TopMedTalk

This essential discussion covers total intravenous anaesthesia (TIVA) versus inhalation anesthesia, the pros, the cons, and the benefits of the process such as monitoring. Included in this extended podcast are the two presentations (2:40mins in and 20:55mins in) and the question and answer session which followed (starts at 33:05mins in). The Safe Brain Initiative is here: http://safebraininitiativ...

Ways to simplify the entire surgical encounter. This piece looks at the process of accepting patients into the surgical journey. Care coordination with a focus on the patient and the workflow associated with them; taking a fully integrated approach to the process from inception to preparation to completion and aftermath. More information about cloud-based Provation® SurgicalValet™ Perioperative Ca...

Care home residents in South East London are to be the first in line to access remote examination technology. Residents across 46 care homes in South East London are first in line to access innovative diagnostic technology from Arc Health ( www.archealth.io ), enabling doctors to remotely perform a clinical examination during a video call. Where next for this sort of technology? Is a face to face...

Perioperative enhancement teams have been a theme on TopMedTalk for years. This program, part two of two, goes into more detail around what could be the crucial next steps for your institution as it distinguishes itself from the pack with excellent value based care instead of excessive volume driven disasters. In this program we cover the importance of prehabilitation, the need for respect in a mu...

This podcast is a look at some of the work done by practitioners who intend to take perioperative medicine to the next level; the "perioperative enhancement teams". The program broadly follows a patient's surgical journey, we start with the UK's PREPWELL project, as explained by Gerard Danjoux , consultant in Anaesthesia and Sleep Medicine at South Tees Hospitals NHS Trust. For more information on...

Post EBPOM Monty and Desiree explain how TopMedTalk is building on the incredible success of the last few years. After producing a podcast every day for 3+ years we are now going to produce a new podcast each week with more focus on specific topics with bespoke documentary style pieces which will help us to present complicated content in a more digestible form. We will also continue to present the...

In this piece we take a bit of time to speak with a newly graduated enhanced recovery after surgery (ERAS) enthusiast. How widely taught is ERAS in the US? Why is it such a game changing concept? How are people discovering and researching it? Presented by Desiree Chappell and Vicki Morton and their guest Caroline Geary , critical care nurse residency, Novant Health Presbyterian Medical Center in C...

This piece is a listener generated question and answer session from EBPOM 2020. Although it works as a stand alone piece it relates directly to this talk here: https://www.topmedtalk.com/ebpom-2020-london-prediction-of-opioid-induced-respiratory-depression-on-the-general-care-floor-does-surveillance-monitoring-help/ Some of the questions considered include: How much do you think partial / inadequa...

"The delivery of good medical care is to do as much nothing as possible." - Samuel Shem. The POCAPALOOZA (POC, perioperative care; apalooza - a celebration of) wraps up in true style with a look at Australia and their current situation. Lauded for their handling of COVID19 but not yet 'through the woods' the conversation looks at how doing the right thing can be innovative and why a good rapport w...

Presenting 2021's POCApalooza West; the annual tradition continues in the wake of last year's hugely successful international gathering of perioperative practitioners; hear how the rest of the world is handling the COVID-19 crisis, how the connectivity between patients and practitioners is improving and how one of TopMedTalk's favourite contributors is now taking perioperative medicine to the hear...

Presenting 2021's POCApalooza East. The now annual tradition continues in the wake of last year's hugely successful international gathering of perioperative practitioners; hear how the rest of the world is handling the COVID-19 crisis, how the vaccines are getting on and why perioperative medicine is primed to help in the near and necessary journey to be taken out of this current situation. Featur...

"Perioperative medicine ... I always think of a Venn diagram where there's truly an intersection between surgery anesthesia and medicine, and perhaps even a subset of medicine called geriatrics, that really create this convergence of what we're now creating as a novel science ... Perioperative medicine, I would say is a new clinical science that really incorporates all that" This piece is a fascin...

"Data is key and having champions is key" This piece provides a truly transatlantic in-depth perspective on an area of opportunity highlighted by our needs in the wake of COVID 19; now more than ever true enhanced recovery after surgery (ERAS) is essential. Optimising value, reducing the need for return visits, decreased length of stay, there is almost no aspect of perioperative medicine and enhan...

"Connected care is a combination of the right tech, to monitor the patient, that's human factor friendly and easy to use" This piece is an in-depth look at how remote patient monitoring is evolving to suit a need that's growing as patients require more from their healthcare. The COVID-19 crisis has pushed these issues to the forefront, how can your institution modernize and evolve in this directio...

"We've been doing cryoneurolysis for total knees now for three years... people gravitate to practices that that practice this technology" This piece focuses upon two 'early adopter' orthopedic surgeons changing up the way we treat joint pain for surgical patients. We mention Iovera, a provider at the forefront of this technology: https://www.iovera.com/ The Doc Social website is here: www.doc.soci...

This piece is a worthwhile deep dive into this perioperative medicine and how we go forward with it. Hear the panel speak about what it is they want for the future and what it is they are doing now. With questions submitted from the online audience the panel get into the detail. Essential listening for any student of perioperative medicine. It includes a mention for the Welsh Perioperative Medicin...

This is a story that starts with some of the challenges faced in our world outside the operating theatre and it's about how we might address some of these problems systematically. Healthcare organizations have to deliver high quality, competitive and sustainable results and costs. Good quality perioperative surgery is absolutely critical to maintain the health and well being of our population goin...

This piece is a worthwhile deep dive into this perioperative medicine and how we go forward with it. Hear the panel speak about what it is they want for the future and what it is they are doing now. With questions submitted from the online audience the panel get into the detail. Essential listening for any student of perioperative medicine. When should we pre-assess patients? Should all anaestheti...

  "More than 300 million patients have surgery annually worldwide and an increasing proportion of them are elderly and at risk of perioperative adverse events. There's very few proven primary or secondary prevention measures, and the resources for monitoring and trading complications are inadequate. So - more action is required". This piece looks at the evidence as regards perioperative outcomes f...

"The song remains the same" The story picks up toward the end of the 1970's; "interesting stuff was going on ... Professor William Shoemaker, a surgeon and intensive care doctor one of the founding members of the American critical care society ... fiddling around with pulmonary artery catheters in his high risk surgical patients in South Los Angeles, and identified that those patients that were su...

"Accelerated surgery for hip fracture is safe and feasable, with troponin elevation before randomization, there was a mortality advantage with accelerated surgery. The logistics and resources required for accelerated surgery need to be balanced with the demonstrated benefits and patient's desires for accelerated surgery" This exciting piece from EBPOM 2020 provides a data download that further ill...

This piece is divided into two parts, the first being discussion between the panelists and the second, part 2, being questions from the online audience: What is your opinion about spinals and hip fractures for patients on clopidogrel? Do you use any near patient tests to confirm residual anticoagulation? Where are the best guidelines to be found? We suggest you listen to this piece alongside part...

The conversation begins with "a day in the life" with respect to managing the anti coagulation questions that come up commonly. The contributors swap stories from their time in practice. The conversation moves to protocols, guidelines and also, when where and how to begin bridging. This piece is divided into two parts, the first being discussion between the panelists and the second, part 2, being...

How can enhanced recovery after surgery (ERAS) be applied to cardiac and what exciting opportunities are there for those who have made this their mission? This detail driven address contains more information on The Society for Enhanced Recovery After Cardiac Surgery (ERAS® Cardiac), more information can be found on their website: https://www.erascardiac.org/ Since this address was given at Evidenc...

"Look at it from where is the patient, and what's best for the patient; I think that the other answers follow and yes, it is higher quality, yes, there can be some opportunities for cost savings; even if it 'breaks even' if the patients are happier, isn't that worth moving into the concept and proving that it does make a difference?" The value proposition is an essential element of advocating peri...