TopMedTalk
829 episodes - English - Latest episode: over 4 years ago - ★★★★★ - 23 ratingsTopMedTalk for the latest medical news surrounding Anaesthesia, Perioperative Care and Enhanced Recovery. Live updates from conferences; Journal Club; Techno Talk and Hot-Topic podcasts. Continuing Medical Education (CME) on the go
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Episodes
Journal Club The FEDORA trial
April 15, 2018 17:13 - 13 minutes - 6.02 MBProfessor Monty Mythen's full presentation regarding 'the FEDORA trial'. This piece was originally presented during the Third Annual Quality Improvement Leadership Forum, 2018, at the Union League Club in Philidelphia. The trial looked at the effect of goal-directed haemodynamic therapy on postoperative complications in low–moderate risk surgical patients: a multicentre randomised controlled trial (FEDORA trial). Randomised Controlled Multicentre trial; n=420; GDHT vs Control Conclus...
Day 3 EBPOM USA with Monty Mythen and Desiree Chappell
April 15, 2018 12:51 - 4 minutes - 2.26 MBJoin 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 hear the conference presentations live from the www.topmedtalk.com website. Go there now to get details, it's free and has proven to be incredibly popular around the world!
Dealing with policy and value based care, The Roundtable Blog
April 14, 2018 21:38 - 38 minutes - 17.6 MBA fascinating discussion and debate regarding the central dichotomy inherent in periperative medicine. No stone is left unturned as the team get their teeth into the subject tackling the always tricky subject of profit and patient optimisation. Recorded on the first day of the conference this piece is a real stand out moment for TopMedTalk, make sure you both listen in and provide us with your thoughts [email protected] Featuring Desiree Chappell, Monty Mythen, Dr Lee A. Fleisher Ch...
TopMed talk live from EBPOM USA
April 14, 2018 19:45 - 8 minutes - 3.72 MBOriginally streamed live from the EBPOM USA conference. Desiree Chappell, Monty Mythen, Dr Tim Miller (anaestheseologist at Duke University) and Dr Angela Edwards (head of perioperative medicine at Wake Forest University School of Medicine) discuss some of the presentations and their personal highlights. Join in the conversation, email us at [email protected]
The Roundtable blog live from EBPOM USA
April 14, 2018 17:23 - 23 minutes - 10.6 MBA fascinating conversation, streamed live from EBPOM-USA on the second day of the conference. Reflections on the conference alongside insightful discussions about how the contributors have each been attracted to perioperative medicine. Also, the perennial debate about patient care and profits, are the two factors in conflict? Featuring Desiree Chappell host of The Roundtable Blog, Dr Brian Woods anesthesiologist and Vice President at NorthStar Anesthesia, Irving Ye Regional Chief medical...
EBPOM USA - Reflections on day 1
April 14, 2018 13:40 - 16 minutes - 7.57 MBFind out what the big stories and talking points were on day one of the highly anticipated "EBPOM-USA Masters Course, A Perioperative Care Practicum". Recorded on the morning of day two; Monty Mythen, Desiree Chappell and Mike Grocott reflect on the first day of the conference. Remember, if you would like to hear the presentations live from EBPOM-USA you can "tune in" through our website to the live stream www.topmedtalk.com Featuring live podcasts alongside the audio from the full sch...
Get your free live stream pass now!
April 13, 2018 16:13 - 3 minutes - 1.64 MBATLANTA conference alert! Mike Grocott and Sol Aronson do a special podcast to alert TopMedTalk listeners to an exciting offer; EBPOM-USA Perioperative Care Practicum "The How to Guide" for evaluation, management and implementation - is to be streamed live, for free, from this year's conference. Presentations will be available to you from our website as they happen, go there now and make sure you take advantage of this unique chance to be at one of the most important events in the global...
TOPMEDTALK NEWS
April 13, 2018 03:36 - 5 minutes - 2.66 MBStories include the call to reclassify cancers, dangerous cannabis substitute causes bleeding from the eyes and a chilli chomping champion gets more than he bargined for. For comment and story suggestions email us [email protected]
JOURNAL CLUB SPECIAL
April 11, 2018 15:57 - 15 minutes - 7.33 MBJournal club special's featured article is today from "Anesthesia & Analgesia" April 2018 - Volume 126 - Number 4 https://journals.lww.com/anesthesia-analgesia/pages/default.aspx The excerpt in this piece comes from an earlier TopMed talk here: https://www.topmedtalk.com/live-from-boston-asa-2017-anaesthesia-and-global-health-an-expert-view/ Remember you can join the TopMed talk team live at one of our conferences - we're in Atlanta later this week for the first Perioperati...
Looking forward to EBPOM-USA
April 11, 2018 09:06 - 3 minutes - 1.49 MBEditor in Chief of TopMed Talk, Monty Mythen and Desiree Chappell, host of the Roundtable blog, talk about the upcoming "EBPOM-USA Masters Course - A Perioperative Care Practicum". More details about the event here: https://www.ebpom.org/EBPOM-USA2-2018 Also - for details of how you can sign up to our live stream for free go to www.topmedtalk.com And, if you are attending the course and would like to meet the TopMed talk team, email us [email protected]
JOURNAL CLUB XPRESS 10th April 2018
April 10, 2018 09:13 - 2 minutes - 951 KBShould continuous rather than single-injection interscalene block be routinely offered for major shoulder surgery? A meta-analysis of the analgesic and side-effects profiles. Br J Anaesth. 2018 Apr;120(4):679-692. See full article here: https://doi.org/10.1016/j.bja.2017.11.104
Consent and anaesthetics.
April 09, 2018 10:32 - 6 minutes - 2.91 MBDr Carol Peden and Dr Lee A. Fleisher join Desiree Chappell in a discussion, taken from The Roundtable blog, which here concerns consent and anaesthetics. The original longer piece you can find here: https://www.topmedtalk.com/2-9-the-brain-health-initiative/
Are we aiming for opioid-lite?
April 06, 2018 15:56 - 3 minutes - 1.77 MBThe 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 speaks with Carol Peden, Lee Fleisher and Andrea Kurz, live at the Third Annual Quality Improvement Leadership Forum, 2018. This clip is a shorter version of a longer conversation to be found here: https://www.topmedtalk.com/how-is-perioperative-medicine-taking-control-in-2018-and-beyond/
Patient monitoring
April 06, 2018 09:03 - 4 minutes - 2.16 MBDr Joff Lacey grabs a quick chat with Matt McEvoy from Vanderbilt University, speaking about patient monitoring, after a presentation at ASER 2018. This, from a larger piece, found here: https://www.topmedtalk.com/monitoring-patients-in-the-post-operative-period/
TOPMEDTALK WEEKLY NEWS
April 05, 2018 15:44 - 4 minutes - 2.21 MBStories 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 suggestions email us [email protected]
ERAS and cancer outcomes
April 04, 2018 09:45 - 3 minutes - 1.39 MBWhat drives enhanced recovery for you and how does it change outcomes? Desiree Chappell presents 'The Roundtable blog'; in this clip she’s in conversation with Dr Neil Seeley Chief of anesthesia for Cancer Treatment Centres of America and Dr Michael Scott Professor of Anesthesiology at Virginia Commonwealth University and Professor at The University of Pennsylvania. This clip is part of a longer conversation which you can find here: https://www.topmedtalk.com/2-6-enhanced-recovery-for-li...
POQI does review what we are doing
April 03, 2018 08:53 - 2 minutes - 1.07 MBJulie 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 piece which can be found here: http://www.topmedtalk.com/what-is-asers-vision-for-2018/
Has ERAS developed an energy of its own?
March 30, 2018 09:43 - 2 minutes - 1.34 MBDr George Nassif explains to Desiree Chappell of The Roundtable blog how Enhanced Recovery After Surgery has grown into a movement which has had far reaching and occasionally unexpected consequences. The domino effect which starts with enhanced recovery, moves to better patient outcomes and then tackling one of the biggest narcotics epidemics the US has ever seen. -- The fuller version of this piece is here: http://www.topmedtalk.com/how-has-enhanced-recovery-changed-your-practice/
ERAS: Implementation and the importance of regular meetings
March 29, 2018 14:16 - 2 minutes - 1.19 MBVicki Morton and Bethany Sarosiek get into a conversation about the importance of regular meetings following the process of ERAS adoption and then its essential maintenance. How have you managed the adoption process at your institution? Email us [email protected] The fuller version of this conversation is here: https://www.topmedtalk.com/using-a-team-approach-to-care/
Enhanced Recovery - is there anyone still in the wilderness?
March 29, 2018 09:03 - 2 minutes - 1.37 MBHas 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 the process is just going to run organically? In this podcast the team assess where we are at as the dissemination process appears to be working. Do you agree that we might in fact be at the tipping point right now? Email us with your thoughts [email protected] -- Join Desiree Chappell, Monty Mythen, Tim Miller and Stefan Holubar, r...
Should pain relief mean you will feel no pain?
March 28, 2018 11:39 - 6 minutes - 3.08 MBPain 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 medicine and our patients are now manifesting in daily newscasts regarding "the opioid epidemic". Patrick Shanahan and Mike Grocott discuss the crisis with Monty Mythen. It's a battle which ASER / ERAS and EBPOM are all helping to fight. The fuller version of this discussion is here: https://www.topmedtalk.com/the-opiate-crisis-topmedtalk-live-...
Journal club; balanced versus saline
March 27, 2018 09:40 - 14 minutes - 6.65 MBThis 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-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 Accompanied by a very balanced Editorial by Professor John Myburgh. Click here: http://www.nejm.org/doi/full/10.10...
Techno Talk: My PreOp
March 26, 2018 09:26 - 14 minutes - 6.5 MBOn this episode Dr Paul Upton explains My Preop. For more information go to: www.ultramed.co Broadcaster Nick Margerrison presents Techno Talk; joined by Professor Monty Mythen, editor in Chief of TopMedTalk and Pete Paterson, a sports psychology master.
2.9 The Brain Health initiative
March 26, 2018 09:08 - 16 minutes - 7.71 MBCarol Peden and Lee A. Fleisher join Desiree Chappell for a fascinating discussion about cognitive function after surgery and a wider conversation about the 'brain health initiative'. What practical simple steps can patients and providers take to bridge the gap between new discoveries in this area and risk minimisation?
How is perioperative medicine taking control in 2018 and beyond?
March 24, 2018 01:10 - 19 minutes - 8.81 MBAn intense and fascinating conversation which acts as a swift update for those interested in where perioperative medicine is currently at and what its ambitions for the future should be. Where are we in the process? Put yourself at the forefront of the debate by listening to this piece. Featuring Carol Peden, Lee Fleisher and Andrea Kurz, live at the Third Annual Quality Improvement Leadership Forum, 2018.
2.7 What does enhanced recovery mean to you?
March 19, 2018 15:13 - 15 minutes - 7.25 MBRuchir Gupta and Joni Brady sit at the Roundtable with Desiree Chappell to discuss implimenting better practices and "ERAS 2.0". The ground up approach via a 'council of nurses' sparks some fascinating debate and discussion. Can a roundtable approach sometimes work better than the traditional hierarchical power structure?
Looking back over ASER 2018
March 18, 2018 20:51 - 5 minutes - 2.74 MBJoff Lacey, Monty Mythen, Mike Grocott and Desiree Chappell look back at a successful and, at points very passionate, ASER 2018. What are we now looking forward to? How did the discussions around leadership pan out? What about the blood pressure sessions? Was this, as the team suggest, a "maturing" of the movement? What are your reflections on ASER 2018? Get it touch email [email protected]
How do you bring perioperative care to your practice?
March 18, 2018 20:07 - 6 minutes - 3.14 MBArman Dagal and Desiree Chappell discuss bringing about change, managing and sustaining it over time and helping relate it to patient outcomes. What is after ERAS, do we have an 'ERAS of ERAS' - so to speak?
How do you promote ERAS both inside and outside your facility?
March 18, 2018 16:15 - 12 minutes - 5.52 MBKara Douglas and Joni Brady speak about the advantages of enhanced recovery and what practicioners can do to promote it. Educating both the wider community and the patients themselves are an important part of the discussion.
Monitoring patients in the post operative period
March 17, 2018 16:02 - 6 minutes - 3.08 MBJoff Lacey catches up with Matt McEvoy after a lively debate about monitoring patients in the post operative period. One of the big moments of ASER 2018 - make sure you hear this.
2.8 Critical care patients and enhanced recovery
March 17, 2018 15:01 - 10 minutes - 4.8 MBDesiree Chappell, Philip Corvo and Vicki Morton discuss critical care patients and enhanced recovery pathways. How do the insights of ERAS apply to these situations?
ERAS Implementation
March 16, 2018 18:36 - 7 minutes - 3.35 MBJoff Lacey catches up with Mike Scott (Virginia Commonwealth University) and Ross Kerridge (John Hunter Hospital, Newcastle, Australia) in the exhibit hall of ASER 2018 for a quick chat on enhanced recovery implementation.
2.6 Enhanced recovery for liver resection patients
March 16, 2018 17:34 - 12 minutes - 5.91 MBMichael Scott, Neil Seeley, Kevin Watkins and Desiree Chappell discuss enhanced recovery pathways, specifically regarding liver sections and other complex operations.
2.5 How ERAS introperative protocols drive outstanding outcomes
March 16, 2018 14:52 - 9 minutes - 4.51 MBRaul Castillo, Jennifer Clark and Kay Smith join Desiree Chappell to discuss their experiences of enhanced recovery. They discuss how just imprementing the ERAS intraoperative protocols drove outstanding outcomes in their practice. They then get into a wider discussion about the importance of putting into practice the bigger plan.
Using a team approach to care
March 16, 2018 13:32 - 10 minutes - 4.64 MBAn entertaining and informative discussion about the implementation process, how do you bring everyone to the table? Desiree Chappell speaks with Robin Anderson, Bethany Sarosiek and Vicki Morton, ASER nursing committee members.
Heated discussions - exponential rise in babies born addicted to opiodes
March 16, 2018 13:00 - 15 minutes - 6.87 MBJoff Lacey, Monty Mythen and Patrick Shanahan get stuck into an informative discussion about yesterday's 'heated' and controversial debate regarding the opiode crisis. Joff Lacey reports he heard one clinician say "over 25% of total knee replacements are still on opiodes 6 months after their operation". Patrick Shanahan pleads with the public "don't connect discomfort with a need for a narcotic to take care of it, there are many other avenues to take care of pain; that message is not out...
How has enhanced recovery changed your practice?
March 15, 2018 20:44 - 12 minutes - 5.93 MBDesiree Chappell, Dr Vijaya Gottumukkala and Dr George Nassif discuss the changes enhanched recovery has brought into their world, the conversation then moves to narcotics and the opiode epidemic.
What is ASER's vision for 2018
March 15, 2018 20:06 - 7 minutes - 3.26 MBThe Roundtable Blog on TopMedTalk, live from ASER 2018. Dr Julie Thacker takes some time with Desiree Chappell to discuss ASER's vision for this year.
Meet the TopMedTalk team for ASER 2018
March 15, 2018 17:47 - 5 minutes - 2.42 MBMonty Mythen, Joff Lacey and Mike Grocott chat with Desiree Chappell about the plan for the TopMedTalk team at ASER 2018. Joff Lacey will be out and about with his roving mic getting on the spot interviews with attendees, gathering late breaking news as it happens. Mike Grocott will be doing Journal Club, a deep dive into some of thre big papers of the last 12 months or so. And finally, Desiree Chappell, will be returning to her popular Round Table Blog podcasts; bringing people from d...
The Opiate crisis - TOPMEDTALK live from ASER 2018
March 15, 2018 14:56 - 13 minutes - 6.33 MBMonty Mythen, Joff Lacey and Mike Grocott look ahead to this years conference and look back over the meeting last year in Washington. The team discuss the association between low blood pressure and outcomes and the first interventional trial related to that. They are then joined by Dr Patrick Shanahan who discusses, amongst other things, the issues related to opiode and narcotic use which can be reduced by the perioperative process.
"My Pre-op". Empowering patients before surgery.
March 14, 2018 22:14 - 20 minutes - 9.31 MBTechno Talk Broadcaster Nick Margerrison presents Techno Talk; joined by Professor Monty Mythen, editor in Chief of TopMedTalk and Pete Paterson, a sports psychology master. On this episode Dr Paul Upton explains My Preop. For more information go to: www.ultramed.co
Are you ready for ASER 2018?
March 14, 2018 17:21 - 16 minutes - 7.46 MBDesiree Chappell, Monty Mythen, Tim Miller and Stefan Holubar discuss some of the big issues at ASER 2018. The team discuss whether or not we're at the point of mass adoption for enhanced surgical recovery? Where next with post operative opitate prescriptions? And finally what to expect this year from ASER 2018.
Optimal analgesia within an enhanced recovery pathway
March 13, 2018 14:02 - 5 minutes - 2.74 MBMike Grocott, Joff Lacey, Monty Mythen and Julie Thacker react to the American Society for Enhanced Recovery (ASER) and Perioperative Quality Initiative (POQI) joint consensus statement on optimal analgesia within an enhanced recovery pathway for colorectal surgery. What is "optimal analgesia" and how rapidly should a patient "return to normal"? The links to the papers are here: Part 1: https://perioperativemedicinejournal.biomedcentral.com/articles/10.1186/s13741-017-0064-5 Part ...
Journal Club Xpress: After non-cardiac surgery myocardial injury is common and dangerous.
March 12, 2018 14:59 - 2 minutes - 1.1 MBMyocardial Injury after Noncardiac Surgery: A Large, International, Prospective Cohort Study Establishing DiagnosticCriteria, Characteristics, Predictors, and 30-day Outcomes TheVascular events In noncardiac Surgery patIents cOhort evaluatioN (VISION)Writing Group, on behalf of The Vascular events In noncardiac Surgery patIentscOhort evaluatioN (VISION) Investigators. Anesthesiology 03 2014,Vol.120, 564-578. International,prospective cohort study of 15,065 patients > 45 yr, having noncar...
Journal Club: Multi-centre trial in BJA: Goal Directed Therapy improves outcomes
March 10, 2018 10:59 - 1 minute - 861 KBEffect of goal-directed haemodynamic therapy on postoperative complications in low–moderate risk surgical patients: a multicentre randomised controlled trial (FEDORA trial) Randomised Controlled Multicentre trial; n=420; GDHT vs Control Conclusions: "Oesophageal Doppler monitor-guided GDHT reduced postoperative complications and hospital length of stay in low–moderate risk patients undergoing intermediate risk surgery, with no difference in mortality at 180 days." Click here for full...
Dr Tim Miller and Dr Julie Thacker
March 10, 2018 09:57 - 7 minutes - 3.5 MBDr Tim Miller, Anesthesiologist from Duke talks about opiods "we're definately opening our eyes in The States". Also, Dr Julie Thacker, President of the American Society of Enhanced Recovery features with her thoughts on colorectal surgery.
Bowel Prep and Opiates
March 08, 2018 11:01 - 9 minutes - 4.16 MBA quick refresher on some of the hot topics from ASER 2017, including the messy issue of bowel prep and the prickly topic of opiates. A couple of highlights from Professor Monty Mythen and Dr Joff Lacey's live coverage of ASER 2017 for TopMedTalk featuring Dr Julie Thacker, President of American Society of Enhanced Recovery and Desiree Chappell a CRNA in Louisville, Kentucky and board member of EBPOM USA. -- 15th - 17th March 2018 ASER/EBPOM 2018 Annual Congress of Enhanced Recovery an...
Is rehabilitation a team sport?
March 07, 2018 10:04 - 5 minutes - 2.31 MBDr Steve Flanagan - Chair of Physical Medicine and Rehabilitation at NYU Langone. Taken from the Roundtable discussions hosted by Desiree Chappell live from the American College of Perioperative Medicine's Interdisciplinary Conference on Orthopedic Value-Based Care. -- The fuller version of this piece is here: http://topmedtalk.libsyn.com/physical-medicine-in-rehabilitation-applying-a-team-approach-in-care-and-pre-and-post-habilitation -- Also - don't forget: 15th - 17th March 2018...
Journal Club Xpress: > 100K patient study of Spinal vs GA for fractured neck of femur
March 06, 2018 17:16 - 2 minutes - 1.03 MBAssociation of Hospital-level Neuraxial Anesthesia Use for Hip Fracture Surgery with Outcomes: A Population-based Cohort Study McIsaac D et al. Anesthesiology 3 2018, Vol.128, 480-491 A population-based cohort study using linked administrative data in Ontario, Canada. 107,317 hip fracture patients > 65 yr of age from 2002 to 2014. Hip fracture surgery patients at hospitals that use more than 20 to 25% neuraxial anesthesia have improved survival independent of patient-level anesthesia t...
Sol Aronson and Monty Mythen speak about the forthcoming EBPOM USA meeting, April 13-15th.
March 06, 2018 12:20 - 10 minutes - 5 MBSol Aronson and Monty Mythen speak about the forthcoming EBPOM 2018 annual conference in Atlanta. -- For more details on the upcoming Perioperative Practicum, Atlanta, April 13-15 2018 click here: https://www.ebpom.org/EBPOM-USA2-2018