TopMedTalk
TopMedTalk for the latest medical news surrounding Anaesthesia, Perioperative Care and Enhanced Recovery. Live updates from conferences; Journal Club; Techno Talk and Hot-Topic podcasts. Continuing Medical Education (CME) on the go
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ANES19 | Alexander Hannenberg, Kris Torgeson
10/21/2019
ANES19 | Alexander Hannenberg, Kris Torgeson
The TopMedTalk team are live from Anesthesiology 2019 at the Orange County Convention Center in Orlando. With over 14,000 delegates, clinicians, thought leaders and professionals, it's the largest gathering of Anesthesiologists and Anesthesia providers in the world. Check out the www.topmedtalk.com website now to hear live audio, while you are there remember to subscribe for updates so you can always be one step ahead of the crowd. Also, if you fancy watching the show as it happens go to our Twitter feed www.twitter.com/topmedtalk to see the team in action. Alongside some reflections on the American Society of Anesthesiologists this piece is focused upon a fascinating foundation, Lifebox, the only NGO devoted to safer surgery and anesthesia in low-resource countries. Find out more here: https://www.lifebox.org Presented by Desiree Chappell with Sol Aronson and their guest Alexander Hannenberg, M.D. Senior Research Scientist, Ariadne Labs; Principal Consultant, ORDx&Rx Surgical Safety Solutions, 2010 president of the American Society of Anesthesiologists and recently served as its Chief Quality Officer. They are joined also by Kris Torgeson, Global CEO, Lifebox Foundation.
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ANES19 | Andrew Shaw
10/21/2019
ANES19 | Andrew Shaw
The TopMedTalk team are live from Anesthesiology 2019 at the Orange County Convention Center in Orlando. With over 14,000 delegates, clinicians, thought leaders and professionals, it's the largest gathering of Anesthesiologists and Anesthesia providers in the world. Check out the www.topmedtalk.com website now to hear live audio, while you are there remember to subscribe for updates so you can always be one step ahead of the crowd. Also, if you fancy watching the show as it happens go to our Twitter feed www.twitter.com/topmedtalk to see the team in action. This piece focuses upon the Perioperative Quality Improvement Initiative (POQI) and perioperative hypotension. Checkout the POQI website here: http://poqi.org/ Presented by Desiree Chappell and Monty Mythen with their guest Andrew Shaw, Chairman, Department of Anesthesiology and Pain Medicine at The University of Alberta, Edmonton, Alberta and Zone Clinical Department Head for Anesthesia, Alberta Health Services Edmonton Zone. He is also a Fellow of the Royal College of Anaesthetists (UK), the American College of Critical Care Medicine and the Faculty of Intensive Care Medicine (UK). -- Like this, want more? Find out more about POQI here: "Desiree's Roundtable | What is the Perioperative Medicine Summit?" https://www.topmedtalk.com/desirees-roundtable-what-is-the-perioperative-medicine-summit/ For more regarding the papers published by POQI, referenced in this piece, go here: "Sunday Special | Blood Pressure" https://www.topmedtalk.com/sunday-special-blood-pressure/ Also, if you enjoyed Andrew Shaw's take on these issues go listen to this fascinating conversation: "Desiree's Roundtable | Fluids in the 2020's" https://www.topmedtalk.com/desirees-roundtable-fluids-in-the-2020s/
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ANES19 | Michael Scott
10/21/2019
ANES19 | Michael Scott
The TopMedTalk team are live from Anesthesiology 2019 at the Orange County Convention Center in Orlando. With over 14,000 delegates, clinicians, thought leaders and professionals, it's the largest gathering of Anesthesiologists and Anesthesia providers in the world. Check out the www.topmedtalk.com website now to hear live audio, while you are there remember to subscribe for updates so you can always be one step ahead of the crowd. Also, if you fancy watching the show as it happens go to our Twitter feed www.twitter.com/topmedtalk to see the team in action. This podcast is about new developments in ERAS and perioperative haemodynamic management. Find out how new technologies, techniques and information are being applied in this piece. Presented by Desiree Chappell and Monty Mythen with their guest Michael Scott, Professor and Division Director, Critical Care Anesthesiology- Virginia Commonwealth University -- Like this, want more? If you enjoyed the insights from Michael Scott in this piece you can hear more here: https://www.topmedtalk.com/asa-2018-san-francisco-optimising-the-perioperative-patient/
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ANES19 | Desiree Chappell, Monty Mythen and Sol Aronson
10/21/2019
ANES19 | Desiree Chappell, Monty Mythen and Sol Aronson
The TopMedTalk team are live from Anesthesiology 2019 at the Orange County Convention Center in Orlando. With over 14,000 delegates, clinicians, thought leaders and professionals, it's the largest gathering of Anesthesiologists and Anesthesia providers in the world. Check out the www.topmedtalk.com website now to hear live audio, while you are there remember to subscribe for updates so you can always be one step ahead of the crowd. Also, if you fancy watching the show as it happens go to our Twitter feed www.twitter.com/topmedtalk to see the team in action. A look ahead to the shows you can expect as our coverage continues. We also congratulate our Editor in Chief who has won a prestegious award. Discussion then moves towards the ongoing development of AI and "Alpha Zero". Presented by Desiree Chappell with Monty Mythen, TopMedTalk's Editor in Chief and Sol Aronson, a tenured professor at Duke University and Executive Vice Chairman in the Department of Anesthesiology. -- Like this, want more? Hugh Montgomery presented an excellent piece for TopMedTalk here: https://www.topmedtalk.com/sunday-special-nasogastric-feeding-2/ President Clinton's appearance on TopMedTalk is here: https://www.topmedtalk.com/sunday-special-bill-clinton-at-the-world-patient-safety-science-technology-summit/
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ANES19 | Jeff Simmons
10/20/2019
ANES19 | Jeff Simmons
The TopMedTalk team are live from Anesthesiology 2019 at the Orange County Convention Center in Orlando. With over 14,000 delegates, clinicians, thought leaders and professionals, it's the largest gathering of Anesthesiologists and Anesthesia providers in the world. Check out the www.topmedtalk.com website now to hear live audio, while you are there remember to subscribe for updates so you can always be one step ahead of the crowd. Also, if you fancy watching the show as it happens go to our Twitter feed www.twitter.com/topmedtalk to see the team in action. This piece focuses on the mission to advocate and apply prehabilitation, pre-optimisation and enhanced recovery. Defined here as "good public health [...] with the crucible of surgery". How do we do that in a way that both patients and front line providers understand the value of it? Can this message help to allow for delays in surgery? Also, how do we take our message to social media, specifically Twitter? Listen in for some excellent tips. -- Like this, want more? The "triple aim for populations" mentioned in this piece is expanded upon here: https://www.topmedtalk.com/ebpom-usa-chicago-2018-wrong-surgery-or-wrong-patient/
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ANES19 | Dane Grenda and Noreen Tiangco
10/20/2019
ANES19 | Dane Grenda and Noreen Tiangco
The TopMedTalk team are live from Anesthesiology 2019 at the Orange County Convention Center in Orlando. With over 14,000 delegates, clinicians, thought leaders and professionals, it's the largest gathering of Anesthesiologists and Anesthesia providers in the world. Check out the www.topmedtalk.com website now to hear live audio, while you are there remember to subscribe for updates so you can always be one step ahead of the crowd. Also, if you fancy watching the show as it happens go to our Twitter feed www.twitter.com/topmedtalk to see the team in action. This piece is a chance to hear from a couple of Temple University residents who presented on two different cases; the first being a critical care case in the ICU involving acute respiratory distress and the second involving a case of surgery for a pheochromocytoma in a patient with neurofibromatosis type 1 and severe pulmonary hypertension and right ventricular failure. Presented by Desiree Chappell with Mike Grocott and their guests Dane Grenda and Noreen Tiangco, Residents at Temple University Hospital. -- Like this, want more? We reference this podcast here: https://www.topmedtalk.com/sca-poster-presenters/
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ANES19 | Prehabilitation with Mike Grocott
10/20/2019
ANES19 | Prehabilitation with Mike Grocott
The TopMedTalk team are live from Anesthesiology 2019 at the Orange County Convention Center in Orlando. With over 14,000 delegates, clinicians, thought leaders and professionals, it's the largest gathering of Anesthesiologists and Anesthesia providers in the world. Check out the www.topmedtalk.com website now to hear live audio, while you are there remember to subscribe for updates so you can always be one step ahead of the crowd. Also, if you fancy watching the show as it happens go to our Twitter feed www.twitter.com/topmedtalk to see the team in action. This piece tackles "prehabilitation", TopMedTalk's word of the year. What is it, why is it so important, who is doing it and why are some people reticent about something that is so obviously good for their health? Furthermore, what are the transatlantic nuances to this debate? Presented by Desiree Chappell with Sol Aronson, tenured professor at Duke University and Executive Vice Chairman in the Department of Anesthesiology, and their guest Mike Grocott, Professor of Anaesthesia and critical care at the University of Southampton. -- Like this, want more? Sol Aronson's excellent talk "EBPOM 2018| Perioperative medicine is Population Health Management" is here: https://www.topmedtalk.com/ebpom-2018-perioperative-medicine-is-population-health-management/ And Mike Grocott co-chair's a gripping debate about prehabilitation, "EBPOM 2019 | System wide change for prehabilitation", is here: https://www.topmedtalk.com/ebpom-2019-system-wide-change-for-prehabilitation/
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TopMedTalks to ... | Sasha Shillcutt
10/19/2019
TopMedTalks to ... | Sasha Shillcutt
--- 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 ---
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TopMedTalks to... | Lee Fleisher and Ross Kerridge
10/18/2019
TopMedTalks to... | Lee Fleisher and Ross Kerridge
--- IF YOU WANT TO HEAR THE FULL SERIES OF EDITOR'S PICKS YOU MUST SUBSCRIBE TO OUR NEWSLETTER ON www.topmedtalk.com NOW --- Is it fair to say that prehabilitation is the new direction for practitioners of Enhanced Recovery After Surgery (ERAS)? Discussion expands into patient awareness initiatives; The Macmillan Cancer Support, Principles and guidance for prehabilitation guide mentioned is here: https://www.macmillan.org.uk/about-us/health-professionals/resources/practical-tools-for-professionals/prehabilitation.html Age care naturally follows as the roundtable discussion continues. This piece gives a truly pan-national perspective with informed comment from prominent perioperative opinion leaders from The UK, Australia and America. How do those different systems work and what can they each learn from the others? The journal article mentioned in this piece is here: https://jamanetwork.com/journals/jamasurgery/fullarticle/2732511 Presented by Desiree Chappell with Monty Mythen and Lee A. Fleisher, Professor and Chair of Anesthesiology and Critical Care, University of Pennsylvania and Ross Kerridge, John Hunter Hospital, Newcastle, Australia, often cited as 'the father of Modern Perioperative Medicine'. --- IF YOU WANT TO HEAR THE FULL SERIES OF EDITOR'S PICKS YOU MUST SUBSCRIBE TO OUR NEWSLETTER ON www.topmedtalk.com NOW ---
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EBPOM 2019 | Overview of perioperative smoking cessation
10/18/2019
EBPOM 2019 | Overview of perioperative smoking cessation
Smoking is bad for you, there's little debate about that, even among users of the drug. However, further to the widely known consequences, the bottom line in the perioperative period is that smokers are 40% more likely to die after major surgery. Do patients also know this? Tissue healing, increased risk of infection and increased possiblities of complications with the anaesthetic; with these risks in mind how do we cut through the ubiquitous, but often ignored, government health risk messaging and get patients to understand the increased risk for those undergoing surgery? How do we use smoking cessation techniques in the perioperative setting? How do we manage to start, ideally, six weeks before surgery? What is the latest thinking on the neuro psychiatric consequences of smoking cessation? How useful is the Fagerstrom test of nicotine dependence? What about "vaping", is it better than smoking from a perioperative perspective? Presented by David Yates, Consultant in Anaesthesia and Critical Care Medicine at York Teaching Hospital, set up one of the UK’s first Perioperative Medicine Services in York, Anaesthesia, Perioperative Medicine and Pain Clinical Lead for the Yorkshire & Humber Comprehensive Research Network.
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Periop SIG18 | Perioperative Evaluation of the Cancer Patient
10/17/2019
Periop SIG18 | Perioperative Evaluation of the Cancer Patient
Cancer continues to present a seirous challenge to health care practitioners, particularly with elderly patients. Operations on cancer patients can occur for a variety of reasons, how do we ensure we make decisions that are right for them? Often cancer surgery is both urgent and emergent; the question of 'how long do we have to prepare' is paramount. How do we get patients to a surgical option that may be curative? How do we deal wirth "deconditioned" patients who have been subjected to difficult treatments as part of their cancer care? What are immune checkpoint inhibitors? What is 'targeted chemotherapy'? What are the pulmonary side effects of chemotherapy? Furthermore who do we deal with anemia in cancer Patients? Finally the talk focuses upon post operative care. The fuller version of this talk is supported by slides which you can see here: http://www.anzca.edu.au/documents/01-sunil-sahai_periop-evaluation-of-cancer-patient.pdf Presented by Sunil K. Sahai, MD, FAAP, FACP, Co-Director, The PeriOperative Evaluation & Management Center Section Chief & Professor of Medicine, Section of Consultative Medicine, Department of General Internal Medicine, MD Anderson Cancer Centre. -- Brought to you by the Perioperative Medicine Special Interest Group (SIG) in association with the Australian and New Zealand Society for Geriatric Medicine and the Internal Medicine Society of Australia and New Zealand at the 7th annual Australasian Symposium of Perioperative Medicine. The Perioperative Medicine Special Interest Group (SIG) has three aims; improve patient safety and outcomes, share knowledge and collaborate with specialty groups, develop the specialty of perioperative medicine with various craft groups. For more information follow this link here: http://www.anzca.edu.au/fellows/special-interest-groups/perioperative-medicine
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EBPOM Highlight | Improving quality, panel discussion
10/16/2019
EBPOM Highlight | Improving quality, panel discussion
Can you teach people to be leaders? Should the we be scared of using fear and greed as motivators? Do practitioners sometimes retain the right to clinical freedom to a degree that may not work in the interests of the patient? Can open and transparant institutions and practices exist without provoking a 'culture of blame'? Should risk scoring and funcitonal assesments be used for patients with aortic aneurysms? Featuring; Dr Ramani Moonesinghe, Professor of Perioperative Medicine at University College London (UCL), Mark Hamilton, Consultant and Honorary Senior Lecturer in Anaesthesia & Critical Care Medicine, clinical lead for the Perioperative Assessment & Planning Unit, at St. George's Hospital and Medical School, member of the Surgical Outcomes Resource Centre at UCL, Co-Director of Evidence Based Perioperative Medicine (EBPOM), Editor in Chief of Perioperative Medicine, he also chairs the System Resilience Group, the Finance and Performance Committee and is a member of the Quality Committee and Carolyn Johnston, consultant Anaesthetist in St Georges hospital in London.
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Desiree's Roundtable | The Global Council on Brain Health
10/15/2019
Desiree's Roundtable | The Global Council on Brain Health
The American Associaton of Retired People (AARP), an organisation with a membership almost equal to the entire voting population of the United Kingdom, are focusing on brain health, in response to the demands of their members. Further conversation includes how practitioners both explain the risks of surgery and also calm possible misunderstandings or fears regarding them, as well as wider reflections on 'The Brain Health Initiative'. Presented by Desiree Chappell with Mike Grocott and their guests Lee Fleisher, Professor of Anesthesiology and Critical Care, University of Pennsylvania and Sarah Lock, Senior Vice President for policy at the American Association of Retired People (AARP) and the director of 'The Global Council on Brain Health'.
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EBPOM 2019 | Multi-modal Prehabilitation
10/14/2019
EBPOM 2019 | Multi-modal Prehabilitation
This panel discussion includes questions such as: In a prehabilitation service what screening tools should we use to assess nutritional risk? What tools are there related to patient self management? What advice would you give a patient about cannabis smoking cessation? Should denial of surgical procedures be used as a motivator for lifestyle change? Can the questions used in interventions sometimes be open to misinterpretation by patients? How do we assess and treat sleep disorders? If not a psychologist, what team members might handle psychological behaviour change? Does immunonutrition work? Are there sensitive approaches to addressing weight loss, physical activity and diet that the panel reccomend? Panel discussion chaired by Sandy Jack and Daniel Santa Mina, featuring, David Yates, Consultant in Anaesthesia and Critical Care Medicine at York Teaching Hospital, Chloe Grimmett, National Institute of Health Research (NIHR) post-doctoral Research Fellow and Senior Research Fellow for the Macmillan Survivorship Research Group at the University of Southampton, Chris Snowden, Consultant Anaesthetist, Freeman Hospital, Newcastle upon Tyne and Senior lecturer at the Institute of Cellular Medicine at Newcastle University, Chelsia Gillis, Registered Dietitian, Canadian Vanier Scholar, and PhD Candidate in Epidemiology at the University of Calgary, Canada, she is leading the first prehabilitation program for colorectal surgery in Alberta.
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Sunday Special | How should we teach perioperative medicine?
10/13/2019
Sunday Special | How should we teach perioperative medicine?
How do we develop an agreed curriculum that speaks to what perioperative medicine should be? Once that's in place, how should it be overseen? What sort of official endorsements would it need? Running in parallel to this are the MOOCs - Massive Online Open Courses - that are being developed. Developing a broad knowledge of the process is distinct from being a perioperative specialist, how do we develop that even further - without developing a schism? These complicated topics are discussed alongside more detail regarding the future of teaching this speciality. Presented by Monty Mythen and Mike Grocott with their guests; Joel Symmons, Staff Consultant Anaesthetist in the Department of Anaesthesia and Perioperative Medicine at the Alfred Hospital, Perioperative Medicine Short Course Convenor, and a Senior Lecturer in Anaesthesia at Monash University, and Paul Myles, Head of Alfred Health's and Monash University's Department of Anaesthesia and Perioperative Medicine.
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Dingle | TopMedTalks to... Desiree Chappell
10/12/2019
Dingle | TopMedTalks to... Desiree Chappell
Coming from this year's "21st Current Controversies in Anaesthesia & Peri-Operative Medicine and SIAA Autumn Congress" at the Dingle Skellig Hotel, Ireland, this podcast gives you a chance to learn more about our lead presenter. What have been the highlights of her time working with the TopMedTalk team so far? Why did she become so compelled to advocate Enhanced Recovery and Perioperative Medicine? Also, what is the conference like and why do so many people rave about Dingle, Ireland? Presented by Vicki Morton, Doctor of Nursing Practice and Director of Clinical and Quality Outcomes at Providence Anesthesiology Associates with her guest Desiree Chappell, lead presenter for TopMedTalk.
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Periop SIG18 | Minimising risk, panel discussion
10/11/2019
Periop SIG18 | Minimising risk, panel discussion
What should we think about issues regarding the Perioperative Ischemic Evaluation Study (POISE)? Is it time to treat men and women equally when it comes to haemoglobin levels? What advice should we give to clinicians who are managing change at a hospital? What should our approach to iron be and can interventions make a real difference? Featuring; Bruce Waxman, Adjunct Associate Professor (Honorary) at Monash University Dept. of Surgery School of Clinical Sciences, Monash Health and Chief Medical Officer, Bass Coast Health, Wonthaggi Hospital, South Gippsland Coast, Victoria, Kate Burbury, Associate Professor, Deputy Chief Medical Officer, Peter MacCallum Cancer Centre and Toby Richards, Academic Professor of Surgery, Vascular Surgeon, University Western Australia.
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EBPOM Highlight | Prehabilitation
10/10/2019
EBPOM Highlight | Prehabilitation
Prehabilitation represents a real opportunity for practitioners to exploit a 'teachable moment' and realise long term positive behavioural changes. Making patients 'partners in their own care' is an essential part of this, with prehabilitation they have a chance to work with practitioners to increase their functional reserve, increase their rate of recovery and avoid difficult long term outcomes. The longer this partnership lasts the more effective it is. In this respect, how do we manage to emphasise the importance of early access to patients? The evidence of the benefits of exercise is overwhelming, even just two weeks of activity can make a huge difference, how do we articulate this to patients? How much focus should there be on nutrition? Presented by Denny Levett, Professor in Perioperative Medicine and Critical Care, Consultant in Perioperative Medicine, Southampton University Hospital NHS Foundation trust (UHS), President of the Perioperative Exercise Testing and Training Society (POETTS).
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Desiree's Roundtable | Adverse outcomes and patient optimisation
10/08/2019
Desiree's Roundtable | Adverse outcomes and patient optimisation
Adverse outcomes, we all know they happen but how do we handle them, record them and avoid them in the first place? The discussion then moves to (Patient Recorded Outcome Measures) PROMS. Patient optimisation is then discussed. Exercise, could it be so effective because it works as an anti inflammatory? A deep dive into the research on that is contained in this conversation. The RELIEF trial is discussed as the team get into a discussion about what a patient sees as a good outcome. How do we communicate the risks, possible benefits and limitations, of surgery to patients? The "P.R.E.P." website mentioned is here: https://www.prepwell.co.uk/ Desiree Chappell and Joff Lacey are presenting with their guests Dr Mark Edwards, Consultant in Anaesthesia and Perioperative Medicine at The University Hospital Southampton NHS Foundation Trust and Professor Gerard Danjoux, Consultant in Anaesthesia and Sleep Medicine at South Tees Hospitals NHS Foundation Trust.
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EBPOM 2019 | Prehab trials; international study
10/07/2019
EBPOM 2019 | Prehab trials; international study
The International PREHAB trial. This short piece explains the trial's protocol and the scope of the study. Presented by Charlotte Molenaar, PhD Candidate, multimodal prehabilitation in colorectal cancer care, BIJ Maxima Medisch Centrum, Coordinator of the international PREHAB trial.
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EBPOM 2019 | Methadone - the overlooked Opiate?
10/06/2019
EBPOM 2019 | Methadone - the overlooked Opiate?
Is methadone "the opioid sparing opioid"? This talk looks at where we are at as regards opioids, in the shadow of a national crisis for the USA; is it possible that methapone might offer us answers? This piece looks at the idea that methadone might be a way to deliver a better more effective, multimodal, opioid sparing, analgesia with a reduced chance of a post operative repiratory events and decreased post-operative pain. This talk is complimented well by our consersation, live from the conference, which you can find here: https://www.topmedtalk.com/prehab-periop-world-congress-evan-kharasch/ The World Health Organisation's analgesic ladder is here: https://www.who.int/cancer/palliative/painladder/en/ Presented by Evan Kharasch, MD, PhD, Professor and Vice Chair for Innovation in the Department of Anesthesiology at Duke University, Director of Academic Entrepreneurship, Duke University School of Medicine.
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TopMedTalks to ... | Dan Cole
10/05/2019
TopMedTalks to ... | Dan Cole
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 with regard to delirium? Can you build up mental resilience in the run up to an operation? Do puzzles and mental activity - such as sudoku or a good crossword - help and is there any evidence of that? Should preoperative sedation be, generally speaking, withheld from people over 60? How do we explain the risks of this procedure to those who need it? Also - are we seeing a rise in post operative delirium and if so why? Finally - what should we make of the "triple low" story where patients with low blood pressure, a low bispectral index, and a low minimum alveolar concentration of volatile anesthesia are said to face an increased risk of adverse outcomes? 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).
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EBPOM 2019 | Moving as medicine
10/04/2019
EBPOM 2019 | Moving as medicine
"Moving as medicine; is it the most underused but proven health promotion and healthcare practice?" Prehabilitation and population health naturally walk alongside each other. Learn here how Sport England's ambitious strategy to reduce inactivity and improve the nation’s physical and mental health is connected to prehabilitation and Enhanced Recovery After Surgery. Should patients be seeking expert condition specific advice before becoming active? How do we improve the quality of conversations between practitioner and patient? The excellent Moving Medicine website can be found here: http://movingmedicine.ac.uk/ Presented by Sarah Ruane, Sport England’s national lead for health, she joined in January 2016 from local government where she oversaw public health, leisure and cultural services.
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Periop SIG18 | Perioperative Anticoagulation
10/03/2019
Periop SIG18 | Perioperative Anticoagulation
Thrombosis is the commonest cause of death and disability worldwide, antithrombotic therapy is incredibly beneficial but it promotes bleeding; how then do we manage anticoagulation in the peri-operative period? How do you assess a patient's risk of bleeding? When should you consider bridging? What are we to think as regards the current status of asprin? How do we approach dual anti platelet therapy (DAPT) and does it promote more bleeding? Lecture slides: http://www.anzca.edu.au/documents/03-harry-gibbs_periop-management-of-antiplatelet.pdf Presented by Harry Gibbs, FRACP, FCSANZ, The Alfred, Melbourne. -- Brought to you by the Perioperative Medicine Special Interest Group (SIG) in association with the Australian and New Zealand Society for Geriatric Medicine and the Internal Medicine Society of Australia and New Zealand at the 7th annual Australasian Symposium of Perioperative Medicine. The Perioperative Medicine Special Interest Group (SIG) has three aims; improve patient safety and outcomes, share knowledge and collaborate with specialty groups, develop the specialty of perioperative medicine with various craft groups. For more information follow this link here: http://www.anzca.edu.au/fellows/special-interest-groups/perioperative-medicine
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EBPOM Highlight | Panel; Best perioperative practice
10/02/2019
EBPOM Highlight | Panel; Best perioperative practice
This panel discussion includes questions on; the multidisciplinary aspect of perioperative medicine, the drop off in Enhanced Recovery that some institutions experience, how to lead and coach an institution into an enhanced recovery programme, outcome data, informed decision making, the importance of strategic flexibility and the importance of good shared decision making when resources are stretched. Chaired by Ramani Moonsinghe this piece features; Monty Mythen, Smiths Medical Professor of Anaesthesia and Critical Care, University College London; Chair, Evidence Based Perioperative Medicine (EBPOM), Founding Editor-in-Chief of Perioperative Medicine; Editorial Board British Journal of Anaesthesia; Founding Editor-in-Chief TopMedTalk; Founding Board Member Perioperative Quality Initiative (POQI); Fiona Walker, Cardiologist, trained in grown-up congenital heart disease (GUCH) and maternal cardiology in Toronto and at UCLH. She is the Service lead for GUCH (2005 – present) and head of the maternal cardiology programme at University College London Hospitals (UCLH); Jugdeep Dhesi, Clinical Lead, POPS and Consultant Geriatrician, Guys and St Thomas' NHS Trust.
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Desiree's Roundtable | Population health in a 'fee for service' environment.
10/01/2019
Desiree's Roundtable | Population health in a 'fee for service' environment.
How do you best work a pre-op clinic? Should they be places where you get your problems documented or where you get your problems 'fixed'? How do you convince your practice to optimise patients for life and not just 90 days? How do we encourage population health? How do we get round the fact that we're still in a 'fee for service world'? What is "PBPM"? Featuring 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.
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EBPOM 2019 | The Barcelona experience
09/30/2019
EBPOM 2019 | The Barcelona experience
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.
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EBPOM 2019 | Prehab trials; panel discussion
09/29/2019
EBPOM 2019 | Prehab trials; panel discussion
Is it still ethically viable to have a standard arm in a prehabilitation trial? Which allied health professionals supervises the exercise part of these trials? What are the biggest reasons for non-adherence to home based exercise programmes? How do you address a possible selection bias with candidates? What is the best time to follow up a study with these patients? Featuring; Krishna Moorthy Senior Lecturer, Consultant Surgeon, Imperial College London, Academic surgeon, with research interests in patient safety and quality of improvement in surgery, Co-lead of the PREPARE for surgery prehabilitation programme, BMJ Surgical Team of the year and Patient Participation awards 2017, Consultant Surgeon, BMI Healthcare, Consultant Surgeon the Wellington Hospital; 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; Suzanne Mcdonald, Research Associate at The University of Queensland (Australia), Visiting Researcher at Newcastle University (UK) and registered Chartered Health Psychologist; Charlotte Molenaar, PhD Candidate, multimodal prehabilitation in colorectal cancer care, BIJ Maxima Medisch Centrum, Coordinator of the international PREHAB trial; Professor Sandy Jack, PhD, Consultant Clinician Scientist in the Anaesthesia and Critical Care Research Unit at University Hospital Southampton NHS Foundation Trust, Southampton and NIHR Southampton Respiratory Biomedical Research Unit and Integrated Physiology and Critical Illness Group, Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Honorary Senior Lecturer at the University of Liverpool, University of Southampton and University College London; James Hernon, Consultant Colorectal Surgeon, Norfolk and Norwich University Hospital NHS Foundation Trust, Chair of the Anglia Cancer Colorectal Network, CO-CI for PREPARE ABC a NIHR HTA funded randomised clinical study.
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EBPOM 2019 | The Science of High Performance: Insights From Elite Sport
09/28/2019
EBPOM 2019 | The Science of High Performance: Insights From Elite Sport
Insights and perspectives on the science of prehabilitation from a very different angle. It's often said on TopMedTalk that preparing for an operation is not unlike getting ready for a marathon; how do the insights of professionals who work with elite sports men and women to ensure they are fully prepared to do their physical best, on the world stage? Also, what about the teamwork inherent in such activities as the pitstop of a formula one car? Athletes, coaches and a wide number of different experts come into play ensuring a multidisciplinary team converge with essentially the same end in sight as a perioperative prehabilitation team; optimum performance at a crucial time. Challenges are similar between the two disciplines; how do we foster a culture of learning and teamwork in a high pressure environment where the bottom line carries enormous life changing consequences? Regular listeners to TopMedTalk may recall the unofficial preamble to this talk, "Prehab Periop World Congress: Gerard Danjoux, Ken Van Someren": https://www.topmedtalk.com/prehab-periop-world-congress-gerard-danjoux-ken-van-someren/ Presented by Ken Van Someren, Director KvS Performance Ltd.
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EBPOM 2019 | Financial aspects of prehabilitation
09/27/2019
EBPOM 2019 | Financial aspects of prehabilitation
This piece presents the prehabilitation 'business case'; why it's important to care about costs, how outcomes and value based care can help and why money has to be important in healthcare. How do we convert health benefits and risk management into something which explains the financial bottom line? Can we really argue that a process which appears, at the point of practice, to take more time, resources and involve a shorter length of stay for patients, is actually cheaper for institutions in the long run and better value for patients? Is there in fact more than one 'business case' for a proper perioperative prehabilitation clinic at your practice? The Fit 4 Surgery website (Netherlands) is here: http://fit4surgery.nl/ Presented by Stefan van Rooijen, surgical resident in Maxima Medical Center, The Netherlands, lecturer at the first Health Innovation School (Ministry of Health, Welfare and Sport and Reshape innovation), Surgical resident, Department of Surgery at Maxima Medical Center (ANIOS).
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