TopMedTalk

This conversation sets the scene for the UK. London now having some hospitals which are overwhelmed, other parts of the UK still in the anticipation period. The conversation moves to the importance of enhanced recovery after surgery and its immediate relevance to the COVID 19 crisis. Then the topic of Personal Protection Equipment (PPE) is raised, possible shortages are discussed. The debate about...

This remarkably prescient conversation was recorded at an Australian National Summit in Adelaide regarding the 'hidden pandemic of postoperative complications'. The dangers presented by them certainly suggest this area needs to be taken more seriously. Although staged in Australia this conversation is of global concern, particularly at a time when the world is realising the benefits of proper peri...

What are the benefits of Cardio Pulmonary Exercise Testing (CPET) in cancer patients? What is the evidence that suggests prehabilitation changes outcomes? Furthermore, what is the National Emergency Laparotomy Audit (NELA) and what are its benefits? Presented by Joff Lacey and Desiree Chappell with their guests; Carolyn Johnston , consultant Anaesthetist in St Georges hospital in London and Improv...

"Enhanced Recovery After Cardiac 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: contact@...

This piece is a detailed and reassuring look at how preparations are being made in North Carolina by our occasional host and regular contributor Vicki Morton. "I was told a few weeks ago [that] my focus was shifting to Covid preparedness"; hear how a taskforce was put together to prepare for the global pandemic. "Various different countries have been in denial" but now the fight back has begun in...

Our guest is an intensivist and specialist in dangerous transmissible diseases as well as being one of the scientists who took part in the Xtreme Everest expedition which investigated the effects of human tolerance of hypoxia. What about continuous positive airway pressure (CPAP)? Information suggests this may be more useful as we head into the pandemic stage "based on the experience the Italians...

Can delirium, the most frequent complication in an elderly patient, be tackled with multimodal prehabilitation? This piece explains how that challenge is being investigated at the moment. A link to the paper is here: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6564537/ Presented by Ties Lukas Janssen , General Surgery Resident at Amphia Ziekenhuis.

Desiree and Monty update each other on how it's going as both the US and UK healthcare services prepare for, and begin battle with, COVID 19. School closures in both the UK and the US; how do the practicalities of cancelling school attendance impact upon frontline providers? What do comparisons with other countries tell us about the oncoming tsunami? Presented by Monty Mythen and Desiree Chappell...

A large part of the journey towards enhanced recovery, better outcomes and fewer complications, is to do with educating patients. How do we explain to patients that an operation is something which is ideally a collaboration between both practitioner and patient? The "Fitter, Better, Sooner" toolkit, which this piece focuses on, can be found here: https://www.rcoa.ac.uk/fitterbettersooner The excel...

"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...

"The parade here in Dingle is usually the first in Ireland..." but this year it is postponed. We speak to a Councillor in Dingle, a place much loved by many TopMedTalk listeners who attend the annual Evidence Based Perioperative Medicine (EBPOM) conference there. Monty Mythen is joined by Cllr. Breandán Fitzgerald , County Councillor on Kerry County Council. Thank you to our sponsor Edwards Lifesc...

"Maintaining your staffing is key"; this piece is a conversation recorded immediately after a deeply concerning report regarding the situation in Bergamo, Italy. The risk of overwhelm at our institutions is present as the understanding sinks in regarding the fact this is a massive population health issue. Presented by Desiree Chappell and Monty Mythen with their guests Dr Michael Scott , Professor...

Preparations in London and the US are discussed before a frontline report regarding Italy and the consequences of the pandemic there. Presented by Desiree Chappell and Monty Mythen with, Dr Michael Scott , Professor of Anesthesiology at Virginia Commonwealth University, Maurizio Cereda , Associate Professor at Hospital of the University of Pennsylvania and Andrea Ciocca from Naples. This conversat...

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...

"There hasn't been any griping, there hasn't been any ill temper and people are coming in to help out in any way..." this piece gives us an idea of how things are going in the UK, in this instance in Whittington, North London. A sense of preparation is in the air. Looking at other countries and the epidemiology "we're about to reach the inflection point when a little trickle of cases [become] a fl...

"The first case of COVID in China was the 8th of December..." this piece looks at the outbreak of the disease from the perspective of healthcare workers in both Hong Kong and Italy. It starts with a summary of a conversation with Professor Mike Irwin, University of Hong Kong. We then move to a conversation with Mirco Nacoti, specialist intensivist at Bergamo, Italy. Presented by Monty Mythen and D...

This piece is the first in a new series of programs we are making in response to COVID-19, now described by The World Health Organisation as a global pandemic. How can we, the TopMedTalk community, rise to this challenge and help each other as we share information and experiences? Where can people look for the sort of information they would ordinarily have gained from the conference circuit this y...

Does perioperative medicine alow institutions to take a broader view? Population health has been a theme on TopMedTalk, is it a logical extension of the perioperative process? How do we manage specialist care for the elderly and ensure high quality shared decision making? What lies behind the mindset change needed for some to accept surgery is not always the answer? Should we expect medical studen...

The concern for patient safety naturally flows throughout the healthcare continuum. In our discussion with Masimo Founder, Joe Kiani, we discuss the 'planning for zero' initiative and how we can realistically reach perfection in this area. The Patient Safety Movement Foundation is an organization dedicated to a goal of ZERO in-hospital preventable deaths by 2020. They request that you and your org...

"ERAS in Colorectal Surgery" - was originally streamed live from the Charles Sammons Cancer Center, Dallas, during EBPOM-USA 2019 on www.topmedtalk.com 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: contact@topmedtalk.com Presented by Anthony Senagore , Professor and Vice...

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...

How do cardiac surgeons adapt to the changing environment and information that we now have at our fingertips? Minimally invasive robotic surgery provides additional options to the perioperative patient, what unconventional therapies might compliment this? This piece gets into specifics regarding pain management and the multimodal approach. How do you prepare patients with an understanding regardin...

This piece focuses on the article "The malnourished surgery patient, a silent epidemic in perioperative outcomes?" which you can find here: https://journals.lww.com/co-anesthesiology/Abstract/2019/06000/The_malnourished_surgery_patient__a_silent.23.aspx The Perioperative Quality Initiative is here: www.poqi.org Presented by Desiree Chappell with Monty Mythen and their guests Jeroen Molinger , Clin...

This podcast covers the physiological principles of goal directed fluid therapy, fluid responsiveness, the stressed system and the glycocalyx. Originally streamed live on www.topmedtalk.com Presented by Dr Joff Lacey with his guest Dr Randall Dull of the University of Illinois, live from the ASA in 2017.

Learn here about The 2nd Sprint National Anaesthesia Project: Epidemiology of Critical Care provision after Surgery (SNAP-2: EpiCCS). Is anxiety the worst thing about an operation? How common a problem for patients is feeling thirsty? What about pain, how do we best manage it? In the second part of the piece we a focus on "Women in Anaesthesia"; Is there an 'opportunity gap'? How do we correct imb...