TopMedTalk

How do new technologies impact the postoperative elements of Enhanced Recovery? Here we discuss "ward monitoring 3.0" and new technologies which are now available, or in the pipeline, to improve outcomes. How do we best use this information and these innovations? The website mentioned in the podcast is here: https://www.michardconsulting.com/ Presented by Desiree Chappell with Monty Mythen and the...

  This panel discussion provides a vital and thought provoking insight into frailty in a perioperative patient. Further, as perioperative medicine evolves, how do we know enhanced recovery after surgery (ERAS) works? Are there any large randomised controlled trials that prove it? This piece is moderated by Dr Ming Loh , Staff Specialist Geriatrician and Clinical Lecturer at Westmead Hospital and t...

Doesn't the decision to delay surgery depend upon the type of cancer? Can you measure complications as an outcome? What's the cause of non cardiac complications that are related to lack of exercise? Can we change the mindset of prehabilitation by explaining that prehabilitation is the start of treatment? How do we convince patients and decision makers that delaying surgery is a good idea? How invo...

This question and answer session is a valuable insight into where the latest thinking is as regards tackling the opioid crisis. How do we get to an understanding where the entire continuum of care is on the same page as regards pain relief? What's the level of adoption for opioid free anaesthesia? Can re-languaging pain or "re-writing the narrative" help, for example is it better to speak of 'comf...

This piece argues that troponin screening is useful, if used appropriately. Is it the case that this test has been 'over sold' and as a result has provoked unhelpful pushback from practitioners? It's part 1 of 3 from The EBPOM 2019 TopMedTalk session which debated the issue. Presented by Duminda Wijeysundera , Professor in the Department of Anaesthesia and the Institute of Health Policy Management...

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 importa...

Post op respiratory complications are the focus of this piece. How can they be anticipated, detected early and dealt with appropriately? What about objective neuromuscular monitoring? Should you revese every single patient? If so, how do you do it? What about the risk of pulmonary complications?   Presented by  Desiree Chappell  with her guest  Frances Chung , Professor, Department of Anesthesiolo...

Learn about the Perioperative Anesthesia and Surgical Screening Clinic (PASS Clinic), do you need one at your practice? What is pain control for a perioperative patient? Hear also about the 'subacute period' and how you can incorporate it into your practice. Also, how do we keep patients 'opioid free' once they leave our care? Finally, how does individualised pain management and pain education fit...

Our Holiday Special, part 3 of 3, is a sampling of our favorite conversations and lectures from 2019. It is a chance for new listeners to the hear the outstanding content that has made TopMedTalk the success it is after 2 amazing years. And for our regular listeners, a check in to make sure they've not missed some of the crucial pieces of the last year. 🙏🙏 All of us at TopMedTalk want to send a...

Our Holiday Special, part 2 of 3, is a sampling of our favorite conversations and lectures from 2019. It is a chance for new listeners to the hear the outstanding content that has made TopMedTalk the success it is after 2 amazing years. And for our regular listeners, a check in to make sure they've not missed some of the crucial pieces of the last year. 🙏🙏 All of us at TopMedTalk want to send a...

Our Holiday Special, part 1 of 3, is a sampling of our favorite conversations and lectures from 2019. It is a chance for new listeners to the hear the outstanding content that has made TopMedTalk the success it is after 2 amazing years. And for our regular listeners, a check in to make sure they've not missed some of the crucial pieces of the last year. 🙏🙏 All of us at TopMedTalk want to send a...

This piece discusses The Brain Health Initiative and the sixth Peri-Operative Quality Initiative which focused upon delirium. How can progress in these areas be built upon and encouraged? Where is the data in regards to detecting and dealing with delirium? Beers Criteria Medication List; Potentially Inappropriate Medications for the Elderly According to the Revised Beers Criteria is here: https://...

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...

What is a "Respect Officer"? Why is respect so important in perioperative care? How does improving 'the culture of safety' also help to improve outcomes? Should we be overly concerned about high cancelation rates for surgery? And what are the advantages of a preoperative risk assessment clinic (PRAC)? Presented by Desiree Chappell and Monty Mythen with their guest Amir Jaffer , Chief Medical Offic...

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 M...

This exciting panel discussion covers a wide variety of questions, including; what is the definition of high risk patients in your clinic? What is your criteria for referal regarding pre-op patients? Who is in the multidisciplinary pre-op team? How long does each patient appointment last? How should we prioritise antihypertensives? Should anaesthetists be more involved in the postoperative care of...

"POETTS 2018 | Psychological Behavioural Change Interventions in Cancer Patients" - 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 questio...

"What drove enhanced recovery for us was not the short lengths of stay but the cancer outcomes" - this conversation explains how enhanced recovery gains traction in practice. Even after a relatively short period of application an evidence based approach is hard to refute. Desiree Chappell presents 'The Roundtable blog'; in this piece she's in conversation with Dr Michael Scott , Professor of Anest...

As a general rule, should ward monitoring be increased? Should continuous blood pressure monitoring be more frequent? This short piece follows on from Tim Miller's talk "Perioperative Blood Pressure (PeriOperative Quality Initiative: POQI 3) how low can you safely go?". Presented by Desiree Chappell and Monty Mythen with Tim Miller , Associate Professor of Anesthesiology from Duke University Medic...

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 pa...

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...

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...

Australia has an interesting history both generally and with perioperative medicine specifically. Here the story is told and their current progress is revealed. How do comparisons between various countries help us to understand where improvements can be made? How do the differences between the way in which healthcare is funded impact patients and providers? Moderated by Dr Mark Edwards , Universit...

"POETTS 2018 | Pre-operative Inspiratory Muscle Training" - 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...

We learn more about what the Perioperative medicine summit is and have a quick fire review of the current literature related to Perioperative Medicine. Discussions in this piece include the use of ACE inhibitors and ARBs, Hypotension, the Measurement of Exercise Tolerance before Surgery (METS) Trial and the improving fortunes of asprin. The SPAQI website is here: https://www.spaqi.org Presented by...