TopMedTalk

Teamwork is an essential part of perioperative care. Here the case is made that we should approach both pre and post habilitation as being akin to playing a team sport. Presented by Desiree Chappell with her guest Dr Steve Flanagan, Chair of Physical Medicine and Rehabilitation at NYU Langone. The fuller version of this piece is here: http://topmedtalk.libsyn.com/physical-medicine-in-rehabilitatio...

Learn how to develop a national Quality Improvement (QI) network which will increase both communication and knowledge implementation. What are the essential elements of a useful network, how do you build a community within one and solidify it as an essential part of your practice?   Presented by Carolyn Johnston , consultant Anaesthetist in St Georges hospital in London.  

"Postoperative changes in cognition: The role of biomarkers" - 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.com/meetings If you have any comments or questions you'd like to send...

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...

This podcast covers the physiological principles of goal directed fluid therapy, fluid responsiveness, the stressed system and the glycocalyx. Originally streamed live on www.topmedtalk.com Presented by Dr Joff Lacey with his guest Dr Randall Dull of the University of Illinois, live from the ASA in 2017.

TopMedTalk catches up with another online media source, The Critical Care Practitioner podcast, organised by our guest who - appropriately enough - is a critical care practitioner. What's it like being a critical care practitioner in the UK at the moment? Originally a lot of nurses moved into the sphere but now paramedics, physiotherapists and many others progress into it. Furthermore what's it li...

Recorded on the first day of the Intensive Care Society's annual conference this conversation starts with some reflections about how conferences have moved into the modern age now with interactivity and new media revitalising the scene in unexpected ways. Conversation then moves out to some of the big questions: Is the pulmonary artery catheter back? What have been some of the big take aways in nu...

Shared decision making is a meeting between experts, on the one hand we have a clinician who understands a diagnosis and a likely prognosis, on the other we have a patient who exclusively understands their values and personal tolerance for risk. Ideally these two perspectives are encouraged to combine into high quality decisions tailored to individual patients. What are the essential elements of t...

"Perioperative nutrition" - 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@topmedt...

"Does choice of opioid influence health outcomes?" - 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...

What is the Enhanced Recovery After Surgery (ERAS) Shared Interest Group (SIG)? How does it relate to the advancement of perioperative medicine? TopMedTalk was at the American Association of Nurse Anaesthetists (AANA) 2018 conference in Boston, check the podcast timeline for more, or click here: https://www.topmedtalk.com/?s=AANA Desiree Chappell speaks with her guests, Josh Newman Lead CRNA at Pa...

How do we address the issue of post operative delirium? Here you will find fascinating further discussion about cognitive function after surgery. What practical, simple steps can patients and providers take to bridge the gap between new discoveries in this area and risk minimisation? Featuring Desiree Chappell interviewing her guests, Carol Peden , Professor of Anesthesiology and Executive Directo...

What is POPS (Proactive care for Older People undergoing Surgery) and how have things gone since this service was introduced to Guy's and St Thomas's back in 2004? How does the team apply the techniques of this programme to the perioperative pathway of a patient? Would a service like this be useful at your practice? Can your institution accommodate a fully comprehensive geriatric assessment and op...

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...

Is it unreasonable to give a patient six months to lose weight before, for example, knee surgery? Going even further should we be considering meditation, mindfullness and yoga as part of a pre-habilitation clinic?   Hosted by Desiree Chappell and Monty Mythen , recorded at the Interdisciplinary Conference on Orthopedic Value-Based Care, with their guests; Shawna Butler (RN, NBA who works with Sing...

The full title of the paper being looked at here is: "Effect of Electroencephalography-Guided Anesthetic Administration on Postoperative Delirium Among Older Adults Undergoing Major Surgery: The ENGAGES Randomized Clinical Trial".   The link to the paper is here:   https://www.ncbi.nlm.nih.gov/pubmed/30721296   The editorial referenced in the piece is here:   https://jamanetwork.com/journals/jama/...

"PQIP Pain: from individual case to systems management" - originally streamed live from The Institute of Engineering and Technology (IET) in London during EBPOM 2018 on  www.topmedtalk.com If you're looking for the talk mentioned here featuring Paul Wishmeyer it is here: https://www.topmedtalk.com/ topmedtalks-to-dr-paul- wischmeyer/   if you'd like to attend an event like this ensure your next cl...

How do we best negotiate working in a multidisciplinary team? Generalisations regarding surgeons and anaesthetists only ever work generally, the specifics of each practitioner and their priorities inevitably contrast. How do we keep sight of these broad differences without falling foul of stereotypes? The conversation evolves; how does the surgical journey fully utilise the team based perioperativ...

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 as regards delirium? Can you build up mental resilience in the run up to an operation, do suggestions that puzzles and mental activity such as sudoku and a good crossword help have any evidence behind them?   This piec...

How is it the case that some people can lose significant muscle mass while they are being cared for on the Intensive Care Unit (ICU)? What can practitioners do to help avoid this? How do we integrate a dynamic stimulus and react to new research relating to nasogastric feeding? In this piece you will hear about a randomised controlled pilot study investigating the effect of intermittent versus cont...

How do you become well known in the NHS for being innovative, particularly in the perioperative area regarding evaluation and communication of risk? How can cardiopulmonary exercise testing lead to shared decision making? Hear how aortic aneurysms are dealt with by a world class professional perioperative physician. Learn how that process and its success then spread out into other areas of healthc...

The gap between ambition and action is familiar to us all but when it's potentially a matter of life and death how do we overcome it? This piece gives you a sense of both the research which illustrates the 'behaviour gap' in patients who are attempting to make good on their promise to regularly exercise. Presented by Chloe Grimmett , behavioural scientist from Southampton University. She works clo...

Interesting thoughts on the use of ACE inhibitors and ARBs, alongside considerations regarding asprin.   We look at the following papers:   Anesthesia and Analgesia : A Systematic Review of Outcomes Associated With Withholding or Continuing Angiotensin-Converting Enzyme Inhibitors and Angiotensin Receptor Blockers Before Noncardiac Surgery.   https://www.ncbi.nlm.nih.gov/pubmed/29381513   Anesthes...

"Perioperative nutrition should be a key part of Enhanced Recovery" - 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...

How does the treatment of anemia fit into the perioperative process? How far should patient optimisation extend to treatment of this condition? Live from the hugely successful EBPOM USA conference, directly after their presentation Desiree Chappell talks with her guests; Dr Lori Heller , Cardiac Anesthesiologist, Swedish Medical Center, through US anaesthesia partners and acting instructor at the...