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Hugh Montgomery | TopMedTalks to... Aug 24, 2020

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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

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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

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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

Show notes

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

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"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

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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

Show notes

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

Show notes

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

Show notes

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

Show notes

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?

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