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POPS Part 2| POPS - meet more of the team from Guy's and St Thomas's Jul 21, 2018

Show notes

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

Show notes

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

Show notes

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

Show notes

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

Show notes

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

Show notes

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

Show notes

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

Show notes

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

Show notes

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

Show notes

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.

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