TopMedTalk

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, Sl...

Trainees with an interest in perioperative medicine ( TRIPOM ) is an ever growing organisation set to continue the global push for perioperative care. This high energy podcast gives you a taste of the enthusiasm people pick up as they learn more about the value of these ideas.   Moving more obviously into the perioperative period this piece continues on from last week's talk regarding mitochondria...

NAP (National Audit Project) 6 is the largest ever prospective study of anaphylaxis related to anaesthesia and surgery. Find out the details behind this intriguing study, how long did it take, how does the data impact upon our day to day practice? There follows a deep dive into the results and recomendations that NAP 6 has produced. Packed with useful information this podcast is one of the stand o...

Community based prehabilitation in the UK is being spearheaded by the Prepwell Initiative. Supported by a grant from Sports England this pioneering work is a great example of the way in which a perioperative enhancement team can be formed around your practice. The "PREP: Preoperative Risk Education Package" website mentioned in this piece is here: https://www.prepwell.co.uk/ Desiree Chappell and J...

This piece ploughs into some of the academic papers that have provoked discussion recently in the perioperative community. We discuss the following papers: Risk factors for opioid-induced respiratory depression in surgical patients: a systematic review and meta-analyses. https://www.ncbi.nlm.nih.gov/pubmed/30552274 Increased Postoperative Glucose Variability Is Associated with Adverse Outcomes Fol...

"Hypotension probability in practice" - 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: con...

How has the Royal College of Anaethestists (RCoA) evolved over the years and why is perioperative medicine so crucial to its agenda? How has this leadership in perioperative medicine become a force for change and improvement worldwide and what are the common themes that emerge as we take a global perspective on the discipline? The RCoA's global partnership programme is explained, how can periopera...

The Silver Tsunami is coming, are you prepared to assess the elderly patient? Mature patients present unique and interesting opportunities to perioperative practitioners. New ways of thinking and different approaches are always necessary. The British Geriatric Society's "Fit For Frailty" is here: https://www.bgs.org.uk/resources/resource-series/fit-for-frailty Presented by Desiree Chappell and Mon...

We begin with a question from the audience; 'how do we drive change in our institutions towards enhanced recovery after surgery?'   The GIRFT (Getting It Right First Time) project is explained. The Health Foundation is also mentioned. This edition of TopMedTalk was recorded at The Institute of Sport Exercise and Health (ISEH) live from an Enhanced Recovery After Surgery (ERAS) leadership forum. Th...

Trainees with an interest in perioperative medicine ( TRIPOM ) is an ever growing organisation set to continue the global push for perioperative care. This high energy podcast gives you a taste of the enthusiasm people pick up as they learn more about the value of these ideas.   The focus here is on promoting healthy aging across two primary domains: cognitive function and physical ability. Discov...

This piece acts as a great summary of some of the big takaways from the conference this year. Discussion about a hugely successful Enhanced Recovery program at a large community hospital, continued improvements and service line expansion.    Presented by Desiree Chappell and Monty Mythen with their guests Kim Duggan , Perioperative Surgical Home (PSH) - Enhanced Recovery After Surgery (ERAS) Manag...

How does one go about becoming a Master of Perioperative Medicine? This piece takes a look at the growing movement which all TopMedTalk listeners are at the forefront of. Further debate covers, "NPO after midnight", getting buy in from the institution to practice perioperatively and keeping the momentum going after one leaves a conference. Presented by Desiree Chappell and Monty Mythen with their...

Post op respiratory complications are the focus of this piece. How can they be anticipated, detected early and dealt with appropriately? What about objective neuromuscular monitoring? Should you revese every single patient? If so, how do you do it? What about the risk of pulmonary complications?   Presented by Desiree Chappell with her guest Frances Chung , Professor, Department of Anesthesiology...

How is the AANA facilitating the care of patients? How can you make a patient a 'partner in safety'? How do we coordinate so many disaparate systems of information and care? Patient records and data ownership is discussed, as is Paul Upton's excellent interview on TopMedTalk regarding "My Preop". The original piece is here: https://www.topmedtalk.com/my-pre-op-empowering-patients-before-surgery/ H...

This piece ploughs into some of the academic papers that have provoked discussion recently in the perioperative community. We discuss the following papers: Risk factors for opioid-induced respiratory depression in surgical patients: a systematic review and meta-analyses. https://www.ncbi.nlm.nih.gov/pubmed/30552274 Increased Postoperative Glucose Variability Is Associated with Adverse Outcomes Fol...

On the last occasion where we spoke with our guest she was a Perioperative Medicine Fellow at Duke University; learn how her experiences have helped change her practice and the edge she now has in dealing with healthcare.   The conference is producing a number of talking points, the Measurement of Exercise Tolerance before Surgery (METS) Trial seems to have shifted opinions, does a genuine 'periop...

Twitter is ablaze with talk of the Society for Perioperative Assessment and Quality Improvement (SPAQI). How did they do it? This piece is a thought provoking discussion about new media and the consequences of our online world for medicine. 'The democratisation of education' is a phrase we've heard here on TopMedTalk in the past. How does direct access to information and experts in our field alter...

Conversation begins with reflections on the conference and the impact of social media, Twitter, Facebook and so forth, on the global perioperative scene before tucking into some of the big stories that are emerging from the conference. Learn more about STOP BANG; Snoring, Tiredness, Observed Apnea, PBP (>140/90) R X or no. How do opioid sensitivity and obstructive sleep apnea effect each other?  ...

What are some of the big take home messages from this conference so far? Lots of material on preoperative assesment, discussion of some of the big trials and papers that have occured in the field and reflections on research into myocardial injury after noncardiac surgery (MINS).   This podcast is recorded 'as live' and the team mention interviews which have now been recorded and are available onli...

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...

Discussion begins with an overview of the conference and its roots. Special mention is made regarding the Frank Michota Memorial Lecture which takes place on the Friday morning of the conference. Also on this podcast, what is a "Respect Officer"? Why is respect so important in perioperative care? How does improving 'the culture of safety' also help to improve outcomes? Should we be overly concerne...

The Society for Perioperative Assessment and Quality Improvement (SPAQI) are in Orlando Florida for their 14th annual summit and, of course, we're there to cover it.   Find out what you can expect, if you are attending the conference, and what we're going to be bringing you on TopMedTalk, if you couldn't make it this year.   Hypotension, the Measurement of Exercise Tolerance before Surgery (METS)...

The full title of today's paper is: Prospective observational cohort study of the association between antiplatelet therapy, bleeding and thrombosis in patients with coronary stents undergoing noncardiac surgery and you can find it here: https://www.ncbi.nlm.nih.gov/pubmed/30686302 Presented by Dr Joff Lacey , registrar in anaesthesia at St George's Hospital in London, currently undertaking a fello...

"Antibiotic stewardship in perioperative care" - 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's it like in rural America working at a small hospital, 'way out on the frontier'? What best practice initiatives are there to help? How can you implement a process of rapid opioid reduction, more than 70%, in just two years?   Presented by Desiree Chappell with her guest Bill Prosser , CRNA Peacehealth Florence Oregon. --   Do you have your ticket to the Dallas Master's Course being organise...