TopMedTalk

"When you start to think about how we can protect ourselves; we have some reasonably robust literature for a few interventions [..] that do seem to associate with the prevention of viral infections…"; maintain a normal vitamin D level, probiotics, vitamin C.

This piece is an edited highlight of a fascinating conversation with a TopMedTalk favorite. How can we optimise ourselves for an oncoming viral attack? How can we make sure our patients get the best possible care and are as informed as they can be? What research is being carried out into COVID 19?

Presented by Desiree Chappell with her guest Paul Wischmeyer, Professor of the Department of Anesthesiology and Critical Care, Duke University.

Thank you to our sponsor Edwards Lifesciences.

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

The debate 'Direct laryngoscopes should be consigned to history', was 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" the profession in an overly enthusiastic race toward new technology or are some resisting it simply because it's not what they are used to?

Where do you stand on this fascinating debate? Send us your thoughts on email: [email protected]

Presented by Joff Lacey and Monty Mythen with their two guests; Professor Tim Cook, Consultant in Anaesthesia and ICM, Royal United Hospitals, Bath and Dr William Harrop-Griffiths, St Mary's Hospital, Imperial College Healthcare NHS Trust.

ACE inhibitors (angiotensin converting enzyme inhibitors) have been mentioned frequently in this series over the last month. This piece sees the long promised focus on ACE and the effects of estrogen as a way of dealing with some of the potentially fatal symptoms caused by COVID 19.

It's still early days in the battle against this terrible virus, this piece presents some speculation as to where the conflict may head to. TopMedTalk provides evidence based discussions, here we ask how more evidence can be gathered as tantalizing theories emerge about dealing more effectively with these patients.

Presented by Desiree Chappell with Monty Mythen and additional questions from Mike Grocott, alongside their guest Hugh Montgomery, Intensive Care Society Board Member and, Professor of Cardiovascular Genetics and Critical Care University College London.

Thank you to our sponsor Edwards Lifesciences.

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

The healthcare profession has a mixed history when it comes to messaging around alcohol. Nowadays, from a public health perspective, it is clear that overall it is not helpful for our physiology and well being.

How often do you have alcohol? How many units do you drink? How often do you have a binge? What are the age groups where drinking problems are most apparent? Where is the latest research regarding a perioperative approach to alcohol consumption? How effective is intervention for risky drinkers, should it also be considered for dependent drinkers?

How have studies and evidence been arranged around this topic and where should it lead us? Is there a need for more research?

Presented by Chris Snowden, Consultant Anaesthetist, Freeman Hospital, Newcastle upon Tyne and Senior lecturer at the Institute of Cellular Medicine at Newcastle University, he has recently secured grant funding from the NIAA (RCOA /BJA) to develop prehabilitative training in the elderly surgical patient.

"You're a bit further down the line with managing these patients. Any particular advice?"

Italy, the situation is difficult but there are now clear lessons to be learned as the first chapter in the front line battle against the consequences of a global pandemic is written.

Hear how the story regarding treatment for this disease evolved in Italy and consequently around the world. Has the debate regarding acute respiratory distress syndrome (ARDS) been a red herring? What is the effectiveness of continuous positive airway pressure (CPAP) in these cases? Are all COVID 19 patients the same? Crucially - what can cardiac dysfunctions in these patients tell us?

This podcast is essential listening for students and medical practitioners who want to hear a real life discussion about one of the most important medical and population health emergencies the world has ever faced.

Presented by Joff Lacey with Monty Mythen and additional questions from Desiree Chappell alongside their guest, Maurizio Cecconi, Head of the Anaesthesia and Intensive Care Department at Humanitas Research Hospital; President-elect of the European Society of Intensive Care Medicine (ESICM) for 2020-2021, Chair Division of Scientific Affairs at ESICM; Director of the Master in Patient Blood Management at Humanitas University.

Thank you to our sponsor Edwards Lifesciences.

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

"Moving as medicine; is it the most underused but proven health promotion and healthcare practice?"

Prehabilitation and population health naturally walk alongside each other. Learn here how Sport England's ambitious strategy to reduce inactivity and improve the nation's physical and mental health is connected to prehabilitation and Enhanced Recovery After Surgery. Should patients be seeking expert condition specific advice before becoming active? How do we improve the quality of conversations between practitioner and patient?

The excellent Moving Medicine website can be found here: http://movingmedicine.ac.uk/

Presented by Sarah Ruane, Sport England's national lead for health, she joined in January 2016 from local government where she oversaw public health, leisure and cultural services.

This piece is something of a ray of hope, here we learn how New Zealand appears to have managed the crisis remarkably well, a low level of infections overall. What lessons can be learned from the political leadership and tactic deployed here? Is there a downside to this, as regards to 'herd immunity', or is the reality that all of us must wait for a vaccine?

Presented by Desiree Chappell and Monty Mythen with Julian Fuller, Anaesthetist in Auckland, New Zealand.

Thank you to our sponsor Edwards Lifesciences.

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

Like this, want more? We mention our Editor in Chief's bought of COVID 19 here, why not listen to this piece which tells the story in full: https://www.topmedtalk.com/covid-19-case-study-professor-monty-mythen-01/

This piece is a catch up with a popular contributor on TopMedTalk, Ross Kerridge, John Hunter Hospital, Newcastle, Australia, (often cited as 'the father of Modern Perioperative Medicine), for an update on how Australia appears to have managed to broadly keep a lid on this crisis. Social distancing, quick action and border controls appear to have worked to forestall the impending crisis.

Our guest writes regularly and is a very popular opinionator, find some of his work here: Newcastle's 'quiet heroes' who helped the sick and injured in wartime https://www.newcastleherald.com.au/story/6725101/the-birth-of-intensive-care-in-newcastle/?cs=4464

Presented by Desiree Chappell and Monty Mythen.

Thank you to our sponsor Edwards Lifesciences.

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

"It's really important just to talk about the situation and not keep it bottled up"

Psychological stress is inevitable at this time for medical practitioners, that's why we here at TopMedTalk are keen to both raise money for the Intensive Care Society (ICS) charity and to remind our listeners of the importance of mental health and self care.

There's a wealth of resources on this topic in the TopMedTalk archive. Here's a good piece to start with: https://www.topmedtalk.com/topmedtalks-to-sasha-shillcutt/

Find our guest's Facebook page here, click like to get an alert when he goes live: https://www.facebook.com/jeremysassoon

Presented by Desiree Chappell and Monty Mythen with Jeremy Sassoon.

Thank you to our sponsor Edwards Lifesciences.

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

"Our mission is to make sure everybody in intensive care can learn [ultrasound]". How important and how possible is it to use ultrasound in your practice? Hear how it can transform the way you diagnose issues with pocket sized point of care ultrasound. Lung ultrasound is discussed as is its use with eyeballs. Hear how one of the pioneers in this area, Professor Sol Aronson, reacts to an enthusiast in the field. "Wherever you are, however novice or new, it just makes you smarter".

Recorded live at the Association of Anaesthetists' Winter Scientific Meeting 2020 in the centre of London from The Queen Elizabeth II Centre. This piece followed on from these two pieces:

TopMedTalk | Matt Wiles and Marcus Peck, Live from London: https://www.topmedtalk.com/topmedtalk-matt-wiles-and-marcus-peck-live-from-london/

TopMedTalk | Gezz Van Zwanenberg, Live from London Part 2: https://www.topmedtalk.com/topmedtalk-gezz-van-zwanenberg-live-from-london-part-2/

Find out more Focused Ultrasound in Intensive Care (FUSIC) here: https://www.ics.ac.uk/ICS/accreditation.aspx

Presented by Desiree Chappell and Monty Mythen with contributions from Sol Aronson, tenured Professor at Duke University and their guest Marcus Peck, NHS Consultant in Anaesthesia and Intensive Care Medicine at Frimley Park Hospital and Chair of Focused Intensive Care Society's (FICE) Committee.

Like this, want more? Marcus Peck featured on TopMedTalk previously here: https://www.topmedtalk.com/intensive-care-society-point-of-care-ultrasound/