TopMedTalk

How do the insights of a 'medical linguistic anthropologist' impact upon our understanding of 'shared decision making'? How do patients make decisions about surgery? When, in the perioperative process, do they decide what is best for them? Does patient autonomy actually even exist? A bubble bursting conversation with a frequent favourite on TopMedTalk, this podcast is bound to get you thinking! Pr...

What are the big things to watch in 2020? "Renablement, rehabilitation and readmission" from a patient perspective and "training compotence, resillience and 'burn out,'" from the practitioner's point of view, according to one of our contributors on this piece. What about Enhanced Recovery, is that still set to be big in 2020? Is it methadone we should be thinking about? Is automation something on...

The TopMedTalk fortnightly digest is your round up of the past 2 weeks. Make sure you never miss out on crucial episodes and are fully up-to-date with your favorite medical podcast. Presented by TopMedTalk's senior producer Nick Margerrison .

Learn how to develop a national Quality Improvement (QI) network which will increase both communication and knowledge implementation. What are the essential elements of a useful network, how do you build a community within one and solidify it as an essential part of your practice? Presented by Carolyn Johnston , consultant Anaesthetist in St Georges hospital in London.

"Enhanced recovery after bariatric surgery" - was originally streamed live from the Charles Sammons Cancer Center, Dallas, during EBPOM-USA 2019 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 to send to the team email: contac...

This piece starts with some words from patients; prehabilitation is "a set of actions that can be taken in advance of treatment to ease your passage through cancer". This vital talk explains how prehabilitation can leave cancer patients feeling personally empowered and ready to live well. Living is one thing, how do we get people to enjoy 'living well'? Further to this how do we do that in such a...

Questions include: Do patients need to be advised about the possible hallucinatory side effects of ketamine? How do we ensure our perioperative pathway reaches patients at the earliest possible junction? Is there a standard pathway which can be applied to all? Featuring; Natasha Curran , pain medicine University College London Hospital (UCLH) and Medical Director at the Health Innovation Network,...

In the military Forward Surgical Teams (FSTs) are deployed into challenging environments to deliver "damage control surgery". They help people who have been injured, relieve the pain, stop the bleeding, 'patch the holes' and move them to a safer environment. It's from this background that our two contributors come, learn how they have been forced to innovate and what insights they can give to prac...

A discussion about consent, staying on the right side of the law, shared decision making and 'The Montgomery case' which has defined a Doctor's duty in these sorts of areas. Presented by Monty Mythen with Desiree Chappell and their guests Hugh Montgomery , and Paul Sankey , Enable Law partner and Clinical Negligence solicitor acting for patients, an accredited expert in his field.

The American Society of Anesthesiologists (ASA) continues to raise the standards of the medical practice of anesthesiology, as well as keeping a particular focus on improving patient care. This conversation is a chance to catch up with their work. For more on the Patient Safety Movement Foundation go here: https://patientsafetymovement.org/ Finally, the wonderful Linda Mason interview which gets m...

'The Practitioner Health Programme' - why do anaesthetists suffer from mental health problems, what help is there available for them? Learn here how people in that profession are uniquely placed to deal with the inevitable pressures related to healthcare. Presented by Desiree Chappell and Monty Mythen with their guest Dr Clare Gerada , Medical Director, Physician Health, Practitioner Health Servic...

Hear how you can transform your practice through team leadership, courage and a finely tuned awareness of the financial aspects of what you are trying to achieve. How can growth be tempered to suit the long term vision of a company? Why is teambuilding so crucial to large organisations? Can we determine the direction in which healthcare is evolving overall? Is 'population health in the perioperati...

This piece focuses on the "Wessex Fit-4-Cancer Surgery Trial"; a unique multi-centre, efficacy pragmatic, factorial design, randomised controlled trial, with patient informed development and process evaluation "You wouldn't run a marathon without preparing," why would you want an operation where you don't get ready for a physically stressful event such as surgery? Prehabilitation is an obvious adv...

How important is it to have a dedicated member of your team focused on starting, maintaining and coordinating your enhanced recovery programme? Does an enhanced recovery programme which comes from the grassroots need support early on in the process? How do you find the right people to support you once the process has begun? Also, how do you explain that these changes will actually reduce workload?...

This piece builds on last week's look at Fluid Physiology, with reference to the book linked to below. "We did not have a concensus view on the very basic subject of fluid physiology and I needed to write a book". The book Fluid Physiology is available now, check out the website here: http://fluidphysiology.org/ Tom's always entertaining twitter feed is here: https://twitter.com/thomaswoodcock Tom...

This piece looks at The WAVi Headset which allows for a multi-faceted panoramic assessment of brain performance. Hear how this device is used to assess the health of one of our most vital organs. For more detail check out the website here: https://wavimed.com/ Presented by Desiree Chappell with her guest Rob Martin , Chief Operating Officer at WAVi.

What is "The Brain Health Initiative"? Why is it that so many aspects of brain function are so hard to understand? Why is cognitive dysfunction such a difficult topic to discuss? How far away are we from the days when we will have a biomarker that can help us in this area? Desiree Chappell presents, with her guests; Dr Lee A. Fleisher Professor and Chair of Anesthesiology and Critical Care, Univer...

Anaesthesia is the official journal of the Association of Anaesthetists with comprehensive coverage of publications in anaesthesia, ICU and pain. This piece gets into the detail of their hugely popular perioperative care supplement, a collaboration with BJS (formerly the British Journal of Surgery). Surgeons and Anaesthetists around the world are engaging in the debate as a result with thousands o...

"It's all about safety and recovery, it's not about speed"; this conversation focuses on enhanced recovery, are we getting it right and where are people getting it wrong? How reliable and well understood is the data behind it? Also, what are the current thoughts on perioperative steroids? How do we refocus and move back to enhanced recovery after surgery rather than "enhanced discharge" after surg...

In this piece we're joined by a TopMedTalk favorite for a few predictions regarding the year 2020. Prehabilitation, "the word of the year" for 2019 and now something we expect to see break into the mainstream? How is anesthesia going to develop and what's the future for artificial intelligence in surgery? PQIP link: https://pqip.org.uk Multimodal analgesia: https://www.topmedtalk.com/ebpom-usa-par...

This panel discussion and extended question and answer session focuses upon troponin screening. Where is the latest evidence as regards this debate? Is MINS ( Myocardial injury after noncardiac surgery) the most common postoperative complication associated with death and if so why is there a transatlantic divide as regards the evidence? Is there a place for troponin screening preoperatively for ri...

To celebrate the launch of his book Fluid Physiology, A Handbook for Anaesthesia and Critical Care Practice: https://books.google.co.uk/books?id=F-m4DwAAQBAJ&printsec=copyright&redir_esc=y#v=onepage&q&f=false What are Tom's big areas to watch in 2020? Also how are surgical teams similar to the team behind the moon landing and what should we be thinking about the use of steroids in surgery? Check o...

This piece dives into "The new www revolution?: Wireless Wearables on the Ward". Improving the monitoring of patients on the wards is an exciting prospect for any modern practitioner and as personal health monitoring technology becomes mainstream for the public it's surely an inevitable part of the future of medicine. The website mentioned in the podcast is here: https://www.michardconsulting.com/...

"One of the best sessions of the entire conference" was presented by our guest on this piece. In this podcast there's a chance to really discuss perioperative optimisation, with a focus on delirium, in post operative patients. Are we getting to where we need to be or is there more work to be done? Presented by Desiree Chappell with Sol Aronson and their guest Charles Brown, associate professor of...

This passionate talk is a call to action for the peioperative practitioners who are serious about the wider issue of population health. How can the protocols and pathways of your practice be adjusted to seriously contend with the global issue regarding the stewardship of one of medicine's most vital resources? Presented by Alison Holmes , Professor of Infectious Diseases at Imperial College, Fello...