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Periop Coach 5.03 | Assessing the risk of delirium

TopMedTalk

Release Date: 02/24/2020

Nutrition and metabolism before surgery - PART 1 of 2 | EBPOM London 2020 show art Nutrition and metabolism before surgery - PART 1 of 2 | EBPOM London 2020

TopMedTalk

"I hope to impress upon you that this is a topic that we can and must do better at ... no malnourished patient should ever have elective surgery without having a nutrition assessment done" This piece is presented in two parts; this is part 1. Using perioperative nutrition to optimize our patients outcomes; data shows us that nutrition therapy or nutrition optimization is literally life saving. Anyone who uses evidence as their guide know it has to be part of their practice. Enhanced Recovery After surgery, sometimes called "fast track surgery" is about ensuring we apply the best information we...

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Monitoring and management of neuromuscular blockade | EBPOM Chicago show art Monitoring and management of neuromuscular blockade | EBPOM Chicago

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"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...

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Redefining Hypotension based on Real-time Cerebral Autoregulation Monitoring | EBPOM Chicago show art Redefining Hypotension based on Real-time Cerebral Autoregulation Monitoring | EBPOM Chicago

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"If you want to take population based data, and define hypotension, you'll be right for the majority of our average patients, but not for all patients and it appears that the amount of time we spend below the lower limit of autoregulation has meaning for patient outcomes" Starting from the origins of blood pressure monitoring, via the father of neurosurgery endocrinology, Harvey Cushing, through to the current debate as to what exactly constitutes hypotension this piece is an important part of a longstanding discussion here on TopMedTalk. How and why does hypotension occur and what is the...

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EBPOM London 2020 | Functional Assesment show art EBPOM London 2020 | Functional Assesment

TopMedTalk

"Perhaps assessing functional performance is something that we've overlooked in medicine" This piece is about the role of functional assessment and status in perioperative medicine. The Duke Activity Status Index (DASI) can be found here: The Mini Cog assessment is here: The video resources mentioned in the piece are here: Presented by Daniel Conway, Consultant in Anaesthesia and Critical Care, Group Lead for Perioperative Medicine, Manchester Royal Infirmary, UK and Chair of the Manchester Perioperative Medicine Society.

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Essential COVID knowledge; Dr. Manuel Ignacio Monge García | COVID 19 show art Essential COVID knowledge; Dr. Manuel Ignacio Monge García | COVID 19

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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...

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New treatments for Post Operative Nausea and Vomiting | TopMedTalk show art New treatments for Post Operative Nausea and Vomiting | TopMedTalk

TopMedTalk

This piece gives us a look at some of the latest thinking on Post Operative Nausea and Vomiting (PONV). It includes a discussion about Amisulpride and discusses new, yet to be published, consensus guidelines for PONV. The original guidelines are here: Also, you may like to check out the details of this paper here: Amisulpride: A New Dopamine Antagonist for Treatment of Postoperative Nausea and Vomiting Presented by Desiree Chappell and Monty Mythen with their guest Tong Joo (TJ) Gan, Professor and Chairman at Stoney Brook in New York. --- Like this, want more? Check out TJ Gan's masterful...

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Practical tips for preoperative risk assessment | Dingle Highlight show art Practical tips for preoperative risk assessment | Dingle Highlight

TopMedTalk

"Some practical tips you can take away and implement in your hospital..." In the UK there is a legal imperative to minimalise and individualise risk now but it's widely understood to be helpful if you want to provide better value and patient outcomes. How can risks be identified and minimised? How can these risks then help to provide better quality shared decision making? How can plan a perioperative pathway tailored to these needs? Presented by Ramani Moonsinghe, Professor of Perioperative Medicine at University College London (UCL). IMPORTANT NOTE: We discuss "The Montgomery Case" in more...

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Critical care for the very elderly patient | Dingle Highlight show art Critical care for the very elderly patient | Dingle Highlight

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"I did a study back in 2002 where I was able to count a grand total of forty patients above the age of eighty in our (Intensive Care Unit) ICU and our (High Dependency Unit) HDU, nowadays I'd count close enough to a hundred and sixty" How do we refine our diagnostic tools? How can teaching in this area help to save lives? Should you consider a 'geriatric intensive care unit'? Is this an area where true perioperative practice and surgery is a guarantee we can immediately see improvement in an institution? Presented by Dr Brian Marsh, Anaesthesia, Critical Care Medicine, Extracorporeal Life...

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Brain Health: Frailty, Delirium and Post-operative cognitive dysfunction Part 2 | Chicago 2020 show art Brain Health: Frailty, Delirium and Post-operative cognitive dysfunction Part 2 | Chicago 2020

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This piece gets deep into a much needed discussion regarding frailty, delirium, post-operative cognitive dysfunction and brain health. Noted as one of the highlights of the year in our recent holiday specials and previously only available to attendees to the incredibly successful EBPOM Chicago 2020; go to www.ebpom.org now for more details on forthcoming events and special offers now. This piece is part two of two. This piece gets a mention "End of life decision planning in the perioperative setting: the elephant in the room?" The Global Council on Brain Health is here on the American...

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Brain Health: Frailty, Delirium and Post-operative cognitive dysfunction Part 1 | Chicago 2020 show art Brain Health: Frailty, Delirium and Post-operative cognitive dysfunction Part 1 | Chicago 2020

TopMedTalk

This piece gets deep into a much needed discussion regarding frailty, delirium, post-operative cognitive dysfunction and brain health. Noted as one of the highlights of the year in our recent holiday specials and previously only available to attendees to the incredibly successful EBPOM Chicago 2020; go to now for more details on forthcoming events and special offers. This piece gets a mention "End of life decision planning in the perioperative setting: the elephant in the room?" The Global Council on Brain Health is here on the American Association of Retired People's website: This is part...

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More Episodes

What can practitioners do to preoperatively screen for signs that their patients may have issues with post operative delirium?

How do we get patients fit for surgery, particularly as regards delirium? Can you build up mental resilience in the run up to an operation, do suggestions that puzzles and mental activity such as sudoku and a good crossword help have any evidence behind them?

This piece features Monty Mythen and Desiree Chappell in conversation with Dan Cole, professor of clinical anesthesiology at the David Geffen School of Medicine, University of California, Los Angeles and former president of the American Society of Anesthesiologists (ASA).