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Point of care ultrasound, POCUS | ASA 2018 Nov 12, 2018

Show notes

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

Show notes

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

Show notes

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

Show notes

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

Show notes

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

Show notes

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

Show notes

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

Show notes

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

Show notes

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

Show notes

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

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