POCAPALOOZA | Sydney: Education, education, education.
Release Date: 10/18/2020
"The people of Wales are particularly unfit", there is a high incidence of smoking, physical inactivity, and alcohol intake. Grim news from one angle but on the other hand it's a huge opportunity to make a massive difference in the prehabilitation stage of the perioperative process. Hear how cancer outcomes are being dramatically improved as a clear pathway of optimisation is rolled out. Presented by Rachael Barlow, National Lead, Enhanced Recovery, Prehabilitation and Optimisation, at Cardiff and Vale health board, Wales.info_outline EBPOM London 2020 | Guidance on prehabilitation for cancer
This piece looks at the most recent guidance regarding prehabilitation for cancer, developed and published in 2009 by Macmillan Cancer Care. Extremely well received across the UK, and internationally, here we look at the details and some context in terms of UK national policy. From an NHS England point of view the desire is to ensure that all patients and participants have personalized care embedded into everyday NHS services. Work around streamlining multidisciplinary team meetings for cancer include the opportunity to discuss the needs of people with cancer and the importance of preparing...info_outline AANA | How to "ACE" pediatric emergence!
Pediatric patients can present quite a challenge when emerging from anesthesia. Here we discuss ways to “ACE” your transition to PACU! “A”void Emergence Agitation, and discover the latest evidence about “C"riteria for “E”xtubation in this challenging population. How do the protocols and standard of care compare between the UK and US. What does the evidence tell us? Also, how is Enhanced Recovery After Surgery progressing in pediatrics? Presented by Desiree Chappell and Monty Mythen with their guest Kristin Henderson, DNAP, CRNA, CHSE, CPT, USAR Assistant Professor, Wake Forest...info_outline EBPOM 2020 London | Models of Prehabilitation in Greater Manchester
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,...info_outline EBPOM 2020 London | Screening assessment of nutritional fitness
What do we mean by "nutritionally fit" and why does it matter? How do we identify those most at risk in terms of screening and assessment and what's the difference between these two processes? How can we use screening and assessment to triage patients into care? Also, in the time of COVID19, are there ways we can perform some tasks related to these processes remotely? Presented by Steve Wooton, Senior Lecturer in Human Nutrition within Medicine at the University of Southampton.info_outline EBPOM 2020 London | The Future of Prehabilitation "Standardisation of definitions and outcomes"
"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...info_outline EBPOM 2020 London | Fit for surgery with Denny Levett
How important is it to screen patients and measure their fitness prior to surgery? What is exercise training in the preoperative period? There is a very clear relationship between physical fitness and mortality. Importantly, when we think of prehabilitation, or exercise training, it's good to remember that you get the greatest benefit in the most unfit patients, in terms of mortality reductions. The "pandemic ... of physical inactivity worldwide" is believed to cause more than 5 million deaths annually. The advantage of fitness in terms of predicting perioperative outcomes is it is an...info_outline Periop SIG | Ward Based postoperative care; where should we focus?
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...info_outline COVID 19 | Essential COVID knowledge; Dr. Manuel Ignacio Monge García.
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: 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...info_outline TopMedTalk | POQI 5 - Fluid Management
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: The Perioperative Quality Initiative (POQI) is a vital part of the process needed to more widely implement sensible practice which, using a clear evidence base, provides better value care with more positive outcomes for the patient. POQI continues to provide its work in an attempt to clarify fundamental concepts in perioperative...info_outline
"It also must start and end in primary care"
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.
And Perioperative Medicine for The Junior Clinician is available here: https://www.amazon.co.uk/Perioperative-Medicine-Junior-Clinician-Symons/dp/1118779169
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.