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Periop Coach 5.03 | Assessing the risk of delirium

TopMedTalk

Release Date: 02/24/2020

The Future of Prehabilitation The Future of Prehabilitation "Standardisation of definitions and outcomes" | EBPOM 2020 London

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"The main challenge around the variability in the perioperative period is nomenclature, definitions and standardized endpoints. Well designed and well conducted randomized control trials determine effectiveness to an unbiased comparison of outcomes, events, or endpoints between intervention groups". If data is destiny it is to this that we must look if we want to understand what the future may hold for prehabilitation. This piece takes a pragmatic approach toward the task of ensuring information and datasets are widely applicable, as free from bias as possible and ultimately standardised by...

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Getting Getting "fit for surgery" | EBPOM 2020 London

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"In this session, we're going to talk about the importance of fitness, frailty, function and perioperative medicine." Fitness, frailty and function are overlapping concepts. In the UK, about quarter of patients will be over the age of 65 by 2034. As patients age they may develop comorbidities. These factors combine to present a unique opportunity for the perioperative physician; fitness increases the chances of a positive outcome, time to ensure every patient is "fit for surgery". The Making Every Contact Count (MECC) campaign is here: Presented by Denny Levett, Professor in Perioperative...

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

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

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"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 2. 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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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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Models of Prehabilitation in Greater Manchester | EBPOM 2020 London show art Models of Prehabilitation in Greater Manchester | EBPOM 2020 London

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It's widely understood that high value care during, before and immediately after surgery is optimal whereas poor quality care in the perioperative period produces long term difficulties which are compounded by the acute stresses produced during and immediately after a procedure. This talk covers three main areas; surgical care for patients in Greater Manchester, "ERAS+"; prehabilitation for cancer, for the population of Greater Manchester; how Manchester has supported patients during the time of COVID19. This piece is mentioned in the introduction and serves as a useful compliment to the talk,...

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Perioperative team: a surgeon’s view | EBPOM London 2020 show art Perioperative team: a surgeon’s view | EBPOM London 2020

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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...

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Introduction to the Pathophysiology of COVID 19 | Dingle 2020 show art Introduction to the Pathophysiology of COVID 19 | Dingle 2020

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This piece is essential listening for any medical practitioner. The pathophysiology of COVID 19 is now being understood, although there are still a number of outstanding questions. This piece attempts to answer those questions; where does it come from, what do we know about it now, what would we like to know about it in the future? Why is the disease more pronounced in men, how come obesity seems to be a factor, what's the mechanism which leaves children less at risk than adults and senior citizens? This piece is a standout part of Evidence Based Perioperative Medicine's (EBPOM) Dingle 2020...

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Depth of anaesthesia and long term outcomes | Dingle 2020 show art Depth of anaesthesia and long term outcomes | Dingle 2020

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"More than 300 million patients have surgery annually worldwide and an increasing proportion of them are elderly and at risk of perioperative adverse events. There's very few proven primary or secondary prevention measures, and the resources for monitoring and trading complications are inadequate. So - more action is required". This piece looks at the evidence as regards perioperative outcomes for the elderly, depth of anesthesia and mortality. Also, what's the latest on depth of anesthesia and delirium? Presented by Kate Leslie, Honorary Professor, Monash University, Melbourne, VIC,...

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The Changes that Change Culture - panel discussion | EBPOM Chicago show art The Changes that Change Culture - panel discussion | EBPOM Chicago

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This panel discussion covers essential ground for any institution that is trying to make real and lasting change. What do we need to know? What do our patients need to know? Who is responsible for questions of safety? How important are checklists? What about "patient advocates"? Presented by Sol Aronson with Mike Ramsey, Chair of the department of Anesthesia and pain management at the Baylor University Medical Center in Dallas and Board Chair of the Patient Safety Movement Foundation, Lee Fleisher, CMO and director for the Center for Clinical Standards and Quality for the centers of Medicare...

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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).