TopMedTalk

A Randomized Trial of a Family-Support Intervention in Intensive Care Units Douglas B. White et al. for the PARTNER Investigators Surrogate decision makers (e.g. family and friends) for incapacitated, critically ill patients can understandably find it very difficult to make decisions related to goals of care. Having to make such decisions can cause them psychological distress and  may  lead to tre...

Geriatricians naturally fit into the perioperative sphere. Shared decision making is an obvious aspect of this, as is preoperative assessment and the consideration of the risks and benefits of surgery. Also in this piece; when do you become geriatric? This piece is taken from a longer conversation to be found here:  https://www.topmedtalk.com/rcoa-06-geriatric-care-and-the-value-of-teamwork/ Desir...

How can perioperative medicine be part of helping less developed healthcare systems? The considerations are different but the principles remain the same. The birth of the NHS gave parity of esteem to anaesthetists, the benefits of this are felt by us all in the Western world, could it be argued that this visionary decision might actually help other healthcare systems to evolve more rapidly? This p...

Big data is a complicated topic and here you will find a discussion about the need to balance the rights of the individual against an obligation to explore and unlock the treasures it offers for wider society. How do we hammer home the fact that responsibly recording data is part of a practitioner's duty of care? Taken from day two of our coverage of the Royal College of Anaesthetists' annual conf...

The pressures of being an anaesthetist are difficult to discuss for some, this conversation might be the start of that for you or a colleague. The message is clear; practitioners are human and they must ask for help if they need it. This piece is taken from a longer piece to be found here: https://www.topmedtalk.com/rcoa-05-if-youre-struggling-seek-help/ Presented by Desiree Chappell and Monty Myt...

NAP (National Audit Project) 6 is the largest ever prospective study of anaphylaxis related to anaesthesia and surgery. This conversation deals with the question; when is the best time to administer antibiotics? This piece is taken from a longer conversation to be found here:  https://www.topmedtalk.com/rcoa-8-nap6-perioperative-anaphylaxis/ Joff Lacey presents with his guest Professor Tim Cook, C...

TopMedTalk set itself a target of over 10,000 downloads in the first year. Much to everyone's delight and surprise, we've smashed that target already! This piece is a chance to hear how you can become a bigger part of what we are doing here; it could be as simple as you connecting with us online, sharing some of our content on your social media feed, emailing us your feedback ( contact@topmedtalk....

The NHS has helped to put the UK into a leading position in perioperative medicine, elsewhere there have been pioneers and innovators pushing it forward. 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? This piece is taken from a longer conversation to...

In this piece Monty Mythen speaks to Professor Paul Wischmeyer from the Department of Anesthesiology, Duke University, about the recently 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, which has just been print published. The link to it is here:   h...

A highlights RCoA's Anaesthesia 2018 A fascinating conversation about the anti-inflammatory effects of exercise. The theory is floated that this could be part of the reason why exercise as a form a prehabilitation might be so effective as part of an enhanced recovery pathway. This is part of a longer piece which you can enjoy in full here: https://www.topmedtalk.com/rcoa-03-adverse-outcomes-and-pa...

Effect of Use of a Bougie vs Endotracheal Tube and Stylet on First-Attempt Intubation Success Among Patients With Difficult Airways Undergoing Emergency Intubation Brian E. Driver, MD1; Matthew E. Prekker, MD1,2; Lauren R. Klein, MD1; et al Key Points Question In patients admitted to the emergency department with difficult airway characteristics undergoing orotracheal intubation with a Macintosh l...

How do we develop an agreed curriculum that speaks to what perioperative medicine should be? Once that's in place, how should it be overseen? What sort of official endorsements would it need? Running in parallel to this are the MOOCs - Massive Online Open Courses - that are being developed. Developing a broad knowledge of the process is distinct from being a perioperative specialist, how do we dev...

A special edition of TopMedTalk recorded at The Institute of Sport Exercise and Health (ISEH) live from an Enhanced Recovery After Surgery (ERAS) leadership forum. 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. The p...

A special edition of TopMedTalk recorded at The Institute of Sport Exercise and Health (ISEH) live from an Enhanced Recovery After Surgery (ERAS) leadership forum. How can cold water adaption help people deal with medical issues? There's evidence to suggest that cold water adaption reduces inflamation, can open water swimming help with issues such as chrohn's disease? On the other hand how importa...

How do you become well known in the NHS for being innovative, particularly in the perioperative area regarding evaluation and communication of risk? 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 healthc...

The debate ' Direct laryngoscopes should be consigned to history ', hosted by The Royal College Of Anaesthetists and carried out by our two guests on this piece. Here we get into the advantages and challenges behind the two techniques; video laryngoscopy and direct laryngoscopy. The conversation explores the fact that these skills are a key part of the job of practitioners, are we "de-skilling" th...

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 does The Royal College of Anaesthetists' move forward from here? A stunning conference with internationally renowned speakers from all around the world, the perioperative process continues to grow and the NHS is leading the world in healthcare. This conversation gets into some of the issues this momentum can now be focused on. How has the conversation moved forward, how has the RCoA contribute...

The Royal College of Anaesthetists' Lifelong Learning platform will replace the e-Portfolio and include a logbook functionality. It's expected to go live in August 2018. Find out the details here. This piece was recorded as part of TopMedTalk's coverage of the RCoA's annual conference at The British Museum in 2018. Joff Lacey presents, with his guests Esma Doganguzel and Lina Fazlanie, from the Ro...

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...

Can artificial intelligence drive new changes in care and the value of big data? We're already comfortable with using tools that help us to do our job better, what are the opportunities and pitfalls related to this new technology? Are we ready yet for big data? The changes it may cause are staggering but equally; nuance is the friend of truth, do we have enough 'data literacy' to handle it all? Al...

How do we best negotiate working in a multidisciplinary team? Generalisations regarding surgeons and anaesthetists only ever work generally, the specifics of each practitioner and their priorities inevitably contrast. How do we keep sight of these broad differences without falling foul of stereotypes? The conversation evolves; how does the surgical journey fully utilise the team based perioperativ...

Why do anaesthetists suffer from mental health problems, what help is there available for them? Learn here about The Practitioner Health Programme and hear why anaesthetists are uniquely placed to deal with the inevitable pressures related to healthcare and how they can become leaders, helping to destigmatise and tackle mental health issues. Presented by Desiree Chappell and Monty Mythen with thei...

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...

Adverse outcomes, we all know they happen but how do we handle them, record them and avoid them in the first place? The discussion then moves to (Patient Recorded Outcome Measures) PROMS. Patient optimisation is then discussed. Exercise, could it be so effective because it works as an anti inflammatory? A deep dive into the research on that is contained in this conversation. The RELIEF trial is di...