TopMedTalk

"We're so invested in outcomes and data that it really gives us an objective view on how to approach things" This wide ranging conversation looks at how a data driven approach to change can produce better results in terms of patient outcomes. How do you highlight those opportunities with tact and clarity? How do we start to reward and recognise the best care that the evidence supports? We also hea...

Warning; this piece may make for uncomfortable listening. It is a fascinating look at the recent history of medicine and how our profession may in fact be sick. Contained within the story is a message of hope; evidence may contain the cure. In our recent history we seem to have enjoyed something of a "Golden Age" of medicine which, by raising quality of life so dramatically, has transformed our un...

"We wanted to know if goal directed therpy using a (Hypotension Prediction Index) HPI monitor can prevent hypotension". This piece looks in detail at the HPI monitor in practice- what is the benefit of this piece of technology in relation to hypotensive episodes? Furthermore how else is it to be tested and when will these tests be carried out? Presented by Desiree Chappell and Monty Mythen with th...

"We have to remember that patients have a team" How do we involve patients in the increasingly complex conversations we have in the perioperative space? This piece is a detailed case study which shows how shared decision making works in the perioperative setting. We know this improves patient experience yet in the last 10 or so years, consistently only 50 to 60% of patients say they were involved...

"In this session, we're going to talk about the importance of fitness, frailty, function and perioperative medicine." Fitness, frailty and function are overlapping concepts. In the UK, about quarter of patients will be over the age of 65 by 2034. As patients age they may develop comorbidities. These factors combine to present a unique opportunity for the perioperative physician; fitness increases...

"If I were to develop a simple uncomplicated urinary tract infection, I may well be able to continue to go to work as I was being treated for that illness but if an older frail patient develops a similar uncomplicated urinary tract infection, that can be a very significant illness, that patient may well be unable to walk or transfer as they could" Frailty in the perioperative period - what is it,...

TopMedTalk in Collaboration with MacMillan Cancer Support in the UK developed this podcast series to support patients during their cancer journey amidst the COVID 19 crisis. We know food gives us energy "but it also provides so much more". This podcast looks at the raw materials you'll need, when facing a cancer diagnosis, to get a better outcome; the vitamins, minerals and proteins, as well as th...

TopMedTalk in Collaboration with MacMillan Cancer Support in the UK developed this podcast series to support patients during their cancer journey amidst the COVID 19 crisis. It's vital you remain active after a cancer diagnosis, why is this? Hear the fascinating story behind the discovery that activity not only reduces your overall levels of fatigue but also improves your chances of recuperation....

TopMedTalk in Collaboration with MacMillan Cancer Support in the UK developed this podcast series to support patients during their cancer journey amidst the COVID 19 crisis. "It's very normal to sit with some difficult thoughts and feelings" after a cancer diagnosis. Broadly there are two types of mindsets; anxiety, which can be helpful, an element of wanting to 'do something' and, on the other ha...

"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 is an Edwards Lifesciences Sponsored Lecture which was originally streamed live on TopMedTalk from the hugely successful EBPOM USA 2019 in Dallas. In this piece we hear about the ongoing need for institutions and healthcare professionals to recognise the damaging consequences of intraoperative hypotension. Evidence has been mounting here on TopMedTalk over the last couple of years; there's no...

"Babies are still being born" Still! Revisiting this conversation from early in the pandemic, we discuss obstetrics during COVID. This piece looks at the area of obstetrics in the midst of an unprecedented global crisis regarding the COVID 19 outbreak. How can the delicate balance between reducing infections and social distancing be interwoven with the needs of modern childbirth. Should we be conc...

What are the latest developments in quality improvement programs that help operative teams around the world take what they do to the next level? When does the surgical journey begin? How has a focus upon patients prior to surgery improved outcomes? What are "the five phases of care"? How has data collection and management helped us to continually improve a patient's surgical journey? This piece is...

This piece, originally streamed live on www.topmedtalk.com features a conversation about the implementation of enhanced recovery protocols and the results practitioners report. The discussion starts with the observation that just implementing the ERAS intraoperative protocols drove outstanding outcomes in practice. The wider discussion focuses on the importance of putting into practice a bigger pl...

"I'm also a United States Air Force Officer and reservist and on April 4th was activated and given approximately 48hrs to deploy on a C-5 Galaxy Military Aircraft to the epicenter, New York City and I've been here for approximately, it's been almost a month now" This piece follows on from a previous exclusive conversation regarding the US military deployment to New York; here we get more detail an...

This piece focuses upon the increasing development of artificial intelligence and automation within the medical profession. Can automated monitoring actually allow practitioners to live more "in the moment" while in the operating theater? How do we use algorithms to avoid information overload? The book "Deep Medicine: How Artificial Intelligence Can Make Healthcare Human Again", your "anxiety anti...

This piece takes a look at the frontline fight against COVID 19 at Penn Medicine Princeton Medical Center in New Jersey, USA. Details of airway, ventilation and hemodynamic management are discussed with the director of Critical care and Anesthesiology. Resource management is a clear front runner as the virus creates a public health emergency for medics to try to battle. Additional beds and treatme...

"Obstetric anaesthesia" - originally streamed live from The Institute of Engineering and Technology (IET) in London during EBPOM 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: https://www.ebpom.org/meetings If you have any comments or questions you'd like to send to the team email: contact@topmed...

"46% pretty much means every other patient who was getting IV opioids was having some sort of a respiratory depression event" After a quick round up of COVID news in the contributor's respective areas this piece gets involved in a much needed discussion about the "PRediction of Opioid-induced Respiratory Depression In Patients Monitored by capnoGraphY (PRODIGY)" trial. PRODIGY trial is here: https...

Armed with a background in biomedical engineering, doubled with an EMBA in Finance, our guest has spent the past 20 years within the medical device industry. In 2010 he was instrumental in setting up MDoloris Medical Systems, with the mission to provide technologies that allow clinicians a reliable, continuous and non-invasive evaluation of autonomic nervous system (ANS) activity. Based on 23 year...

This piece highlights four papers published in the May 2019 edition of the (British Journal of Anaesthesia) BJA. Find them on www.poqi.org Furthermore, there's an interesting piece about the Perioperative Quality Initiative (POQI) here: https://www.topmedtalk.com/anesthesia-and-analgesia-go-big-on-poqi/ Presented by Desiree Chappell with Monty Mythen and Sol Aronson , tenured professor at Duke Uni...

"The peak keeps getting pushed..." What's the difference between a strategy of rationing as compared with one where the aim is concordence? As the crisis rumbles on, how do we decide who should have surgery, as well as the pressing question of how and where? The principles of perioperative medicine kick in here, pre-optimisation and enhanced recovery are uniquely suited within the profession to as...

This piece gives you clear practical suggestions which you might want to include in your practice and institution. How do we improve the physiological reserve of patients? Is there a way to do enhanced recovery with an extra edge? Specifically, how do we reduce pulmonary complications? What is 'surgery school'? How does 'icough' fit into this? How can practitioners and admin staff help to reduce a...

The opioid crisis "a unique American problem". This piece uncovers the origin of some of the misinformation about opioids, the consequences of calling pain a "fifth vital sign" and the absurd practice of waking patients up in the middle of the night to ask them if they are in any pain. As these factors combined fatalities started to spiral into the crisis we see today. Recent statistics make for g...

"Patients undergo surgery for important reasons, we need to improve surgical outcomes to the point where anyone can have surgery - and I believe that is do-able; we need to implement what we know, we need to avoid missed opportunities and we need to conduct more research. We should learn from the history of anesthesiology and how intraoperative care so dramatically improved outcomes" This powerful...