TopMedTalk

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EBPOM Highlight | Exercise capacity and sarcopenia Jul 29, 2020

Show notes

"Exercise capacity and sarcopenia" - was originally streamed live from the Charles Sammons Cancer Center, Dallas, during EBPOM-USA 2019 on www.topmedtalk.com

Hear this excellent talk, for free, on this podcast.

If you'd like to attend an event like this ensure your next click is here: www.ebpom.org/meetings

If you have any comments or questions you'd like to send to the team email: contact@topmedtalk.com

Presented by John Whittle, assistant Professor at Duke University Medical Centre.

Substance Use Disorder - Peer Support: An Empathetic Information Resource | AANA 2019 Jul 28, 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: www.AANAPeerAssistance.com. Also see www.AANA.com/AboutPeerAssistance for additional facts and information.

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.

Enhanced Recovery with Monty and Desiree | EBPOM Ireland 2019 Jul 27, 2020

Show notes

TopMedTalk has recently engaged with a large number of new listeners, we are delighted to have you join our family of perioptimists! This piece works as a primer, it explains what lies at the core of the world's favorite perioperative medicine podcast; enhanced recovery. What is it? How do you implement it? And, what are its core principles?

If you've never heard TopMedTalk before but you are a medical practitioner this piece is a great place to start; if you're already onboard it will be a welcome refresher regarding the ideas we all gather around daily.

How widespread is enhanced recovery after surgery and, perhaps more importantly, how widespread are its principles? Are patients living the drinking, eating and mobilising early on and so "living the (drink, eat, mobilise) dream?".

The "POWER" study "Association Between Use of Enhanced Recovery After Surgery Protocol and Postoperative Complications in Colorectal Surgery: The Postoperative Outcomes Within Enhanced Recovery After Surgery Protocol (POWER) Study" is here: https://pubmed.ncbi.nlm.nih.gov/31066889/

The App Store has our app here: https://apps.apple.com/gb/app/topmedtalk/id1438159784

Google Play has it here: https://play.google.com/store/apps/details?id=com.topmedtalk.android.medtalk&hl=en_GB

There is a recent conversation with Henrik Kehlet here: https://www.topmedtalk.com/topmedtalk-henrik-kehlet-and-nick-scott/

There's also a recent one with Angela Bader here: https://www.topmedtalk.com/covid-19-angela-bader-the-need-for-end-of-life-conversations/

Our famous Bill Clinton piece is here: https://www.topmedtalk.com/sunday-special-bill-clinton-at-the-world-patient-safety-science-technology-summit-2/

The excellent Chris Snowden piece we mention is here: https://www.topmedtalk.com/dingle-2019-the-opportunity-in-variability/

(Enhanced Recovery After Surgery) ERAS Guidelines are here "Guidelines for Perioperative Care in Cardiac SurgeryEnhanced Recovery After Surgery Society Recommendations" : https://jamanetwork.com/journals/jamasurgery/fullarticle/2732511?guestAccessKey=04f7090d-122c-4e94-a46f-22e49dab7c51

The Perioperative Quality Initiative is here: https://thepoqi.org/

Presented by Desiree Chappell and Monty Mythen.

Have you heard the incredible news about EBPOM Chicago yet? Go now to ebpom.org and find out more!

Michelle Chew | TopMedTalks to... Jul 26, 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.

Periop SIG 2019 | Part 1, Delirium: The brain and the older surgical patient Jul 25, 2020

Show notes

"Delirium: The brain and the older surgical patient Part 1" was a presentation originally given at 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.

"Acute brain failure is really the concept we're talking about", this piece covers delirium and dives into why this common and long discussed condition is not yet something we can always predict and prevent.

Find out more about ANZCA here: http://www.anzca.edu.au/

Presented by Professor Alison Mudge, Conjoint Professor of Medicine, Royal Brisbane Clinical Unit, Faculty of Medicine and Gideon Caplan Associate Professor of Geriatrics, Prince Of Wales Hospital, Sydney.

TopMedTalk | A step between a simple monitor and a fully automated system Jul 24, 2020

Show notes

This piece focuses upon goal directed fluid therapy, with an automated system, for decision support; "a step between a simple monitor and a fully automated system".

The "proof of concept" paper we highlight towards the end of the podcast, "Feasibility of closed-loop titration of norepinephrine infusion in patients undergoing moderate - and high-risk surgery" has now been published and can be found here: https://bjanaesthesia.org/article/S0007-0912(19)30443-X/abstract

This paper here "Perioperative goal directed therapy using automated closed-loop fluid management: the future?" is also referenced: https://www.ncbi.nlm.nih.gov/pubmed/26578397

You may also find this piece, which our guest is also part of, here interesting: https://www.ncbi.nlm.nih.gov/pubmed/29068831

Presented by Desiree Chappell and Monty Mythen with their guest Alexandre Joosten, Anesthetist at Hospital Erasme.

ASA 2019 | A data based conversation about payment methods Jul 23, 2020

Show notes

Away from the world of politics there is a sensible debate to be had about payment methods for healthcare. Here you will find evidence, shared goals and specific payment models from the US being looked at in detail. It's a debate about total cost of care and a two sided risk model that could potentially be cheaper and better for both patients and providers.

Bundle payments provoke debate, "the interesting question is; 'post operatively, do you need that expensive care'?" Population health is an inevitable terrain for the discussion, could alternative payment models benefit wider society?

"Healthy people don't need anything other than wellness care, the poorly managed chronically co-morbid medical conditions are the population that is costing us and driving the cost of care up disproportionately greater than everyone else"; how do the needs of these two groups knit together in a way that is helpful and equitable financially?

How is enhanced recovery and perioperative medicine helping to reduce the cost of healthcare? Can prehabilitation help reduce costs even further?

The Centers for Medicare and Medicaid services (CMS) website is here: https://www.cms.gov/

Presented by Desiree Chappell with Monty Mythen, Sol Aronson and their guest Lee Fleisher, Professor and Chair of Anesthesiology and Critical Care, University of Pennsylvania.

If you enjoyed this conversation you will certainly find value in this piece as well: https://www.topmedtalk.com/roundtable-highlight-the-maryland-funding-experiment/

EBPOM Highlight | Pain Strategies with methadone Jul 22, 2020

Show notes

"Pain Strategies" - was originally streamed live from the Charles Sammons Cancer Center, Dallas, during EBPOM-USA 2019 on www.topmedtalk.com

Hear this excellent talk, for free, on this podcast.

If you'd like to attend an event like this ensure your next click is here: www.ebpom.org/meetings

If you have any comments or questions you'd like to send to the team email: contact@topmedtalk.com

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.

A Novel Use of the Erector Spinae Block in the Austere Environment | AANA 2019 Jul 21, 2020

Show notes

In the military Forward Surgical Teams (FSTs) are deployed into challenging environments to deliver "damage control surgery". They help people who have been injured, relieve the pain, stop the bleeding, 'patch the holes' and move them to a safer environment. It's from this background that our two contributors come, learn how they have been forced to innovate and what insights they can give to practitioners working in more familliar and well resourced contexts.

Hear how a 25 year-old male presented with penetrating chest trauma and an Erector Spinae Block was utilized in an incredibly dramatic context.

This inteview works well in tandem with this link to the paper discussed in the piece: https://www.ncbi.nlm.nih.gov/pubmed/31247096

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 and Monty Mythen with their guests Robert Fabich, Doctor of Nursing Practice, CRNA, Veteran and Sharrod R. Greene, CRNA, Sentara Anesthesiology Specialists.

Can medicine be cured? | EBPOM Ireland 2019 Jul 20, 2020

Show notes

Warning; this piece may make for uncomfortable listening. It is a fascinating look at the recent history of medicine and how our profession may in fact be sick. Contained within the story is a message of hope, evidence alongside a message that may contain the cure.

In our recent history we seem to have enjoyed something of a "Golden Age" of medicine which, by raising quality of life so dramatically, has transformed our understanding of concepts such as "public health" and even "standard of living". However, running alongside that is an industry and society that is primarily interested in business and profit above evidence and health. Has the industry which built up around our profession during the 'Golden Age' now become a parasite which weakens its host to the point of near exhaustion?

After a concise critique of the current culture of research this talk asks why we are wasting time on research that is not reliable, not useful and does not impact care. Could it be that market forces have strangely made us less efficient? Evidence based medicine is the way forward but can we overcome the inherent bias behind the fact that often big business funds the evidence gathering and its publication?

Some assumed the period of rapid development, which included discovering the DNA helix, successful organ transplant and vaccinations, would soon inevitably be followed by equally epoch transforming breakthroughs, others are less optimistic. Are genomics and big data more often 'science' than medicine? Is "digital health" "simply one part of what has now been called surveillance capitalism"?

This challenging but ultimately hopeful and inspirational talk was given at the EBPOM Dingle conference last year, please share it to as wide an audience of your peers as you can to help make this important and healing conversation happen.

Presented by Seamus O'Mahony, Consultant Gastroenterologist at Cork University Hospital, associate editor for medical humanities of the Journal of the Royal College of Physicians of Edinburgh and is a regular contributor to the Dublin Review of Books.

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