TopMedTalk (TopMedTalk)

Why do anaesthetists suffer from mental health problems, what help is there available for them? Learn here about The Practitioner Health Programme and hear why anaesthetists are uniquely placed to deal with the inevitable pressures related to healthcare and how they can become leaders, helping to destigmatise and tackle mental health issues.

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

More from our coverage of the 7th Collaborative Clinical Trials in Anaesthesiology Conference, Prato, Italy.

This piece discusses trials in the wake of COVID-19 specifically we focus upon the PROTECT Platform Trial.

Presented by Monty Mythen and Kate Leslie with their guests Tom Abbott, anaesthetist and clinical lecturer at Queen Mary University of London and James Glasbey, NIHR Academic Clinical Lecturer in Global Surgery, University of Birmingham and General Surgery Registrar.

This piece is 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 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.

This piece digs deep into the realities of coping with COVID 19 patients who have had their care escalated to the Intensive Care Unit (ICU); "we don't seem to be looking at our typical sepsis patients who get multiple organ failure in the classical way" and "you're surprised at how young some of the patients are...".

Our guest provides us further insight; a 'household name' in the haemodynamic monitoring space; he is treating patients in a medium sized hospital (500 beds) with mostly COVID patients in Spain. How are things going there, how does it compare to Italy? How are the patients being dealt with, what can we learn about the basics here, airway, breathing, ventilation (ABC)?

There is also a gripping discussion regarding dynamic arterial elastance. If you'd like to know more about that do check out our discussion here: https://www.topmedtalk.com/periop-coach-2-09-haemodynamic-monitoring/

The webinar mentioned in this piece can be found here: https://www.esicm.org/education/webinars/

Presented by Desiree Chappell and Monty Mythen with their guest Dr. Manuel Ignacio Monge García who works in an ICU in the South of Spain.

Thank you to our sponsor Edwards Lifesciences.

Edwards clinical education (ECE): https://www.edwards.com/clinicaleducation

This piece focuses upon the African Surgical Outcomes Study (ASOS-2). More than a thousand people across Africa have combined forces to make this research into perioperative medicine in a resource limited environment happen. We know patients in Africa are twice as likely to die following surgery when compared to the global average, why is this? How does "failure to rescue" play into this?

The website mentioned in this piece for more details: https://www.asos.org.za

Presented by Desiree Chappell with Monty Mythen and their guest Bruce Biccard, consultant anaesthetist at the University of Kwazulu-Natal, Director, Perioperative Research Unit, Department of Anaesthetics, Nelson R Mandela School of Medicine.

Why has 'prehabilitation' suddenly picked up pace in terms of both practice and interest? This piece takes a serious look at the widening interest in an idea familiar to many sportsmen.

Learn how the marginal gains we get through the application of science to optimise the moment of surgery as a real opportunity to apply everything we know.

Also; what are ketones and how can they be used to promote health?

Presented By Desire Chappell and Monty Mythen with their guests Gerard Danjoux, consultant in Anaesthesia and Sleep Medicine at South Tees Hospitals NHS Trust and Ken Van Someren, Director KvS Performance Ltd.

This piece is a fascinating in-depth conversation moving through various medical perspectives on perioperative medicine from Australia and New Zealand. A real highlight of the festival. How has perioperative medicine evolved over the years around the world? What's the status of Perioperative Care as a specialty? How does one specialise in this area, in terms of education? 

Discussing the development of the International Board:- "We decided perioperative education should not only be available for developed countries".  We hear that TopMedTalk engaging with the African Perioperative Research Group (APORG) has helped move the cause of perioperative care forward, both in Africa and elsewhere. 

The conversation further evolves:-  Once educated how do we demonstrate the value of perioperative practice? How do we launch projects that will really make a difference? Where, from a research perspective, do the more fruitful areas of investigation present themselves? Would a minimum data set help?  Moving to clinical trials we hear how research is being conducted, both the challenges and the sources of success. 

"Perioperative medicine is a team sport" - how do we use the interdisciplinary aspect of what we do to enhance our educational options?

Regular listeners to TopMedTalk may recall the series we did about the Perioperative Special Interest Group (SIG) - if you want more details of http://www.anzca.edu.au/fellows/special-interest-groups/perioperative-medicine

The ANZCA Clinical Trials Network can be found at http://www.anzca.edu.au/ctn

Also, The International Board of Perioperative Medicine is here: https://www.internationalboardpom.org/

Further, make sure you check out https://www.periopmedicine.org.uk/ for more information on the perioperative medicine short course we discuss.

Presented by Desiree Chappell alongside co-host Ross Kerridge, Anaesthetist from Newcastle in Australia - sometimes called the 'Father of Perioperative Medicine'.  Guests are Jill Van Acker, Staff Specialist Anaesthetist and Clinical Lead Perioperative Services, Canberra Hospital, and Chair of the ANZ Perioperative Special Interest Group;  Vanessa Beavis, President, Australian & New Zealand College of Anaesthetists, & until recently Director of Perioperative Services, Auckland District Health Board;  Prof. Jackie Close Orthogeriatrician at the Prince of Wales Hospital in Sydney and Clinical Director of the Falls, Balance and Injury Research Centre at Neuroscience Research Australia; Prof. Dave Story, Head of the ANZCA Clinical Trials Network, and Chair of the Anaesthesia, Perioperative and Pain Medicine Unit within the University of Melbourne Medical School. Joel Symons, Anaesthetist at the Alfred Hospital in Melbourne and Senior Lecturer at Monash University, Leader in the development of Educational Programs based at Monash University and member of International Board of Perioperative Medicine.

"In the United States approximately 112,000 patients annually are at risk for adverse events associated with discharge from the operating room with residual neuromuscular blockade"

This talk highlights the latest thinking on both monitoring and management of neuromuscular blockade. Where does the data lead us to? How big a problem do they suggest poor efficiency in this area is? What are the realities behind postoperative pulmonary complications? How can we reduce the risk of residual block?

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.

Desiree Chappell catches up with John Boudreaux and Phillip Gallegos from the Baylor Orthopedic and Spine Hospital, Arlington. They discuss improving patient outcomes and their approach to value based care.

More from our coverage of the 7th Collaborative Clinical Trials in Anaesthesiology Conference, Prato, Italy.

The South African Perioperative Research Group (SAPORG) is a multidisciplinary group of researchers interested in improving perioperative outcomes in South Africa, through collaborative research

Presented by Monty Mythen and Desiree Chappell with their guest Bruce Biccard, Professor and Second Chair at Groote Schuur Hospital and University of Cape Town, Chair of the South African Perioperative Research Group (SAPORG).

Bruce’s book is here: https://www.amazon.co.uk/Safer-Surgery-Africa-Challenges-Solutions/dp/0796153116

Earth Cast is here: https://podcasts.apple.com/gb/podcast/earth-cast/id1548400137

Freedom Challenge is here: https://www.freedomchallenge.org.za/

Celebrating 5 years of TopMedTalk at 'Anesthesiology'; the Annual General Meeting of the American Society of Anesthesiologists.

This piece is presented by Desiree Chappell with her guests; representatives of the ASA Global Scholars Program; supporting young leaders in the specialty from low- and middle-lower income countries.

Part One of this piece is here: https://directory.libsyn.com/episode/index/id/24794133

This conversation was triggered by our meeting with Elizabeth Drum which you can also listen to here: https://www.topmedtalk.com/global-humanitarian-outreach-with-elizabeth-drum-anesthesiology-2022/

TopMedTalk is very proud to be partnered with the American Society of Anesthesiologists® at ANESTHESIOLOGY® 2022. Now in our fifth year TopMedTalk is bringing you our most comprehensive and extensive coverage of the largest gathering of anesthesiologists in the world!

This audio is presented to you "as live" - if you'd like to see our coverage as it happens go now to: https://live.topmedtalk.com/

TopMedTalk is provided to you for free; if you want to help support our work and help give these conversations a wider audience please like and subscribe (if and where possible) before sharing it on your social media.

TopMedTalk can be found on YouTube here: https://www.youtube.com/channel/UC-HYQmeIwcFCYO1hoQ8jShQ

We are on Twitter here: https://twitter.com/topmedtalk

We are on LinkedIn here: https://www.linkedin.com/company/topmedtalk

We are on Facebook here: https://www.facebook.com/TopMedTalk1/

Our coverage of Anesthesiology 2023, continues. It's the annual meeting of the American Society of Anesthesiologists (ASA); it's the largest and most important gathering of anesthesiologists in the world and we're your free front row seat.

For more on the ASA go here: https://www.asahq.org/

Check out our YouTube page for a record of the live stream video of this podcast: https://www.youtube.com/@topmedtalk7687/streams

This piece focuses in on physician payments and Medicare.

Presented by Desiree Chappell and Mike Grocott with their guests Lois Connolly, ASA Vice President for Professional Affairs, Professor, Department of Anesthesiology, Medical College of Wisconsin and Jonathan Gal, Chair of ASA Committee on Economics, Professor, Anesthesiology, Ichan School of Medicine, Medical Director for Offsite Ambulatory Surgery Centers Anesthesia, Director of Governmental and Reimbursment Affairs.

This standalone piece allows us to explore further some of the issues raised in this podcast "TopMedTalks to... | Rick Dutton". If you missed it follow this link here: https://www.topmedtalk.com/topmedtalks-to-rick-dutton/

Originally streamed live on www.TopMedTalk.com under the title; "Educational Dinner Symposium: Q&A Session" as part of our coverage of the EBPOM USA Dallas Master's Course.

Presented by Monty Mythen and Desiree Chappell with Rick Dutton, Chief Quality Officer at United States Anesthesia Partners Baltimore, Maryland Area.

Featuring questions and comments from, in this order; Jamie Harris, Tulsa Oklahoma, Tim Miller, Duke University, North Carolina, Sol Aronson, Duke University, Linda Marie Sutton, Duke Univeristy, Tony Senagore, Western Michigan University, Attilla Kett, St Peter's University Hospital at New Jersey, Dan Engleman, Springfield, Massachusetts.

This piece is a reflection of the fact that The Society of Cardiovascular Anesthesiologists Annual General Meeting is coming up this weekend, we hope to hear from people who attend. What are the big debates this year? Email contact@topmedtalk.com

TopMedTalk’s proud association with the SCA continues as we look back on our ‘as live’ coverage in the past and look forward to future updates in the future.

The clips used in this piece have been taken from:

https://topmedtalk.libsyn.com/emily-methangkool-at-the-sca-topmedtalk

https://topmedtalk.libsyn.com/julius-balogh-at-the-sca-topmedtalk

https://topmedtalk.libsyn.com/brad-cardonell-at-the-sca-topmedtalk

https://topmedtalk.libsyn.com/monty-and-desiree-at-sca-topmedtalk

https://topmedtalk.libsyn.com/andy-shaw-at-the-sca-topmedtalk

Presented by, Professor Mike Grocott, recorded live at 'The Xtreme Everest Symposium' organised by the Department of Anesthesiology, Duke University, USA.

--

Human Tolerance of Hypoxia: Going to Extremes to Understand Critical Illness.

This series also includes:

TUESDAY:

What Happens to Healthy Humans in Hypoxia? Denny Levett

WEDNESDAY:

Cardiovascular Adaptation to Hypoxia. Daniel Martin

THURSDAY:

Metabolic Adaptation to Hypoxia. Andrew Murray

Oxygen Therapy: The Yin and Yang of Our Favorite Drug. Monty Mythen.

FRIDAY:

Oxygen and the Brain. Chris Imray

The Epigenetics of Hypoxia. Kay Mitchell

SATURDAY:

A Slightly Different Path to Everest: The Pyramid Lab 2012 & 2016, David MacLeod

Therapeutic Hyperoxia: Medicine Under Pressure. Richard Moon

SUNDAY

Morpheus Consortium Distinguished Lecture: Xtreme Everest: Physiology on Top of the World. Mike Grocott

How do hospitals and institutions best use their assets in a world of big data where we can deploy predictive analytics and the new metrics they make available to us? Currently we tend to use the clumsy metrics of averages when there now exists the possibility to use more high fidelity predictive patterns adapted to the unique flow of users and situations. Learn how constraint based optimisation and forecasting has allowed for an exponential rise in the effectiveness of our already existing resources.

Desiree Chappell and her guests Sanjeev Agrawal, President & CMO at LeanTaaS, ex Google, Aloqa and Collegefeed and Mike Grocott, Anaesthesia and Critical Care Medicine, University of Southampton.

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.

Live from Anaesthesia 2019, on day two of the conference; a 'must-attend event' for the specialty where world-renowned experts present the latest advances in perioperative medicine, critical care and pain medicine.

If you're looking for the hugely popular debate regarding direct laryngoscopy we mention in the podcast go here:

https://www.topmedtalk.com/sunday-special-should-direct-laryngoscopy-be-consigned-to-the-history-books/

Presented by Monty Mythen with Tim Cook, Consultant in Anaesthesia and ICM, Royal United Hospitals, Bath and Paul Wischmeyer, Professor of the Department of Anesthesiology, Duke University.

In no particular order we're playing some of the content that listeners have voted for with their downloads. This episode is one of the top ten most downloaded podcasts we've done so far.

The NHS, a national institution beloved by the people of the United Kingdom is 70 years old. EBPOM celebrated this fact with a talk that gets right to the heart of why this institution is so special and also how it can move forward in the brave new world we find ourselves in now.

This piece was streamed live, from the IET at EBPOM 2018, on www.topmedtalk.com

Sir Bruce Keogh KBE, FRCS, FRCP, is a giant in the world of UK healthcare. A British surgeon and physician who specialises in cardiac surgery he was, until this year, Medical Director of the National Health Service in England and National Medical Director of the NHS Commissioning Board (NHS England).

Go check out the website: www.topmedtalk.com

This piece is the first of TopMedTalk's 'as live' coverage from the 5th Collaborative Clinical Trials in Anaesthesiology Meeting, Prato, Italy. It's your chance to get virtual a place at one of the most influential gatherings of its kind in the world.

This piece is a discussion regarding the SQUEEZE Study: A prospective multi-centre international observational study of postoperative vasopressor use.

Presented by Desiree Chappell with Monty Mythen and their guest Ben Creagh-Brown, Clinical Academic Intensivist, Director of Research and Development, Royal Surrey County Hospital NHS Foundation Trust and Co-Chief Investigator of the "Squeeze Study".

TopMedTalk live is a gathering of Trainees with an interest in Perioperative Medicine (TRIPOM) alongside TopMedTalk listeners and EBPOM 2018 attendees in the IET London, England.

This conversation is driven by questions from listeners online and attendees in the audience. Two pain management experts alongside the TRIPOM representatives and Desiree and Monty respond in detail to some of the key controversies in Perioperative medicine.

Is there an opioid crisis and is it unique to the USA? Is there a problem with opioids and cancer outcomes? How do we educate junior doctors on this topic? What about patients who demand opioids to handle their pain? Should we be looking more closely at where and why Oxycodone specifically is prescribed?

Part two will follow next week.

TopMedTalk live was presented by Monty Mythen and Desiree Chappell in front of a live audience with panellists; John Whittle, assistant Professor at Duke University Medical Centre and one of the founders of TRIPOM, Katie Samuel, TRIPOM co-chair and perioperative medicine fellow at UCL Hospitals, Dr Padma Gulur, Duke University Medical Centre, Dr Natasha Curran, UCL Hospitals.

Join in the debate: contact@topmedtalk.com

This wide ranging talk asks where and how we should focus on the needs of postoperative care patients. "Brain care has an impact way beyond the acute surgical episode"; how do we minimise the risks of a poor outcome when it comes to postoperative care?

"Advanced recovery from anaesthesia and surgery" is a talk 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.

Presented by Professor Jacqueline Close, Principal Research Fellow, NeuRA Conjoint Professor, UNSW Consultant Geriatrician, Prince of Wales Hospital.

TopMedTalk continues tracking the incredibly important work done by Perioperative Quality Initiative (POQI), check out their website here: http://thepoqi.org/

This piece acts as an introduction to this year’s POQI - 12.

Recorded at the Evidence Based Perioperative Medicine (EBPOM) Ireland conference this piece features an exclusive conversation between Desiree Chappell and Mike Grocott speaking with Guy Ludbrook, Professor of Anaesthesia at the University of Adelaide and Royal Adelaide Hospital and Andrew Shaw, Chairman, Department of Intensive Care and Resuscitation at The Cleveland Clinic, Cleveland, Ohio.

"The delivery of good medical care is to do as much nothing as possible."
- Samuel Shem.

The POCAPALOOZA (POC, perioperative care; apalooza - a celebration of) wraps up in true style with a look at Australia and their current situation. Lauded for their handling of COVID19 but not yet 'through the woods' the conversation looks at how doing the right thing can be innovative and why a good rapport with your patient is invaluable.

Presented by Desiree Chappell with her guest Ross Kerridge, Senior Staff Specialist Anaesthetist Clinician at the John Hunter Hospital, Newcastle, Australia and Associate Professor at the University of Newcastle.

This piece starts with some words from patients; prehabilitation is "a set of actions that can be taken in advance of treatment to ease your passage through cancer". This vital talk explains how prehabilitation can leave cancer patients feeling personally empowered and ready to live well. Living is one thing, how do we get people to enjoy 'living well'? Further to this how do we do that in such a way that respects patient decisions and life choices? How can we get to a position where exercise, nutrition and psychological support are integral to a cancer diagnosis?

Ideally prehabilitation gets to a point where all patients feel like the ones quoted in this talk; "It's a win win situation [...] do that and you'll be healthier".

Presented by June Davis; June has 22 years of experience working in the NHS as a Dietician, service and professional lead, general manager for a number of service areas within the acute setting and senior project lead for several large scale change projects across London; 10 years experience working as Head of Therapies for large acute Trusts. She is also a Director of Allied Health Solutions, Allied Health Professions Advisor (part time) for Macmillan Cancer Support and a professional advisor to the Care Quality Commission.

"I believe most people can be leaders or better leaders. You can create or participate in change and a better future. You can make a difference in your own lives, the lives of others and the life of your organization. If you believe you can."

This piece contains a powerful, inspirational and prescient talk about leadership. Part 1 contains some conversation and the talk, to be followed by questions from the audience in Part 2. Where do leaders come from, what makes them stand out and how do they learn the skills necessary to take what they do to the next level?

Presented by Desiree Chappell and Monty Mythen with Jeff Vender, Emeritus, Harris Family Foundation Chairman of the Department of Anesthesiology at NorthShore University Health System, Evanston, Illinois and Clinical Professor at the University Of Chicago Pritzker School Of Medicine in Chicago, Illinois.

In this piece the team talk about possibly one of the most interesting funding experiments in the US; The Maryland global budgeting experiment. January 2014, after months of negotiations between Maryland and federal authorities, global budgeting went statewide. It was voluntary for hospitals, but within six months every hospital in the state had signed up. Four years on and it is a fascinating case study in how healthcare can be funded in such a way as to essentially incentivise public health measures within the American system, something that was previously seen as a perennial problem.

Recorded on the first day of the 'EBPOM USA - Masters Course' this podcast features Desiree Chappell, Monty Mythen, Dr Lee A. Fleisher Chair of Anesthesiology and Critical Care (University of Pennsylvania) and Vicki Morton DNP and Director of Clinical and Quality Outcomes at Providence Anesthesiology Associates University of South Carolina.

This piece is taken from a longer conversation to be found here: https://www.topmedtalk.com/dealing-with-policy-and-value-based-care-the-roundtable-blog/

This piece works as a summary of our coverage of Anesthesiology 2023, so far. It's the annual meeting of the American Society of Anesthesiologists (ASA); it's the largest and most important gathering of anesthesiologists in the world and we're your free front row seat.

For more on the ASA go here: https://www.asahq.org/

Check out our YouTube page for a record of the live stream video of this podcast: https://www.youtube.com/@topmedtalk7687/streams

Presented by Desiree Chappell, our lead US presenter, a Certified Registered Nurse Anesthetist (CRNA) and Vice President of Clinical Quality for NorthStar Anesthesia, Mike Grocott, Professor of Anaesthesia and Critical Care Medicine at the University of Southampton and an NIHR Senior Investigator, and Guy Ludbrook, Professor of Anaesthesia at the University of Adelaide and Royal Adelaide Hospital.

The team take a minute to review some of this year's coverage of Anesthesiology 2023 and look forward to some of the conversations still to come here on TopMedTalk's podcast feed.

Some of the highlights mentioned in this piece include:

Anesthesiology as a career, "the future of the profession"; https://topmedtalk.libsyn.com/anesthesiology-as-a-career-in-the-2020s-anes23

The piece on Howard University; https://topmedtalk.libsyn.com/opportunities-in-anesthesiology-anes23

The discussion about pricing; https://topmedtalk.libsyn.com/physician-payments-and-medicare-anes23

The conversation about sustainability; https://topmedtalk.libsyn.com/or-sustainability-end-tidal-control-anes23

"If you ring up and start to apply pressure to them to say 'have you thought about giving my loved one drug A or drug B?' It might be helping them to get better but you might be encouraging them to do something that might hurt your loved one; so we have to do this with trials".

This piece gets into one of the debates surrounding the treatment of COVID 19. What do we mean when we suggest people think outside the box? Do we still need to bother about ideas and principles such as evidence and data collection or should a more cavalier approach be taken to medicine in this unusual time?

The following articles are discussed in this piece:

"Incidence of thrombotic complications in critically ill ICU patients with COVID-19"
https://doi.org/10.1016/j.thromres.2020.04.013

"Chloroquine diphosphate in two different dosages [...];"
https://www.medrxiv.org/content/10.1101/2020.04.07.20056424v1.full.pdf

"Effectiveness of Hydroxychloroquine in Covid-19 Patients (Covid)"
https://clinicaltrials.gov/ct2/show/NCT04328272

"Infectious Diseases Society of America Guidelines on the Treatment and Management of Patients with COVID-19"
https://www.idsociety.org/practice-guideline/covid-19-guideline-treatment-and-management/

Presented by Desiree Chappell with Monty Mythen.

Thank you to our sponsor Edwards Lifesciences.

Edwards clinical education (ECE): https://www.edwards.com/clinicaleducation

The RELIEF (Restrictive versus liberal fluid therapy in major abdominal surgery) trial has been a huge story for us here at TopMedTalk, recorded on the second day of The Royal Collage of Anaesthetists' annual conference at the British Museum this is the moment the team get to pick over the results in detail.

One of the biggest trials ever, it has both raised questions and provided answers. Inevitably there has been a huge debate, this piece puts all the major questions and concerns to the organiser of the trial.

Send us your thoughts on The RELIEF trial: contact@topmedtalk.com

Presented by the TopMedTalk team; Professor Monty Mythen, Dr Joff Lacey, Desiree Chappell and Professor Mike Grocott, with their guest Paul Myles, Head of Alfred Health's and Monash University's Department of Anaesthesia and Perioperative Medicine and organiser of the RELIEF trial.

Our coverage of Anesthesiology 2023, continues. It's the annual meeting of the American Society of Anesthesiologists (ASA); it's the largest and most important gathering of anesthesiologists in the world and we're your free front row seat.

For more on the ASA go here: https://www.asahq.org/

Check out our YouTube page for a record of the live stream video of this podcast: https://www.youtube.com/@topmedtalk7687/streams

This piece looks into equal opportunities in anesthesiology.

Presented by Desiree Chappell, and Guy Ludbrook with Elijah McMillan, MD Candidate at Howard University College of Medicine and Majesty Greer, MD Candidate at Howard University College of Medicine.

"POETTS 2018 | CPET and Shared Decision Making" - originally streamed live from The Institute of Engineering and Technology (IET) in London during EBPOM 2018 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 Dr Helen Anderson, a Consultant Anaesthetist and Peri-operative Physician at Derriford Hospital, Plymouth, and currently the lead for Pre-operative Assessment and CPET.

As a general rule, should ward monitoring be increased? Should continuous blood pressure monitoring be more frequent?

This short piece follows on from Tim Miller's talk "Perioperative Blood Pressure (PeriOperative Quality Initiative: POQI 3) how low can you safely go?".

Presented by Desiree Chappell and Monty Mythen with Tim Miller, Associate Professor of Anesthesiology from Duke University Medical Centre.

"TopMedTalk Down Under" continues 'as live' coverage of the 2024 Australian and New Zealand College of Anaesthetists (ANZCA) and Faculty of Pain Medicine's Annual Scientific Meeting.

Here we recap on what we've seen so far and anticipate what is yet to come.

If you're at the meeting and have been supporting us on social media, thank you. Keep spreading the word for us!

If you'd like to catch up with our coverage here's what we've done so far:

TopMedTalk Down Under - exclusive coverage of the ANZCA meeting | #ASM24BRIS - https://topmedtalk.libsyn.com/topmedtalk-down-under-exclusive-coverage-of-the-anzca-meeting-asm24bris

TopMedTalk Down Under talks to... Chris Cokis and Kieran Davis | #ASM24BRIS - https://topmedtalk.libsyn.com/topmedtalk-down-under-talks-to-chris-cokis-and-kieran-davis-asm24bris

Pain medicine, cannabis, ketamine and psilocybin in focus | #ASM24BRIS - https://topmedtalk.libsyn.com/pain-medicine-cannabis-ketamine-and-psilocybin-in-focus-asm24bris

Sustainability in healthcare | #ASM24BRIS - https://topmedtalk.libsyn.com/sustainability-in-healthcare-asm24bris

#Breaking Trials on TopMedTalk down under | #ASM24BRIS - https://topmedtalk.libsyn.com/breaking-trials-on-topmedtalk-down-under-asm24bris

Presented by Andy Cumpstey, Clinical lecturer, University Hospital Southampton NHS Foundation Trust and the University of Southampton, England, and Kate Leslie, Professor, Specialist Anaesthetist and Head of Research at the Royal Melbourne Hospital and the University of Melbourne.

You can find out more about ANZCA here: https://www.anzca.edu.au/

What happens when cutting edge computer game creators, fresh from working on top titles in their industry such as 'Hunger Games' and 'Mission Impossible', use their skills to simulate high stress moments from the real world of anesthesia and surgery? Using "the neuro-science of game design" to help accelerate learning within the profession:

"The motivation for starting Level Ex, what if we actually took the top game designers and developers in the industry? We're talking the executive producer of "Mortal Kombat", the creative director of "Call of Duty", the marketing director of "Words with Friends"; put them with top physicians from multiple specialties, to capture the challenges of the practice of medicine using video game mechanics".

"This doesn't recreate the mannequin, what this does replace is the five hundred live patients you need to train on in order to encounter those five to ten rare scenarios because we can recreate the rare and the difficult and then we can help you train your visualization skills, your recognition skills, your deductive reasoning skills, on those cases."

The key point here is not that motor function is being copied by a screen interactive experience but instead the aim is to "optimise cognitive load" and recreate the thought process alongside an emotional experience.

"We're not introducing you to how to do a fiber optic intubation, we're going to present dozens of rare difficult challenging once in a lifetime cases". Here computer games can currently excel in their teaching ability, "it's a cognitive skill, it's a decision making algorithm". As time ticks by in the simulation "you do get to a point where there's no return and you have like three minutes to do this successfully and so your algorithm and decision making is absolutely crucial". It's about taking in data and making decisions in a way that is not possible on a mannequin or ethical on a live patient.

"Everything that goes into the app is peer reviewed" and, with any computer game you can earn points as you go along; this game though gives you (Continuing Medical Education) CME points.

Google Play:
https://play.google.com/store/apps/details?id=com.levelex.airwayex&hl=en_GB

Apple:
https://apps.apple.com/us/app/airway-ex/id1154656060

Open Anesthesia is here: https://www.openanesthesia.org/

Presented by Desiree Chappell and Monty Mythen with their guests. Sam Glassenberg, CEO and Founder of Level Ex, before which he was CEO of the leading independent game publisher in Hollywood, releasing games based on popular films, including The Hunger Games and Mission: Impossible, he also led the DirectX graphics team at Microsoft, where he accepted a Technical Emmy on behalf of his team for advancing the visual realism of video games across the industry. His career began at LucasArts, creating Star Wars games for PlayStation and Xbox. Sam serves on numerous industry advisory boards and speaks internationally on video games in medicine. Robert H. Thiele, Associate Professor, Departments of Anesthesiology and Biomedical Engineering, Division Chief, Critical Care Anesthesiology, Board of Directors, University Physicians Group, University of Virginia School of Medicine. He has a background in engineering and has been using technology to improve education since his residency in 2008. He is co-founder of www.OpenAnesthesia.org which lead to the development of Self-Study, and also authored one of the first iBooks focused on cardiac and critical care ultrasound.

"4-10% of opioid naïve patients will continue to use opioids more than 90 days after surgery"

Opioids are good for pain control but there's another issue, they also numb emotional pain. How do we responsibly deal with this? It's important to remember: "When you give patients high doses, you're putting them at risk".

Long term listeners will recall TopMedTalk spent the best part of our launch year on this topic. If you're one of our many new listeners please use this huge resource of podcasts to help update your practice and cut down unnecessary risk: https://www.topmedtalk.com/?s=opioid

"We should be minimizing opioids every chance we can", if you want to cut straight to our groundbreaking talk on opioid free anesthesia please go here: https://www.topmedtalk.com/ebpom-2019-opioid-free-anaesthesia-2/

Presented by Desiree Chappell and Monty Mythen with their guest Jennifer Lanzillotta-Rangeley, CRNA, PhD, Assistant Professor, College of Nursing, University of Cincinnati, Cincinnati, Ohio.

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EBPOM | Dingle - the hottest tickets in anaesthesia and perioperative medicine - go now to the website: https://www.ebpom.org/

TopMedTalk’s Co-editors in Chief, Desiree Chappell and Mike Grocott get proceedings underway with a conversation about this year’s Anesthesiology 2024, the largest gathering of anesthesiologists in the world and the annual general meeting of the American Society of Anesthesiologists (ASA).

We’re here and we’re bringing you exclusive conversations from the conference. Ensure you are subscribed to TopMedTalk to hear all our pieces from #ANES24 as they become available.

What is a 'micromort'? Even more of a worry, what does ten of them mean? How do we measure and communicate risk to patients? Everyday activities all carry inherent risks, how do we put surgery into a context 'everyday people' can more easily understand?

Recorded on day two of EBPOM 2017; Professor Monty Mythen presents with guests, Professor Sol Aronson, a tenured professor at Duke University and Executive Vice Chairman in the Department of Anesthesiology, and Dr Mike Irwin, Professor and Head, Department of Anaesthesiology, University of Hong Kong.

Sponsored by EBPOM and Edwards Life Sciences.

Join in the debate: contact@topmedtalk.com

Taken from a longer conversation to be found here: http://www.topmedtalk.com/ebpom-2017-pod-two-live-from-london/

Recorded at Evidence Based Perioperative Medicine (EBPOM) in London last year this presentation is the second of a series of four sessions under the heading: “Implementation – what works and what doesn’t?”. This piece is the second talk in the series, the first is here: https://topmedtalk.libsyn.com/joyce-yeung-why-dont-we-implement-trial-results-ebpom-world-congress

There is one more presentation to come and then we will release a fascinating panel discussion to conclude.

In this presentation we cover the historical development and implementation of Enhanced Recovery After Surgery (ERAS); key milestones from Henrik Kellett's pioneering work in the late 1990s, to the formation of the ERAS Study Group and subsequent international efforts. Also, the differences in implementation between countries, particularly the coordinated efforts in the UK through the NHS and the more fragmented approach in the USA.

There’s an emphasis on the importance of protocol adherence, auditing, and feedback and barriers to implementation such as lack of agreement with evidence, organizational challenges, and institutional hurdles.

Presented by Timothy Miller, Professor of Anesthesiology at Duke University Medical Center. Timothy completed his anesthesia training in Nottingham, UK followed by a fellowship in cardiothoracic anaesthesia at Glenfield Hospital, Leicester, UK. He is a fellow of the Royal College of Anaesthetists.

He then joined the Department of Anesthesiology at Duke University Medical Center. His clinical interest is management of the high-risk surgical patient undergoing non-cardiac surgery. His practice is varied and involves general, vascular, major urology and thoracic anesthesia, as well as anaesthesia for transplantation. He founded and is co- director of the Enhanced Recovery After Surgery (ERAS) program at Duke.

This talk is a powerful look at a new world where we commit your institution and practice to achieving an end goal of "zero preventable deaths". The Patient Safety Movement Foundation (PSMF) has generated an enormous amount of global news media coverage as it promotes that aim; celebrities, statesmen, politicians and industry leaders are all getting behind an ambition which, after hearing this talk, you are likely to want to see come to pass as much as they do.

The clips used in this presentation are sourced from the PSMF's YouTube channel, find it here: https://www.youtube.com/channel/UCLLtyscblA8aquiXSSrZ1bA

Their official website is here: https://patientsafetymovement.org/

You can find out more about Mike Ramsay and his work there by listening the "TopMedTalks to..." series, where we discuss healthcare with global thought leaders from around the world: https://www.topmedtalk.com/topmedtalks-to-michael-ramsey/

Presented by Michael Ramsay, Chairman, Department of Anesthesiology and Pain Management, Baylor University Medical Center; President, Baylor Scott & White Research Institute with an introduction from Sol Aronson, tenured professor at Duke University and Executive Vice Chairman in the Department of Anesthesiology.

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Looking for more about EBPOM Live from London? Go now to www.ebpom.org

This piece gives you the evidence base required to deliver an even higher standard of perioperative medicine where you work. Hear about the "Fit 4 surgery" studies; the "fit 4 surgery consortium", the ongoing e-studies, key findings, recent studies and the set up in Southampton.

Physical fitness is greatly affected by chemotherapy; poor outcomes are significantly linked to physical fitness; learn how preoperative cardio-pulmonary exercise testing and training can monitor and track this potentially dangerous spiral. Hear how multiple studies are now providing a clear evidence base for this exciting area of perioperative care.

Could more such targeted interventions, alongside shared decision making, provide a real difference to outcomes for your patients and a higher standard of value based care in your institution?

For more on this go here: http://wesfit.org.uk/

Read more about the great work being done by MacMillan Cancer Trust here: https://www.macmillan.org.uk/

The video version of this presentation, along with slides, was presented to the many thousands of people who attended the hugely successful Evidence Based Perioperative Medicine (EBPOM) virtual conference, "Live from London". For more details on this and future conferences please visit www.ebpom.org

Presented by Professor Sandy Jack, PhD, Consultant Clinician Scientist in The Anaesthesia and Critical Care Research Unit at University Hospital Southampton NHS Foundation Trust, Honorary Senior Lecturer at the University of Liverpool, University of Southampton and University College London.

This piece is 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/

Middle Tennessee School of Anesthesia's website is here: https://mtsa.edu/

Our guest kindly shares their email with us: bill.johnson@mtsa.edu

Presented by Desiree Chappell and Monty Mythen with their guest, Bill Johnson, DNAP, CRNA, Director, Acute Surgical Pain Management Fellowship at Middle Tennessee School of Anesthesia.

"ERAS in Colorectal Surgery" - was originally streamed live from the Charles Sammons Cancer Center, Dallas, during EBPOM-USA 2019 on www.topmedtalk.com

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 Anthony Senagore, Professor and Vice Chair Western Michigan University-Homer Stryker MD School of Medicine Borgess Medical Center Kalamazoo, MI.

--- IF YOU WANT TO HEAR THE FULL SERIES OF EDITOR'S PICKS YOU MUST SUBSCRIBE TO OUR NEWSLETTER ON www.topmedtalk.com NOW ---

This piece focuses on the question of looking after yourself as a practitioner and interlinking into your team. How important is it to listen to your team? What is "burn out"? How does it express itself in people? What signs should we look for in our friends and colleagues?

Presented by Desiree Chappell, Sol Aronson and Monty Mythen with their guest Sasha Shillcutt, Vice Chair of Strategy and Innovation, Department of Anesthesiology, UNMC Founder, Brave Enough LLC.

Find Sasha's excellent website (and podcast) here: https://www.becomebraveenough.com/

--- IF YOU WANT TO HEAR THE FULL SERIES OF EDITOR'S PICKS YOU MUST SUBSCRIBE TO OUR NEWSLETTER ON www.topmedtalk.com NOW ---

Originally recorded during Evidence Based Perioperative Medicine (EBPOM)'s London conference this piece focuses upon pulmonary complications in the perioperative period. What do the data say, what are the key trials?

Presented by Denny Levett, Professor in Perioperative Medicine and Critical Care at Southampton University Hospital NHS Foundation trust and Honorary Associate Professor at the University of Southampton with Mark Hamilton, Consultant and Honorary Senior Lecturer in Anaesthesia & Critical Care Medicine at St. George’s Hospital and Medical School, clinical lead for the Perioperative Assessment & Planning Unit at St. George’s Hospital, clinical director for critical care at St. George’s Hospital, alongside, Linda Denehy, Head of the Melbourne School of Health Sciences and Professor of Physiotherapy at The University of Melbourne, Australia, Rinaoldo Bellomo, Professor of Intensive Care Medicine, University of Melbourne, Honorary Professor, Faculty of Medicine, Monash University, Honorary Professorial Fellow, Faculty of Medicine, The University of Sydney, Honorary Professorial Fellow, The George Institute, Honorary Fellow, Florey Institute of Physiology, Honorary Professor, Faculty of Medicine, Nanjing University, Visiting Professor, Università Vita-Salute San Raffaele, he was awarded an Officer of the Order of Australia for distinguished service and Rupert Pearse, Professor of Intensive Care Medicine at Queen Mary, University of London.

This piece has been released to coincide with the first virtual International Fluid Academy Day (IFAD). TopMedTalk listeners have enjoyed following the meeting annually for some time now; we're equally as excited about their online proposition. Find out more here: https://www.fluidacademy.org/

This piece digs deep into the realities of coping with COVID 19 patients who have had their care escalated to the Intensive Care Unit (ICU); "we don't seem to be looking at our typical sepsis patients who get multiple organ failure in the classical way" and "you're surprised at how young some of the patients are...".

Our guest provides us further insight; a 'household name' in the haemodynamic monitoring space; he is treating patients in a medium sized hospital (500 beds) with mostly COVID patients in Spain. How are things going there, how does it compare to Italy? How are the patients being dealt with, what can we learn about the basics here, airway, breathing, ventilation (ABC)?

There is also a gripping discussion regarding dynamic arterial elastance. If you'd like to know more about that do check out our discussion here: https://www.topmedtalk.com/periop-coach-2-09-haemodynamic-monitoring/

The webinar mentioned in this piece can be found here: https://www.esicm.org/education/webinars/

Presented by Desiree Chappell and Monty Mythen with their guest Dr. Manuel Ignacio Monge García who works in an ICU in the South of Spain.

In this piece we cover frailty in perioperative and end-of-life care, the assessment of frailty, the challenges of clinical momentum, multidisciplinary team meetings, and the importance of palliative approaches. The conversation also delves into the trajectories at the end of life and the impact of electronic medical records in automating frailty measurement. The episode concludes with reflections on living a healthy life and the dignity of end-of-life care.

This piece comes from our coverage of the Perioperative Medicine Special Interest Group Meeting in Melbourne, Australia.

Presented by Kate Leslie and Desiree Chappell with their guests Jai Darvall, Associate Professor, anaesthetist and intensive care specialist at the Royal Melbourne Hospital in Australia, where he is co-lead of the perioperative medicine service within the Department of Anaesthesia and Pain Management; and Chuan-Whei Lee, anaesthetist and pain medicine specialist at Royal Melbourne Hospital, and joint clinical lead of perioperative medicine in the Department of Anaesthesia and Pain Management, clinical senior lecturer in the Department of Critical Care, University of Melbourne; and supervisor of training for the Faculty of Pain Medicine, ANZCA.

This piece focuses upon the Hypotension Predictive Index (HPI) technology. We look at the validation process of HPI, addressing criticisms and clarifying its predictive ability for hemodynamic instability. How important is it to understand the underlying causes of instability rather than solely relying on blood pressure readings? What is the role of HPI in early detection and proactive management? The discussion also touches on the limitations of traditional mean arterial pressure (MAP) monitoring and the need for a holistic approach to hemodynamic assessment.

Presented by Desiree Chappell, TopMedTalk’s co-editor in Chief, speaking with Monty Mythen, Senior Vice President Medical Affairs, Edwards Lifesciences, Critical Care, Emeritus Professor of Anaesthesia and Critical Care, University College London, Thomas Sheeran, Senior Director Medical Affairs, Edwards Lifesciences, and Simon Davies, Consultant Anaesthetist at York Teaching Hospital NHS Foundation Trust.

The paper 'Comparison of Differences in Cohort (Forward) and Case Control (Backward) Methodological Approaches for Validation of the Hypotension Prediction Index' is here: https://pubs.asahq.org/anesthesiology/article/doi/10.1097/ALN.0000000000004989/139987/Comparison-of-Differences-in-Cohort-Forward-and?searchresult=1

Here’s the link to the Physiology Lab section of last year’s ASA symposium on YouTube: https://youtu.be/yfl1VMMgIRs?si=YxGfOs-pdlIVVGt1

Here are publications relating HPI to hemodynamic instability at a microcirculation level:

https://pubmed.ncbi.nlm.nih.gov/33755645/

https://pubmed.ncbi.nlm.nih.gov/36335548/

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

Celebrating 5 years of TopMedTalk at 'Anesthesiology'; the Annual General Meeting of the American Society of Anesthesiologists.

This piece is presented by Desiree Chappell and Monty Mythen with their guest Bernd Saugel, Professor and Vice Chair of the Department of Anesthesiology, Center of Anesthesiology and Intensive Care Medicine at the University Medical Center Hamburg-Eppendorf, Germany.

Bernd has previously appeared on TopMedTalk here: https://www.topmedtalk.com/bernd-saugel-at-euroanesthesia-2022-topmedtalk/

TopMedTalk is very proud to be partnered with the American Society of Anesthesiologists® at ANESTHESIOLOGY® 2022. Now in our fifth year TopMedTalk is bringing you our most comprehensive and extensive coverage of the largest gathering of anesthesiologists in the world!

This audio is presented to you "as live" - if you'd like to see our coverage as it happens go now to: https://live.topmedtalk.com/

TopMedTalk is provided to you for free; if you want to help support our work and help give these conversations a wider audience please like and subscribe (if and where possible) before sharing it on your social media.

TopMedTalk can be found on YouTube here: https://www.youtube.com/channel/UC-HYQmeIwcFCYO1hoQ8jShQ

We are on Twitter here: https://twitter.com/topmedtalk

We are on LinkedIn here: https://www.linkedin.com/company/topmedtalk

We are on Facebook here: https://www.facebook.com/TopMedTalk1/

Recorded at Evidence Based Perioperative Medicine (EBPOM) in London last year this presentation is the third of a series of four sessions under the heading: “Implementation – what works and what doesn’t?”.

This piece is the third talk in the series, the first is here: https://topmedtalk.libsyn.com/joyce-yeung-why-dont-we-implement-trial-results-ebpom-world-congress

The second is here: https://topmedtalk.libsyn.com/professional-organisations-the-ebb-and-flow-of-eras-ebpom-world-congress

Next week we will release the panel discussion.

In this talk we get an NHS leader’s perspective on the challenges and obstacles in implementing new innovations within the NHS. Drawing from his extensive experience, David Probert highlights the impact of funding reductions, increasing waiting lists, and strict performance metrics on healthcare delivery. He uses case studies, including robotic surgery, to illustrate successful strategies for gaining approval for innovations, emphasizing the importance of aligning proposals with leadership priorities, utilizing first-mover advantage, and integrating patient care systems.

Presented by David Probert, Chief Executive Officer at University College London Hospitals NHS Foundation Trust.

"Our mission is to make sure everybody in intensive care can learn [ultrasound]". How important and how possible is it to use ultrasound in your practice? Hear how it can transform the way you diagnose issues with pocket sized point of care ultrasound. Lung ultrasound is discussed as is its use with eyeballs. Hear how one of the pioneers in this area, Professor Sol Aronson, reacts to an enthusiast in the field. "Wherever you are, however novice or new, it just makes you smarter".

Recorded live at the Association of Anaesthetists' Winter Scientific Meeting 2020 in the centre of London from The Queen Elizabeth II Centre. This piece followed on from these two pieces:

TopMedTalk | Matt Wiles and Marcus Peck, Live from London:
https://www.topmedtalk.com/topmedtalk-matt-wiles-and-marcus-peck-live-from-london/

TopMedTalk | Gezz Van Zwanenberg, Live from London Part 2:
https://www.topmedtalk.com/topmedtalk-gezz-van-zwanenberg-live-from-london-part-2/

Find out more Focused Ultrasound in Intensive Care (FUSIC) here: https://www.ics.ac.uk/ICS/accreditation.aspx

Presented by Desiree Chappell and Monty Mythen with contributions from Sol Aronson, tenured Professor at Duke University and their guest Marcus Peck, NHS Consultant in Anaesthesia and Intensive Care Medicine at Frimley Park Hospital and Chair of Focused Intensive Care Society’s (FICE) Committee.

Like this, want more? Marcus Peck featured on TopMedTalk previously here: https://www.topmedtalk.com/intensive-care-society-point-of-care-ultrasound/

This panel discussion is an honest and challenging look at blood pressure management. Questions include but are not limited to: How should practitioners maintain blood pressure in patients and where is the threshold? How much precaution is inspired by eminence rather than actual evidence? What is the best and safest way to attenuate sympathetic responses intraoperatively? If harmful hypotension occurs between induction and incision should we refuse to induce anaesthesia until the surgeon is scrubbed and ready? If we had better, more specific or sensitive ways to monitor tissue perfusion rather than blood pressure and now - almost discounted - urine output, would this lead to better care? Is it the case that minimally invasive cardiac output technology may be of much greater value in the ward than in theatre?

Presented by Desiree Chappell with Monty Mythen and Dr Simon Davies, Consultant Anaesthetist at York Teaching Hospital NHS Foundation Trust with Timothy Miller, Associate Professor of Anaesthesiology from Duke University Medical Centre.

“Every single one of you can and should go build an AI model. It's actually pretty simple these days. But then think about; what actually is the problem here? And where could the system go wrong?”

This podcast opens up the first in a four part series here on TopMedTalk about a topic which has defined the last few years; what does the development of artificial intelligence (AI) systems mean for perioperative medicine, what will the benefits be and where do we already see potential challenges? This first part “An Introduction to AI” gets the conversation going.

With a short introduction from Mike Grocott this piece is presented by Adriane Chapman, Professor at University of Southampton, Head of Digital Health Research Group, Director for the Centre for Health Technologies.

This piece is taken from a four part presentation, three talks and a discussion, first given at Evidence Based Perioperative Medicine (EBPOM) 2023.

What is the Perioperative Quality Initiative (POQI) and why is this episode always a popular download - each year - for TopMedTalk listeners? How can POQI help practitioners make informed choices?

Where's the POQI website and the resources? It's here: http://thepoqi.org/

This is the first of a three part series which will cover the entire POQI session from the Evidence Based Perioperative Medicine (EBPOM) conference 2022.

Hosted by Mike Grocott, Professor of Anaesthesia and critical care at the University of Southampton; it begins with a short introductory presentation from Tong Joo (TJ) Gan, Professor and Chairman at Stoney Brook in New York; moving onto Tim Miller, Associate Professor of Anesthesiology from Duke University Medical Centre, on the subject of "POQI I".

This discussion covers many topics including; preoperative medicine and its evolution, frailty in various age groups, brain health and anesthesia in older adults, cognitive decline and executive function testing.

It is presented by Desiree Chappell and Guy Ludbrook with their guest, BobbieJean Sweitzer, Systems Director, Preoperative Medicine, Inova Health, Falls Church, Virginia, and Professor of Medical Education, University of Virginia and the author and editor of 'Preoperative Assessment and Management' (currently 3rd edition).

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Originally streamed live as part of our coverage of Anesthesiology 2023; the annual meeting of the American Society of Anesthesiologists, the largest and most important gathering of anesthesiologists in the world. We're your free front row seat.

For more on the ASA go here: https://www.asahq.org/

Check out our YouTube page for a record of the live stream video of this podcast: https://www.youtube.com/@topmedtalk7687/streams

How did your intensive care unit manage during COVID19? What are the common experiences of practitioners from the developed world who bravely faced a pandemic like no other?

This is part one of a two part piece.

The TV show mentioned in this piece is available here:
https://www.channel4.com/programmes/help

Editor's note; parts of this conversation which suffered from technical issues have been removed from this podcast.

Chaired by Ramani Moonesinghe, OBE, Professor of Perioperative Medicine at UCL and a consultant anesthetist at UCL hospitals, Director of the Health Services Research Center of the Royal College of Anaesthetists and national Clinical Director for critical and perioperative care at NHS England, with remote assistance from Catherine Motherway, consultant in Anaesthesia and Intensive Care in University Hospital Limerick and contributions from panelists; David Walker, Professor in Anaesthesia and Critical Care Medicine, University College London Hospitals, Honorary Senior Lecturer UCL, Jim Down, Intensivist and Consultant Anaesthetist, University College London Hospital. Colman O'Loughlin, consultant Anaesthesia, Critical Care Medicine, Extracorporeal Life Support at the Mater Hospital, Dublin, Enda O'Connor, physician intensivist and current ICU Lead and Education Lead in St James’s Hospital.

In the UK community based prehabilitation is being spearheaded by the Prepwell Initiative, supported by a grant from Sports England. Their pioneering work is a great example of the way in which prehabilitation is gathering pace at the moment.

The “PREP: Preoperative Risk Education Package” website is here: https://www.prepwell.co.uk/

What are the economics of such a programme? Why did the project start to get referrals from initially sceptical surgeons? How did the programme impact the lives and treatment of patients?

Presented by Gerard Danjoux, Consultant in Anaesthesia and Sleep Medicine at South Tees Hospitals NHS Foundation Trust.

This piece is a fascinating discussion regarding research and safety in anaesthesia management; "in the past five or six years there's been a shift from high risk patients to all types of patients". How are we improving methods, evaluation and monitoring? What are some of the more essential elements of the process? Where is the latest research? What is a sensible policy when it comes to opioids?

Presented by Desiree Chappell and Monty Mythen with their guest Dan Longrois, Professor of Anaesthesia and Intensive Care Medicine, Department of Anaesthesia and Intensive care, Bichat Hospital.

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EBPOM 2020 - Live from London - is on!

For those who have listened to Desiree's special announcement go now to: https://ebpom.org/EBPOM2020

Hear the complete live session with questions from the online audience at one of the stand out presentations of Evidence Based Perioperative Medicine (EBPOM)'s Dingle Conference.

Don't forget if you want full access to our video presentations on demand and are interested in attending the next EBPOM conference ensure you check out www.ebpom.org

Here are the two articles referenced in this piece:

Current status of perioperative hypnotics, role of benzodiazepines, and the case for remimazolam: a narrative review

https://doi.org/10.1016/j.bja.2021.03.028

Intraoperative hypotension and the risk of postoperative adverse outcomes: a systematic review

https://doi.org/10.1016/j.bja.2018.04.036

Presented by Desiree Chappell VP Clinical Quality for NorthStar Anesthesia and Vicki Morton, Director of Clinical and Quality Outcomes at Providence Anesthesiology Associates, P.A. with their guests; Rob Sneyd, Emeritus Professor, University of Plymouth, Jeff Gadsden, Associate Professor of Anesthesiology, Duke University, USA, Dru Riddle Associate Professor of Professional Practice and Director of Clinical Education, Fort Worth Texas.

TopMedTalk is live from Euroanaesthesia 2019; recognised worldwide as one of the most important and influential annual congress in anaesthesiology. Over 6000 international delegates alongside more than 100 exhibitors from more than 80 countries, Euroanaesthesia is truly an outstanding international platform. Join Us at the conference in this series of special live podcasts.

Presented by Monty Mythen and Desiree Chappell.

This piece has been supported by the "Know AKI campaign" – a bioMérieux global campaign to raise awareness about acute kidney injury. It features a wide selection of clips on the subject of acute kidney injury, restrictive versus liberal fluid therapy and the trials we've seen in recent years which have revitalized debate and learning.

The clips used come from the following podcasts:

Michelle Chew's clip comes from here:
EUROANAES2019 | Michelle Chew
http://www.topmedtalk.com/euroanaes2019-michelle-chew/

Andy Shaw's clip comes from here:
SCA | Improving your practice
http://www.topmedtalk.com/sca-improving-your-practice/

John Kellum is here:

Perioperative Nephrology Fluids and the Kidney
http://www.topmedtalk.com/periop-coach-4-06-perioperative-nephrology-fluids-and-the-kidney/

Renal Injury Biomarkers
http://www.topmedtalk.com/renal-injury-biomarkers/

Urine Output
http://www.topmedtalk.com/urine-output/

Vincent D’Intini's contribution originally appeared here:
Periop SIG18 | Goal directed therapy to prevent acute kidney injury
http://www.topmedtalk.com/periop-sig18-goal-directed-therapy-to-prevent-acute-kidney-injury/

Paul Myles's contributions feature also in this pertinent piece alongside Rupert Pearse:
EBPOM London 2018 – any answers | Part 3 The Big Trials
http://www.topmedtalk.com/ebpom-london-2018-any-answers-part-3-the-big-trials/

Tim Miller is worth listening to in more detail here:
Live from Boston ASA 2017 – Intraoperative Goal Directed Fluid Therapy
http://www.topmedtalk.com/live-from-boston-asa-2017-intraoperative-goal-directed-fluid-therapy/

Dan Sessler is here:
Live from Boston ASA 2017 – The Elephant In The Room – intraoperative hypotension
http://www.topmedtalk.com/live-from-boston-asa-2017-the-elephant-in-the-room-intraoperative-hypotension/

David Kauffman and Greg Martin feature here:
Fluid Matters 3/6 | Fluid Responsiveness and venous capacitance
http://www.topmedtalk.com/fluid-matters-3-6-fluid-responsiveness-and-venous-capacitance/

Dan Engelman features here:
Daniel Engelman Q&A | EBPOM Chicago
http://www.topmedtalk.com/daniel-engelman-qa-ebpom-chicago-2/

EBPOM Highlight | Enhanced Recovery After Cardiac Surgery
http://www.topmedtalk.com/ebpom-highlight-enhanced-recovery-after-cardiac-surgery/

For more from (Trainees in Perioperative Medicine) TRIPOM and Mike Grant go here:
TRIPOM 1.02 | EBPOM USA 2019
http://www.topmedtalk.com/tripom-1-02-ebpom-usa-2019/

TopMedTalk is proud to act as the broadcasting arm of Evidence Based Perioperative Medicine (EBPOM) for more information please go now to www.ebpom.org

"Perioperative brain health initiative: A population health safety initiative" - one of the lectures which www.topmedtalk.com streamed live from The Institute of Engineering and Technology (IET) in London during EBPOM 2018.

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 Dr Lee A. Fleisher Professor and Chair of Anesthesiology and Critical Care, University of Pennsylvania

TopMedTalk is live from Euroanaesthesia 2019; recognised worldwide as one of the most important and influential annual congress in anaesthesiology. Over 6000 international delegates alongside more than 100 exhibitors from more than 80 countries, Euroanaesthesia is truly an outstanding international platform. Join Us at the conference in this series of special live podcasts.

The website mentioned in this piece is here: https://www.vyaire.com

Presented by Desiree Chappell and Monty Mythen with their guest Michael Pedro, VP, Medical Director at Vyaire Medical.

"Perioperative nutrition should be a key part of Enhanced Recovery" - originally streamed live from The Institute of Engineering and Technology (IET) in London during EBPOM 2018 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 Paul Wischmeyer, Professor of the Department of Anesthesiology, Duke University.

"Post-operative critical care: what should we do?" was originally streamed live from The Institute of Engineering and Technology (IET) in London during EBPOM 2018 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

Presented by Denny Levett, Professor in Perioperative Medicine and Critical Care at the University of Southampton.

"As Anaesthetists the ultimate goal of almost all of our interventions and monitoring is to support cell energy production to provide mitochondria with the oxygen and the fuel they need to produce enough adenosine triphosphate (ATP) to power cell function and integrity".

How human cells produce energy, how this changes in response to stress and how this may influence survival; this piece focuses what we know about how our bodies get the fuel they need to survive surgery and thrive as a result, providing a positive long term outcome. This is not a piece about nutrition, it's a provocative session exploring concepts designed to provide food for thought.

Presented by Helen McKenna, is in the final year of her PhD at University College London, investigating bioenergetic and redox function in critically ill patients.

This essential TopMedTalk Highlight represents the culmination of a number of important threads we’ve been examining over the last few years around interoperative hypotension (IOH). Now though we’re hearing from practitioners who are looking at the consequences of new methods and technology to deal with this threat at scale. Could we see an end to the era of dangerous interoerative hypotension?

Selected and edited for your convenience this was originally released as a long form conversation; part of our exclusive coverage of the annual International Anesthesia Research Society, (IARS) meeting organised with the Association of University Anesthesiologists (AUA) and The Society of Critical Care Anesthesiologists (SOCCA).

Check out their website here: ​https://iars.org/

It features Monty Mythen, Desiree Chappell and Mike Grocott in conversation with Wael Saasouh, Regional Director of Research at NorthStar Anesthesia.

If you have comments or questions about the research and would like to take it further email: contact@topmedtalk.com

NOTES:

FEDORA trial: https://www.bjanaesthesia.org/article/S0007-0912(17)54207-5/fulltext

TOPMEDTALK PREVIOUSLY: https://topmedtalk.libsyn.com/journal-club-the-fedora-trial

The RELIEF (Restrictive versus liberal fluid therapy in major abdominal surgery) trial: https://www.nejm.org/doi/full/10.1056/NEJMoa1801601

TOPMEDTALK PREVIOUSLY: https://topmedtalk.libsyn.com/the-relief-trial-results 

TopMedTalk brings you more exclusive coverage, direct from the 18th WFSA World Congress of Anaesthesiologists in Singapore.

Now its tenth year, the Global Scholars Program provides support for young leaders in the specialty from low- and middle-lower income countries, more detail here: https://www.asahq.org/charity/programs/globalscholars

Here Desiree Chappell has a conversation with two global scholars, Kpehe Maimie, West African College of Surgeons and Faculty, SAFE obstetrics & Neonatal Rescucitation at Mercy Ships UK and Naima Zakaria, Medical Director, Tanga Regional Referral Hospital, Tanzania

Dr Kpehe Maimie is featured in this fascinating article here: https://wfsahq.org/news/latest-news/my-story-training-to-be-liberias-first-home-grown-anaesthesiologist/

Welcome to TopMedTalk's 'as live' coverage from the 5th Collaborative Clinical Trials in Anaesthesiology Meeting, Prato, Italy. It's your chance to get virtual a place at one of the most influential gatherings of its kind in the world.

Presented by Desiree Chappell and Monty Mythen with Lis Evered, neuroscientist and Head of Research in the Department of Anaesthesia and Acute Pain Medicine, St Vincent’s Hospital, Melbourne. She has led an international group to standardise nomenclature for cognitive change associated with anaesthesia and surgery. She is an Editorial Board member of British Journal of Anaesthesia.

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.

How can cold water adaption help people deal with medical issues? There's evidence to suggest that cold water adaption reduces inflamation, can open water swimming help with issues such as chrohn's disease? On the other hand how important is it to ensure patients do not become cold while in our care? Hypothermia is never good, how important is it to keep patients warm? Keeping patients and their environments warm is discussed, as is pre-warming, going beyond the standard blankets and patient insulation to include active warming and even patients exercising as a method of warming up. Further to this conversation, how do you measure a patient's temperature?

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 attributed questions from the audience.

Desiree Chappell, Philip Corvo and Vicki Morton discuss critical care patients and enhanced recovery pathways. How do the insights of ERAS apply to these situations?

TopMedTalk is live from Euroanaesthesia 2019; recognised worldwide as one of the most important and influential annual congress in anaesthesiology. Over 6000 international delegates alongside more than 100 exhibitors from more than 80 countries, Euroanaesthesia is truly an outstanding international platform. Join Us at the conference in this series of special live podcasts.

For more information on the American Society of Anesthesiologists (ASA) go here: www.ASAHQ.org

Presented by Desiree Chappell and Monty Mythen with their guest Linda Mason, President of the American Society of Anesthesiologists.

TopMedTalk catches up with another online media source, The Critical Care Practitioner podcast, organised by our guest who - appropriately enough - is a critical care practitioner. What's it like being a critical care practitioner in the UK at the moment? Originally a lot of nurses moved into the sphere but now paramedics, physiotherapists and many others progress into it.

Furthermore what's it like taking your professional passion into the world of podcasting?

You can hear the Critical Care Practitioner podcast here.

Presented by Desiree Chappell with her guest Jonathan Downham, Critical Care Practitioner and podcaster.

Celebrating 5 years of TopMedTalk at 'Anesthesiology'; the Annual General Meeting of the American Society of Anesthesiologists.

This piece is presented by Desiree Chappell and Sol Aronson with their guest Elizabeth Drum, Associate Professor of Clinical Anesthesiology and Critical Care Medicine at the Perelman School of Medicine, University of Pennsylvania, Philadelphia.

For more information about the American Society of Anesthesiologist's global humanitarian outreach go here: https://www.asahq.org/charity

TopMedTalk is very proud to be partnered with the American Society of Anesthesiologists® at ANESTHESIOLOGY® 2022. Now in our fifth year TopMedTalk is bringing you our most comprehensive and extensive coverage of the largest gathering of anesthesiologists in the world!

This audio is presented to you "as live" - if you'd like to see our coverage as it happens go now to: https://live.topmedtalk.com/

TopMedTalk is provided to you for free; if you want to help support our work and help give these conversations a wider audience please like and subscribe (if and where possible) before sharing it on your social media.

TopMedTalk can be found on YouTube here: https://www.youtube.com/channel/UC-HYQmeIwcFCYO1hoQ8jShQ

We are on Twitter here: https://twitter.com/topmedtalk

We are on LinkedIn here: https://www.linkedin.com/company/topmedtalk

We are on Facebook here: https://www.facebook.com/TopMedTalk1/

A staffing crisis globally in healthcare is pushing forward the need for sedation in non anaesthetic areas. What does this mean for medical practitioners? What are the safest ways to work within this crisis? This is not a conversation about shortcuts and poor practices, it's about delivering a higher and better standard of care within a perioperative environment. Listen in to find out more.

Recorded - as live - at EBPOM 2022; go now to www.ebpom.org for more details about Evidence Based Perioperative Medicine (EBPOM).

Presented by Desiree Chappell and Monty Mythen with their guest Amit Prakash, Consultant in Anaesthesia & Perioperative medicine, Clinical lead Neuroanaesthesia at Cambridge University Hospital, Addenbrookes NHS trust, UK.

This EBPOM extra for TopMedTalk listeners was graciously supported by Medtronic. Thanks to our sponsors we are able to bring you TopMedTalk entirely for free.

This episode is one of the top ten most downloaded podcasts we've done so far.

The debate 'Direct laryngoscopes should be consigned to history' was hosted by The Royal College Of Anaesthetists and carried out by our two guests on this piece. TopMedTalk sat down to have our own mini-debate during the conference.

Presented by Joff Lacey and Monty Mythen with their two guests; Professor Tim Cook, Consultant in Anaesthesia and ICM, Royal United Hospitals, Bath and Dr William Harrop-Griffiths, St Mary's Hospital, Imperial College Healthcare NHS Trust.

Can artificial intelligence drive new changes in care and the value of big data? We're already comfortable with using tools that help us to do our job better, what are the opportunities and pitfalls related to this new technology?

Are we ready yet for big data? The changes it may cause are staggering but equally; nuance is the friend of truth, do we have enough 'data literacy' to handle it all? Also - can the way you pronounce 'scone' give you an idea of your life expectancy?

How do we balance privacy concerns with the need for data to be accessible? Can such information be truly anonymised? Discussion moves here to 'Google flu tracker' and its, initially quite good, results.

Finally how do doctors adapt to the new world where they are being told in front of their patients what the right course of action is? Will patients retain trust in the Doctor's decisions?

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, Monty Mythen and Joff Lacey, with their guest Professor Iain Moppett, Professor of Anaesthesia and Perioperative Medicine, University of Nottingham.

What can the experiences of a team who helped to introduce pre-operative assesment and prehabilitation to Barcelona teach us about how to most effectively implement and sustain similar programmes where we are?

How and why is prehabilitation helpful in terms out outcomes and value based care? How long can the benefits of prehabilitation be maintained? What is the value of nutritional consultation, how important is it to asses your patients pre-operative protien intake? Would it help to offer all of your patients mindfullness sessions? How important is it to include patient's partners or carers in sessions?

Also, is it possible for you to tap into and harness the enthusiasm of sporting professionals?

Presented by Graciela Martinez-Palli, Consultant in the Department of Anaesthesia and Perioperative Care at Hospital Clinic, Barcelona. She attends as anaesthesiologist for oncologic digestive surgery and liver transplantation.

Prehabilitation is about planned pathways, preparing our patients for a journey which we as practitioners have already travelled. 4.2 million deaths are attributable to surgery each year globally, this presents a huge opportunity to improve the world for those who focus on perioperative surgery and prehabilitation. On the financial side, complications from surgery are proven to put costs up.

It's now widely accepted that perioperative medicine is the future of anaesthesia, how do we help the discipline evolve smoothly as it moves in this direction? The multidisciplinary aspect and the move away from the silo approach to healthcare is important, as is the challenge of the profession expanding out into 'population health'. With this in mind how might training evolve? What opportunities are about to be unlocked as a result of both big data, wearables and genoimcs?

For more information on "Getting it right first time" (GIRFT) go here: https://www.topmedtalk.com/rcoa-13-the-girft-getting-it-right-first-time-project/

Presented by Mike Grocott, Professor of Anaesthesia and Critical Care Medicine, University of Southampton.

The TopMedTalk team brings you more of our live coverage of 'The Society of Cardiovascular Anesthesiologists' (SCA) annual conference, 2019.

This piece highlights four papers recently published in the May edition of the (British Journal of Anaesthesia) BJA. Find them on www.poqi.org

Furthermore, there's an interesting piece about the Perioperative Quality Initiative (POQI) here: https://www.topmedtalk.com/anesthesia-and-analgesia-go-big-on-poqi/

Presented by Desiree Chappell with Monty Mythen and Sol Aronson, tenured professor at Duke University and Executive Vice Chairman in the Department of Anesthesiology.

A discussion about oxygen and the Xtreme Everest research studies into human adaptation to hypoxia. How does the human body adapt to extreme conditions? We assume it will inevitably cause damage but this is not always the case. How do people who have inherited a tolerance for low levels of oxygen manage?

Monty Mythen, Mike Grocott and Joff Lacey are joined by special guest Dr Dan Martin OBE, Consultant in Intensive Care and Everest summiteer.

This piece looks at some of the advantages to having a perioperative interdisciplinary team reducing complications, understanding and discussing risk, facilitating better shared decision making and increased patient satisfaction, even among those who - as part of this process - decide not to go ahead with an operation.

It also incorporates evidence regarding what we know about COVID-19; "The risks ... of the COVID-19 virus is that if people contract it during or after their surgery, they have a much worse result with perhaps 51% pulmonary complications or 24% mortality".

The World Health Organisation report mentioned in this piece, "Smoking greatly increases risk of complications after surgery", is here: https://www.who.int/news/item/20-01-2020-smoking-greatly-increases-risk-of-complications-after-surgery

The Montgomery ruling is covered on a previous TopMedTalk in more detail in "Sunday Special | Being on the right side of the law" here: https://www.topmedtalk.com/sunday-special-being-on-the-right-side-of-the-law-2/

The Centre for Perioperative Care website is an excellent resource, here is the section specifically for your patients: https://www.cpoc.org.uk/patients

The Royal College of Surgeons is here: https://www.rcseng.ac.uk/

Our presenter has a website dedicated to her work here: http://www.scarlettmcnally.co.uk/

And she maintains a twitter feed - focused on medical issues - here: https://twitter.com/scarlettmcnally

Presented by Scarlett McNally, Deputy Director of The Centre for Perioperative Care (CPOC) consultant Orthopaedic Surgeon, Eastbourne DGH, UK.

This piece is designed to get you in excited about the The American Society of Anesthesiologists (ASA)'s annual general meeting; Anesthesiology 2024, being held this month October 18 - 22 in Philadelphia.

As usual TopMedTalk will be there; building on our reputation for exclusive cutting edge conversations recorded at the conference with some of the key speakers.

On today's program we intend to whet your appetite for the future with some clips taken from conversations of our coverage from last years conference.

The fuller conversations from which the clips in this piece come are to be found on our YouTube channel here:

https://youtu.be/V6RomXG3JpM?si=fmlYi0HlFv6aNb3L

https://youtu.be/vmdhEeIKv5g?si=bzuQ789vMI01TGbq

https://youtu.be/Yhd5mmBnlH8?si=eAK4kXXnrIzFQbtY

Join the team on the first day of the ASA in San Francisco. Originally streamed live on http://www.topmedtalk.com from the Smith's Medical Booth in the exhibition hall of the conference.

Presented by Monty Mythen, Desiree Chappell, Mike Grocott and Joff Lacey.

Should you have to lose weight before you get a new knee.

A short sampler from Desiree's round table discussion with TopMedTalk.

2020 was a big year for prehabilitation, the advent of a global pandemic has only increased the importance of this exciting field of medicine.

Various questions from EBPOM 2020 attendees were tackled by the panel: Can you use "Timed Up and Go" (TUG) and The Duke Activity Status Index (DASI) to screen out unnecessary cardio-pulminary exercise testing (CPET)? What exactly is prehabilitation and what's its natural scope? How important is nutrition? Is it possible to standardise these areas more? What areas are being significantly worked on in prehabilitation medicine in the UK this year? What about - in these COVID 19 times - remote screening and assessment? Also, what about the possibilities regarding aerosolisation, particularly of COVID-19, during CPET? Can prehabilitation work to minimise time spent in hospital?

Presented by Mike Grocott, Professor of Anaesthesia and Critical Care Medicine at the University of Southampton with Karen Kerr, Consultant Anaesthetist, Departmental Lead for CPET, Sheffield Teaching Hospitals (STH) and featuring panelists; Denny Levett, Professor in Perioperative Medicine and Critical Care at the University of Southampton and a Consultant in Perioperative Medicine at Southampton University Hospital NHS Foundation trust (UHS), June Davis, Director of Allied Health Solutions, Allied Health Professions Advisor (part time) for Macmillan Cancer Support and a professional advisor to the Care Quality Commission and Steve Wootton, OBE, Associate Professor in Nutrition at the University of Southampton with an honorary appointment with University Hospital Southampton in Clinical Nutrition.

Desiree Chappell and Monty Mythen in conversation with Seenu Reddy, Cardiothoracic Surgeon at HCA‘s TriStar Cardiovascular Surgery in Nashville, National Physician Director, HCA Healthcare's CV Service line.

We start with discussion about the ERAS Cardiac society, more about them here: https://www.erascardiac.org/

The paper discussed in this piece (10 minutes in) “Advanced artificial intelligence–guided hemodynamic management within cardiac enhanced recovery after surgery pathways: A multi-institution review” is available here: https://doi.org/10.1016/j.xjon.2023.06.023

TopMedTalk is the broadcasting arm of Evidence Based Perioperative Medicine (EBPOM). For more information on EBPOM Ireland go here: https://ebpom.org/

As mentioned in the piece we’ve enjoyed conversations with Seenu Reddy previously: https://topmedtalk.libsyn.com/the-eras-cardiac-society-conference-day-2-topmedtalk-0

https://topmedtalk.libsyn.com/eras-cardiac-2019-seenu-reddy

And we mention a forthcoming “mini-doc” on the subject of Drinking Eating and Mobilising which will include part of our essential interview with Henrik Kehlet, that you can hear here: https://topmedtalk.libsyn.com/asa-henrik-kehlet-recovery-is-all-about-inflammation

This piece discusses the changes enhanched recovery brings, the conversation then moves to narcotics and the opioid epidemic.

Presented by Desiree Chappell, Dr Vijaya Gottumukkala, cardiac anaesthesiologist from MD Anderson and member of the board of directors for the American Society of Enhanced Recovery (ASER) and Dr George Nassif, colorectal surgeon at the Center for Colon & Rectal Surgery in Florida.

Monty Mythen and Desiree Chappell of The Roundtable blog speak with Jan Vest, C.E.O of Signature Medical Group and Josh Luke, America's leading health-care futurist and writer of "EX-Acute, a former hospital CEO tells all on what's wrong with American healthcare".

These pieces have been released to coincide with IFAD, the 7th International Fluid Academy Day. Make sure you subscribe to TopMedTalk to ensure you hear some of the pieces we recorded there.

Coming from this summer's Peroperative Quality Initiative (POQI) hosted at Washington Duke University in Durham this podcast is presented by Monty Mythen and Henry Howe with their guests Tom Woodcock, an independent consultant in patient safety, medical law and ethics, and Manu Malbrain, Professor at Faculty of Medicine and Pharmacology Vrije University in Brussells.

The website mentioned in this piece is here: https://www.fluidacademy.org/

This timely discussion considers the wisdom of day case total knee replacement: What do the data say? Can we do this without the use of opioids? What is reasonable to consider as part of an enhanced recovery after surgery program? How do patients make an informed decision when this kind of surgery is in their possible future?

The first TopMedTalk piece mentioned in the discussion is here:
TopMedTalk | Henrik Kehlet and Nick Scott: https://www.topmedtalk.com/topmedtalk-henrik-kehlet-and-nick-scott-2/

And the second is here: https://www.topmedtalk.com/cryoneurolysis-and-pain-management-topmedtalk-2/

Chaired by Sol Aronson, Emeritus Professor, Duke University & Desiree Chappell, VP Clinical Quality Northstar Anaesthesia with David Howard, Honorary Consultant, Ear Nose and Throat / Head and Neck Surgeon, Imperial and UCLH NHS Trust Hospitals, Brian O'Donnell, consultant anaesthesiologist, Cork University Hospital, Vinod Dasa, VP for Academic Affairs, Dept of Orthopedics, LSU.

This piece provides an update on the Perioperative Exercise, Testing and Training Society (POETTS); "established back in 2017, in the context, in the United Kingdom, of cardiopulmonary exercise testing becoming much more common in the preoperative period". Now, more than half of acute hospital trusts in the United Kingdom have a cardiopulmonary exercise testing service to evaluate their patient's functional capacity prior to surgery. Furthermore exercise interventions to optimise a patient's fitness before surgery have seen a sudden and growing interest.

With just over 400 members POETTS exists to help standardize education and training in the field, develop consensus clinical guidelines, look after patients around the time of surgery and help club together acute hospital trusts across the UK, so that they can do collaborative research.

Their website is here: https://www.poetts.co.uk/

Presented by Denny Levett, Professor of Perioperative Medicine at the University of Southampton and President of the Perioperative Exercise, Testing and Training Society (POETTS).