TopMedTalk

The results of the Enhanced Peri-Operative Care for High-risk patients (EPOCH) trial are a huge talking point in the perioperative sphere; this stand alone piece follows on from "EBPOM Conference Highlight | Lessons on EPOCH in the UK". To hear that click here: https://www.topmedtalk.com/ebpom-conference-highlight-1-21-lessons-on-epoch-in-the-uk/ Originally streamed live from the Charles Sammons C...

Where does anemia fit in the perioperative process? How do we optimise patients who have this condition in such a way as to get them best prepared for surgery? How do we know these procedures are improving outcomes?     Presented by Desiree Chappell and Monty Mythen with Mike Grocott and their guest Michael Scott , Professor and Division Director, Critical Care Anaesthesiology - Virginia Commonwea...

Preoperative optimisation and prehabilitation are key areas where your institution can increase value for patients. How do you negotiate the different pitfalls presented by the various core stakeholders? Smoking cessation, nutrition, exercise; all are proven to help produce better outcomes for a patient. How do we express this in such a way that we get buy-in from everyone concerned? When it comes...

Perioperative nutrition is a topic which has fascinates us here on TopMedTalk. Ever evolving and moving forward the questions continue as we explore an area which will only keep growing. Should evidence based arguments be the way we make the case for true investment in this area?   Presented by K orey Springman with her guest William Wooden , Director of Operative Services at Indiana University of...

Our coverage of ASER's annual meeting continues with a piece which focuses on prehabilitation and clinical nutrition, specifically as relates to surgery. Can the sarcopenic elderly patient build muscle in a reasonable timeframe with the right nutritional support? Are there particular 'magic protiens' we should use? Where does exercise fit into the picture? The interview regarding nasogastric feedi...

Welcome to the first of our exclusive podcasts covering this year's American Society for Enhanced Recovery (ASER) Annual Congress of Enhanced Recovery and Perioperative Medicine. ASER's web presence is here: https://aserhq.org/ This conversation focuses on the big talking points of the meeting so far. The discussion evolves into questions regarding data use and collection before moving into whethe...

Could a smoking cessation clinic be the next step in perioperative enhancement at your practice? This piece gives you an introduction to the idea and tackles some of the key elements.   Originally streamed live on TopMedTalk further listening is available here:  https://www.topmedtalk.com/?s=smoking   Presented by  James Davis , MD, Director Duke Smoking Cessation Program.

This piece focuses on the winning EBPOM USA poster presenter whose team were responsible for the excellent ' Understanding of delirium amongst the surgical team; a multidisciplinary survey'.   Go see the poster on the EBPOM website here: https://www.ebpom.org/EBPOM-USA-2019   Presented by  Robin Schiller  and  Bridger Bach  with their guest Zhaosheng Jin , Queen's hospital, Barking Havering Redbri...

The results of the Enhanced Peri-Operative Care for High-risk patients (EPOCH) trial; where does it put perioperative practice in 2019? What have we learned?   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 com...

This standalone piece allows us to explore further some of the issues raised by Saturday's podcast "TopMedTalks to... | Rick Dutton". If you missed it follow this link here: https://www.topmedtalk.com/topmedtalks-to-rick-dutton/   Originally streamed live on www. TopMedTalk.com under the title; "Educational Dinner Symposium: Q&A Session" as part of our coverage of the EBPOM USA Dallas Master's Cou...

This piece is about the importance of early mobilisation after surgery; "your first physical therapy session may very well be in the recovery room".   Desiree Chappell  presents with  Monty Mythen  and their guests; Dr  Steve Flanagan , Chair of Physical Medicine and Rehabilitation at NYU Langone and  Colleen Walsh , Assistant Professor, Nursing, University of Southern Indiana, President, National...

This piece explores the current thinking on hemodynamics, get ready for a deep dive into the conversation and controversies.   Originally streamed live from www.topmedtalk.com as part of our coverage of The EBPOM USA Dallas Master's Course 2019.   This panel discussion is chaired by Desiree Chappell , CRNA from Louisville Kentucky and Board Member of ASER. It features Monty Mythen , TopMedTalk Edi...

Speaking with a legend in the world of anaesthesia; this piece allows us to explore some of the bigger issues and milestones in the profession. How has it evolved, particularly in relation to the simultanious evolution of perioperative practice? Where are we now and where do things look set to go in the future?   This piece was originally streamed live on www. TopMedTalk.com under the title: "Educ...

How can your value based care proposition be further enhanced by a centre for geriatric surgey and palliative care? How important is shared decision making to your practice? What are the opportunities for an institution to improve in this area?   Presented by Desiree Chappell and Monty Mythen with their guest Angela Bader , Vice Chair of Perioperative Medicine at Brigham and Women's Hospital.

  From a leadership perspective should enhanced recovery for obstetrics be "standard of care" across the nation? Interest in this field seems to be growing, how widely accepted is this practice in the US?   Finally, what recommendations are there for institutions and practitioners who want to try to apply some of the principles of enhanced recovery after surgery for obstetrics immediately after li...

"Leading a large, single group towards excellence" - 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:...

Discussion begins with a hugely successful Enhanced Recovery program at a large community hospital, continued improvements and service line expansion. Learn about both the advantages and the challenges of a perioperative practice here.   Presented by  Desiree Chappell  and  Monty Mythen  with their guests  Kim Duggan , Perioperative Surgical Home (PSH) - Enhanced Recovery After Surgery (ERAS) Mana...

In critically ill patients where are we with haemodynamic monitoring and management? What is an ideal mean arterial pressure (MAP) during the process? What about chronic hypotensive patients? How do we safely avoid being too dogmatic about guidelines? Presented by Monty Mythen and Desiree Chappell with their guests Professor Mervyn Singer , Intensive Care Medicine at University College London and...

The debate ' Direct laryngoscopes should be consigned to history ', was hosted by The Royal College Of Anaesthetists and carried out by our two guests on this piece. Here we get into the advantages and challenges behind the two techniques; video laryngoscopy and direct laryngoscopy. The conversation explores the fact that these skills are a key part of the job of practitioners, are we "de-skilling...

Can artificial intelligence drive new changes in care and the value of big data? We're already comfortable with using tools that help us to do our job better, what are the opportunities and pitfalls related to this new technology? Are we ready yet for big data? The changes it may cause are staggering but equally; nuance is the friend of truth, do we have enough 'data literacy' to handle it all? Al...

This piece focuses on the rise of cardiopulmonary exercise testing (CPET) in the wake of the Measurement of Exercise Tolerance before Surgery (METS) Trial, which seems to have shifted opinions, does a genuine 'perioptimist' have a deeper insight into the issues there?   Presented by Desiree Chappell and Monty Mythen with their guest Dr Elena Koepke , Assistant Professor at Moffitt Cancer Center/US...

What's the need for a perioperative surgical home? How do issues with aging populations and higher risk patients increase the need to intervene early in their care and treatment? How do you build institutional credibility in this area? How do you approach this area from the point of view of patient need? Crucially, how do you build and inspire a multidisciplinary team around these essential strate...

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...

Originally streamed live from the EBPOM USA 2019 conference in Dallas this piece looks into the realities of enhanced recovery. Patient satisfaction and outcomes rise to the top of the priority list as an institution invests in the idea, how long does it take for a clear financial return on the investments required to get it off the ground? How do we get a team motivated to work towards these idea...

"Without data you cannot sustain your programme" - this piece is about understanding the importance of data collection as part of the perioperative process.   Quality improvement stems from this, consistent definitions and measures allow you to do the job properly. They also allow you to build the case and put a story to the process which higher management and resource allocation can work with.  ...