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

How can cold water adaption help people deal with medical issues? There's evidence to suggest that cold water adaption reduces inflamation, can open water swimming help with issues such as chrohn's disease? On the other hand how important is it to ensure patients do not become cold while in our care? Hypothermia is never good, how important is it to keep patients warm? Keeping patients and their environments warm is discussed, as is pre-warming, going beyond the standard blankets and patient insulation to include active warming and even patients exercising as a method of warming up. Further to this conversation, how do you measure a patient's temperature?

How do we drive change in our institutions towards enhanced recovery after surgery? The GIRFT (Getting It Right First Time) project is explained. The Health Foundation is also mentioned. The piece also includes patient communication and the question of 'how much is too much?', when administering a dose of morphine. Also, is there a hierarchy on the pathway of enhanced recovery after surgery?

The conversation features Professor Monty Mythen and his two guests; Dr Simeon West, consultant anaethetist at (University College London Hospitals) UCLH who sits on the board at Regional Anaesthesia UK (RAUK) and Mark Harper Consultant Anaesthetist at Brighton and Sussex University Hospitals, with a research interest in the prevention of perioperative hypothermia and the use of cold water adaptation for theraputic purposes. There are also attributed questions from the audience.

Post op respiratory complications are the focus of this piece. How can they be anticipated, detected early and dealt with appropriately? What about objective neuromuscular monitoring? Should you revese every single patient? If so, how do you do it? What about the risk of pulmonary complications? Presented by Desiree Chappell with her guest Frances Chung, Professor, Department of Anesthesiology and Pain Medicine, University of Toronto.

Learn about the Perioperative Anesthesia and Surgical Screening Clinic (PASS Clinic), do you need one at your practice? What is pain control for a perioperative patient? Hear also about the 'subacute period' and how you can incorporate it into your practice. Also, how do we keep patients 'opioid free' once they leave our care? Finally, how does individualised pain management and pain education fit into this picture?

Presented by Desiree Chappell and Vicki Morton, with their guests; Professor Padma Gulur, Anaesthesia and Executive Vice-Chair at Duke University and Dr Natasha Curran, pain medicine University College London Hospital (UCLH) and Medical Director at the Health Innovation Network.

The fuller version of this conversation is available here: https://www.topmedtalk.com/ebpom-2018-14-the-realities-of-pain-management/

Our Holiday Special, part 3 of 3, is a sampling of our favorite conversations and lectures from 2019. It is a chance for new listeners to the hear the outstanding content that has made TopMedTalk the success it is after 2 amazing years. And for our regular listeners, a check in to make sure they've not missed some of the crucial pieces of the last year.

🙏🙏 All of us at TopMedTalk want to send a BIG thank you to ALL of our amazing fans and listeners. The support these past 2 years is inspiring and much appreciated. We want to thank our guests and lecturers from this past year as well. Your contribution to the show is what makes TopMedTalk so special. And a final THANK YOU to our Sponsors. Your generous support keeps TopMedTalk free open access to the world! Happy Holidays and Cheers to the New Year!! 🥂🥂🎉

More about caring for the transgender patient is here: https://www.topmedtalk.com/aana-2019-caring-for-the-transgender-patient/

Emotional intelligence is explored further here: https://www.topmedtalk.com/aana-2019-emotional-intelligence-and-occupational-stress/

Paul Myles is here: https://www.topmedtalk.com/live-from-asa-2017-paul-myles-3000-patients-in-study-of-fluid-restriction/

Joan Mythen may feature in the future on TopMedTalk.

The Grenfell fire episode is here: https://www.topmedtalk.com/topmedtalk-the-grenfell-inquiry-2/

The Dingle conference for 2020 is here: https://www.ebpom.org/Dingle2020

Carol Peden is here: https://www.topmedtalk.com/anes19-carol-peden-robin-cresner-shane-dickinson-snow-shoo-son/

Mike Scott is here: https://www.topmedtalk.com/anes19-michael-scott/

The interview with Andrew Shaw is here: https://www.topmedtalk.com/anes19-andrew-shaw/

Presented by Desiree Chappell with Monty Mythen alongside a selection of clips from the last year.

Our Holiday Special, part 2 of 3, is a sampling of our favorite conversations and lectures from 2019. It is a chance for new listeners to the hear the outstanding content that has made TopMedTalk the success it is after 2 amazing years. And for our regular listeners, a check in to make sure they've not missed some of the crucial pieces of the last year.

🙏🙏 All of us at TopMedTalk want to send a BIG thank you to ALL of our amazing fans and listeners. The support these past 2 years is inspiring and much appreciated. We want to thank our guests and lecturers from this past year as well. Your contribution to the show is what makes TopMedTalk so special. And a final THANK YOU to our Sponsors. Your generous support keeps TopMedTalk free open access to the world! Happy Holidays and Cheers to the New Year!! 🥂🥂🎉

Sol Aronson's inimitable style is on display here: https://www.topmedtalk.com/sca-poster-presenters/

Sasha Shillcut gets a mention, her piece is here: https://www.topmedtalk.com/topmedtalks-to-sasha-shillcutt/

The piece with Tjorvi Perry will be available next year.

Charles Brown gets a mention, his piece is here: https://www.topmedtalk.com/topmedtalks-to-charles-brown/

The piece regarding emergency laparotomys is here: https://www.topmedtalk.com/anaesthesia-2019-tim-cook-and-paul-wischmeyer/

The Fitter Better Sooner initiative is outlined here: https://www.topmedtalk.com/sunday-special-fitter-better-sooner/

Anaesthesia 2019 | Developmental neurotoxicity: https://www.topmedtalk.com/anaesthesia-2019-developmental-neurotoxicity/

Linda Mason's full interview is here: https://www.topmedtalk.com/euroanaes2019-linda-mason/

Paul Pomerance is here: https://www.topmedtalk.com/euroanaes2019-paul-pomerance/

Maurizio Cecconi is here: https://www.topmedtalk.com/euroanaes2019-maurizio-cecconi/

The piece featuring Dan Longrois is here: https://www.topmedtalk.com/euroanaes2019-dan-longrois/

The fascinating Paul Myles piece is here: https://www.topmedtalk.com/prato-2019-paul-myles/

Discover more about Bruce Biccard's work here: https://www.topmedtalk.com/prato-2019-bruce-biccard/

Find out more about WakeMed here: https://www.topmedtalk.com/eras-cardiac-2019-judson-williams-and-gina-mcconnell/

Ken Van Someren is here: https://www.topmedtalk.com/prehab-periop-world-congress-gerard-danjoux-ken-van-someren/

Find out more about our "forgotten friend" from Evan Karesh here: https://www.topmedtalk.com/topmedtalk-methadone-a-forgotten-friend/

Presented by Desiree Chappell with Monty Mythen alongside a selection of clips from the last year.

Our Holiday Special, part 1 of 3, is a sampling of our favorite conversations and lectures from 2019. It is a chance for new listeners to the hear the outstanding content that has made TopMedTalk the success it is after 2 amazing years. And for our regular listeners, a check in to make sure they've not missed some of the crucial pieces of the last year.

🙏🙏 All of us at TopMedTalk want to send a BIG thank you to ALL of our amazing fans and listeners. The support these past 2 years is inspiring and much appreciated. We want to thank our guests and lecturers from this past year as well. Your contribution to the show is what makes TopMedTalk so special. And a final THANK YOU to our Sponsors. Your generous support keeps TopMedTalk free open access to the world! Happy Holidays and Cheers to the New Year!! 🥂🥂🎉

In the order discussed on the podcast here are the pieces mentioned:

President Bill Clinton features on TopMedTalk here: https://www.topmedtalk.com/sunday-special-bill-clinton-at-the-world-patient-safety-science-technology-summit/

Joe Kiani from the Patient Safety Movement Foundation link: https://www.topmedtalk.com/topmedtalks-to-joe-kiani/

Angela Bader is here: https://www.topmedtalk.com/perioperative-medicine-summit-2019-1-03-angela-bader/

Periperative Cognition workshop: https://www.topmedtalk.com/sunday-special-the-perioperative-cognition-workshop-part-4-2/

Our discussion regarding muscle quality is here: https://www.topmedtalk.com/desirees-roundtable-the-malnourished-surgery-patient/

Our discussion with Rick Dutton is here: https://www.topmedtalk.com/topmedtalks-to-rick-dutton-2/

The TRIPOM series is here: https://www.topmedtalk.com/?s=tripom

Liz Pratt's interview is here: https://www.topmedtalk.com/desirees-roundtable-changing-the-culture-around-surgical-recovery/

Jamie Harris is here: https://www.topmedtalk.com/desirees-roundtable-aser-2019-jamie-harris-and-carol-schmidt/

Presented by Desiree Chappell with Monty Mythen alongside a collection of highlights from the last twelve months of TopMedTalk.

This piece discusses The Brain Health Initiative and the sixth Peri-Operative Quality Initiative which focused upon delirium. How can progress in these areas be built upon and encouraged? Where is the data in regards to detecting and dealing with delirium?

Beers Criteria Medication List; Potentially Inappropriate Medications for the Elderly According to the Revised Beers Criteria is here: https://dcri.org/beers-criteria-medication-list/

The website for the AARP is here: https://www.aarp.org/

Presented by Lee A. Fleisher Professor and Chair of Anesthesiology and Critical Care, University of Pennsylvania. There is a short question and answer session at the end hosted by Desiree Chappell and Monty Mythen.

Twitter is ablaze with talk of the Society for Perioperative Assessment and Quality Improvement (SPAQI). How did they do it?

This piece is a thought provoking discussion about new media and the consequences of our online world for medicine. 'The democratisation of education' is a phrase we've heard here on TopMedTalk in the past. How does direct access to information and experts in our field alter the state of play in the perioperative field?

Desiree Chappell and Monty Mythen are presenting with their guest Avital O'Glasser, Assistant Professor of Medicine at OHSU, Oregon Health & Science University and member of the communications committee for SPAQI.

If you enjoyed this, carry on listening with this piece here:

Sunday Special | Social Media http://topmedtalk.libsyn.com/sunday-special-social-media

What is a "Respect Officer"? Why is respect so important in perioperative care? How does improving 'the culture of safety' also help to improve outcomes? Should we be overly concerned about high cancelation rates for surgery? And what are the advantages of a preoperative risk assessment clinic (PRAC)?

Presented by Desiree Chappell and Monty Mythen with their guest Amir Jaffer, Chief Medical Officer, New York Presbyterian / Queens.

Shared decision making is key to any perioperative enhancement team, this piece is a fascinating debate between various interesting positions.

For more on the (Perioperative Optimization of Senior Health) POSH clinic mentioned in this piece look here: https://medicine.duke.edu/divisions/geriatrics/patient-care/duke-perioperative-optimization-senior-health

Presented by Monty Mythen with his guest Mike Grocott, Professor of Anaesthesia and Critical Care Medicine, University of Southampton and contributions from Lee Fleisher, Professor of Anesthesiology and Critical Care, University of Pennsylvania and Sol Aronson, tenured Professor at Duke University, Dr Tim Miller, Duke University and Dr Attilla Kett, St Peter's University Hospital at New Jersey.