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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Monitoring and management of neuromuscular blockade - questions | EBPOM Chicago
03/07/2021
Monitoring and management of neuromuscular blockade - questions | EBPOM Chicago
This piece, part 2 of 2, is a series of questions related to part 1; "Monitoring and management of neuromuscular blockade | EBPOM Chicago". This piece gets into the detail regarding one of the stand out moments of EBPOM Chicago 2020; questions from the online audience facilitate the discussion. Given the fact that our methods of monitoring residual neuromuscular blockade are often inadequate do you transport and do you recommend routine transport to patients from the operating room to the post-anesthesia care unit? Sugammadex is a unique drug that does exactly what we want it to do; why are alternatives still used and available? Some wearables have accelerometer hardware, are you aware of, or do you know if anyone is studying, firm software solutions, marshaling this ubiquitous hardware? Don't forget, for more details on Evidence Based Perioperative Medicine EBPOM conferences go now to Presented by Sol Aronson, tenured Professor at Duke University, Glenn Murphy, Jeffery S. Vender Chair of Anesthesiology Research and Education and Director of Cardiac Anesthesia and Clinical Research at NorthShore University HealthSystem, a hospital affiliated with the University of Chicago Pritzker School of Medicine.
/episode/index/show/topmedtalk/id/17863022
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The Perioperative Care Team | EBPOM Chicago
03/06/2021
The Perioperative Care Team | EBPOM Chicago
This piece is an informative conversation about "the Perioperative Care Team"; who is essential to the team and how do we make sure everyone feels included? What elements do you need to make up such a team, how do you keep people energized and excited about it over the long term? How do we ensure, in this context, that a fee for service system interlocks with the needs of both the institution and its patients? Furthermore, how does such a team increase our commitment to value based care and good quality long term outcomes? Also, an exciting commitment is made toward a journal club, stick with TopMedTalk for more details. Presented by Vicki Morton with panelists Dennie Levett, Professor in Perioperative Medicine and Critical Care at Southampton University Hospital NHS Foundation trust and Honorary Associate Professor at the University of Southampton, Kay Mitchell, Senior Research Manager for Critical Care Research, NIHR Biomedical Research Center, University Hospital, Southampton, UK and Gina McConnell, ERAS Coordinator for all WakeMed health systems.
/episode/index/show/topmedtalk/id/17862944
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Enhanced Recovery After Surgery (ERAS) Part 2 | Chicago 2020
03/05/2021
Enhanced Recovery After Surgery (ERAS) Part 2 | Chicago 2020
Part 2 of this conversation continues the momentum of Part 1 with a conversation about electronic medical records (EMR), how important data is to the process, the need for those who collect it to understand it and then, more broadly, the importance of putting the patient at the heart of what you do. Presented by Desiree Chappell with Vicki Morton, Director of Clinical and Quality Outcomes at Providence Anesthesiology Associates, P.A, Cheryl Crisafi, Cardiac Surgery Care Coordinator Nurse at Baystate Medical Center in Springfield, MA and Gina McConnell, ERAS Coordinator for all WakeMed health systems.
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Enhanced Recovery After Surgery (ERAS) Part 1 | Chicago 2020
03/04/2021
Enhanced Recovery After Surgery (ERAS) Part 1 | Chicago 2020
This piece is a two part conversation about the essence of what many of TopMedTalk's listeners do; Enhanced Recovery. A fascinating conversation between a number of experts in the field the conversation presented here was part of the hugely popular EBPOM Chicago 2020 meeting. For more on Evidence Based Perioperative Medicine (EBPOM) go to This first part of the conversation covers what the main elements of an Enhanced Recovery After Surgery program entail, what literature our contributors favor and what service lines include enhanced recovery at their practice. Presented by Desiree Chappell with Vicki Morton, Director of Clinical and Quality Outcomes at Providence Anesthesiology Associates, P.A, Cheryl Crisafi, Cardiac Surgery Care Coordinator Nurse at Baystate Medical Center in Springfield, MA and Gina McConnell, ERAS Coordinator for all WakeMed health systems.
/episode/index/show/topmedtalk/id/17862710
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"The international prehabilitation society" | EBPOM 2020 London
03/03/2021
"The international prehabilitation society" | EBPOM 2020 London
What are the aims of The International Prehabilitation Society? Its vision is about "bringing together international multidisciplinary expertise, across healthcare and beyond, creating a platform of shared learning, research and education for the benefit of patients". This piece updates you on the current board members, the roles of committee members, conferences that the society has previously supported alongside those being planned for the future. Also there's an update on some exciting new sponsorship news and a brief overview of future plans. The society's website is here: Presented by Gerard Danjoux, consultant in Anaesthesia and Sleep Medicine at South Tees Hospitals NHS Trust.
/episode/index/show/topmedtalk/id/17446283
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Models of prehabilitation in Cardiff in Wales | EBPOM 2020 London
03/02/2021
Models of prehabilitation in Cardiff in Wales | EBPOM 2020 London
"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.
/episode/index/show/topmedtalk/id/17469047
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The Anesthesia Patient Safety Foundation | COVID 19
03/01/2021
The Anesthesia Patient Safety Foundation | COVID 19
This piece focuses on the great work done by The Anesthesia Patient Safety Foundation. We turn to their specific focus on COVID 19 and then look at the wider benefits of a network dedicated to patient safety in our field. Their section on COVID 19 is here: Furthermore there is a remarkably prescient article by Mike Grocott and Monty Mythen on there in which we discuss, Perioperative Fluid Management: Cheers to the Dream of Moderation: https://www.apsf.org/article/perioperative-fluid-management-cheers-to-the-dream-of-moderation/ Presented by Desiree Chappell and Monty Mythen with their guest Steven Greenberg, MD, FCCP, FCCM, Editor-in-Chief, Anesthesia Patient Safety Foundation (APSF) Newsletter, Vice Chairperson, Education, Department of Anesthesiology, Director of Critical Care Services, Evanston Hospital NorthShore University HealthSystem, Clinical Professor, Department of Anesthesiology Critical Care, University of Chicago, Pritzker School of Medicine.
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Enabling Enhanced Recovery Part 2 | EBPOM 2020
02/28/2021
Enabling Enhanced Recovery Part 2 | EBPOM 2020
"Accelerated surgery is not a panacea" This piece, presented in two parts, is a discussion about enabling enhanced recovery. Originally part of EBPOM London this is an 'as live' discussion with four of the main presenters from the conference. Get more detail on nutrition, hip fractures, psychological optimisation and discover both where the difficulties are and what opportunities they provide. For more of this sort of content go now to to find out more about how you can be part of Evidence Based Perioperative Medicine. Presented by Professor Denny Levett and Jugdeep Dhesi with their guests P.J. Devereaux, cardiologist, clinical epidemiologist, and perioperative care physician, Professor in the Departments of Health Research Methods, Evidence, and Impact (HEI) and Medicine, Director of the Division of Perioperative Care, McMaster University, Associate Deputy Director of the Population Health Research Institute, President of the Society of Perioperative Research and Care, 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, Dr Paul Wischmeyer, Professor of Anaesthesiology and Surgery at Duke Anesthesiology.
/episode/index/show/topmedtalk/id/17750510
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Enabling Enhanced Recovery Part 1 | EBPOM 2020
02/27/2021
Enabling Enhanced Recovery Part 1 | EBPOM 2020
"Accelerated surgery is not a panacea" This piece, presented in two parts, is a discussion about enabling enhanced recovery. Originally part of EBPOM London this is an 'as live' discussion with four of the main presenters from the conference. Get more detail on nutrition, hip fractures, psychological optimisation and discover both where the difficulties are and what opportunities they provide. For more of this sort of content go now to to find out more about how you can be part of Evidence Based Perioperative Medicine. Presented by Professor Denny Levett and Jugdeep Dhesi with their guests P.J. Devereaux, cardiologist, clinical epidemiologist, and perioperative care physician, Professor in the Departments of Health Research Methods, Evidence, and Impact (HEI) and Medicine, Director of the Division of Perioperative Care, McMaster University, Associate Deputy Director of the Population Health Research Institute, President of the Society of Perioperative Research and Care, 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, Dr Paul Wischmeyer, Professor of Anaesthesiology and Surgery at Duke Anesthesiology.
/episode/index/show/topmedtalk/id/17750435
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Models of Prehabilitation | EBPOM 2020
02/26/2021
Models of Prehabilitation | EBPOM 2020
This piece is an informative conversation about the models of prehabilitation from a number of different angles. Questions come in from an online audience as our panelists tackle the topic from their respective areas. What are the risks and how are they mitigated? Where does your funding come from and why? How safe is iron for cancer patients? The link to Safe Fit self referal is here: Presented by Denny Levett, Professor in Perioperative Medicine and Critical Care at Southampton University Hospital NHS Foundation trust and Honorary Associate Professor at the University of Southampton and Gerard Danjoux, consultant in Anaesthesia and Sleep Medicine at South Tees Hospitals NHS Foundation Trust with their guests John Moore, Clinical Director for Intensive Care at Manchester Royal Infirmary and Medical Lead for Enhanced Recovery After Surgery, Professor Sandy Jack, PhD, Consultant Clinician Scientist in The Anaesthesia and Critical Care Research Unit at University Hospital Southampton NHS Foundation Trust, Honorary Senior Lecturer at the University of Liverpool, University of Southampton and University College London and Rachel Barlow, National Lead, Enhanced Recovery, Prehabilitation and Optimisation, at Cardiff and Vale health board, Wales.
/episode/index/show/topmedtalk/id/17750387
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Nutrition and metabolism before surgery - PART 2 of 2 | EBPOM London 2020
02/25/2021
Nutrition and metabolism before surgery - PART 2 of 2 | EBPOM London 2020
"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 have to the process. This talk focuses on how and why this ties into a sensible attitude towards nutrition and nutritional assessment. This talk pulls no punches and yet is powerfully optimistic in its message. We implore TopMedTalk listeners to share it with colleagues. The entertaining audio clips used in this piece are available, with video and in full here: Our speaker kindly shares his email address for further correspondence and questions: Presented by Paul Wischmeyer, Professor of Anaesthesiology and Surgery at Duke Anesthesiology.
/episode/index/show/topmedtalk/id/17750270
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Nutrition and metabolism before surgery - PART 1 of 2 | EBPOM London 2020
02/24/2021
Nutrition and metabolism before surgery - PART 1 of 2 | EBPOM London 2020
"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 have to the process. This talk focuses on how and why this ties into a sensible attitude towards nutrition and nutritional assessment. This talk pulls no punches and yet is powerfully optimistic in its message. We implore TopMedTalk listeners to share it with colleagues. The entertaining audio clips used in this piece are available, with video and in full here: Our speaker kindly shares his email address for further correspondence and questions: Presented by Paul Wischmeyer, Professor of Anaesthesiology and Surgery at Duke Anesthesiology.
/episode/index/show/topmedtalk/id/17750210
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Monitoring and management of neuromuscular blockade | EBPOM Chicago
02/23/2021
Monitoring and management of neuromuscular blockade | EBPOM Chicago
"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 Director of Cardiac Anesthesia and Clinical Research at NorthShore University HealthSystem, a hospital affiliated with the University of Chicago Pritzker School of Medicine.
/episode/index/show/topmedtalk/id/17750150
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Redefining Hypotension based on Real-time Cerebral Autoregulation Monitoring | EBPOM Chicago
02/22/2021
Redefining Hypotension based on Real-time Cerebral Autoregulation Monitoring | EBPOM Chicago
"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 correct evidence based strategy now the data are mounting as regards potential patient harm and unsatisfactory outcomes? Presented by Charles Hogue, Professor and Chair of Anesthesiology at Northwestern University in Chicago.
/episode/index/show/topmedtalk/id/17750063
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EBPOM London 2020 | Functional Assesment
02/21/2021
EBPOM London 2020 | Functional Assesment
"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.
/episode/index/show/topmedtalk/id/17633516
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Essential COVID knowledge; Dr. Manuel Ignacio Monge García | COVID 19
02/20/2021
Essential COVID knowledge; Dr. Manuel Ignacio Monge García | COVID 19
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 dealt with, what can we learn about the basics here, airway, breathing, ventilation (ABC)? There is also a gripping discussion regarding dynamic arterial elastance. If you'd like to know more about that do check out our discussion here: The webinar mentioned in this piece can be found here: Presented by Desiree Chappell and Monty Mythen with their guest Dr. Manuel Ignacio Monge García who works in an ICU in the South of Spain.
/episode/index/show/topmedtalk/id/17649149
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New treatments for Post Operative Nausea and Vomiting | TopMedTalk
02/19/2021
New treatments for Post Operative Nausea and Vomiting | 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 presentation "EBPOM USA Part 5| Practical realities; How and why multimodal Analgesia matters" here:
/episode/index/show/topmedtalk/id/12123341
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Practical tips for preoperative risk assessment | Dingle Highlight
02/18/2021
Practical tips for preoperative risk assessment | Dingle Highlight
"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 detail here; this piece is very relevant to you and your patients, legally speaking, if you work in the UK:
/episode/index/show/topmedtalk/id/17723561
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Critical care for the very elderly patient | Dingle Highlight
02/17/2021
Critical care for the very elderly patient | Dingle Highlight
"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 Support, The Mater Hospital, Dublin.
/episode/index/show/topmedtalk/id/17677460
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Brain Health: Frailty, Delirium and Post-operative cognitive dysfunction Part 2 | Chicago 2020
02/16/2021
Brain Health: Frailty, Delirium and Post-operative cognitive dysfunction Part 2 | Chicago 2020
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 Association of Retired People's website: This is part one of a two part piece, part two features questions from the online conference audience. Presented by Monty Mythen with Angela Bader, Professor of Anesthesia at Harvard Medical School and Vice Chair for Perioperative Medicine in the Department of Anesthesiology, Perioperative and Pain Medicine at Brigham and Women’s Hospital, founding Director of the Weiner Center for Preoperative Evaluation, Sarah Lenz Lock, Senior Vice President for Policy and Brain Health in the American Association of Retired People's (AARP) Policy, Research and International Affairs (PRI), Executive Director of the Global Council on Brain Health, Jeanna Blitz associate professor of Anesthesiology at Duke University School of Medicine, Director of the Preoperative Anesthesia Surgical Screening (PASS) Clinic. There's also a surprise appearance from the EBPOM Chicago 2020 host, Sol Aronson, tenured Professor at Duke University.
/episode/index/show/topmedtalk/id/17659556
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Brain Health: Frailty, Delirium and Post-operative cognitive dysfunction Part 1 | Chicago 2020
02/15/2021
Brain Health: Frailty, Delirium and Post-operative cognitive dysfunction Part 1 | Chicago 2020
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 one of a two part piece, part two features questions from the online conference audience. Presented by Monty Mythen with Angela Bader, Professor of Anesthesia at Harvard Medical School and Vice Chair for Perioperative Medicine in the Department of Anesthesiology, Perioperative and Pain Medicine at Brigham and Women’s Hospital, founding Director of the Weiner Center for Preoperative Evaluation, Sarah Lenz Lock, Senior Vice President for Policy and Brain Health in the American Association of Retired People's (AARP) Policy, Research and International Affairs (PRI), Executive Director of the Global Council on Brain Health, Jeanna Blitz associate professor of Anesthesiology at Duke University School of Medicine, Director of the Preoperative Anesthesia Surgical Screening (PASS) Clinic. There's also a surprise appearance from the EBPOM Chicago 2020 host, Sol Aronson, tenured Professor at Duke University.
/episode/index/show/topmedtalk/id/17659550
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Perioperative Quality Initiative P.O.Q.I. news | ASA HIGHLIGHT
02/14/2021
Perioperative Quality Initiative P.O.Q.I. news | ASA HIGHLIGHT
"It might just be 'boring old blood pressure ... (but) ... every fourth operation there is evidence of a modifiable risk factor". The Perioperative Quality Initiative (POQI) is our starting point for this conversation, seven concensus conferences focusing on various topics of interest to the perioperative practitioner. Check out their extensive open source resources here: Hypotension and Mean Arterial Pressure (MAP) are discussed in detail; how are patients now being managed? How can a 'hazard index' help? "25% of our patients experience hypotension!"; regular TopMedTalk listeners know this has been frequently highlighted as an issue for patient mortality. Also, 26 minutes in, hear about the recent POQI and Acute Dialysis Quality Initiative (ADQI) meeting of 2019. "There is no such thing as a bit of a creatinine bump that is 'normal'". Presented by Desiree Chappell, Monty Mythen and a surprise appearance from Sol Aronson, 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?" For more regarding the papers published by POQI, referenced in this piece, go here: "Sunday Special | Blood Pressure" We speak with Dan Sessler here: 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" Finally, Professor Sol Aronson, tenured, Duke University, who features on this podcast, delivered a talk you're bound to love here: "Perioperative Medicine is population health"
/episode/index/show/topmedtalk/id/17659613
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Somnia Anesthesia Services | TopMedTalk
02/13/2021
Somnia Anesthesia Services | TopMedTalk
"We're so invested in outcomes and data that it really gives us an objective view on how to approach things" This wide ranging conversation looks at how a data driven approach to change can produce better results in terms of patient outcomes. How do you highlight those opportunities with tact and clarity? How do we start to reward and recognise the best care that the evidence supports? We also hear more about Evidence Based Perioperative Medicine (EBPOM) in 2021; for more on the opportunities mentioned in this piece please go to www.ebpom.org Also, if you're aligned with the great nation of Wales or you love perioperative medicine, you'll be delighted to hear about the Welsh Perioperative Medicine Society: Their Twitter is here: Their Facebook page is here: And their excellent website is here: Presented by Desiree Chappell and Monty Mythen with Marc Koch, President and CEO of Somnia Anesthesia and Shelley Sharma, Acute Pain service line Director for Somni Anesthesia.
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Can medicine be cured? | Dingle Highlight
02/12/2021
Can medicine be cured? | Dingle Highlight
Warning; this piece may make for uncomfortable listening. It is a fascinating look at the recent history of medicine and how our profession may in fact be sick. Contained within the story is a message of hope; evidence may contain the cure. In our recent history we seem to have enjoyed something of a "Golden Age" of medicine which, by raising quality of life so dramatically, has transformed our understanding of concepts such as "public health" and even "standard of living". However, running alongside that is an industry and society that is primarily interested in business and profit above evidence and health. Has the industry which built up around our profession during the 'Golden Age' now become a parasite which weakens its host to the point of near exhaustion? After a concise critique of the current culture of research this talk asks why we are wasting time on research that is not reliable, not useful and does not impact care. Could it be that market forces have strangely made us less efficient? Evidence based medicine is the way forward but can we overcome the inherent bias behind the fact that often big business funds the evidence gathering and its publication? Some assumed the period of rapid development, which included discovering the DNA helix, successful organ transplant and vaccinations, would soon inevitably be followed by equally epoch transforming breakthroughs, others are less optimistic. Are genomics and big data more often 'science' than medicine? Is "digital health" "simply one part of what has now been called surveillance capitalism"? This challenging but ultimately hopeful and inspirational talk was given at the EBPOM Dingle conference 2019, please share it to as wide an audience of your peers as you can to help make this important and healing conversation happen. Presented by Seamus O'Mahony, Consultant Gastroenterologist at Cork University Hospital, associate editor for medical humanities of the Journal of the Royal College of Physicians of Edinburgh and is a regular contributor to the Dublin Review of Books.
/episode/index/show/topmedtalk/id/17677427
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Testing the Hypotension Prediction Index | TopMedTalk
02/11/2021
Testing the Hypotension Prediction Index | TopMedTalk
"We wanted to know if goal directed therpy using a (Hypotension Prediction Index) HPI monitor can prevent hypotension". This piece looks in detail at the HPI monitor in practice- what is the benefit of this piece of technology in relation to hypotensive episodes? Furthermore how else is it to be tested and when will these tests be carried out? Presented by Desiree Chappell and Monty Mythen with their guest Marit Habicher, Specialist, Department of Anesthesia and Critical Care at UKGM Giessen.
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Shared decision-making: a team game? | EBPOM 2020 London
02/10/2021
Shared decision-making: a team game? | EBPOM 2020 London
"We have to remember that patients have a team" How do we involve patients in the increasingly complex conversations we have in the perioperative space? This piece is a detailed case study which shows how shared decision making works in the perioperative setting. We know this improves patient experience yet in the last 10 or so years, consistently only 50 to 60% of patients say they were involved in decision making. How can shifting towards a value based care model help? What is "moral injury" and how do we avoid it? Can a data driven analysis actually show shared decision making reduces costs? Perioperative medicine for older people undergoing surgery (POPS) is an award winning geriatrician led service and the first of its kind in the UK - find out more here: The Centre for Perioperative Care is here: Presented by Ramai Santhirapala, Consultant Anaesthetist and Perioperative Medicine Lead at Guy’s and St Thomas’ NHS Foundation Trust, fellow of the Royal College of Anaesthetists, Faculty of Intensive Care Medicine and Higher Education Academy, Honorary Associate Professor at University College London, Clinical Lead for the UK arm of an international programme in shared decision making, “Choosing Wisely”, which is led by the Academy of Medical Royal Colleges, Shared Decision Making Lead at the Centre for Perioperative Care and sits on the Choosing Wisely International Roundtable.
/episode/index/show/topmedtalk/id/17607725
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Getting "fit for surgery" | EBPOM 2020 London
02/09/2021
Getting "fit for surgery" | EBPOM 2020 London
"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 Medicine and Critical Care at Southampton University Hospital NHS Foundation trust and Honorary Associate Professor at the University of Southampton.
/episode/index/show/topmedtalk/id/17634200
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Perioperative Frailty with Jude Partridge | EBPOM 2020 London
02/08/2021
Perioperative Frailty with Jude Partridge | EBPOM 2020 London
"If I were to develop a simple uncomplicated urinary tract infection, I may well be able to continue to go to work as I was being treated for that illness but if an older frail patient develops a similar uncomplicated urinary tract infection, that can be a very significant illness, that patient may well be unable to walk or transfer as they could" Frailty in the perioperative period - what is it, what is it not and how do we work with and manage it before, during and after an operation so as to increase the value of care to our patients? The opening article refered to in this piece is here: The British Geriatrics Society "Fit for Frailty" document is here: More information on Perioperative medicine for older people undergoing surgery (POPS), an award winning geriatrician led service and the first of its kind in the UK, go here: Presented by Jude Partridge, consultant geriatrician POPS, honorary senior lecturer, King's College London, Chairs the British Geriatrics Society POPS SIG.
/episode/index/show/topmedtalk/id/17633627
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Healthy eating and cancer | TopMedTalk & MacMillan Cancer Support
02/07/2021
Healthy eating and cancer | TopMedTalk & MacMillan Cancer Support
TopMedTalk in Collaboration with MacMillan Cancer Support in the UK developed this podcast series to support patients during their cancer journey amidst the COVID 19 crisis. We know food gives us energy "but it also provides so much more". This podcast looks at the raw materials you'll need, when facing a cancer diagnosis, to get a better outcome; the vitamins, minerals and proteins, as well as the energy sources you're best using. What is a balanced diet when you have cancer? "We're talking about eating well to stay well [...] we're not really looking for people to lose weight"; it's often important for people to try to maintain their weight during a cancer diagnosis, should you track your weight throughout your cancer journey? Recorded at the height of the COVID 19 crisis this podcast also reflects upon how this information is applied in the context of a global pandemic. What foods can we store which also contain the vital building blocks of our body's natural defenses? Presented by Nick Margerrison with his guest Clare Shaw, consultant Dietician at The Royal Marsden NHS Foundation Trust. For more information, in the UK, phone: 0808 808 00 00 email: Twitter:
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Get active and feel good? | TopMedTalk & MacMillan Cancer Support
02/06/2021
Get active and feel good? | TopMedTalk & MacMillan Cancer Support
TopMedTalk in Collaboration with MacMillan Cancer Support in the UK developed this podcast series to support patients during their cancer journey amidst the COVID 19 crisis. It's vital you remain active after a cancer diagnosis, why is this? Hear the fascinating story behind the discovery that activity not only reduces your overall levels of fatigue but also improves your chances of recuperation. "You have to pace yourself [...] listen to your body"; but any physical activity will help fight feelings of tiredness. In short, if you get active you feel good. Also in this podcast, with direct reference to medical trials and studies, our guests give you the mechanism behind incredibly helpful changes caused by moderate exercise in cancer patients, evidence which has led medics to conclude that "exercise is real medicine". "When we're talking about being active during cancer it's at any stage of the cancer journey: from prehabilitation through recovery". Prehabilitation is the process by which people prepare their bodies for a major obstacle such as an operation or chemotherapy. It's like rehabilitation but it takes place before the event. Just as when you start your recovery after treatment you would expect to get your body back to full health, here you try to achieve the best possible physical health before you start. The key point is that the medicine of exercise can be useful from diagnosis right through to full recovery and beyond. Again, with direct reference to the evidence, find out how incredible research into prehabilitation is changing the way we think about cancer and recovery. Recorded specifically at the height of the COVID 19 crisis hear how this research is being applied in the context of a global pandemic. Group forms of exercise are not an option while social distancing restrictions are in place, can exercising with other people bring us special benefits? If so, can those benefits be matched if we use the internet to continue the social side of going to a gym or a class? Presented by Nick Margerrison with the Professor of Clinical Exercise Science, Anna Campbell, MBE, of Edinburgh Napier University and the director of CAN Rehab and the Professor of Prehabilitation Medicine, Sandy Jack, a consultant clinician scientist from The University of Southampton and University of Southampton NHS Foundation Trust . For more information, in the UK, phone: 0808 808 00 00 email: Twitter:
/episode/index/show/topmedtalk/id/17723918