TopMedTalk

This week begins with an update on Monty's progress after his COVID 19 diagnosis. Have the symptoms returned or is he back to his usual self?

One thing we know for certain when it comes to this virus and our treatment of it's symptoms; it is a dynamic situation. Management of the COVID patient is constantly changing. Do we treat our patients as having Acute respiratory distress syndrome (ARDS) or do we take a standard approach to ventilation? This piece looks at how our understanding of COVID 19 is developing as more evidence comes in.

There then follows a conversation about the various uses medical research might be able to put Monty's blood to, now he's a recovering COVID 19 patient.

Are there possible treatments on the horizon? Inevitably this requires evidence and rapid trials; "equipoise" is the word of the moment.

The International Society on Thrombosis and Haemostasis (ISTH) - mentioned in this piece - can be found here: https://www.isth.org/

Presented by Desiree Chappell with Monty Mythen.

Thank you to our sponsor Edwards Lifesciences.

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

Burn out and stress management have been an important theme on TopMedTalk recently, here we have a top medical professional sharing their story in relation to the topic. How do we describe "burn out", are certain words a barrier to discussion? How do we cut through to people who are most likely to suffer from this incredibly dangerous condition? Is the medical profession finally making progress here?

Our interview with Sasha Shillcut is here "Sunday Special | Burn out": https://www.topmedtalk.com/sunday-special-burn-out/

This piece was originally streamed live from 'The Society of Cardiovascular Anesthesiologists' (SCA) annual conference, 2019.

Presented by Desiree Chappell and Monty Mythen with Sol Aronson, Tenured Professor, Duke University and Executive Vice Chairman in the Department of Anesthesiology, and their guest Tjorvi Perry, Assistant Professor, Department of Anesthesiology, University Minnesota

This hugely important talk was the centerpiece of EBPOM 2019 and, appropriately enough, it focuses on a big topic for us here at TopMedTalk; the future of fluid therapy.

Originally given as the EBPOM 2019 Ernest Henry Starling plenary lecture the talk is complimented by this piece which was recorded on the same day: https://www.topmedtalk.com/desirees-roundtable-fluids-in-the-2020s/

Where is the latest thinking on fluid therapy, what new evidence and understandings do we now have?

Presented by Dr Andrew Shaw, Chairman, Department of Anesthesiology and Pain Medicine at The University of Alberta, Edmonton, Alberta and Zone Clinical Department Head for Anesthesia, Alberta Health Services Edmonton Zone. He is also a Fellow of the Royal College of Anaesthetists (UK), the American College of Critical Care Medicine and the Faculty of Intensive Care Medicine (UK).

This week's Women In Anaesthesia focuses in on TopMedTalk favourite Carol Peden.

The British Journal of Anaesthesia article, which inspired this series, is here: https://bjanaesthesia.org/article/S0007-0912(20)30003-9/fulltext

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"The Power of The Interdisciplinary Team"; introducing the Enhanced Recovery team from Keck Medical Center at The University of Southern California (USC).

Our guests kindly share an email address you can contact them on: [email protected]

Presented by Desiree Chappell and Monty Mythen with their guests Professor Carol Peden, Robin Cresner, CCRN, Dr Shane Dickinson, anesthesiologist and Snow Shoo Son; The Enhanced Recovery Team from Keck Medical Center at USC.

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Like this, want more?

There's a fascinating conversation with Carol Peden here: https://www.topmedtalk.com/talks-to-carol-peden/

This piece focuses upon the African Surgical Outcomes Study (ASOS-2). More than a thousand people across Africa have combined forces to make this research into perioperative medicine in a resource limited environment happen. We know patients in Africa are twice as likely to die following surgery when compared to the global average, why is this? How does "failure to rescue" play into this?

The website mentioned in this piece for more details: https://www.asos.org.za

Presented by Desiree Chappell with Monty Mythen and their guest Bruce Biccard, consultant anaesthetist at the University of Kwazulu-Natal, Director, Perioperative Research Unit, Department of Anaesthetics, Nelson R Mandela School of Medicine.

This piece is a reliable first hand account of COVID 19, directly from a patient, our Editor in Chief Monty Mythen.

"This kind of reassurance that seemed to go with it, to seem to say to people: 'nah, nah, nah, it's ok; you've just got a bit of a sore throat and a bit of a dribbly nose, crack on!' Was not supported by the available evidence at all"

How is Monty feeling? What are the actual symptoms of COVID 19? Why has misleading information been apparently knowingly released regarding this? What are the details on The Nightingale Hospital in London? Further discussion includes best practice related to COVID 19 patient care including ventilatory strategies and fluid management. Previous information is reviewed in the light of new evidence. We also congratulate our partner in TopMedTalk Dr Henry Howe who has graduated today!

Presented by Desiree Chappell with Monty Mythen.

Dr Henry Howe featured on TopMedTalk here: https://www.topmedtalk.com/covid-19-uk-calls-on-medical-students-to-join-the-fight/

COVER IMAGE:

In this image: Colorized scanning electron #micrograph of an apoptotic cell (red) heavily infected with #SARS-COV-2 virus particles (yellow), isolated from a patient sample. Image captured at the @niaid Integrated Research Facility

Thank you to our sponsor Edwards Lifesciences.

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

"We're not a big teaching hospital [...] and I think there is a slightly different perspective..."

This piece focuses on the realities of preparing for and dealing with COVID 19 patients in the town of Bath in the UK. Innovation with staff training, cautionary tales regarding our advance warning of the current situation and fluctuating guidelines are the opening points of discussion before a fascinating deep dive into the potential merits of video laryngoscopy.

Further discussion includes reflections on the anaesthetics and forms of treatment which might be used in such a case.

Presented by Desiree Chappell and Monty Mythen with their guest Professor Tim Cook, Consultant in Anaesthesia and ICM, Royal United Hospitals, Bath.

Email us [email protected]

If you found this piece interesting there is more from Tim Cook here: https://www.topmedtalk.com/sunday-special-should-direct-laryngoscopy-be-consigned-to-the-history-books/

Thank you to our sponsor Edwards Lifesciences.

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

The team aspect of perioperative care is an essential element, this piece gets into the details as thought leaders and key opinion makers engage with the debate regarding how that actually works in practice.

Moderated by Ross Kerridge, John Hunter Hospital, Newcastle, Australia, often cited as 'the father of Modern Perioperative Medicine'; the panel consists of, Charlie Corke, Associate Professor, Senior Intensive Care Specialist, Barwon Health, Kerin Fielding, Associate Professor, University of Notre Dame, Australia School of Medicine, Sydney and Don Campbell, Professor of Medicine at Monash University and Head of General Medicine at Southern Health.

This piece dives into "The new www revolution?: Wireless Wearables on the Ward". Improving the monitoring of patients on the wards is an exciting prospect for any modern practitioner and as personal health monitoring technology becomes mainstream for the public it's surely an inevitable part of the future of medicine.

The website mentioned in the podcast is here: https://www.michardconsulting.com/

The Global burden of postoperative death - The Lancet is here: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(18)33139-8/fulltext?rss=yes

This paper in The Lancet is also mentioned: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(12)61148-9/fulltext

Presented by Desiree Chappell and Monty Mythen with their guest Frederic Michard of MiCo Consulting.

Like this, want more?

Our guest previously featured on TopMedTalk here:

https://www.topmedtalk.com/asa-2018-san-francisco-the-practical-applications-of-innovation/

This piece takes a look at the frontline fight against COVID 19 at Penn Medicine Princeton Medical Center in New Jersey, USA. Details of airway, ventilation and hemodynamic management are discussed with the director of Critical care and Anesthesiology. Resource management is a clear front runner as the virus creates a public health emergency for medics to try to battle. Additional beds and treatment facilities are being prepared, what other innovations are being brought to the fore.

Presented by Desiree Chappell with Monty Mythen and their guests Michael Scott, M.B., Ch.B. Professor of Anesthesiology at the University of Pennsylvania, Jasmeet Bajaj, MD, Chief of Critical Care and Bridget Ruscito, MD Chair of the Dept of Anesthesiology at the Penn Medicine Princeton Medical Center and Jesse James Kiefer, MD, Anesthesiologist Assistant Professor of Clinical Anesthesiology and Critical Care at the University of Pennsylvania.

If you found this interesting listen to more on the topic here: https://www.topmedtalk.com/covid-19-epidemiology-revisited-a-case-for-virtual-meetings/

Thank you to our sponsor Edwards Lifesciences.

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