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Methadone use in Perioperative Medicine | EBPOM USA - Chicago 2020 Nov 13, 2020

Show notes

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

Show notes

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

Show notes

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

Show notes

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

Show notes

"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

Show notes

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

Show notes

"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

Show notes

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

Show notes

"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

Show notes

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

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