Department of Anesthesiology.

This piece is taken from a longer conversation to be found here: http://www.topmedtalk.com/aser-ebpom-2017-recap-pod-three-live-from-london/

Join the debate: contact@topmedtalk.com

Pain Management for ESR "optimal analgesia" | ASER 2017 Aug 30, 2017

Pain Relief in Enhanced Surgical Recovery.

Monty Mythen asks Dr Joff Lacey and Professor Mike Grocott to reflect on the pain management discussions from day 1 of the American Society of Enhanced Recovery 2017.

For further reading see the articles in Perioperative Medicine Journal:

https://perioperativemedicinejournal.biomedcentral.com/articles/10.1186/s13741-017-0064-5

This conversation taken from a longer piece to be found here: http://www.topmedtalk.com/aser-ebpom-2017-recap-pod-three-live-from-london/

Join in the debate: contact@topmedtalk.com

Standardised Outcomes from Surgery. Drink, Eat, Mobilise (DrEaM) | ASER 2017 Aug 30, 2017

Dr Ramani Moonesinghe on Standardised Outcomes from Major Surgery.

Dr Joff Lacey and Professor Monty Mythen talk to Dr Ramani Moonesinghe, Director of the Heath Services Research Centre at the Royal College of Anaesthetists and a lead author of the Perioperative Quality Initiative (POQI http://www.poqi.org) guidelines on outcomes from surgery.

Simple objective measures such as Drinking, Eating and Mobilising (DrEaM). For further reading see this article in Perioperative Medicine: https://perioperativemedicinejournal.biomedcentral.com/articles/10.1186/s13741-017-0062-7

Attend our next meeting: http://www.ebpom.org/EBPOM-USA

This piece is taken from a longer conversation here: http://www.topmedtalk.com/aser-ebpom-2017-recap-pod-three-live-from-london/

Length of stay after Major Surgery. Less than 3 days with >90% mobilised on day 1 | ASER 2017 Aug 30, 2017

Discussion focused on: outcomes, length of stay and DREAMS (Drinking, Eating and Mobilising) within hours after major surgery, all key process and outcome measures. This in depth discussion relates to the recently published consensus paper from the Perioperative Quality Initiative.

Monty Mythen and Joff Lacey with Mike Grocott presenting with contributions from Dr Julie Thacker, Colorectal Surgeon from Duke University and President of the American Society of Enhanced Recovery and Dr Tim Miller, Anesthesiologist from Duke University.

POQI website is here: http://www.poqi.org

For further CME read the paper in Perioperative Medicine:

https://perioperativemedicinejournal.biomedcentral.com/articles/10.1186/s13741-017-0062-7

Attend our next meeting: http://www.ebpom.org/EBPOM-USA

This piece is taken from a longer discussion here: http://www.topmedtalk.com/aser-ebpom-2017-pod-two-live-from-washington-dc/

Critical Care Provision after Major Surgery | ASER 2017 Aug 30, 2017

What is the SNAP-2 project? This piece explains in detail, the 2nd Sprint National Anaesthesia Project: Epidemiology of Critical Care provision after Surgery (SNAP-2: EpiCCS)

SNAP-2: EpiCCS will describe the epidemiology of perioperative risk, outcome, critical care referral and admission after inpatient surgery in the UK. It also aims to examine whether planned postoperative critical care admission is effective as an intervention to reduce postoperative morbidity.

http://www.niaa-hsrc.org.uk/SNAP-2-EpiCCS

Monty Mythen speaking with Dr Ramani Moonesinghe, Director of the UK National Institute of Academic Anaesthesia Health Services Research Centre.

This taken from a longer conversation here: http://www.topmedtalk.com/aser-ebpom-2017-recap-pod-three-live-from-london/

Join in the discussion: contact@topmedtalk.com

Bowel Prep for colorectal surgery patients on enhanced recovery pathways? EBPOM World Congress 2017 Aug 30, 2017

Bowel Prep and Enhanced Recovery After Surgery.

Monty Mythen interviewing Dr Julie Thacker, President of the American Society of Enhanced Recovery and a Colorectal Surgeon at Duke, USA.

Dr Thacker explains the consensus statement from ASER and the Perioperative Quality Initiative (http://www.poqi.org).

Taken from a longer conversation here: http://www.topmedtalk.com/ebpom-2017-pod-one-live-from-london/

Join in the debate: contact@topmedtalk.com

Too many patients presenting for surgery are malnourished. We need to do more to fix this | ASER 2017 Aug 30, 2017

"More than half our patients who come to us for surgery with enhanced recovery are malnourished"; nutrition for patients scheduled for major surgery.

Monty Mythen and Joff Lacey speak with Dr Paul E Wischmeyer, Professor of Anesthesiology and Surgery at Duke University School of Medicine.

Hear more from Dr Wischemeyer on YouTube: https://www.youtube.com/watch?v=XAYrjf1dhJU

This piece is taken from a longer TopMed talk conversation which you can hear in full here: http://www.topmedtalk.com/aser-ebpom-2017-recap-pod-three-live-from-london/

Join in the debate: contact@topmedtalk.com

Fit for Surgery? Can exercise fight cancer? | ASER 2017 Aug 30, 2017

Fit 4 Surgery School and can exercise help fight cancer.

Monty Mythen and Joff Lacey talk to Professor Mike Grocott about the 'pre-habillitation re-habilitation' on day one of the ASER 2017 meeting in Washington DC. Prof Grocott also gives more detail on on-going research that is exploring the impact of exercise on cancer therapy.

For more CME read "Re-designing the pathway to surgery: better care and added value" in Perioperative Medicine here: https://perioperativemedicinejournal.biomedcentral.com/articles/10.1186/s13741-017-0065-4

This taken from a longer conversation here: http://www.topmedtalk.com/aser-ebpom-2017-pod-two-live-from-washington-dc/

Join in the debate: contact@topmedtalk.com

What I tell my patients to expect after colorectal surgery | EBPOM World Congress 2017 Aug 30, 2017

Colorectal surgery and Enhanced Surgical Recovery.

Dr. Julie Thacker is an Associate Professor of Surgery at Duke University and Dr Julie Thacker and president elect at ASER.

This conversation is taken from a longer piece found here: http://www.topmedtalk.com/ebpom-2017-pod-one-live-from-london/

Join the debate: contact@topmedtalk.com

Goals for Short Term Recovery after Major Surgery | EBPOM World Congress 2017 Aug 30, 2017

(http://www.ebpom.org/EBPOM-USA) about getting back to normal after major colorectal surgery.

Attend our next meeting: http://www.ebpom.org/EBPOM-USA

Monty Mythen speaks with his guest Dr. Julie Thacker is an Associate Professor of Surgery at Duke University and president elect at ASER.

This taken from a longer conversation here: http://www.topmedtalk.com/ebpom-2017-pod-one-live-from-london/

Measuring Outcomes following Surgery | ASER 2017 Aug 30, 2017

Measuring Outcomes

Monty Mythen and Joff Lacey talk to Prof Mike Grocott (UK), Tim Miller (USA) and special guest Dr Ramani Moonesinghe about outcomes from major surgery for patients on enhanced recovery pathways.

Dr Moonesinghe also talks in some detal about the UK perioperative quality improvement program (https://pqip.org.uk/content/home).

"A multidisciplinary initiative supporting local quality improvement to benefit patients undergoing major surgery."

Attend our next meeting: http://www.ebpom.org/EBPOM-USA

This piece is taken from a longer conversation to be found here: http://www.topmedtalk.com/aser-ebpom-2017-recap-pod-three-live-from-london/

The Perioperative Quality Initiative | ASER 2017 Aug 30, 2017

Discussion of the ASER and POQI papers of 2017.

Joff Lacey and Monty Mythen talk to Dr Tim Miller, Anaesthesiologist at Duke and vice-president of the American Society of Enhanced Recovery.

Recorded on day one of ASER 2017 meeting in Washington DC this interview is taken from a longer conversation which you can find here: http://www.topmedtalk.com/aser-ebpom-2017-pod-two-live-from-washington-dc/

Join in the debate: contact@topmedtalk.com

Enhanced Surgical Recovery: Goal Directed for all ESR Patients? DR Tim Miller, Duke, USA | ASER 2017 Aug 30, 2017

Dr Tim Miller anaesthesiologist at Duke Medical Centre and Vice President of ASER on Fluid Management in ESR and the recent guidelines from ASER and The Perioperative Quality Initiative (POQI http://www.poqi.org).

For more come to our meetings: http://www.ebpom.org/EBPOM-USA

This highlight clip is taken from a longer conversation to be found here: http://www.topmedtalk.com/aser-ebpom-2017-pod-two-live-from-washington-dc/

Perioperative Fluid Management. Get that i.v. down ASAP! | ASER 2017 Aug 30, 2017

Reflections on ASER Fluid management; NPO; preop drinks and keeping the i.v down.

Monty Mythen is presenting with his guest Dr Scott Brudney, Professor, Departments of Anaesthesiology and Internal Medicine, University of Manitoba, Winnipeg, Canada.

"AmericanSociety for Enhanced Recovery (ASER) and Perioperative Quality Initiative (POQI) joint consensus statement on perioperative fluid management withinan enhanced recovery pathway for colorectal surgery."

https://perioperativemedicinejournal.biomedcentral.com/articles/10.1186/s13741-016-0049-9

This conversation is taken from a longer piece to be found here: http://www.topmedtalk.com/aser-ebpom-2017-recap-pod-three-live-from-london/

Enhanced Surgical Recovery: Tackling the Narcotic Crisis | ASER 2017 Aug 30, 2017

The horrors of 'the opioid crisis'.

The fuller version of this piece is to be found here: http://www.topmedtalk.com/aser-ebpom-2017-recap-pod-three-live-from-london/

Featuring Joff Lacey and Monty Mythen with their guest Desiree Chappell, CRNA from Louisville Kentucky and Board Member of ASER on Narcotics in Enhanced Surgical Recovery.

Check out EBPOM's meetings here: http://www.ebpom.org/EBPOM-USA

ERAS: Team working and managing change | ASER 2017 Aug 30, 2017

Dr Julie Thacker, President of ASER talking to TopMedTalk Radio live at ASER 2017, Washington DC, USA.

Multidisciplinary teams and managing change - 'it's all about the patient'.

Pod Two - LIVE from London | EBPOM World Congress 2017 Jul 26, 2017

The team begin with a fascinating discussion regarding statistics and the assessment of risk. The generalised risks of surgery and the way in which NELA (National Emergency Laparotomy Audit) data may soon make it possible to work out specific odds for a specific patient.

Handling modifiable risk factors; how do we get patients ready for surgery, particularly if they are suffering from comorbidities? A patient may need an operation but is it worth asking, do they need it now? How can we bend the risk curve with proactive advice which may change pathological health issues? How do we inspire patients to look after themselves and become more active within their treatment? Does confronting the realities of surgery help with that education process?

Recorded on day two of EBPOM 2017; Professor Monty Mythen presents, alongside Dr Joff Lacey and their guests Professor Sol Aronson, a tenured professor at Duke University and Executive Vice Chairman in the Department of Anesthesiology, and Dr Mike Irwin, Professor and Head, Department of Anaesthesiology, University of Hong Kong.

Sponsored by EBPOM and Edwards Life Sciences.

Join in the debate: contact@topmedtalk.com

Pod One - LIVE from London | EBPOM World Congress 2017 Jul 26, 2017

This discussion, recorded on day one of EBPOM 2017, a truly international gathering with many countries represented. The Intraoperative hypotension is discussed. New information regarding cognitive function for patients raises big questions. Should shared decision making be re-evaluated? The team then discuss the Perioperative Quality Initiative (POQI) and new information regarding intraoperative hypotension. How rapidly should you attend to fluctuations? What is an appropirate response nowadays? The subject of perioperative nephrology is discussed, including topics such as the fluid challenge, urine output, biomarkers and the timing of renal replacement therapy. Presented by Professor Monty Mythen and Dr Joff Lacey featuring guests Dr Tim Miller from Duke University Medical Centre and John A. Kellum, Tenured Professor, Critical Care Medicine from The University of Pittsburgh. Join in the debate: contact@topmedtalk.com

Recap - Pod Three - LIVE from London | ASER 2017 Jul 26, 2017

Discussion includes a recap of the last few podcasts.

Desiree Chappell joins us to update the team on 'the opioid crisis'; 50 overdoses in a twenty hour period reported in Kentucky? Can a perioperative multimodal approach to pain management help tackle it? How important is managing patient expectations as regards pain?

Dr Ramani Moonesinghe, Director of the Health Services Research Centre at the RCoA, discusses patient data. Why is important to report both median and mean length of stay when collating data in relation to enhanced recovery after surgery. Various UK patient data initiatives are discussed including the Perioperative Quality Improvement Programme (PQIP) , what's the importance of making this data available to all? Should we also work towards making it more available to patients? The SNAP-2 project is also discussed.

The PQIP website mentioned is here: http://www.pqip.org.uk/

Scott Brudney Professor Departments of Anaesthesiology and Internal Medicine, University of Manitoba, Winnipeg joins us to discuss fluid management: Is it really ok to have a drink before an operation? What about a carbohydrate drink? Is it really for the best to have had 'nil by mouth' from 6pm the night before?

Mike Grocott Professor of Anaesthesia and Critical Care Medicine at the University of Southampton joins us on the line with some other guests including; Professor Sol Aronson, a tenured professor at Duke University and Executive Vice Chairman in the Department of Anesthesiology, and Dr Paul E Wischmeyer of Duke University. They provide some insight into the ASER conference, more depth regarding what to do with someone who is mulnourished, the advantages of pre-habilitation and the importance of nutrition clinics as part of preparation for surgery. How do you build a robust financial model for such an enterprise?

Sol Aronson explains the acronym POET - a truly multidisciplinary Perioperative Enhancement Team, responsible for project managing optimisation programmes. The fundamental philosophy is espoused that people should have surgery, when they are ready.

Finally Dr. Timothy Miller, Assistant Professor of Anesthesiology at Duke University Medical Center, joins us to discuss ASER and an optimistic future for the perioperative movement.

The link mentioned in the podcast is here: https://ebpom.org/ASER-EBPOM-2017

Sponsored by EBPOM and Edwards Life Sciences

Guests include; Desiree Chappell, a nurse anaesthetist CRNA and ASER board member from Kentucky; Dr Ramani Moonesinghe Director of the Health Services Research Centre at the RCoA; Scott Brudney Professor Departments of Anesthesiology and Internal Medicine, University of Manitoba, Winnipeg; Mike Grocott Professor of Anaesthesia and Critical Care Medicine at the University of Southampton; Professor Sol Aronson, a tenured professor at Duke University and Executive Vice Chairman in the Department of Anesthesiology; Dr Paul E Wischmeyer of Duke University; Dr. Timothy Miller, Assistant Professor of Anesthesiology at Duke University Medical Center. The show is presented by Professor Monty Mythen.

This is a recorded programme, the phone number used is not applicable for podcast listeners.

Join the debate: contact@topmedtalk.com

Find us online: http://www.topmedtalk.com/

Pod Two - LIVE from Washington DC | ASER 2017 Jul 26, 2017

In this piece you will hear more discussion regarding the POQI papers, a growing concensus on goal directed fluid therapy and the move away from opioids. One of the big stories, The American College of Surgeons's announcement that ERAS is to be rolled out to more than 750 hospitals, is also discussed.

The POQI (Perioperative Quality Initiative) papers on outcomes and fluid management are discussed.

The outcomes paper offers a framework for how data on ERAS might be collected. How quickly are people drinking eating and mobilising? What are the lengths of stay and readmission rates? How should these numbers be coallated? How can outcomes continue to be improved beyond the initial adoption of enhanced recovery after surgery (ERAS)? The importance of DREAMS (Drinking Eating Mobilising and Sleep) is emphasised in the discussion.

The fluid management paper is said to offer a general concensus. The key message regarding shortening the gap between the time a patient stops, and then resumes, taking fluid orally is empahasised in the discussion. The importance of getting the IV down and minimising maintainence fluid is also discussed.

Shouldn't all fluid therapy be goal directed? What about fluid restriction?

Finally there's discussion about some of the sessions at ASER 2017; prehabilitation and rehabilitation, dealing with patients on chemotherapy who are less physically fit than average and the possible improvement in cancer tumour regressions brought about by physical exercise.

The link mentioned in the podcast is here: https://ebpom.org/ASER-EBPOM-2017

Sponsored by EBPOM and Edwards Life Sciences

Featuring Dr Tim Miller anaesthesiologist at Duke Medical Centre and Vice President of ASER and presented by Monty Mythen, live from London, with Joff Lacey and Mike Grocott in Washington.

Join the debate: contact@topmedtalk.com

Find us online: www.topmedtalk.com

Pod One - LIVE from Washington DC | ASER 2017 Jul 26, 2017

ASER 2017 a “truly multidisciplinary conference” and "one of the best ones yet"; looking to continue to increase membership and push further education; taking on the challenge of applying new ideas on site; the challenge of reaching both surgeons and anaesthetists; tips for people trying to engage multidisciplinary teams and also overcoming concerns related to perioperative surgery by 'keeping it about the patient, don’t give it a name, focus on outcomes and remembering that data talks'. Furthermore, download this podcast for a comprehensive introduction to the POQI (Perioperative Quality Initiative) papers; a method adopted to bring 20-30 experts together for 2-3 days, seminar style. With equal numbers of anaesthetists and surgeons alongside some industry sponsors, nurses and CRNA members they face topical questions in a process which is useful because it raises more questions than answers. Each manuscript they produce contains ‘future steps’ and produces ‘more mature questions’. Dealing with 4 main areas – pain infection, outcomes and fluid management. Also, how does ERAS apply to elective colorectal surgery? By, amongst other thing, discussing expectations with patients, staying 'patient focused' and having a protocol which starts right at the point of diagnosis the perioperative process has brought dramatic reductions in length of stay and increased patient satisfaction. Discover more about “the POQI Pain paper”. Should we be encouraging patients to 'DRink EAt Mobilise and Sleep – DREAMS'? What is optimal analgesia? Should we minimise pain rather than aim to be ‘pain free’? Should we set our target to be opioid free if we can use the multimodal approach? Finally, the bowel prep discussion is included here. Bowel prep has moved on and become “less harmful”, patient satisfaction is now part of the process, which it wasn’t always previously. Difference in fluid management are discussed and the need for more reports regarding it. How is surgical site infection balanced with patient comfort? Sponsored by EBPOM and EDWARDS life sciences. This is the first ever pilot episode of TopMedTalk; Monty couldn’t make it to ASER that year so worked with some friends to pick up on the big stories. Dr Joff Lacey and Professor Mike Grocott join him live from Washington DC with their guest Dr Julie Thacker, the then president elect at ASER. Join in the debate contact@topmedtalk.com Or check out the website for more http://www.topmedtalk.com/

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