TopMedTalk

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"...

This piece is intended as a chance for listeners to TopMedTalk to both raise money for the effort to tackle COVID 19 and have a bit of relaxation and entertainment while doing so. Our Editor in Chief Monty Mythen will be joining our guest, Jeremy Sassoon live on Facebook at 5pm on Saturday 11th of April. In advance of that this piece explains how the two of them got to know each other along with s...

This piece is both a chance to relax and an opportunity to join the TopMedTalk team online as we unwind to our favourite Jazz musician, Jeremy Sassoon. As well as being an excellent and renowned musical talent he also happens to be a school friend of Monty's so we managed to convince him to join us for an exclusive interview tomorrow, in advance of which we're giving you a heads up that he will be...

Smoking is bad for you, there's little debate about that, even among users of the drug. However, further to the widely known consequences, the bottom line in the perioperative period is that smokers are 40% more likely to die after major surgery. Do patients also know this? Tissue healing, increased risk of infection and increased possiblities of complications with the anaesthetic; with these risk...

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. 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 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...

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" but how h...

Why has 'prehabilitation' suddenly picked up pace in terms of both practice and interest? This piece takes a serious look at the widening interest in an idea familiar to many sportsmen. Learn how the marginal gains we get through the application of science to optimise the moment of surgery as a real opportunity to apply everything we know. Also; what are ketones and how can they be used to promote...

We get a quick update from Monty, how is his return to work going after quarantining at home with COVID 19 Further conversation takes a look at the care being given to COVID 19 patients and their providers. What is PPE fatigue? Where is the debate regarding COVID 19 positive patients and fluid management? A lot of it boils down to the mantra "keep it simple", do the job as correctly and properly a...

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 sees us catch up with a the TopMedTalk team favorite; Joff Lacey. A popular presenter here on TopMedTalk, Joff tells us of his first hand experiences in the ongoing battle against COVID 19 in South London. We also get an update on Monty's condition. Presented by Desiree Chappell with Dr Joff Lacey , Consultant Anaesthetist at St George's Hospital in South West London. Thank you to our s...

Emotional intelligence is the ability to perceive, integrate, understand and utilize emotions in an effective and meaningful way in order to cope and adapt to the situation. It's a hot topic at the moment, here we speak with the first CRNA to be certified in emotional intelligence. Stress and burn out is a common problem in the CRNA community, handling that could have a real impact on performance...

This week begins with an update on Monty's progress after his COVID 19 diagnosis. Have the symptoms returned or is he back to his usual self? One thing we know for certain when it comes to this virus and our treatment of it's symptoms; it is a dynamic situation. Management of the COVID patient is constantly changing. Do we treat our patients as having Acute respiratory distress syndrome (ARDS) or...

Burn out and stress management have been an important theme on TopMedTalk recently, here we have a top medical professional sharing their story in relation to the topic. How do we describe "burn out", are certain words a barrier to discussion? How do we cut through to people who are most likely to suffer from this incredibly dangerous condition? Is the medical profession finally making progress he...

This week's Women In Anaesthesia focuses in on TopMedTalk favourite Carol Peden. The British Journal of Anaesthesia article, which inspired this series, is here: https://bjanaesthesia.org/article/S0007-0912(20)30003-9/fulltext -- "The Power of The Interdisciplinary Team"; introducing the Enhanced Recovery team from Keck Medical Center at The University of Southern California (USC). Our guests kind...