TopMedTalk

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...

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).