TopMedTalk

This piece is taken from the free papers presentations given at EBPOM 2019. Malnutrition and functional capacity; what is the effect of multimodal prehabilitation? What can the six minute walk test really show us? Does nutritional status predict preoperative change in a six minute walk test in colorectal cancer patients following a prehabilitation programme?

Presented by Lauren Richer, Director, Nutritional Services, Keyto, Registered Dietician, Greene Family Medicine Clinic and Montreal General Hospital, Montreal, Quebec.

The Covid 19 crisis - and our collective response to it - has had an immediate and, in some instances worrying, drop off in cases that are not directly related to the virus.

As the normalisation process in medicine begins and we find a way to live with this new virus in our midst how do we adapt and promote healthcare? What are the exciting opportunities available for patient optimisation? Further, there is a detailed and engaging discussion about fluid management.

Presented by Desiree Chappell with Monty Mythen and Dr Arthur Martella, Cardiothoracic surgeon in Camden, New Jersey.

Thank you to our sponsor Edwards Lifesciences.

Edwards clinical education (ECE): https://www.edwards.com/clinicaleducation

"Babies are still being born"

This piece looks at the area of obstetrics in the midst of an unprecedented global crisis regarding the COVID 19 outbreak. How can the delicate balance between reducing infections and social distancing be interwoven with the needs of modern childbirth.

Should we be concerned that some patients may shun hospital assisted births for fear of contagion? How has the data from China, much of which focused upon cesarean section births, been useful to us in the West? Why do the data have that angle?

Are there benefits to the new ways in which we have found to communicate during this global crisis which can be moved into a new life with COVID present but in a more manageable form?

Presented by Desiree Chappell and Monty Mythen with Sam Bampoe, University College London Hospital, Consultant Anesthetist, Director, Trainees with an Interest in Perioperative Medicine (TRIPOM), Nuala Lucas, Consultant Anesthetist at Northwick Park Hospital, Executive Committee Member for the Obstetric Anesthetists' association and Pat O'Brien, Consultant Obstetrician at University College London Hospital, Vice President of Royal College of Obstetricians and Gynecologists.

Thank you to our sponsor Edwards Lifesciences.

Edwards clinical education (ECE): https://www.edwards.com/clinicaleducation

"I'm also a United States Air Force Officer and reservist and on April 4th was activated and given approximately 48hrs to deploy on a C-5 Galaxy Military Aircraft to the epicenter, New York City and I've been here for approximately, it's been almost a month now"

This piece follows on from a previous exclusive conversation regarding the US military deployment to New York; here we get more detail and spend time thinking about how Enhanced Recovery must be an essential part of any "new normal".

The fascinating Carol Peden piece is here: https://www.topmedtalk.com/covid-19-disruptive-innovation/

And Bobbie Jean Sweitzer is here: https://www.topmedtalk.com/covid-19-promote-your-anemia-clinics-in-the-pandemic-era

The previous conversation we mention is here: https://www.topmedtalk.com/covid-19-rapid-deployment-of-us-national-reserves-ease-stress-in-new-york/

Presented by Desiree Chappell with Captain Joel Sherwood, United States Air Force Reserves and Medical Science Liaison, National Director, Government Affairs, Pacira Pharmaceuticals.

Thank you to our sponsor Edwards Lifesciences.

Edwards clinical education (ECE): https://www.edwards.com/clinicaleducation

The Perioperative Quality Initiative (POQI) is a vital part of the process needed to more widely implement sensible practice which, using a clear evidence base, provides better value care with more positive outcomes for the patient. POQI continues to provide its work in an attempt to clarify fundamental concepts in perioperative care. The fact this one focuses upon fluid management makes it particularly appropriate in these times.

Link to the paper: https://perioperativemedicinejournal.biomedcentral.com/articles/10.1186/s13741-020-00142-8

Presented by Desiree Chappell with Monty Mythen and their guests Tim Miller, Associate Professor of Anesthesiology from Duke University Medical Centre and Greg Martin Professor of Medicine, Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Emory University School of Medicine

Thank you to our sponsor Edwards Lifesciences.

Edwards clinical education (ECE): https://www.edwards.com/clinicaleducation

Like this, want more?

Try our popular in depth series "Fluid Matters" http://topmedtalk.libsyn.com/fluid-matters-1

TopMedTalk provides world leading information about perioperative medicine like this every day. Dr Greg Martin's deeper dive into these issues is here: http://topmedtalk.libsyn.com/fluid-matters-3

"There's no advertisements popping up, non of that nonsense, this is just the data you need on the front lines to help save time and save lives"

This piece focuses on the Ventilator Training Alliance APP, developed to meet the need practitioners have to use and understand ventilation equipment which may be new or unfamiliar to them. Download the APP now and share it with all friends and colleagues who may find themselves in this situation.

The app is here: https://www.allego.com/ventilator-training-alliance/

Don't forget if you have any comments or questions, email us [email protected]

Presented by Desiree Chappell with Monty Mythen and Michelle Jones, Senior Director, Global Marketing, Patient Monitoring and Minimally Invasive Therapies, Medtronic, and their guests Pat Berges, Vice President of Global Commercial Capabilities, Medtronic and Ariel Mactavish, Vice President, General Manager of Respiratory Interventions, Medtronic

"If you have major surgery and you are COVID positive at the time your outcomes are severely reduced"

This piece takes a look at how we try to move back to some semblance of "normal" as the peak appears in many parts of the Western world to have reacted to social distancing measures. How have thought leaders and anesthesiologists tried to come together to produce guidance for each other? What should that guidance be? What specific areas of practice have been changed by the pandemic?

Also - more widely - what are we learning about the issues presented by COVID 19 and how do we move forward in a constructive way?

Links to the papers here:

Adult Cardiac Surgery and the COVID-19 Pandemic: Aggressive Infection Mitigation Strategies are Necessary in the Operating Room and Surgical Recovery: https://www.sciencedirect.com/science/article/pii/S0022522320310114

Adult cardiac surgery during the COVID-19 Pandemic: A Tiered Patient Triage Guidance Statement: https://www.sciencedirect.com/science/article/abs/pii/S0022522320308904

Also, the Cardiothoracic Surgery in the COVID Crisis: Global Summit on Reactivating Cardiothoracic Surgery Programs is here: https://www.sts.org/meetings/calendar-of-events/cardiothoracic-surgery-covid-crisis-global-summit-reactivating-cardiothoracic-surgery-programs

Presented by Desiree Chappell with Monty Mythen and their guest Dan Engelman, Director CIVCU, Baystate Medical, MA (unit now managing COVID patients). President of ERAS Cardiac

Thank you to our sponsor Edwards Lifesciences.

Edwards clinical education (ECE): https://www.edwards.com/clinicaleducation

In the UK community based prehabilitation is being spearheaded by the Prepwell Initiative, supported by a grant from Sports England. Their pioneering work is a great example of the way in which prehabilitation is gathering pace at the moment.

The "PREP: Preoperative Risk Education Package" website is here: https://www.prepwell.co.uk/

What are the economics of such a programme? Why did the project start to get referrals from initially sceptical surgeons? How did the programme impact the lives and treatment of patients?

Presented by Gerard Danjoux, Consultant in Anaesthesia and Sleep Medicine at South Tees Hospitals NHS Foundation Trust.

Mixed in with conversation about EBPOM's plans to push forward with online conferencing and other ideas this piece asks how Ireland has and is faring in the battle against COVID. Decisive and brave action began with cancelling the world famous St Patrick's Day celebrations. How have things progressed from there?

Presented by Desiree Chappell with Monty Mythen and Jan Brohan, Consultant in Anaesthesia and Intensive Care Medicine in Cork University Hospital.

Thank you to our sponsor Edwards Lifesciences.

Edwards clinical education (ECE): https://www.edwards.com/clinicaleducation

The war against COVID 19 is ongoing but some relief has reached the frontlines in New York. Hear how a rapid response military team, United States Air Force Reserves, deployed into the "war zone" built and supported the first wave of our battle against this terrible virus.

How has this effort been received and implemented? What is the significance for this unprecedented move in the US? What lessons are being learned and could the end result improve healthcare for all?

Presented by Desiree Chappell with Monty Mythen and their guests USAF Col Jennifer 'Robyn' Ratcliff, Orthopedic surgeon, Orlando VA Hospital, USAF Lt Col Reco Evans CRNA, Temple TX VA Hospital and Captain Joel Sherwood, Medical Science Liaison, National Director, Government Affairs, Pacira Pharmaceuticals

Thank you to our sponsor Edwards Life Sciences.

Edwards clinical education (ECE): https://www.edwards.com/clinicaleducation