TopMedTalk

Leading medical conversation

Sunday Special | Enhanced Recovery After Surgery (ERAS) leadership 05/26/2019

Sunday Special | Enhanced Recovery After Surgery (ERAS) leadership 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. /episode/index/show/topmedtalk/id/8194241

TopMedTalks to ... | Paul Grant 05/25/2019

TopMedTalks to ... | Paul Grant This piece ploughs into some of the academic papers that have provoked discussion recently in the perioperative community. We discuss the following papers: Risk factors for opioid-induced respiratory depression in surgical patients: a systematic review and meta-analyses. https://www.ncbi.nlm.nih.gov/pubmed/30552274 Increased Postoperative Glucose Variability Is Associated with Adverse Outcomes Following Total Joint Arthroplasty. https://www.ncbi.nlm.nih.gov/pubmed/29975266 Effect of A1C and Glucose on Postoperative Mortality in Noncardiac and Cardiac Surgeries. https://www.ncbi.nlm.nih.gov/pubmed/29440113 Frailty as a Predictor of Death or New Disability After Surgery: A Prospective Cohort Study. https://www.ncbi.nlm.nih.gov/pubmed/30048320 Presented by Desiree Chappell and Monty Mythen with their guest Paul Grant, Hospitalist and Director of Perioperative and Consultant Medicine at the University of Michigan. /episode/index/show/topmedtalk/id/8915336

POET 3.04 | Is paternalism always bad? 05/24/2019

POET 3.04 | Is paternalism always bad? Shared decision making is key to any perioperative enhancement team, this piece is a fascinating debate between various interesting positions. For more on the (Perioperative Optimization of Senior Health) POSH clinic mentioned in this piece look here: https://medicine.duke.edu/divisions/geriatrics/patient-care/duke-perioperative-optimization-senior-health Presented by Monty Mythen with his guest Mike Grocott, Professor of Anaesthesia and Critical Care Medicine, University of Southampton and contributions from Lee Fleisher, Professor of Anesthesiology and Critical Care, University of Pennsylvania and Sol Aronson, tenured Professor at Duke University, Dr Tim Miller, Duke University and Dr Attilla Kett, St Peter's University Hospital at New Jersey. /episode/index/show/topmedtalk/id/9576185

SCA | Davinder Ramisingh 05/23/2019

SCA | Davinder Ramisingh Live from 'The Society of Cardiovascular Anesthesiologists' (SCA) annual conference, 2019, the TopMedTalk team takes you right to the heart of the 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 Davinder Ramsingh, Director of Research and Perioperative Ultrasound at Loma Linda University Medical Center, Department of Anesthesiology. /episode/index/show/topmedtalk/id/9897284

Anaesthesia 2019 | Fitter, Better, Sooner 05/23/2019

Anaesthesia 2019 | Fitter, Better, Sooner 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. The "Fitter, Better, Sooner" toolkit can be found here: https://www.rcoa.ac.uk/fitterbettersooner The excellent video we mention is here: https://www.youtube.com/watch?v=0NMHMX-nFgY Presented by Nick Margerrison with his guest Dr Hilary Swales, lead for Patient Information at The Royal College of Anaesthetists. /episode/index/show/topmedtalk/id/9881618

Periop Medicine SIG18 | Emergency laparotomy 05/23/2019

Periop Medicine SIG18 | Emergency laparotomy This piece is a chance to hear how and why an emergency laparotomy can work as part of the perioperative process. Ideally perioperative medicine involves preparation, consideration, shared decision making and 'enhanced recovery'; which of these elements can be incorporated into a procedure which is unplanned? Can your practice be adjusted to improve outcomes for patients who might have as little as a few hours before big decisions about their treatment and future are made? Presented by Michael Cox, Professor of Surgery, Nepean Hospital. /episode/index/show/topmedtalk/id/9757673

Anaesthesia 2019 | Rupert Pearse 05/22/2019

Anaesthesia 2019 | Rupert Pearse 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. You can find the OSIRIS website here: https://osiris-programme.org/ Presented by Monty Mythen with Mike Grocott, Professor of Anaesthesia and Critical Care Medicine, University of Southampton and Rupert Pearse, Professor of Intensive Care Medicine at Queen Mary, University of London. /episode/index/show/topmedtalk/id/9881117

Anaesthesia 2019 | Tim Cook and Paul Wischmeyer 05/22/2019

Anaesthesia 2019 | Tim Cook and Paul Wischmeyer 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. /episode/index/show/topmedtalk/id/9880871

Anaesthesia 2019 | Paul Wischmeyer 05/22/2019

Anaesthesia 2019 | Paul Wischmeyer 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. A powerful and wide ranging conversation with one of our most popular contributors. We mention this piece here, one of TopMedTalk's most downloaded podcasts: https://www.topmedtalk.com/topmedtalks-to-dr-paul-wischmeyer/ Presented by Monty Mythen with Paul Wischmeyer, Professor of the Department of Anesthesiology, Duke University. /episode/index/show/topmedtalk/id/9879770

EBPOM Highlight 1.25 | Pain Management to Enhance Recovery after joint replacements 05/22/2019

EBPOM Highlight 1.25 | Pain Management to Enhance Recovery after joint replacements "Pain strategies" - was originally streamed live from the Charles Sammons Cancer Center, Dallas, during EBPOM-USA 2019 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 Dr. Ryan Hanson, Anesthesiologist in Boston, Massachusetts, affiliated with Brigham and Women's Hospital, received his medical degree from Penn State College of Medicine. /episode/index/show/topmedtalk/id/9827207

Anaesthesia 2019 | The Centre for Perioperative Care (CPOC) 05/21/2019

Anaesthesia 2019 | The Centre for Perioperative Care (CPOC) 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. This piece focuses on The Centre for Perioperative Care. Presented by Monty Mythen and Mike Grocott with their guest David Selwyn, Deputy Medical Director at Nottingham University Hospitals NHS Trust and Director of The Centre for Perioperative Care (CPOC). /episode/index/show/topmedtalk/id/9864404

SCA | Poster presenters 05/21/2019

SCA | Poster presenters Live from 'The Society of Cardiovascular Anesthesiologists' (SCA) annual conference, 2019, the TopMedTalk team takes you right to the heart of the debate. Presented by Desiree Chappell with Sol Aronson, tenured Professor at Duke University and Executive Vice Chairman in the Department of Anesthesiology and their guests Robert and Shanari, poster presenters and residents at Temple University. /episode/index/show/topmedtalk/id/9864335

Anaesthesia 2019 | Live from the conference 05/21/2019

Anaesthesia 2019 | Live from the conference 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. The piece mentioned regarding developmental neurotoxicity is here: https://www.topmedtalk.com/anaesthesia-2019-developmental-neurotoxicity/ For lots more on the METS trial go here: https://www.topmedtalk.com/?s=mets Presented by Monty Mythen, TopMedTalk's Editor in Chief with Nick Margerrison, TopMedTalk producer. /episode/index/show/topmedtalk/id/9864092

SCA 2019 | Michael Eaton 05/21/2019

SCA 2019 | Michael Eaton Live from 'The Society of Cardiovascular Anesthesiologists' (SCA) annual conference, 2019; the TopMedTalk team takes you right to the heart of the debate. Presented by Desiree Chappell and Monty Mythen with Sol Aronson, tenured Professor at Duke University and Executive Vice Chairman in the Department of Anesthesiology and Michael Eaton, Professor and Chair of Anesthesiology and Perioperative Medicine at the University of Rochester, New York. /episode/index/show/topmedtalk/id/9863705

Desiree's Roundtable | One of the best career decisions I've made 05/21/2019

Desiree's Roundtable | One of the best career decisions I've made How does one go about becoming a Master of Perioperative Medicine? This piece takes a look at the growing movement which all TopMedTalk listeners are at the forefront of. Further debate covers, "NPO after midnight", getting buy in from the institution to practice perioperatively and keeping the momentum going after one leaves a conference. Presented by Desiree Chappell and Monty Mythen with their guests, Marc Koch President & CEO of Somnia Inc and Gregory Pato, internal medicine physician assistant, New York Presbyterian/Weill Cornell. /episode/index/show/topmedtalk/id/8914151

SCA 2019 | Blood pressure 05/20/2019

SCA 2019 | Blood pressure 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. /episode/index/show/topmedtalk/id/9852911

SCA 2019 | Are you burned out? 05/20/2019

SCA 2019 | Are you burned out? The TopMedTalk team bring you coverage of 'The Society of Cardiovascular Anesthesiologists' (SCA) annual conference, 2019. This piece focuses on the question of looking after yourself as a practitioner and interlinking into your team. 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/ /episode/index/show/topmedtalk/id/9852791

Anaesthesia 2019 | The Future of Anaesthesia 05/20/2019

Anaesthesia 2019 | The Future of Anaesthesia How will the profession evolve as the years pass? Change is inevitable and the direction of change is becoming clearer but how will we adapt to the new roles and requirements we can see coming towards us in the near future? Will Anaesthetists be able to tackle the leadership role which many expect to become commonplace? Also, what is the "technological singularity"? Should we be concerned about it? Finally, some thoughts on what it really means to work in healthcare, how are we different to the super computers we imagine doing our work in years to come? Presented by Joff Lacey with Mike Swart, Consultant in Anaesthesia and Critical Care Medicine at Torbay Hospital and advisor to the UK Department of Health for the Enhanced Recovery Programme. /episode/index/show/topmedtalk/id/9852248

Anaesthesia 2019 | Developmental neurotoxicity 05/20/2019

Anaesthesia 2019 | Developmental neurotoxicity This conversation covers one of the conference's talking points; developmental neurotoxicity. Can human infants exposed to anaesthesia early in their early development really be facing risks which we were previously unaware of? There's a lack of evidence at the moment but outcomes for young animals have raised concern. Given the complexities of human neurodevelopment how can such issues be reliably detected? Presented by Joff Lacey with his guest Hugh Hemmings Senior Associate Dean for Research, Professor and Chair of Anesthesiology at Weill Cornell Medicine. /episode/index/show/topmedtalk/id/9851807

Anaesthesia 2019 | It is all about the patient 05/20/2019

Anaesthesia 2019 | It is all about the patient TopMedTalk is at Anaesthesia 2019. It's one of the big events of the global perioperative calendar. Find out what the hot topics and big talking points are. What else can we expect to come from the conference this year? Presented by Dr Joff Lacey with his guest Mike Grocott, Professor of Anaesthesia and Critical Care Medicine, University of Southampton and Royal College of Anaesthetists Council Member. /episode/index/show/topmedtalk/id/9849896

Periop Coach 3.04 | Perioperative Fluid Management to Enhance Recovery After Surgery 05/20/2019

Periop Coach 3.04 | Perioperative Fluid Management to Enhance Recovery After Surgery Discussion initially focuses upon fluid management in the operating room. We then take a wider view as discussion moves to concerns about diabetic patients undergoing surgery. Presented by Monty Mythen with Desiree Chappell featuring their guests Mike Grocott, Professor of Anaesthesia and Critical Care Medicine, University of Southampton and Tim Miller, Associate Professor of Anaesthesiology from Duke University Medical Centre. The Henrik Kehlet piece mentioned in this episode is available here: http://topmedtalk.libsyn.com/asa-2018-san-francisco-exclusive-professor-henrik-kehlet /episode/index/show/topmedtalk/id/9354329

Sunday Special | Social media and the democratisation of education 05/19/2019

Sunday Special | Social media and the democratisation of education Twitter is ablaze with talk of the Society for Perioperative Assessment and Quality Improvement (SPAQI). How did they do it? This piece is a thought provoking discussion about new media and the consequences of our online world for medicine. 'The democratisation of education' is a phrase we've heard here on TopMedTalk in the past. How does direct access to information and experts in our field alter the state of play in the perioperative field? Desiree Chappell and Monty Mythen are presenting with their guest Avital O'Glasser, Assistant Professor of Medicine at OHSU, Oregon Health & Science University and member of the communications committee for SPAQI. If you enjoyed this, carry on listening with this piece here: Sunday Special | Social Media http://topmedtalk.libsyn.com/sunday-special-social-media /episode/index/show/topmedtalk/id/8914430

TopMedTalks to ... | Davinder Ramsingh 05/18/2019

TopMedTalks to ... | Davinder Ramsingh Most people are familiar with ultrasound these days, next to the stethoscope and thanks largely to baby photographs, it's one of the most frequent public facing technologies in medicine. New developments in transesophageal echocardiography have brought about huge advancements in its use as a technology; not to mention the incredible images now available from three dimensional echocardiography. As ultrasound becomes more available and more portable this conversation gives you an idea of where, when, why and how you can use this incredible tool. Is it really a piece of bedside assessment equipment which is about to become as ubiquitous as a doctor's thermometer? It's difficult not to get excited about the ability to take a quick look at a patient's cardiac function, at the bedside, with a handheld piece of kit. Scanning a patient's abdomen, seeing how to apply appropriate measures of care rapidly on the spot, these are just some of the advantages discussed in this piece. See more here: Acute Care and Perioperative Ultrasound Workshop Co-sponsored by the Departments of Anesthesiology at Loma Linda and UCLA Medical Centers. www.pocusededucation.com Evidence-Based Perioperative Ultrasound Educational Curriculum (created as a free, open-source, platform for point of care ultrasound education) www.foresightultrasound.com Professor Monty Mythen is presenting, with his guest, Davinder Ramsingh MD, Director of Research and Perioperative Ultrasound at Loma Linda University Medical Center - Dept. of Anesthesiology. /episode/index/show/topmedtalk/id/8264636

POET 3.03 | Surgery school 05/17/2019

POET 3.03 | Surgery school The need for patient education is a constant theme on TopMedTalk, many are keen to soak up information and become and active team player in their operation, how can we make the most of their patricipation? For example, do you let your patients go to "surgery school"? Presented by John Moore, Adult Critical Care Clinical Director and Consultant Critical Care & Anaesthesia at Manchester. The fuller version of the original talk is here: http://topmedtalk.libsyn.com/poetts-2018-pre-operative-inspiratory-muscle-training /episode/index/show/topmedtalk/id/9615152

Periop Medicine SIG18 | Advanced Care Planning 05/16/2019

Periop Medicine SIG18 | Advanced Care Planning Advanced care planning and shared decision making; what happens when you reach a patient and realise conversations have not been had and systems around them have failed? Presented by Debra Leung, staff anaesthetist, Peter MacCallum. /episode/index/show/topmedtalk/id/9757511

EBPOM Highlight 1.24 | The evolution of a community-based Prehabilitation service 05/15/2019

EBPOM Highlight 1.24 | The evolution of a community-based Prehabilitation service "POETTS 2018 | The evolution of a community-based Prehabilitation service" - 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 Gerard Danjoux, consultant in Anaesthesia and Sleep Medicine at South Tees Hospitals NHS Trust. /episode/index/show/topmedtalk/id/8916026

Desiree's Roundtable | Can you bite your upper lip? Assessing patients to reduce post-op respiratory complications 05/14/2019

Desiree's Roundtable | Can you bite your upper lip? Assessing patients to reduce post-op respiratory complications Obstructive sleep apnea is important to identify in patients, this piece explains how; use the official STOP BANG website here: http://www.stopbang.ca/osa/screening.php Opioids and pain management strategy is discussed, alongside reflections on the differences between the healthcare systems of Canada, the UK and America. Finally, what is "the beard test" and "the upper lip bite test"? Presented by Desiree Chappell and Monty Mythen with their guests, Frances Chung, Professor, Department of Anesthesiology and Pain Medicine, University of Toronto and Kurt J. Pfeifer, Professor of Medicine, General Internal Medicine, Medical Director, Preoperative Evaluation Clinic, Froedtert and Medical College Eye Institute, Medical College of Wisconsin, Milwaukee, WI. /episode/index/show/topmedtalk/id/9511487

Periop Coach 3.03 | Psychological optimisation 05/13/2019

Periop Coach 3.03 | Psychological optimisation Psychological optimisation for surgery; who should have it, what does it mean and how does it work? Further conversation moves into weaning patients off opioids in advance of surgery and cutting their dependency afterwards. Hosted by Desiree Chappell and Vicki Morton with their guest Dr. Padma Gulur, anesthesiologist and a Pain Medicine Specialist who sees patients at Davis Ambulatory Surgical Center, Duke Pain Medicine and Duke Perioperative Pain Care. /episode/index/show/topmedtalk/id/9354317

Sunday Special | Pets as therapy 05/12/2019

Sunday Special | Pets as therapy Pets as Therapy are a fantastic charity who have provided a practical theraputic service to various people in assorted contexts, here you can hear them work their magic on the TopMedTalk team. What are the advantages of taking pets into the ward? Can patients benefit from some therapy from our 'hairy friends'? Meet the volunteers and practitioners who have a dogged determination to cheer up our patients. Presented by Desiree Chappell and Monty Mythen with their guests; Hillary Burbage, with Matlock, Pamela Pearl, with Frankie, Suzy Emsden with Alfie the therapy dog and Matthew Robinson, national project co-ordinator for Pets as Therapy. /episode/index/show/topmedtalk/id/9575018

TopMedTalks to ... | Angela Bader 05/11/2019

TopMedTalks to ... | Angela Bader Does perioperative medicine alow institutions to take a broader view? Population health has been a theme on TopMedTalk, is it a logical extension of the perioperative process? How do we manage specialist care for the elderly and ensure high quality shared decision making? What lies behind the mindset change needed for some to accept surgery is not always the answer? Should we expect medical students to be taught the principles of perioperative medicine? What are some of the unique tensions in the US system that can frustrate the adoption of a truly perioperative practice? Presented by Desiree Chappell and Monty Mythen with their guest Angela Bader, Vice Chair of Perioperative Medicine at Brigham and Women's Hospital. /episode/index/show/topmedtalk/id/8915357

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