TopMedTalk

The healthcare profession has a mixed history when it comes to messaging around alcohol. Nowadays, from a public health perspective, it is clear that overall it is not helpful for our physiology and well being. How often do you have alcohol? How many units do you drink? How often do you have a binge? What are the age groups where drinking problems are most apparent? Where is the latest research re...

"You're a bit further down the line with managing these patients. Any particular advice?" Italy, the situation is difficult but there are now clear lessons to be learned as the first chapter in the front line battle against the consequences of a global pandemic is written. Hear how the story regarding treatment for this disease evolved in Italy and consequently around the world. Has the debate reg...

"Moving as medicine; is it the most underused but proven health promotion and healthcare practice?" Prehabilitation and population health naturally walk alongside each other. Learn here how Sport England's ambitious strategy to reduce inactivity and improve the nation's physical and mental health is connected to prehabilitation and Enhanced Recovery After Surgery. Should patients be seeking expert...

This piece is something of a ray of hope, here we learn how New Zealand appears to have managed the crisis remarkably well, a low level of infections overall. What lessons can be learned from the political leadership and tactic deployed here? Is there a downside to this, as regards to 'herd immunity', or is the reality that all of us must wait for a vaccine? Presented by Desiree Chappell and Monty...

This piece is a catch up with a popular contributor on TopMedTalk, Ross Kerridge, John Hunter Hospital, Newcastle, Australia, (often cited as 'the father of Modern Perioperative Medicine), for an update on how Australia appears to have managed to broadly keep a lid on this crisis. Social distancing, quick action and border controls appear to have worked to forestall the impending crisis. Our guest...

"It's really important just to talk about the situation and not keep it bottled up" Psychological stress is inevitable at this time for medical practitioners, that's why we here at TopMedTalk are keen to both raise money for the Intensive Care Society (ICS) charity and to remind our listeners of the importance of mental health and self care. There's a wealth of resources on this topic in the TopMe...

"Our mission is to make sure everybody in intensive care can learn [ultrasound]". How important and how possible is it to use ultrasound in your practice? Hear how it can transform the way you diagnose issues with pocket sized point of care ultrasound. Lung ultrasound is discussed as is its use with eyeballs. Hear how one of the pioneers in this area, Professor Sol Aronson, reacts to an enthusiast...

"It's heartbreaking - we have to recognise the fact, and continue to think; 'we've all got it, we can all get it and we can all give it!'" This urgent release from TopMedTalk will force the many leaders in our profession to tackle a very serious and important subject, what does the data reveal regarding COVID deaths among staff members and healthcare workers? Stark questions need to be asked; why...

The Intubate Covid project is an essential contribution to an evidence based answer to the issue posed by dangers of health care workers contracting and spreading the virus. By both collecting and sharing data the project gives you both a track record of where you are, in relation to your own safety, as well as the knowledge you are contributing to vital research. Find out more about the project b...

"The concept of 'disruptive innovation' in healthcare and that's what this has been; a major challenge to healthcare has forced us to do something very differently, very quickly." This piece starts with a quick update on the current situation from Monty and Desiree regarding where they are, London and Louisville Kentucky, in both the US and UK respectively. We then move to the fascinating and inev...

This is the second and concluding part of our real life case study of a COVID 19 patient. In this instance our Editor in Chief Monty Mythen has - during the course of presenting this series - contracted COVID 19. Fortunately for us, it was a comparatively mild case. This short documentary takes the story up right after Monty's decision to take a test to see if his symptoms were as we feared. Prese...

This piece looks at our recent archive and pieces together the story of our Editor in Chief, Monty Mythen's bout of COVID 19. From the start TopMedTalk was keen to reflect the global battle against this terrible virus and - as you will hear - concerns for our friends and contributors in the medical world was never far from our minds. In retrospect it is particularly interesting listening to how ev...

A quick surprising poll of perioperative practitioners sets the tone for a robust advocation of the responsibility of surgeons and practitioners to do surgery right; as opposed to being inclined to feeling it must be done "right now!". A data driven approach combined with a patient focused attitude are at the centre of the argument. How do these factors combine to produce a business case which all...

The UK has accelerated the graduation of medical students to help fight COVID 19. We speak to some of Britain's newest doctors to hear what it's like getting ready for - and going into - action against one of the most dramatic health crisis in living memory. Discussions about palliative care, end of life decisions and rapid patient decline are just some of the experiences they are learning to cope...

All treatments have unintended consequences, "locking down" most of The Western World is certainly no exception. In the medical world we're faced with a familiar set of problems which has been intensified thanks to the sidelining and postponement of treatment for people who do not have the corona virus. It's a complicated debate, with many strands, here we focus upon how prehabilitation, specifica...

This piece digs deep into the realities of coping with COVID 19 patients who have had their care escalated to the Intensive Care Unit (ICU); "we don't seem to be looking at our typical sepsis patients who get multiple organ failure in the classical way" and "you're surprised at how young some of the patients are...". Our guest provides us further insight; a 'household name' in the haemodynamic mon...

"It was taken pretty seriously, right from the start" After a quick update with both Monty, UK, and Desiree, US, we join one of our friends and colleagues at the University of Hong Kong; what's the situation there? What useful comparisons can be drawn from speculation about the differences between Hong Kong's response in contrast to ours? How can it be that in spite of such proximity to the epicen...

"It's airway, breathing, circulation" This piece focuses upon treating patients outside of Philidelphia at an "all COVID unit"; what can we learn from someone who stands at the cutting edge of fighting this terrible virus? How are staffing concerns being dealt with? What about on the job training and upskilling? How do we maximise human resources during this crisis? There is also a detailed conver...

Why does the US have the highest maternal mortality rate of any developed country? This piece tackles a very controversial issue in healthcare head on, could the problem be due to racism? The chances of a serious issue is "substantially higher if you come from a minority group, in particular if you are African-American". We also cover the issue of postpartum hemorrhage, what are the key signs that...

This piece sees the welcome return of our favorite live musician, Jeremy Sassoon, intended as a chance for listeners to TopMedTalk to both raise money for the effort to tackle COVID 19 and fight the 'burnout blues' while doing so. If you enjoyed this piece please check out this live video (which features on the podcast) here: https://www.youtube.com/watch?v=HbdJAFpRz34 And find Jeremy Sassoon here...

"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...

"Increasing the richness and the reach of what we do" is the mantra of 'Anesthesiology'; hear from its Editor in Chief how it managed to self study and discover the essential idea behind the journal: "trusted evidence, from discovery to practice". Conversation then moves on to methadone, the overlooked opiate; where do you use it and what sort of dose is appropriate? What are the benefits of inclu...

"If you ring up and start to apply pressure to them to say 'have you thought about giving my loved one drug A or drug B?' It might be helping them to get better but you might be encouraging them to do something that might hurt your loved one; so we have to do this with trials". This piece gets into one of the debates surrounding the treatment of COVID 19. What do we mean when we suggest people thi...

The UK has accelerated the graduation of medical students to help fight COVID 19. We speak to some of Britain's newest doctors to hear what it's like getting ready for - and going into - action against one of the most dramatic health crisis in living memory. Discussions about palliative care, end of life decisions and rapid patient decline are just some of the experiences they are learning to cope...

(REPOST) After a quick update from Desiree and Monty this piece focuses on Philadelphia Pennsylvania and gets into specifics regarding caring for COVID 19 positive patients. As regards The Jefferson Hospital; where has the ICU "take over" expanded to? Have critical care ventilators been deployed to all new ICU beds or have acceptable compromises been made? "Staffing is tougher than the equipment"...