TopMedTalk

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RCoA Conference Highlight: Big data privacy concerns are legitimate Jun 05, 2018

Show notes

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

Show notes

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

Show notes

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

Show notes

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

Show notes

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

Show notes

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

Show notes

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

Show notes

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

Show notes

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

Show notes

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.

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