TopMedTalk

Desiree and Monty catch up with Dan Martin, OBE, and speak with him about treating infectious diseases and in particular patients with ebola.   Presented by  Desiree Chappell  and  Monty Mythen  with their guest  Dan Martin , OBE anaesthetist and intensivist at the Royal Free Hospital and Reader at University College London (UCL).

This piece discusses how the contributors are driving better perioperative care in their clinics; the importance of getting patient records in advance; ERAS for obstetrics; challenging opioid use with the multimodal pain management; shared decision making in pain management; the importance of clear communication pathways and patient literacy. This podcast features Desiree Chappell interviewing; Dr...

Triple-low Alerts Do Not Reduce Mortality: A Real-time Randomized Trial. Sessler DI, Turan A, Stapelfeldt WH, Mascha EJ, Yang D, Farag E, Cywinski J, Vlah C, Kopyeva T, Keebler AL, Perilla M, Ramachandran M, Drahuschak S, Kaple K, Kurz A. Anesthesiology. 2019 Jan;130(1):72-82. doi: 10.1097/ALN.0000000000002480. https://www.ncbi.nlm.nih.gov/pubmed/30312182 Why Money Alone Can't (Always) "Nudge" Phy...

"Post-operative critical care: what should we do?" - 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 th...

Should we still measure urine output? How useful is permissive oliguria? Presented by Professor  Monty Mythen  and Dr  Joff Lacey  featuring guests Dr  Tim Miller  from Duke University Medical Centre and John A. Kellum, Tenured Professor, Critical Care Medicine from The University of Pittsburgh.

How do the insights of a 'medical linguistic anthropologist' impact upon our understanding of 'shared decision making'? How do patients make decisions about surgery? When, in the perioperative process, do they decide what is best for them? Does patient autonomy actually even exist? A bubble bursting conversation with a frequent favourite on TopMedTalk, this podcast is bound to get you thinking! Pr...

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...

How important is it to screen patients for anaemia before surgery? Has anaemia fallen off the health care agenda?   We begin with a conversation about patients who are anaemic and then turn to why this is sometimes not checked enough. Monty Mythen mentions UK University students appear to suffer from the condition more these days and Lori Heller points out that treating the condition, as part of p...

Journal Club Express this week focuses upon a piece in Anesthesiology ; Cognitive Effects of Perioperative Pregabalin: Secondary Exploratory Analysis of a Randomized Placebo-controlled Study. Link here: http://anesthesiology.pubs.asahq.org/article.aspx?articleid=2708941  

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@topmedtalk.com Presented by Angela...

How do the insights from experience in Enhanced Recovery apply to critical care patients and care postoperative care pathways? We also discuss utilization of advanced monitoring technology for the critically ill patient postoperatively. Presented by Desiree Chappell with her guests Philip Corvo , Chairman of Surgery Stanley J Dudrick Dept of Surgery at Saint Mary's Hospital and Vicki Morton , DNP...

This episode of The Perioperative Coach reflects on the pain management discussions being had by the American Society of Enhanced Recovery (ASER) and its members. For further reading see the articles in Perioperative Medicine Journal: https://perioperativemedicinejournal.biomedcentral.com/articles/10.1186/s13741-017-0064-5 This conversation taken from a longer piece to be found here:  http://www.t...

Joff and his guests visit the hallowed turf that is the Boston Ether Dome, in the Bulfinch Building, Massachusetts General Hospital. How have times moved on since those early pioneering days when the relatively young profession of Anaesthesia was born? Back then the word wasn't as widely used and the gentlemen in question described their activities as "rendering people insensible using sulphuric e...

This podcast concerns sleep apnea as part of pre-operative patient optimisation. How important is it to evaluate patients for sleep disorders before surgery? Are patients with sleep apnea aware of their condition and are they using some form of treatment? What are the health problems associated with sleep disorders? How do you build a financial case for including this in your practice? A piece ori...

This piece discusses the changes enhanched recovery brings, the conversation then moves to narcotics and the opioid epidemic. Presented by Desiree Chappell , Dr Vijaya Gottumukkala , cardiac anaesthesiologist from MD Anderson and member of the board of directors for the American Society of Enhanced Recovery (ASER) and Dr George Nassif, colorectal surgeon at the Center for Colon & Rectal Surgery in...

J Clin Anesth. 2018 Dec 29;55:83-91. doi: 10.1016/j.jclinane.2018.12.038. [Epub ahead of print] The effects of dexamethasone, light anesthesia, and tight glucose control on postoperative fatigue and quality of life after major noncardiac surgery: A randomized trial. Abdelmalak BB, You J, Kurz A, Kot M, Bralliar T, Remzi FH, Sessler D. https://www.ncbi.nlm.nih.gov/pubmed/30599425

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@topmedtalk.com Presented by Sarah H...

A discussion about the changes enhanched recovery has brought into practices, the conversation then moves to narcotics and the opiode epidemic.    Desiree Chappell speaks with Dr  Vijaya Gottumukkala , Professor of Anesthesia and Deputy Chair at MD Anderson and Dr  George Nassif  colorectal surgeon from The Florida Hospital.

Professor John Kellum gives a thumbnail sketch summary of the fluid debate.   Presented by Professor  Monty Mythen  and Dr  Joff Lacey  with guest  John A. Kellum , Tenured Professor, Critical Care Medicine from The University of Pittsburgh.   Join in the debate:  contact@topmedtalk.com   This conversation taken from a longer piece here:  http://www.topmedtalk.com/ebpom-2017-pod-one-live-from-lond...

A discussion about consent, staying on the right side of the law, shared decision making and a 'The Montgomery case' which has defined a Doctor's duty in these sorts of areas. Presented by Monty Mythen with Desiree Chappell and their guests Hugh Montgomery , and Paul Sankey , Enable Law partner and Clinical Negligence solicitor acting for patients, an accredited expert in his field.

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...

Discussion begins with an explanation of 'Trainees with an Interest in Perioperative Medicine' (TRIPOM), a big hit at the conference this year, then a wider discussion follows which includes thoughts regarding further research and application of the perioperative method as well as where it impacts medicine and care. The importance of a multidisciplinary team based approach is strongly emphasised....

Two articles, which both feature in The British Journal of Anaesthesia (BJA), are dissected in this week's Journal Club. They both discuss oxygen, the two articles are linked to here: Effectiveness of 80% vs 30–35% fraction of inspired oxygen in patients undergoing surgery: an updated systematic review and meta-analysis: https://bjanaesthesia.org/article/S0007-0912(18)31346-1/fulltext Safety of 80...

Originally streamed live from The Institute of Engineering and Technology (IET) in London during EBPOM 2018 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 Dr Ramani Moonesinghe , Professor of Perioperative Medicine...

An entertaining and informative discussion about the implementation process; how do you bring everyone to the table? Desiree Chappell  speaks with  Robin Anderson , Enhanced Recovery (ERAS) program coordinator at Duke University,  Bethany Sarosiek , Enhanced Recovery After Surgery (ERAS) Development Coordinator at UVA Health System, and  Vicki  Morton , Director of Clinical and Quality Outcomes at...