TopMedTalk

Insights and perspectives on the science of prehabilitation from a very different angle. It's often said on TopMedTalk that preparing for an operation is not unlike getting ready for a marathon; how do the insights of professionals who work with elite sports men and women to ensure they are fully prepared to do their physical best, on the world stage? Also, what about the teamwork inherent in such...

What are the opportunities presented to a perioperative practitioner when political devolution becomes a reality? What can we learn from the experiences of a team leading the introduction of ERAS+ and prehabilitation across Greater Manchester with a 'Spread and Scale innovation grant' from the Health Foundation? How do you demonstrate benefits which patients and fee payers can understand? How do y...

This piece gives us a look at some of the latest thinking on Post Operative Nausea and Vomiting (PONV). It includes a discussion about Amisulpride and discusses new, yet to be published, consensus guidelines for PONV. The original guidelines are here: https://www.ncbi.nlm.nih.gov/pubmed/24356162 Also, you may like to check out the details of this paper here: Amisulpride: A New Dopamine Antagonist...

Is it fair to say that prehabilitation is the new direction for practitioners of Enhanced Recovery After Surgery (ERAS)? Discussion expands into patient awareness initatives, The Macmillan Cancer Support, Principles and guidance for prehabilitation guide mentioned is here: https://www.macmillan.org.uk/about-us/health-professionals/resources/practical-tools-for-professionals/prehabilitation.html Ag...

This piece focuses upon patient safety and the work of our guest. How does perioperative medicine fit into the picture, are anesthetists right to take the lead in this field? You can find the Anesthesia Patient Safety Foundation here: https://www.apsf.org/ Learn more about the Perioperative Surgical Home here: https://www.asahq.org/psh Presented by Desiree Chappell with Monty Mythen and Henry Howe...

"POETTS 2018 | The evolution of a community-based Prehabilitation service" - 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'...

The focus for the first part of this POCAPALOOZA was Duke University's PASS clinic. Find out more about the PASS clinic: https://www.dukehealth.org/locations/duke-pre-anesthesia-testing-center-clinic-2d "So it's a new approach to really changing the paradigm from just evaluating a patient and sort of passing that information forward to the receiving team [...] rather we take a much more proactive...

Some of the big questions: Is the pulmonary artery catheter back? What have been some of the big take aways in nutrition? Why should you feed a cold and starve a fever? More Protein or less? Finally, 'humanizing intensive care' is discussed, do we need more ITU pets? Presented by Desiree Chappell and Monty Mythen confer on the events of the day with their guest Hugh Montgomery , Intensive Care Soc...

Learn how and why the benefits of real-life health care simulation situations are used by institutions such as Northern Kentucky University. Interviewing a patient, reading an X-ray, or administering an injection, in a convincing virutal environment. The St. Elizabeth Healthcare Simulation Center features seven simulation rooms including an operating room and intensive care unit. What are the futu...

Care of older people in surgery (COPS). Are you properly assesing your patients for cognition? Surgery can be appropriate for some to reduce pain in palliative care, how do we make decisions regarding a possible intervention? How important is frailty in this process? The slides from this talk are here: http://www.anzca.edu.au/documents/03-jacqueline-close_care-of-older-people-in-surger.pdf Present...

This discussion begins with a focus upon some of the networking and information sharing events that go on in our field; The Society for Perioperative Assessment and Quality Improvement (SPAQI, website here: https://www.spaqi.org/2020/ ) The 17th World Congress of Anaesthesiologists, September 5-9, 2020, Prague, Czech Republic (website: https://www.wcaprague2020.com/ ). Discussion then moves to spe...

"It's like running an election campaign..." Perioperative hemodynamic management; how do you make it really work within an institution? With extensive reference to real life experience hear first hand stories from our guest and Editor in Chief's experience of doing just that. How do you get people both in and outside of the team to understand the importance of it? Hear about new developments in En...

The POCAPALOOZA story begins with our fascination with The African Surgical Outcomes Study. Over the last year regular listeners have heard key parts of the narrative fall into place during TopMedTalk interviews and discussions. Learn how the European Surgical Outcomes Study (EUSOS), presented at a previous Evidence Based Perioperative Medicine (EBPOM) conference, helped to inspire the African Sur...

Pediatric patients can present quite a challenge when emerging from anesthesia. Here we discuss ways to "ACE" your transition to PACU! "A"void Emergence Agitation, and discover the latest evidence about "C"riteria for "E"xtubation in this challenging population. How do the protocols and standard of care compare between the UK and US. What does the evidence tell us? Also, how is Enhanced Recovery A...

After working at a Veterans Affair Medical Center, hear how our guests moved into the field of emergence delirium: "upon emergence our patients were swinging and very aggressive ... there must be some way to prevent this". This fascinating piece enjoys an engaging discussion about an important topic for both patients and practitioners; how important is it for you to know a patient may suffer from...

The electronic cigarette market is a $14 billion industry worldwide. As of August 2019, 215 cases of severe pulmonary illness related to e-cigarette use are being investigated in the United States. The known hazards of e-cigarette use are rapidly coming to light with the sudden onset of serious bronchiolitis-related pulmonary disease in otherwise healthy people who were known to use e-cigarettes....

Pain is a subjective experience that affects all segments of the population. However, there are inter-individual differences in pain. The biopsychosocial model proposes that the intersection of biological, psychological, and social factors create a pain experience and pain outcomes that differ by sex, race, and socioeconomic status. "The minority stress theory ... the idea that for racial minoriti...

This invaluable piece is a chance to attend a workshop which looks at the latest thinking on "perioperative cognition" and 'post-operative cognitive dysfuntion'. We advise you use this link here to find the PDF of the paper being discussed: https://bjanaesthesia.org/article/S0007-0912(17)54082-9/fulltext Presented by David Scott , Professor, University of Melbourne, Director, Anaesthesia and Acute...

"My first thought was - why can't we do this here?" What is ketamine, what sort of drug is it and how is it used? How was it first synthesized? Was it intentionally found or another of science's happy accidents? This piece is a fascinating look into the history and future of ketamine with a focus on outpatient infusion centers. Could this unusual and "dirty" drug - meaning it acts on many parts of...

"4-10% of opioid naïve patients will continue to use opioids more than 90 days after surgery" Opioids are good for pain control but there's another issue, they also numb emotional pain. How do we responsibly deal with this? It's important to remember: "When you give patients high doses, you're putting them at risk". Long term listeners will recall TopMedTalk spent the best part of our launch year...

"Our job is to tell them; there is another solution ... there's another way to solve this problem and I can help you" This piece takes a bold and honest look at suicide in anesthesia, although it has a US set of contributors the issues here are to do with everyone in healthcare. TopMedTalk is keen to promote the fact help is available, please seek it out if you are concerned you might be affected...

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...

This piece looks at innovations in our field, through the lens of the Hypotension Prediction Index (HPI). Innovations in medicine are always exciting, "neuro-monitoring" is discussed "if you told me two years ago that I was going to be able to understand an EG waveform I would have laughed at you". "Data is what drives any change", how can new insights regarding hypotension potentially revolutioni...

"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...

"Thank you for taking this meeting beyond these walls" - this piece was the final part of our coverage of The American Association of Nurse Anesthetists (AANA) 2019 Annual Congress in Chicago, Illinois. We begin with the global audience in mind and break down what it is to be a Nurse Anesthetist. It's a role which is expanding in scope, our guest walks us through how and why that's the case. This...