TopMedTalk

TopMedTalk catches up with another online media source, The Critical Care Practitioner podcast, organised by our guest who - appropriately enough - is a critical care practitioner. What's it like being a critical care practitioner in the UK at the moment? Originally a lot of nurses moved into the sphere but now paramedics, physiotherapists and many others progress into it.   Furthermore what's it...

The RELIEF (Restrictive versus liberal fluid therapy in major abdominal surgery) trial has been a huge story for us here at TopMedTalk, recorded on the second day of The Royal Collage of Anaesthetists' annual conference at the British Museum this is the moment the team get to pick over the results in detail. One of the biggest trials ever, it has both raised questions and provided answers. Inevita...

How is it the case that some people can lose significant muscle mass while they are being cared for on the Intensive Care Unit (ICU)? What can practitioners do to help avoid this? How do we integrate a dynamic stimulus and react to new research relating to nasogastric feeding?   In this piece you will hear about a randomised controlled pilot study investigating the effect of intermittent versus co...

How essential is training in focused transthoracic echo for adult intensive care? Ultrasound technology has evolved in recent years, some people say handheld devices look set to become as ubiquitous as a doctor's stethoscope. Could the nurse at the bedside get more involved in the process or is it 'protected turf'? Also, can this technology help patients to become more involved in their treatment...

This piece starts with a discussion about indirect calorimetry and the challenges associated with it as well as recent improvements in the field. The penn state equation is discussed. Muscle wastage and the need for resistence training, as well as protein feeding is covered.   More widely; what does good ICU feeding look like? How can friends and relatives of patients be sure that a loved one is g...

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...

The Pets as Therapy team have been a huge hit at the Intensive Care Society annual conference. How would you incorporate something like this into your practice? There are currently over 6,000 dogs and cats working in healthcare in the UK. Presented by Desiree Chappell with Monty Mythen and their guests Alfie the therapy dog, Suzy Emsden , volunteer for Pets as Therapy and a pediatric intensivist f...

How do we maintain hydration in a way which is both safe and comfortable for the patients we treat? What about the post-surgical patient who is full of salt and water but tells us they are thirsty? How can we allow patients to hydrate themselves? Presented by Desiree Chappell with Monty Mythen and their guests Professor Hugh Montgomery , Intensive Care Society Board Member and Professor of Cardiov...

Recorded live at the Intensive Care Society This piece is a fascinating discussion regarding the use of antibiotics and fluid balance. The conversation then moves into haemodynamic monitoring and the differences between protocols guidelines and algorythms. Presented by Monty Mythen and Desiree Chappell with their guests Professor Mervyn Singer , Intensive Care Medicine at University College London...

"Post-operative critical care: what should we do?" 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 Presented by Denny Levett, Professor in Perioperative Medicine a...

A discussion about consent, staying on the right side of the law, shared decision making and '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.

Pets as Therapy are a fantastic charity who have provided a practical theraputic service to everyone in attendance at the Intensive Care Society annual conference. The TopMedTalk team were determined to catch up with them and have a discussion about how animals can help us all take the woof with the smooth. Presented by Desiree Chappell with her four special guests, Hillary Burbage , with Matlock...

This piece covers; physical medicine and rehabilitation, applying a team approach in care and 'pre and post-habilitation'. Desiree Chappell presents with Monty Mythen and their guests; Dr Steve Flanagan , Chair of Physical Medicine and Rehabilitation at NYU Langone Brian Stewart , Partner/Clinic Director California Rehabilitation and Sports Therapy and Colleen Walsh , Assistant Professor, Nursing...

  The first day of the Intensive Care Society's annual conference comes to a close. Heart failure session has 'standing room only'. Is the pulmonary artery catheter back? What have been some of the big take aways in nutrition? Why should you feed a cold and starve a fever? More Protein or less? Finally, 'humanizing intensive care'. Do we need more ITU pets? Dogs in particular. Desiree Chappell and...

Desiree and Monty catch up with Dan Martin, OBE, and speak with him about the Intensive Care Society's annual conference, treating infectious diseases and in particular patients with ebola. Desiree Chappell and Monty Mythen presenting Dan Martin , OBE anaesthetist and intensivist at the Royal Free Hospital and Reader at University College London (UCL).

Live from The Intensive Care Society, reflections on the opening session of the UK's annual critical care conference. Presented by Desiree Chappell and Monty Mythen. Find out more www.topmedtalk.com Join the debate contact@topmedtalk.com

A conversation about enhanced recovery implementation. Dr Joff Lacey catches up with Mike Scott , Virginia Commonwealth University and Ross Kerridge , John Hunter Hospital, Newcastle, Australia.

This piece was originally streamed live on www.topmedtalk.com and is taken from the hugely successful "EBPOM-USA: Masters Course, A Perioperative Care Practicum". Hear the full presentation from Dr Lee A. Fleisher Professor and Chair of Anesthesiology and Critical Care, University of Pennsylvania. If you like the sound of this and think you and your practice would benefit from attending such a cou...

"Value based care - it's an interdisciplinary team sport" Desiree Chappell speaks with Zeev Kain , organiser of the American college of perioperative medicine interdisciplinary conference on orthopaedic value based care. Find his podcast here: http://drzeevkain.health/podcast/ If you'd like to find out more about the conference follow this link: https://acpm.health/ovbc2019/

Why do you need a "poet"? The POET acronym - a truly multidisciplinary Perioperative Enhancement Team; responsible for project managing optimisation programmes. Monty Mythen speaks with Professor Sol Aronson , a tenured professor at Duke University and Executive Vice Chairman in the Department of Anesthesiology. This piece is taken from a longer conversation to be found here: http://www.topmedtalk...

This edition of journal club looks at two articles in the New England Journal of Medicine (NEJM) of circa 30,000 patients studied at Vanderbilt Medical Centre, USA. One in non-critically ill patients. Click here: http://www.nejm.org/doi/full/10.1056/NEJMoa1711586?query=featured_home The other in critically ill adult patients: http://www.nejm.org/doi/full/10.1056/NEJMoa1711584?query=featured_home A...

EBPOM Conference Highlight This week's conference highlight "Exercise and cancer" was 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 Presented by Mike Grocott , Professor of Anaesthesia and Critical Care Medicine, Unive...

This conversation is a fascinating glimpse into the spread of Enhanced Recovery After Surgery (ERAS) in Saudi Arabia. Desiree Chappell interviews her guests; Fatimah Alsalah , Anesthesiologist at King Fahad Specialist Hospital in Dammam, Deputy head of the transplant anesthesia section, alongside Nicole Greenshields and Douglas Blackwood , Perioperative Medicine Fellows at The University College L...

"An operation is like a marathon, nobody prepares for that by starving themselves" Monty Mythen talks to Professor Paul Wischmeyer from the Department of Anesthesiology, Duke University, USA about the e.published American Society of Enhanced Recovery (ASER) and Perioperative Quality Initiative (POQI) joint consensus statement on Nutrition and Screening Therapy within an Surgical Enhanced Program....

When it comes to breathlessness how do we better diagnose and apply treatment? How do we overcome the fact that referring to a specialist can sometimes take a patient 'down the wrong route' with a condition that might not be just heart or lung related? Ronan Astin , clinical consultant in respiratory medicine at UCL Hospital, explains his more holistic approach to treatment and diagnosis. "Nick th...