TopMedTalk

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...

Recorded live at The British Museum in London this piece contains a lot of discussion about the NHS; how does it rank in terms of outcomes? What does the offer of universal healthcare mean in terms of that? How does it compare to the way things are done in America and around the world? The team then discuss the shared goals and huge crossoever which exists between perioperative practitioners and T...

TopMedTalk is covering the flagship meeting of the Royal College of Anaesthetists from the British Museum, London. In this piece, discussion is had about the importance of perioperative medicine leading to conversation about the naming of the conference and differences between terminology; are you an 'anaesthetist' or an 'anaesthesiologist'? The contributors emphasise the global perspective as wel...

What motivates an institution to adopt a value based care programme? How do readmission rates react to optimisation? How do you work care coordination into a successful practice? This piece was originally part of our coverage of 'The American College of perioperative medicine interdisciplinary conference on value based care for orthopedics'. Desiree Chappell speaks with Allan Beck Chief Executive...

This piece explains the 2nd Sprint National Anaesthesia Project: Epidemiology of Critical Care provision after Surgery (SNAP-2: EpiCCS)   SNAP-2: EpiCCS aims to describe the epidemiology of perioperative risk, outcome, critical care referral and admission after inpatient surgery in the UK. It will also examine whether planned postoperative critical care admission is effective as an intervention to...

Goal directed fluid therapy and enhanced surgical recovery, are there still some battles not yet won? How do you get anaesthetists to curb their fluid? How do you cure the random element of fluid therapy?   Dr Joff Lacey interviews his guest Dr Randall Dull, University of Illinois, live from the ASA 2017.   This piece taken from a longer conversation, "Physiological Principles of Goal Directed Flu...

Association between intraoperative opioid administration and 30-day readmission: a pre-specified analysis of registry data from a healthcare network in New England High intraoperative opioid dose is a modifiable anaesthetic factor that varies in the practice of individual anaesthetists and affects postoperative outcomes. Conservative standards for intraoperative opioid dosing may reduce the risk o...

Anaesthesia, surgery, and life-threatening allergic reactions: management and outcomes in the 6th National Audit Project (NAP6) N.J.N. Harper et al. Anaphylaxis, a life threatening allergic reaction, is thankfully rare but a very serious complication in the perioperative period, around the time of surgery. The 6th National Audit Project of the Royal College of Anaesthetists (NAP6) collected and re...

The Xtreme Everest project has won numerous awards and received both local, national and international media coverage. Here we have a discussion with some of the key players about oxygen and the Xtreme Everest team's research studies into human adaptation to hypoxia. How can the human body adapt to extreme conditions, we assume it will inevitably cause damage but this is not always the case. How d...

ASER 2017 and 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.com/aser-eb...

A discussion about the importance of screening and risk mitigation regarding cognitive dysfunction and delirium in the perioperative period, with particular focus on elderly patients. Monty Mythen and Mike Grocott are joined by their guests Dr Liam Brennan, President of the Royal College of Anaesthetists, and Dr Fay Gilder, Addenbrooke's, Cambridge. This piece taken from a longer piece to be found...

Dr Ramani Moonesinghe on Standardised Outcomes from Major Surgery. Dr Joff Lacey and Professor Monty Mythen talk to Dr Ramani Moonesinghe, Director of the Heath Services Research Centre at the Royal College of Anaesthetists and a lead author of the Perioperative Quality Initiative (POQI http://www.poqi.org) guidelines on outcomes from surgery. Simple objective measures such as Drinking, Eating and...

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? Recorded on day two of EBPOM 2017; Professor Monty Mythen presents with guests, Professor Sol Aronson, a tenured professor at Duke University and...

Monty Mythen presents the results of the RELIEF (Restrictive versus liberal fluid therapy in major abdominal surgery) trial. Does it answer the questions you hoped? Does this trial put to bed the questions about liberal vs restricted fluid therapy or is it a debate that's set to run and run? Can a trial ever be truly definitive? Send us your thoughts:  contact@topmedtalk.com Hear Monty Mythen disc...

In this piece find out how renal injury biomarkers can offer practitioners and patients hope. Presented by Professor Monty Mythen and Dr Joff Lacey featuring guests John A. Kellum, Tenured Professor, Critical Care Medicine from The University of Pittsburgh and Dr Tim Miller from Duke University Medical Centre. Join in the debate:  contact@topmedtalk.com This piece taken from a longer conversation...