TopMedTalk

This podcast is part 4 in a series which is supported by the "Know AKI campaign", a bioMérieux global campaign to raise awareness about AKI. For part one go here: https://topmedtalk.libsyn.com/part-1-know-aki-and-say-no-to-acute-kidney-injury-for-patients-perioperative-renal-injury For part two go here: https://topmedtalk.libsyn.com/part-2-know-aki-and-say-no-to-acute-kidney-injury-for-patients-pe...

How did your intensive care unit manage during COVID19? What are the common experiences of practitioners from the developed world who bravely faced a pandemic like no other? This is part one of a two part piece. The TV show mentioned in this piece is available here: https://www.channel4.com/programmes/help Editor's note; parts of this conversation which suffered from technical issues have been rem...

"Kidney disease ... is clearly a public health concern" Health systems perspectives in acute kidney injury, this podcast is part 3 in a series which is supported by the "Know AKI campaign", a bioMérieux global campaign to raise awareness about AKI. For part one go here: https://topmedtalk.libsyn.com/part-1-know-aki-and-say-no-to-acute-kidney-injury-for-patients-perioperative-renal-injury For part...

This piece is the first of a four part series, supported in part through an unrestricted educational grant from Acacia Pharma, Inc, tackling the subject of post operative nausea and vomiting. How do practitioners who have an emphasis upon value based care incorporate dealing with one of the less pleasant realities of surgery for a patient? For the fuller conversations quoted in this piece please c...

For part one of this series go here: https://topmedtalk.libsyn.com/part-1-know-aki-and-say-no-to-acute-kidney-injury-for-patients-perioperative-renal-injury This piece is a series of recommendations from the Acute Disease Quality Initiative (ADQI-24) and the Perioperative Quality Initiative (POQI-7). The article mentioned in this piece is here: https://www.nature.com/articles/s41581-021-00418-2 Or...

"We have to decide; if it's safe, how do we do it, and how do we do it right?" This piece provides a much needed overview of anesthesia in the USA, clinical innovation, best practice and enhanced recovery. How do we deliver on the value proposition safely and efficiently? What is the responsibility of practitioners to patients when measuring the impact of new products, medications and equipment? H...

This deep dive into intraoperative hypotension provides an essential update on this area. Does the cause of hypotension reveal more about the specifics of the condition and therefore treatments? How can we understand what it is that we are doing well when it comes to prevention? Presented by Desiree Chappell and Monty Mythen with their guests Thomas Scheeran , Professor of Anaesthesiology, Univers...

This piece has been supported by the "Know AKI campaign" – a bioMérieux global campaign to raise awareness about acute kidney injury. It features a wide selection of clips on the subject of acute kidney injury, restrictive versus liberal fluid therapy and the trials we've seen in recent years which have revitalized debate and learning. The clips used come from the following podcasts: Michelle Chew...

"Our top priority must be safety" A real stand out piece from this year's incredible Evidence Based Perioperative Medicine (EBPOM) Dingle/Chicago conference. This piece dives into the realities of sedation from the point of view of a patient focused practitioner. For more conversations along these lines make sure you listen to our coverage of the annual general meeting of the American Society of A...

"There are so many, many studies on prophylaxis, but very few on treatment" Post operative nausea and vomiting, secondary nausea, how can we put the danger of these unfortunate moments behind us in a modern practice? This piece focuses upon nausea and treatment in particular as part of an Enhanced Recovery practice. Fourth Consensus Guidelines for the Management of Postoperative Nausea and Vomitin...

What are the known challenges for patients and practitioners who face anemia preoperatively? How do you set up and run an anemia clinic? Is there any need for this to be considered an essential part of the perioperative process? This piece follows on from a presentation regarding how to set up and run an anemia clinic, follow this link here to hear that presentation: https://topmedtalk.libsyn.com/...

This piece continues the discussion regarding blood pressure regulation, moving from the brain to the kidney, heart and lungs via a number of distinguished experts in the field. How do we safely cut through the opinions on these areas and focus instead on relevant data? How do these organs interact in terms of auto regulation? How closely do our clinical tools allow us to infer accurately what a p...

The focus of this conversation is auto regulation in the brain, it leads into a longer conversation - part 2 - where the subject is discussed more broadly. What tools do we now have and how are they changing the way we see and understand this area? Are there hard and fast rules when it comes to blood pressure or is there still significant debate? Although this works as a stand alone listen it is i...

"Choosing Wisely is an initiative of the American Board of Internal Medicine started about 10 years ago to advertise important aspects of medicine ... their number one recommendation was to not proceed with elective surgery in patients with properly diagnosed and correctable anemia, until the anemia has been appropriately treated." Taken from the hugely popular EBPOM Chicago meeting this piece exp...

Near infrared spectroscopy (NIRS) ... 'a variation of pulse oximetry; it transmits red and infrared light into tissue' measures information from arterial venous and capillary blood simultaneously to deduce tissue saturation; an aggregate estimate of arteriovenous capillary blood and whatever tissue you're shining the light into. 'So typically, we're using it in on the brain at least in the cardiac...

Originally recorded during Evidence Based Perioperative Medicine (EBPOM)'s London conference this piece focuses upon pulmonary complications in the perioperative period. What do the data say, what are the key trials? Presented by Denny Levett , Professor in Perioperative Medicine and Critical Care at Southampton University Hospital NHS Foundation trust and Honorary Associate Professor at the Unive...

One of the standout moments of Evidence Based Perioperative Medicine (EBPOM) 2021 this piece is a bonus podcast for the holiday season which looks in detail at oxygen from a perioperative medicine perspective, amongst other things this talk throws up some troubling and challenging observations about pulse oximetry. The piece is introduced by Mike Grocott, Professor of Anaesthesia and critical care...

"We have seen a very significant transition (in respiratory care) through COVID" What have we learned about how to treat lung and breathing issues over the last few years? Away from alarming headlines and looking instead at data - is there a consensus on how COVID-19 should be treated? How has ventilation improved and developed? This podcast focuses on respiratory intervention and was originally b...

Amisulpride is an antiemetic medication used at lower doses intravenously to prevent and treat postoperative nausea and vomiting; what does it look like in practice? Can it work as a 'rescue therapy'? What does the data tell us? Could a treatment for post-operative nausea and vomiting be a way to really enhance value based care and enhanced recovery? Supported in part through an unrestricted educa...

"Precision anesthesia [...] where we can give patients the anesthetic and the doses that they require on a patient specific basis" This piece looks at nociception, the neural processes of encoding and processing "noxious" stimuli. By monitoring this anesthetic practitioners can deploy a level of precision not previously possible. Regular listeners may wish to refer back to previous podcasts on thi...

The Hypotension Prediction Index is rapidly gaining a well deserved place in the hands of modern perioperative practitioners. Here we look at the history of this tool, why it is needed so badly and how it has developed. Many of the conversations referenced in this piece are worthy of further attention. The clips used are taken from the following TopMedTalk programmes: Live from Boston ASA 2017 – T...

With a global focus this piece moves into obstetric anesthesia, perioperative medicine and anemia management. Covering iron deficiency, hemoglobin, post-partum management and how to improve outcomes for all. For more on this go now to www.ebpom.org where you will find the pre-recorded video contributions made by our speakers in anticipation of this discussion. Presented by Sam Bampoe , Tripom Co-F...

"I think it really comes down to teamwork" How rapidly should you perform a tracheostomy? When do you "start the conversation" about the procedure? What about when it comes to patients with COVID19? Where does a data driven approach take us to? This essential piece is provided to TopMedTalk listeners as a sneak preview of EBPOM Dingle and Chicago; recorded in advance of the meeting and shared with...

Welcome to TopMedTalk's exclusive - as live - coverage of The American Society of Anesthesiologists (ASA) annual general meeting; join Desiree Chappell, TopMedTalk's lead presenter, Monty Mythen TopMedTalk's Editor in Chief and Sol Aronson, tenured Professor, Duke University speak with their guest, Mary Dale Peterson, M.D., MHA, FACHE, FASA, ASA Immediate Past President.

Welcome to TopMedTalk's exclusive - as live - coverage of The American Society of Anesthesiologists (ASA) annual general meeting; join Desiree Chappell, TopMedTalk's lead presenter, Monty Mythen TopMedTalk's Editor in Chief and Sol Aronson, tenured Professor, Duke University speak with their guest, TJ Gan , MD, MHS, FRCA, MBA, Professor and Chairman of the Deptartment of anesthesiology at Stony Br...