TopMedTalk

Fluid - Matters | Part 6 'Goal Directed Fluid Therapy'

28 Jun 2018

Contributed by Lukas

This is another excerpt from "Controversies in perioperative medicine"; "The Great Fluid Debate". A fascinating piece containing Dr Tim Miller's enthu...

Journal Club Express: Intraoperative hyperoxia and surgical site infections

27 Jun 2018

Contributed by Lukas

Effect of intraoperative hyperoxia on the incidence of surgical site infections: a meta-analysis B. Cohen, Y.N. Schacham, K. Ruetzler, S. Ahuja, D. Ya...

Fluid - Matters | Part 5 the nil by mouth (NPO) debate

26 Jun 2018

Contributed by Lukas

Fluid Matters - the ‘nil by mouth’ or ‘NPO’ debate This piece is taken from "The Great Fluid Debate", it's about changes in practice that have...

RCoA Conference Highlight: Global views on Perioperative Medicine - real concerns - prisms or schisms?

25 Jun 2018

Contributed by Lukas

How do we develop a way to teach perioperative medicine and once that's in place, how should it be overseen? What sort of official endorsement might i...

ISEH Highlight: ERAS what's the 'secret sauce'?

24 Jun 2018

Contributed by Lukas

This piece starts with the question: Is there a hierarchy amongst the various elements of an enhanced recovery pathway? The conversation that follows ...

Fluid - Matters | Part 4 'The Great American Fluid Debate'

23 Jun 2018

Contributed by Lukas

This is an excerpt from 'The Great American Fluid Debate' which was hosted at Duke University Medical Centre's "Controversies in Perioperative Medicin...

Controversies in perioperative medicine; "is pain the fifth vital sign"?

22 Jun 2018

Contributed by Lukas

  What is 'the morpheus consortium'? What's the current thinking on pain management and the 'opioid crisis'? On reflection were people wrong to empha...

Controversies in perioperative medicine

21 Jun 2018

Contributed by Lukas

Monty sits down with one of the co-organisers of this year's meeting in Orlando and discusses this year's annual conference, "Controversies in periope...

Fluid Matters | Part 3 Fluid Responsiveness and venous capacitance

20 Jun 2018

Contributed by Lukas

This conversation reflects a discussion had at the Perioperative Quality Inititative (POQI). It originally ran under the title, "Intervascular volume ...

Fluid - Matters | Part 2 Total body water and electrolytes

19 Jun 2018

Contributed by Lukas

This discussion focuses on the perioperative quality initiative's intense focus this year on total body water and electrolights. How often should we w...

Enhanced recovery for cesarean section patients

18 Jun 2018

Contributed by Lukas

How does perioperative care relate to obstetrics? Who does it benefit, the patient, the hospital or both? How does it help to engage pregnant patients...

Fluid - Matters|Part 1 Definite definitions, fluid physiology

17 Jun 2018

Contributed by Lukas

Names, titles and definitions were sliced, diced and discussed at the Perioperative Quality Initiative (POQI). This conversation, recorded on the morn...

ISEH Highlight: Getting it right first time (GIRFT)

16 Jun 2018

Contributed by Lukas

We begin with a question from the audience; 'how do we drive change in our institutions towards enhanced recovery after surgery?' The GIRFT (Getting I...

Journal Club Express - multimodal pain management

15 Jun 2018

Contributed by Lukas

Association of Multimodal Pain Management Strategies with Perioperative Outcomes and Resource Utilization: A Population-based Study. Memtsoudis SG1, P...

RCoA Conference Highlight: Do we still care about direct laryngoscopy?

14 Jun 2018

Contributed by Lukas

The debate 'Direct laryngoscopes should be consigned to history' was hosted by The Royal College Of Anaesthetists and carried out by the two guests on...

ISEH Highlight: Give your patients a warm welcome.

13 Jun 2018

Contributed by Lukas

The patient experience can be quite passive and, as a result, people can lose temperature quickly. The consequences can be very negative, this convers...

'Anesthesia and Analgesia' go big on POQI

12 Jun 2018

Contributed by Lukas

This piece focuses on the latest print issue of 'Anesthesia and Analgesia' which is saturated with coverage of the Perioperative Quality Initiative (P...

Good noises for ultrasound.

11 Jun 2018

Contributed by Lukas

Most people are familiar with ultrasound these days, next to the stethoscope and thanks largely to baby photographs, it's one of the most frequent pub...

An interview with Professor Monty Mythen, our Editor in Chief

10 Jun 2018

Contributed by Lukas

What is TopMedTalk and how did it come about? Why is perioperative medicine such an inspiration to us? Why is our Editor in Chief such an advocate? Wh...

RCoA Conference Highlight: It's time to get it right, first time

09 Jun 2018

Contributed by Lukas

The GIRFT (Getting It Right First Time) project. The stated aim is 'to help improve the quality of care within the NHS by reducing unwarranted variati...

Journal Club Express: ICU Nurse-Led Communication, shorter stay and better ratings?

08 Jun 2018

Contributed by Lukas

A Randomized Trial of a Family-Support Intervention in Intensive Care Units Douglas B. White et al. for the PARTNER Investigators Surrogate decision ...

RCoA Conference Highlight: When do you become geriatric?

07 Jun 2018

Contributed by Lukas

Geriatricians naturally fit into the perioperative sphere. Shared decision making is an obvious aspect of this, as is preoperative assessment and the ...

RCoA Conference Highlight: Perioperative medicine for the world

06 Jun 2018

Contributed by Lukas

How can perioperative medicine be part of helping less developed healthcare systems? The considerations are different but the principles remain the sa...

RCoA Conference Highlight: Big data privacy concerns are legitimate

05 Jun 2018

Contributed by Lukas

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 ex...

RCoA Conference Highlight: Need help? Ask for it.

04 Jun 2018

Contributed by Lukas

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 mes...

RCoA Conference Highlight: Antibiotics - when is the right time?

03 Jun 2018

Contributed by Lukas

NAP (National Audit Project) 6 is the largest ever prospective study of anaphylaxis related to anaesthesia and surgery. This conversation deals with t...

What next for TopMedTalk?

02 Jun 2018

Contributed by Lukas

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!...

RCoA Highlight: Who leads the way in perioperative medicine ?

02 Jun 2018

Contributed by Lukas

The NHS has helped to put the UK into a leading position in perioperative medicine, elsewhere there have been pioneers and innovators pushing it forwa...

Vital information about nutrition and screening therapy

01 Jun 2018

Contributed by Lukas

In this piece Monty Mythen speaks to Professor Paul Wischmeyer from the Department of Anesthesiology, Duke University, about the recently published Am...

RCoA Highlight: Inflammatory claims about exercise

31 May 2018

Contributed by Lukas

A highlights RCoA’s Anaesthesia 2018 A fascinating conversation about the anti-inflammatory effects of exercise. The theory is floated that this cou...

Journal Club Express 30/05/18

30 May 2018

Contributed by Lukas

Effect of Use of a Bougie vs Endotracheal Tube and Stylet on First-Attempt Intubation Success Among Patients With Difficult Airways Undergoing Emergen...

RCoA 14 - How should we teach perioperative medicine?

29 May 2018

Contributed by Lukas

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 sor...

Morphine doses - how high is too high? Live from the ISEH (Part 2)

28 May 2018

Contributed by Lukas

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

Cold, kill or cure? Live from the ISEH (Part 1)

27 May 2018

Contributed by Lukas

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

RCoA 13 - The GIRFT (Getting It Right First Time) Project

26 May 2018

Contributed by Lukas

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

RCoA 12 - Should direct laryngoscopy be consigned to the history books?

25 May 2018

Contributed by Lukas

The debate 'Direct laryngoscopes should be consigned to history', hosted by The Royal College Of Anaesthetists and carried out by our two guests on th...

RCoA 11 - The RELIEF Trial; your essential 'deep dive' into the results.

24 May 2018

Contributed by Lukas

The RELIEF (Restrictive versus liberal fluid therapy in major abdominal surgery) trial has been a huge story for us here at TopMedTalk, recorded on th...

RCoA 10 - The Royal College of Anaesthetists, leading the debate.

23 May 2018

Contributed by Lukas

How does The Royal College of Anaesthetists' move forward from here? A stunning conference with internationally renowned speakers from all around the ...

RCoA 09 - What is the Lifelong Learning platform?

23 May 2018

Contributed by Lukas

The Royal College of Anaesthetists' Lifelong Learning platform will replace the e-Portfolio and include a logbook functionality. It's expected to go l...

RCoA 08 - NAP6: Perioperative Anaphylaxis

23 May 2018

Contributed by Lukas

NAP (National Audit Project) 6 is the largest ever prospective study of anaphylaxis related to anaesthesia and surgery. Find out the details behind th...

RCoA 07 - Big data, AI and the changing face of medicine

23 May 2018

Contributed by Lukas

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...

RCoA 06 - Geriatric care and the value of teamwork

23 May 2018

Contributed by Lukas

How do we best negotiate working in a multidisciplinary team? Generalisations regarding surgeons and anaesthetists only ever work generally, the speci...

RCoA 05 - 'If you're struggling ... seek help'

23 May 2018

Contributed by Lukas

Why do anaesthetists suffer from mental health problems, what help is there available for them? Learn here about The Practitioner Health Programme and...

RCoA 04 - The Royal College of Anaesthetists, world leading healthcare

22 May 2018

Contributed by Lukas

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 lead...

RCoA 03 - Adverse outcomes and patient optimisation

22 May 2018

Contributed by Lukas

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 (Pati...

RCoA 02 - Outcomes, universal healthcare and the goals of the RCoA

22 May 2018

Contributed by Lukas

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 ...

RCoA 01 - Live from the annual meeting of The Royal College of Anaesthetists

22 May 2018

Contributed by Lukas

TopMedTalk is covering the flagship meeting of the Royal College of Anaesthetists from the British Museum, London. In this piece, discussion is had ab...

Why practice value based care?

20 May 2018

Contributed by Lukas

What motivates an institution to adopt a value based care programme? How do readmission rates react to optimisation? How do you work care coordination...

What is SNAP-2?

19 May 2018

Contributed by Lukas

This piece explains the 2nd Sprint National Anaesthesia Project: Epidemiology of Critical Care provision after Surgery (SNAP-2: EpiCCS)   SNAP-2: E...

Curb your fluid?

18 May 2018

Contributed by Lukas

Goal directed fluid therapy and enhanced surgical recovery, are there still some battles not yet won? How do you get anaesthetists to curb their flui...

Journal Club Express 17/05/18

17 May 2018

Contributed by Lukas

Association between intraoperative opioid administration and 30-day readmission: a pre-specified analysis of registry data from a healthcare network i...

Journal Club Express 21/05/18

16 May 2018

Contributed by Lukas

Anaesthesia, surgery, and life-threatening allergic reactions: management and outcomes in the 6th National Audit Project (NAP6) N.J.N. Harper et al. A...

The Xtreme Everest Oxygen Research Consortium | Xtreme Everest

16 May 2018

Contributed by Lukas

The Xtreme Everest project has won numerous awards and received both local, national and international media coverage. Here we have a discussion with ...

Do you need a poet to do surgery?

15 May 2018

Contributed by Lukas

ASER 2017 and the POET acronym - a truly multidisciplinary Perioperative Enhancement Team; responsible for project managing optimisation programmes. M...

Elderly patients and post operative delirium

14 May 2018

Contributed by Lukas

A discussion about the importance of screening and risk mitigation regarding cognitive dysfunction and delirium in the perioperative period, with part...

Standardised Outcomes from Surgery. Drink, Eat, Mobilise, Sleep (DrEaMS)

13 May 2018

Contributed by Lukas

Dr Ramani Moonesinghe on Standardised Outcomes from Major Surgery. Dr Joff Lacey and Professor Monty Mythen talk to Dr Ramani Moonesinghe, Director of...

Measuring risk in surgery; what is a micromort?

12 May 2018

Contributed by Lukas

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 c...

The RELIEF trial results

11 May 2018

Contributed by Lukas

Monty Mythen presents the results of the RELIEF (Restrictive versus liberal fluid therapy in major abdominal surgery) trial. Does it answer the quest...

Perioperative nephrology and renal injury biomarkers

11 May 2018

Contributed by Lukas

In this piece find out how renal injury biomarkers can offer practitioners and patients hope. Presented by Professor Monty Mythen and Dr Joff Lacey fe...

Sleep disorders from the perioperative perspective?

09 May 2018

Contributed by Lukas

Where should sleep apnea be on the perioperative surgeon's priority list? A fascinating introduction to the topic, sleep disorders affect every area o...

The evolving role of the anaesthetist

08 May 2018

Contributed by Lukas

A conversation that is now even more relevant, the changing role of the anaesthetist. Matters such as population health, lifestyle choices and a wider...

The RELIEF Trial - are you ready?

05 May 2018

Contributed by Lukas

Standby for the results of The RELIEF Trial; coming soon on TopMedTalk, Professor Monty Mythen will be presenting an exclusive programme here covering...

A council of nurses

04 May 2018

Contributed by Lukas

This piece begins with the question, what does Enhanced Recovery mean to you? Here we go for a ground up approach via a 'council of nurses'. Can a 'ro...

Success means our insurance provider reduced our reimbursements?

03 May 2018

Contributed by Lukas

How do we bend cost curve to our advantage? How do we assert the irreducible minimum? Is it possible to spend less money and get better outcomes? Is i...

METS trial - exercise tolerance and surgery outcomes.

02 May 2018

Contributed by Lukas

METS trial - exercise tolerance and surgery outcomes. The results of the METS trial were presented at the International Anaesthesia Research Society m...

Opioid addiction can happen to anyone.

01 May 2018

Contributed by Lukas

Opioid addiction can happen to anyone, even world leading Professors like Dr Paul Wischmeyer. Listen to Paul's story and then spread this important me...

ERAS for Obstetrics?

30 Apr 2018

Contributed by Lukas

Dr Attilla Kett explains how he applies Enhanced Recovery after Surgery to obstetrics. This podcast features Desiree Chappell interviewing Dr Attila K...

Journal Club Express 27/04/18

27 Apr 2018

Contributed by Lukas

Steroids in cardiac surgery: a systematic review and meta-analysis BJA April 2018, Volume 120, Pages 657-667. See full article here: https://www.ncbi...

How do we encourage population health in a 'fee for service' environment?

26 Apr 2018

Contributed by Lukas

The first conference highlight from EBPOM USA 2018: How do you best work a pre-op clinic? Should they be places where you get your problems documented...

If patients come to us anaemic - they just do worse EBPOM USA

26 Apr 2018

Contributed by Lukas

How important is it to screen patients for anaemia before surgery? Has anaemia fallen off the health care agenda? We begin with a conversation about p...

Treating patients properly, EBPOM USA

25 Apr 2018

Contributed by Lukas

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 come...

EBPOM USA: How are you driving perioperative care?

24 Apr 2018

Contributed by Lukas

This piece discusses how the contributors are driving better perioperative care in their clinics; the importance of getting patient records in advance...

This is a not to miss experience EBPOM USA

23 Apr 2018

Contributed by Lukas

Marc Koch President & CEO of Somnia Inc reviews the conference with Desiree Chappell. What should you expect at an EBPOM meeting? How useful is the p...

Why are you short of breath?

21 Apr 2018

Contributed by Lukas

When it comes to breathlessness how do we better diagnose and apply treatment earlier? How do we overcome the fact that referring to a specialist can ...

Journal Club Express - Postoperative delirium in total knee and hip arthroplasty patients

20 Apr 2018

Contributed by Lukas

Professor Monty Mythen presents Journal Club Express. Postoperative delirium in total knee and hip arthroplasty patients: a study of perioperative mod...

Sleep disorders in surgical patients, EBPOM USA

20 Apr 2018

Contributed by Lukas

This podcast concerns sleep apnea as part of pre-operative patient optimisation. How important is it to evaluate patients for sleep disorders before s...

Psychological optimisation, EBPOM USA

20 Apr 2018

Contributed by Lukas

Originally streamed live from Atlanta Georgia during TopMedTalk's coverage of "EBPOM-USA Masters Course, A Perioperative Care Practicum" this podcast...

The importance of what you eat and what you do, EBPOM USA

18 Apr 2018

Contributed by Lukas

The importance of exercise, weight and perioperative nutrition. Which is worse, being fat or not being fit? Malnutrition, a silent epidemic? How usef...

Journal Club The FEDORA trial

15 Apr 2018

Contributed by Lukas

Professor Monty Mythen's full presentation regarding 'the FEDORA trial'. This piece was originally presented during the Third Annual Quality Improveme...

Day 3 EBPOM USA with Monty Mythen and Desiree Chappell

15 Apr 2018

Contributed by Lukas

Join Desiree and Monty as they reflect on the EBPOM USA weekend so far and look ahead to what remains. Also - a reminder that you still have chance to...

Dealing with policy and value based care, The Roundtable Blog

14 Apr 2018

Contributed by Lukas

A fascinating discussion and debate regarding the central dichotomy inherent in periperative medicine. No stone is left unturned as the team get their...

TopMed talk live from EBPOM USA

14 Apr 2018

Contributed by Lukas

Originally streamed live from the EBPOM USA conference. Desiree Chappell, Monty Mythen, Dr Tim Miller (anaestheseologist at Duke University) and Dr An...

The Roundtable blog live from EBPOM USA

14 Apr 2018

Contributed by Lukas

A fascinating conversation, streamed live from EBPOM-USA on the second day of the conference. Reflections on the conference alongside insightful discu...

EBPOM USA - Reflections on day 1

14 Apr 2018

Contributed by Lukas

Find out what the big stories and talking points were on day one of the highly anticipated "EBPOM-USA Masters Course, A Perioperative Care Practicum"....

Get your free live stream pass now!

13 Apr 2018

Contributed by Lukas

ATLANTA conference alert! Mike Grocott and Sol Aronson do a special podcast to alert TopMedTalk listeners to an exciting offer; EBPOM-USA Perioperativ...

TOPMEDTALK NEWS

13 Apr 2018

Contributed by Lukas

Stories include the call to reclassify cancers, dangerous cannabis substitute causes bleeding from the eyes and a chilli chomping champion gets more t...

JOURNAL CLUB SPECIAL

11 Apr 2018

Contributed by Lukas

Journal club special's featured article is today from "Anesthesia & Analgesia" April 2018 - Volume 126 - Number 4   https://journals.lww.com/anesthes...

Looking forward to EBPOM-USA

11 Apr 2018

Contributed by Lukas

Editor in Chief of TopMed Talk, Monty Mythen and Desiree Chappell, host of the Roundtable blog, talk about the upcoming "EBPOM-USA Masters Course - A ...

JOURNAL CLUB XPRESS 10th April 2018

10 Apr 2018

Contributed by Lukas

Should continuous rather than single-injection interscalene block be routinely offered for major shoulder surgery? A meta-analysis of the analgesic an...

Consent and anaesthetics.

09 Apr 2018

Contributed by Lukas

Dr Carol Peden and Dr Lee A. Fleisher join Desiree Chappell in a discussion, taken from The Roundtable blog, which here concerns consent and anaesthet...

Are we aiming for opioid-lite?

06 Apr 2018

Contributed by Lukas

The opioid crisis is a big concern for the Western World. Should we be aiming for opioid-lite, or trying to get rid of them entirely? Monty Mythen spe...

Patient monitoring

06 Apr 2018

Contributed by Lukas

Dr Joff Lacey grabs a quick chat with Matt McEvoy from Vanderbilt University, speaking about patient monitoring, after a presentation at ASER 2018. Th...

TOPMEDTALK WEEKLY NEWS

05 Apr 2018

Contributed by Lukas

Stories include the UK obesity crisis, nightmare bacteria in the US and The Duke Of Edinburgh has an operation on his hip. For comment and story sugge...

ERAS and cancer outcomes

04 Apr 2018

Contributed by Lukas

What drives enhanced recovery for you and how does it change outcomes? Desiree Chappell presents 'The Roundtable blog'; in this clip she’s in conver...

POQI does review what we are doing

03 Apr 2018

Contributed by Lukas

Julie Thacker discusses where we're at with enhanced recovery and POQI. This clip, presented by Desiree Chappell at ASER 2018, is part of a longer pie...

Has ERAS developed an energy of its own?

30 Mar 2018

Contributed by Lukas

Dr George Nassif explains to Desiree Chappell of The Roundtable blog how Enhanced Recovery After Surgery has grown into a movement which has had far r...

ERAS: Implementation and the importance of regular meetings

29 Mar 2018

Contributed by Lukas

Vicki Morton and Bethany Sarosiek get into a conversation about the importance of regular meetings following the process of ERAS adoption and then its...

Enhanced Recovery - is there anyone still in the wilderness?

29 Mar 2018

Contributed by Lukas

Has enhanced recovery reached the mass adoption point or are there still medical institutions which do not know about it? Is it now at a point where t...

Should pain relief mean you will feel no pain?

28 Mar 2018

Contributed by Lukas

Pain is seen by many as the so-called fifth vital sign but is it reasonable to expect us to eliminate it entirely? The long term consequences for medi...

Journal club; balanced versus saline

27 Mar 2018

Contributed by Lukas

This edition of journal club looks at two articles in March 1st NEJM of circa 30,000 patients studied at Vanderbilt Medical Centre, USA One in non-cri...