TopMedTalk

A discussion about fluid management in an enhanced surgical recovery pathway in relation to the guidelines from ASER and the work of The Perioperative Quality Initiative (POQI  http://www.poqi.org ).   Presented by  Monty Mythen  with his guest Dr  Tim Miller , anaesthesiologist at Duke Medical Centre and Vice President of ASER.   For more come to our meetings:  http://www.ebpom.org/EBPOM-USA   Th...

2019 brings lots of new opportunities for your favourite medical podcast, including the chance to see us at a live event. Maybe you'll join us in real life, or maybe you'll join us online. This conversation looks forward to 2019, inviting you to become a bigger part of TopMedTalk. We're also extending an invitation to listeners to join us in an episode of TopMedTalk soon, listen to the podcast for...

Treating patients as people rather than 'jobs to be done' and 'boxes to be ticked' is the focus of this piece. What can Doctors do better when it comes to treating patients? Find out what happened when a perioperative care doctor became a patient. A fascinating conversation streamed live from Atlanta Georgia during the second day of TopMedTalk's coverage of "EBPOM-USA Masters Course, A Perioperati...

Should we refuse surgery to those who won't change? What about pathological issues, such as smoking, should practitioners become more didactic in their approach? How do we effectively communicate risk, both to the patient and the institution you work for? Professor Monty Mythen presents with Dr Joff Lacey and guests, Professor Sol Aronson , a tenured professor at Duke University and Executive Vice...

This week's Journal Club takes a piece from Anaesthesia and Analgesia; "Implication of Major Adverse Postoperative Events and Myocardial Injury on Disability and Survival: A Planned Subanalysis of the ENIGMA-II Trial". A link to the article is here: https://www.ncbi.nlm.nih.gov/pubmed/29533264 Presented by Monty Mythen and Desiree Chappell .

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 want 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 Andrew...

What is after ERAS, do we have an 'ERAS of ERAS' - so to speak? This conversation focuses upon bringing about change, managing and sustaining it over time and helping relate it to patient outcomes.   Desiree Chappell interviews her guest Arman Dagal , Medical Director - Spine COAP at Foundation for Health Care Quality.

Implementing better practice and "ERAS 2.0". The ground up approach of a 'council of nurses' sparks some fascinating debate and discussion. Can a roundtable approach sometimes work better than the traditional hierarchical power structure? Presented by Desiree Chappell with her guests Dr Ruchir Gupta , medical lead for enhanced recovery at Stony Brook University and Joni Brady , Perianesthesia, Pai...

This piece is a chance to reflect upon the importance of new media within the sphere of medical education. As the run away success of TopMedTalk and other podcasts in this area shows people are hungry to use the unique potential of this medium. Also - how has social media, video casting and live streaming altered the way conferences are both organised, executed and received? Finally, our team of e...

The Hypotension Prediction Index (HPI), which uses a machine learning algorithm to help predict intraoperative hypotension. Regular listeners to  www.topmedtalk.com  will be familiar with concerns about perioperative hypotension. For those who have just joined us, or anyone who fancies a quick refresher on this issue, it is covered in detail here:   https://www.topmedtalk.com/ live-from-boston-asa...

What is a 'micromort'? Even more of a worry, what does ten of them mean? How do we measure and communicate risk to patients? Everyday activities all carry inherent risks, how do we put surgery into a context 'everyday people' can more easily understand? Professor Monty Mythen presents with guests, Professor Sol Aronson , a tenured professor at Duke University and Executive Vice Chairman in the Dep...

The piece discussed in this week's Journal Club is called "Acute kidney injury in postoperative shock: is hyperoncotic albumin administration an unrecognized resuscitation risk factor?". The link is here: https://perioperativemedicinejournal.biomedcentral.com/track/pdf/10.1186/s13741-018-0110-y Additional links here: "Association between albumin administration and survival in cardiac surgery: a re...

A three part series covering the year in TopMedTalk. Here are some links to the pieces discussed: The Randy Moore piece: https://www.topmedtalk.com/aana-2018-is-there-a-global-shortfall-of-anesthesia-providers/ Here's the piece Monty mentions which celebrated the 60th anniversary of Edwards Life Sciences: https://www.topmedtalk.com/the-hypotension-prediction-index-hpi/ Here's are the pieces with M...

A three part series covering the year in TopMedTalk. Here are some links to the pieces discussed: Paul Myles and the RELIEF trial results: https://www.topmedtalk.com/the-relief-trial-results/ And here is the "deep dive" we mention: https://www.topmedtalk.com/the-topmedtalk-top-ten-rcoa-11-the-relief-trial-your-essential-deep-dive-into-the-results-2/ And here are all the RELIEF trial pieces we've d...

A three part series covering the year in TopMedTalk. Here are some links to the pieces discussed: The conversation with Zeev Kain is here: https://www.topmedtalk.com/zeev-kain-organiser-of-the-american-college-of-perioperative-medicine-interdisciplinary-conference-on-orthopaedic-value-based-care/ The Eric J Schneidewind piece is here: http://topmedtalk.libsyn.com/the-topmedtalk-top-ten-i-want-to-d...

Fresh from an expedition to Antarctica, on the National Geographic Explorer, Mike Grocott gives us an update on the "Anaesthesia at the Extreme" conference. Regular listeners will remember his excellent talk about Xtreme Everest, which you can find here: https://www.topmedtalk.com/10-xtreme-everest-physiology-on-top-of-the-world/ Presented by Desiree Chappell and Monty Mythen with their guest Mike...

Lessons learned from the Enhanced Peri-Operative Care for High-risk patients (EPOCH) trial. This conversation focuses upon the challenges of quality improvement programmes; how do we keep track of patients and improve follow up questions after surgery? How do we clearly show Quality Improvement Programmes work for the patient? Further discussion encompasses innovation and utilization in practice....

Fitness for surgery and an understanding of the realities of risk. How important is it for surgery to take place when balanced against the specific health needs of the patient? How do we encourage patients to alter pathological aspects of their lives in order to minimise the chances of a negative outcome? Professor Monty Mythen presents with Dr Joff Lacey and guests, Professor Sol Aronson, a tenur...

Here we have a very special edition of Journal Club, in two distinct parts; the The Measurement of Exercise Tolerance before Surgery (METS) trial is discussed here both before and after the results were released into the public domain. The Measurement of Exercise Tolerance before Surgery (METS) trial has both raised, and answered, complicated questions. How will it change practice? Will it alter t...

"Sprint National Anaesthesia Project, SNAP" was 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 em...

Desiree Chappell of The Roundtable blog, with Monty Mythen of TopMedTalk discuss outcomes and patient care, what matters the most? They are joined by two of the guest speakers from the American College of Perioperative Medicine's 2018 conference; Eric J Schneidewind  president of the AARP and  Kevin Bozic , Chair of Surgery & Perioperative Care at the Dell Medical School.

A conversation about ASER fluid management; NPO; preop drinks and keeping the i.v down. Monty Mythen is presenting with his guest Dr Scott Brudney , Professor, Departments of Anaesthesiology and Internal Medicine, University of Manitoba, Winnipeg, Canada. Click here for the American Society for Enhanced Recovery (ASER) and Perioperative Quality Initiative (POQI) joint consensus statement on periop...

A transatlantic perspective. This conversation explores the extended role of the anaesthetist, brought about partly by perioperative care but more widely because of societal changes. Practitioners face a dilemma; how do you best impact value based care, as a specialist, when multidisciplinary approaches are becoming essential? In the UK, The Royal College of Anaesthetists, are working on this very...

The Elephant In The Room - intraoperative hypotension.   A discussion regarding the exciting results from the first multicentre, randomised controlled trial into targeted intraoperative blood pressure management. This conversation reflects the start of many debates and concern regarding hypotension, a frequent topic here on TopMedTalk.   Monty Mythen and Mike Grocott are with Tim Miller , Duke Uni...

POET - The Perioperative Enhancement Team How can cardiopulmonary exercise testing lead to shared decision making? Hear how aortic aneurysms are dealt with by a world class professional perioperative physician. Learn how that process and its success then spread out into other areas of healthcare within his institution. Do you need to develop a broad knowledge of all surgery and medicine so that yo...