TopMedTalk

The Society for Perioperative Assessment and Quality Improvement (SPAQI) are in Orlando Florida for their 14th annual summit and, of course, we're there to cover it.   Find out what you can expect, if you are attending the conference, and what we're going to be bringing you on TopMedTalk, if you couldn't make it this year.   Hypotension, the Measurement of Exercise Tolerance before Surgery (METS)...

The full title of today's paper is: Prospective observational cohort study of the association between antiplatelet therapy, bleeding and thrombosis in patients with coronary stents undergoing noncardiac surgery and you can find it here: https://www.ncbi.nlm.nih.gov/pubmed/30686302 Presented by Dr Joff Lacey , registrar in anaesthesia at St George's Hospital in London, currently undertaking a fello...

"Antibiotic stewardship in perioperative care" - 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 te...

What's it like in rural America working at a small hospital, 'way out on the frontier'? What best practice initiatives are there to help? How can you implement a process of rapid opioid reduction, more than 70%, in just two years?   Presented by Desiree Chappell with her guest Bill Prosser , CRNA Peacehealth Florence Oregon. --   Do you have your ticket to the Dallas Master's Course being organise...

What are the results if you apply Enhanced Recovery to obstetrics? This podcast features Desiree Chappell interviewing Dr Attila Kett, anaesthesiologist and Chairman at St Peter's University Hospital at New Jersey. Join in the debate: contact@topmedtalk.com

Global health is something TopMedTalk listeners are naturally passionate about; here you can listen to the keynote address from the 42nd President of The United States, Bill Clinton, to the World Patient Safety, Science & Technology Summit. 273,077 lives have been saved over the last 7 years with over 90,000 of those in just the last year alone. 4,700 hospitals around the world that are part of th...

The Patient Safety Movement Foundation (PSMF) has ambitious targets to limit preventable deaths in healthcare, this piece explains how they intend to reduce them down to zero. They need your help, this is a global movement with an action plan to improve the world in an important but achievable way.   Their website is here: https://patientsafetymovement.org/   Monty Mythen and Desiree Chappell spea...

The patient experience can be quite passive and, as a result, people can lose temperature quickly. The consequences can be very negative, this conversation revolves around how you can keep your patients warm.   This piece is taken from a longer conversation to be found here:  https://www.topmedtalk.com/live-from-the-iseh-part-1/ This edition of TopMedTalk was recorded at The Institute of Sport Exe...

This week on Journal Club we reflect upon the pulmonary artery (PA) catheter. The following articles were discussed: JAMA: The effectiveness of right heart catheterization in the initial care of critically ill patients. SUPPORT Investigators: https://www.ncbi.nlm.nih.gov/pubmed/8782638 BJA: Effect of goal-directed haemodynamic therapy on postoperative complications in low–moderate risk surgical pa...

"Rehabilitation post critical care" - 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: ...

How is the AANA facilitating the care of patients? How can you make a patient a 'partner in safety'? How do we coordinate so many disaparate systems of information and care? Patient records and data ownership is discussed, as is Paul Upton's excellent interview on TopMedTalk regarding "My Preop". The original piece is here: https://www.topmedtalk.com/my-pre-op-empowering-patients-before-surgery/ H...

In short; Post-Op recovery in less than 3 days with over 90% mobilised on day 1. This in depth discussion relates to the consensus paper from the Perioperative Quality Initiative, see link below. It focuses on: outcomes, length of stay and DREAMS (Drinking, Eating and Mobilising) within hours after major surgery- all key measures of compliance and success in an Enhanced Recovery Program. Monty Myt...

Please do all you can to help share this a hugely important piece, both for practitioners and patients. Adverse outcomes can be avoided , stories like the one on this podcast are fuel in the engine of those who advocate true perioperative care.   If you want to help go to the Greater National Advocates website here: https://www.gnanow.org/   The Patient Safety Movement is here: https://patientsafe...

Desiree and Monty catch up with Dan Martin, OBE, and speak with him about treating infectious diseases and in particular patients with ebola.   Presented by  Desiree Chappell  and  Monty Mythen  with their guest  Dan Martin , OBE anaesthetist and intensivist at the Royal Free Hospital and Reader at University College London (UCL).

This piece discusses how the contributors are driving better perioperative care in their clinics; the importance of getting patient records in advance; ERAS for obstetrics; challenging opioid use with the multimodal pain management; shared decision making in pain management; the importance of clear communication pathways and patient literacy. This podcast features Desiree Chappell interviewing; Dr...

Triple-low Alerts Do Not Reduce Mortality: A Real-time Randomized Trial. Sessler DI, Turan A, Stapelfeldt WH, Mascha EJ, Yang D, Farag E, Cywinski J, Vlah C, Kopyeva T, Keebler AL, Perilla M, Ramachandran M, Drahuschak S, Kaple K, Kurz A. Anesthesiology. 2019 Jan;130(1):72-82. doi: 10.1097/ALN.0000000000002480. https://www.ncbi.nlm.nih.gov/pubmed/30312182 Why Money Alone Can't (Always) "Nudge" Phy...

"Post-operative critical care: what should we do?" - 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 th...

Should we still measure urine output? How useful is permissive oliguria? Presented by Professor  Monty Mythen  and Dr  Joff Lacey  featuring guests Dr  Tim Miller  from Duke University Medical Centre and John A. Kellum, Tenured Professor, Critical Care Medicine from The University of Pittsburgh.

How do the insights of a 'medical linguistic anthropologist' impact upon our understanding of 'shared decision making'? How do patients make decisions about surgery? When, in the perioperative process, do they decide what is best for them? Does patient autonomy actually even exist? A bubble bursting conversation with a frequent favourite on TopMedTalk, this podcast is bound to get you thinking! Pr...

The concern for patient safety naturally flows throughout the healthcare continuum. In our discussion with Masimo Founder, Joe Kiani, we discuss the 'planning for zero' initiative and how we can realistically reach perfection in this area. The Patient Safety Movement Foundation is an organization dedicated to a goal of ZERO in-hospital preventable deaths by 2020. They request that you and your org...

How important is it to screen patients for anaemia before surgery? Has anaemia fallen off the health care agenda?   We begin with a conversation about patients who are anaemic and then turn to why this is sometimes not checked enough. Monty Mythen mentions UK University students appear to suffer from the condition more these days and Lori Heller points out that treating the condition, as part of p...

Journal Club Express this week focuses upon a piece in Anesthesiology ; Cognitive Effects of Perioperative Pregabalin: Secondary Exploratory Analysis of a Randomized Placebo-controlled Study. Link here: http://anesthesiology.pubs.asahq.org/article.aspx?articleid=2708941  

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 Angela...

How do the insights from experience in Enhanced Recovery apply to critical care patients and care postoperative care pathways? We also discuss utilization of advanced monitoring technology for the critically ill patient postoperatively. Presented by Desiree Chappell with her guests Philip Corvo , Chairman of Surgery Stanley J Dudrick Dept of Surgery at Saint Mary's Hospital and Vicki Morton , DNP...

This episode of The Perioperative Coach reflects on the pain management discussions being had by the American Society of Enhanced Recovery (ASER) and its members. For further reading see the articles in Perioperative Medicine Journal: https://perioperativemedicinejournal.biomedcentral.com/articles/10.1186/s13741-017-0064-5 This conversation taken from a longer piece to be found here:  http://www.t...