TopMedTalk

This piece takes a look at some of the big areas we expect to see over the next twelve months as Desiree Chappell and Monty Mythen are joined in the studio by TopMedTalk favourite Mike Grocott , Professor of Anaesthesia and critical care at the University of Southampton. Could political change and necessity improve things in the UK? Hopefully this time next year will be a "champagne moment" rather...

"The predominant emotion was fear..."; this piece is essential listening for every TopMedTalk listener who really cares about the experience of their patients. Hear what it was like to participate in the pioneering, tailored exercise training programme, The Encourage Trial. Also, find out about "the Buddy Scheme" and how becoming a member of a local support group: SPICOS (Support for People Impact...

Hear how evidence based practices can reduce costs and improve outcomes. What are the key areas most institutions can work on to get the best and most rapid return on time invested? Neuro, atrial fibrillation, acute kidney injury (AKI) and blood management are big key areas. The article discussed in this piece is here: https://www.scahq.org/Portals/0/Documents/Clinical%20Practice%20Guidelines/SCA_...

Enhanced Recovery After Surgery, (ERAS) is a familiar concept to the typical TopMedTalk listener but what is ERAS+? How can you target high risk surgery patients with a comprehensive plan for them to help themselves get a better outcome? From managing expectations, to breathing exercises all the way up to significant lifestyle changes such as exercise and smoking cessation. The ERAS+ website is he...

  Frailty is a common condition which has been topical in geriatric medicine for some time but now it is appearing in the surgical and anaesthetic literature. This talk explores how our understanding and discussion has improved regarding a condition that is still yet to have a clear, universally accepted, definition. How do we build a patient's physical reserve? What is the best way to conceptuali...

Should prehabilitation be thought of also as "primary prevention" and used to avoid health problems occuring in the first place? If "exercise is real medicine" how do we change the culture so GPs are comfortable prescribing physical activity to patients? How can we get people to exercise more when the political mood is turning against Government interference and the so-called "nanny state"? What i...

This is TopMedTalk's first in a our series 'Women in Anaesthesia': a celebration of the women who drive academic research and perioperative practice around the world. Inspired by the British Journal of Anaesthesia's March edition of the same name this series will profile some of the women who take frontline roles in our profession, all of them contributors to TopMedTalk. Angela Bader features on T...

Global health is something TopMedTalk listeners are naturally passionate about; here you can listen to the keynote address from the 42nd President of The United States, Bill Clinton, to the World Patient Safety, Science & Technology Summit. 273,077 lives have been saved over the last 7 years with over 90,000 of those in just the last year alone. 4,700 hospitals around the world that are part of th...

This podcast includes discussion about psychological optimisation for surgery; who should have it, what does it mean and how does it work? Further conversation moves into weaning patients off opioids in advance of surgery and cutting their dependency afterwards. Also, the question of consent to opioids during and after surgery comes up - should we be educating patients more and is it time to look...

"Does choice of opioid influence health outcomes?" - 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 to send to the te...

What insights does a history of working in military healthcare bring? How do we cut back on readmissions to hospital after time spent in the intensive care unit? How serious an issue is 'burn out' within healthcare? How did standardisation help when designing an award winning patient transfer bag? What's the best way to transfer a patient from ward to ward or from institution to institution? How d...

Recorded live at the Association of Anaesthetists' Winter Scientific Meeting 2020 in the centre of London from The Queen Elizabeth II Centre. Hear the conversation and questions asked by our online audience. In our online world is there still a place for a paper based journal? What are the big stories and hot topics of 2020 going to be? What about hyperoxia? How does what we do effect the environm...

This piece is a discussion regarding the SQUEEZE Study: A prospective multi-centre international observational study of postoperative vasopressor use. The website mentioned in this piece is here: https://www.esahq.org/research/clinical-trial-network/planned-trials/squeeze/ Our conversation with Konstantin Balonov is here: https://www.topmedtalk.com/euroanaes2019-konstantin-balonov/ Presented by De...

What can practitioners do to preoperatively screen for signs that their patients may have issues with post operative delirium? How do we get patients fit for surgery, particularly as regards delirium? Can you build up mental resilience in the run up to an operation, do suggestions that puzzles and mental activity such as sudoku and a good crossword help have any evidence behind them? This piece fe...

This panel discussion reacts to various questions from the online audience and those in attendance. Questions include; Is there any good evidence for the use of wearable tech in prehabilitation? How come, if the evidence is almost there, prehabilitation is not yet included in every pathway? In this respect, is change just around the corner? How do we have patients are partners rather than passive...

This piece focuses on the "SupPoRtive Exercise Programmes for Accelerating REcovery after major ABdominal Cancer surgery" (PREPARE-ABC) trial. How do we establish the effectiveness of pre and post exercise plans? Do they really form a sensible part of a "value based care" package? This concise presentation gives you a clear idea of the aims and structure of the trial. Prepare ABC tweet here: https...

"Evidence ... is only as useful as the end user is willing to put it into practice". This piece begins with a discussion about translational research, the way in which individual studies are looked at and combined into more accessible guidelines. How do you become an 'informed consumer' of information and evidence? Also, what is the latest thinking as regards "pharmacogenomics"? Is it true to say...

This piece gives you information that will empower you when using Warfarin in the perioperative period. How should you sensibly balance bleeding and thrombotic risk? Anti-coagulants are increasing in number, what are the principles behind them which we should learn? An understanding of patient, procedure and type of drug being used is essential, are there other factors that can come into play? Her...

"Perioperative nutrition" - 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 to send to the team email: contact@topmedt...

The Hypotension Prediction Index (HPI) Monitor takes 2.6 million features from a single waveform which it then applies to 150 million different wave forms looking for factors which can predict hypotension. It's the first fully approved foray into predictive analyitics for the world of anaesthesia. This conversation looks at how it works and how it is being adopted in detail. Presented by Desiree C...

This piece starts with the question: Is there a hierarchy amongst the various elements of an enhanced recovery pathway? The conversation that follows tackles some of the essential elements of perioperative care. This conversation is taken from a longer piece to be found here: https://www.topmedtalk.com/live-from-the-iseh-part-2/ For further expert discussion regarding the Drink, Eat, Mobilise, Sle...

Please do all you can to help share this a hugely important piece, both for practitioners and patients. Adverse outcomes can be avoided, stories like the one on this podcast are fuel in the engine of those who advocate true perioperative care. If you want to help go to the Greater National Advocates website here: https://www.gnanow.org/ The Patient Safety Movement is here: https://patientsafetymov...

The Perioperative Quality Initiative (POQI) have featured frequently on TopMedTalk, here we discuss their focus on hypotension and blood pressure. Perioperative Quality Initiative consensus statement on the physiology of arterial blood pressure control in perioperative medicine: https://bjanaesthesia.org/article/S0007-0912(19)30047-9/fulltext Perioperative Quality Initiative consensus statement on...

This talk is a powerful look at a new world where we commit your institution and practice to achieving an end goal of "zero preventable deaths". The Patient Safety Movement Foundation (PSMF) has generated an enormous amount of global news media coverage as it promotes that aim; celebrities, statesmen, politicians and industry leaders are all getting behind an ambition which, after hearing this tal...

This piece is a fascinating overview of Australia and New Zealand's Emergency Laparotomy Audit - Quality Improvement (ANZELA-QI). It works as an update on the initiative, provides all the background you need including explanations regarding, structure, organisation and additional support as well as answering key questions such as: Do we need it? How do you join and what happens when you do? A link...