TopMedTalk

"Increasing the richness and the reach of what we do" is the mantra of 'Anesthesiology'; hear from its Editor in Chief how it managed to self study and discover the essential idea behind the journal: "trusted evidence, from discovery to practice".

Conversation then moves on to methadone, the overlooked opiate; where do you use it and what sort of dose is appropriate? What are the benefits of including this in your practice and should it really be considered in the same category as most other opioids?

The podcasts mentioned are here: https://anesthesiology.pubs.asahq.org/multimedia.aspx?mediaType=Podcasts

Presented by Desiree Chappell and Monty Mythen with Korey Springman and their guest Evan Kharasch, Professor of Anesthesiology, Vice Chair for Innovation, Director, Academic Entrepreneurship, Duke University School of Medicine and Editor-in- Chief, Anesthesiology.

The results of the Enhanced Peri-Operative Care for High-risk patients (EPOCH) trial; where does it put perioperative practice in 2019? What have we learned?

Originally streamed live from the Charles Sammons Cancer Center, Dallas, during EBPOM-USA 2019 on www.topmedtalk.com

If you'd like to attend an event like this ensure your next click is here: www.ebpom.org/meetings

If you have any comments or questions you'd like to send to the team email: [email protected]

Presented by Carol Peden, Professor of Anesthesiology and Exec. Director of the Center for Health System Innovation, University of Southern California, University of Bath and the Institute for Healthcare Improvement (IHI).

How does one go about becoming a Master of Perioperative Medicine? This piece takes a look at the growing movement which all TopMedTalk listeners are at the forefront of. Further debate covers, "NPO after midnight", getting buy in from the institution to practice perioperatively and keeping the momentum going after one leaves a conference.

Presented by Desiree Chappell and Monty Mythen with their guests, Marc Koch President & CEO of Somnia Inc and Gregory Pato, internal medicine physician assistant, New York Presbyterian/Weill Cornell.

When it comes to blood pressure, hypotension is associated with poor outcomes for patients, how do we react to this? How do we manage and avoid hypotension where possible? How has technology caught up with this challenge? Could automated closed loop systems be helpful here? The bottom line is simple; "If we measure blood pressure properly, we can predict it".

Presented by Dr Simon Davies, Consultant Anaesthetist at York Teaching Hospital NHS Foundation Trust.

This invaluable piece is a chance to attend a workshop which looks at the latest thinking on "perioperative cognition" and 'post-operative cognitive dysfuntion'.

We advise you use this link here to find the PDF of the paper being discussed: https://bjanaesthesia.org/article/S0007-0912(17)54082-9/fulltext

Presented by David Scott, Professor, University of Melbourne, Director, Anaesthesia and Acute Pain Medicine, St Vincent's Hospital, Melbourne and Lis Evered, Scientific Head of Research, Department of Anaesthesia, St. Vincent's Hospital, Melbourne.

This is Part 3, to find Part 1 follow this link here: https://www.topmedtalk.com/sunday-special-the-perioperative-cognition-workshop-part-1/

Part 2 is here:

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

Part 4 is here:

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

Brought to you by the Perioperative Medicine Special Interest Group (SIG) in association with the Australian and New Zealand Society for Geriatric Medicine and the Internal Medicine Society of Australia and New Zealand at the 7th annual Australasian Symposium of Perioperative Medicine.

The Perioperative Medicine Special Interest Group (SIG) has three aims; improve patient safety and outcomes, share knowledge and collaborate with specialty groups, develop the specialty of perioperative medicine with various craft groups.

For more information follow this link here: http://www.anzca.edu.au/fellows/special-interest-groups/perioperative-medicine

More of our coverage of the American Society of Enhanced Recovery (ASER) annual general meeting. Reflections regarding the rise of Cardiopulmonary Exercise Testing (CPET); a growing field, particularly in the US.

The "Prehabilitation World Congress in association with POETTS & EBPOM" meeting discussed in this podcast is here: https://ebpomusa.org/Prehab-2019

If you are interested in hearing more about the Measurement of Exercise Tolerance before Surgery (METS) trial: https://www.topmedtalk.com/journal-club-1-03-the-mets-trial/

Presented by Desiree Chappell and Monty Mythen with their guest Mike Grocott, Professor of Anaesthesia and critical care at the University of Southampton.

Perioperative medicine is defined here as: "the practice of patient centred multidisciplinary and integrated medical care of patients from the moment of contemplation of surgery until full recovery". Population health is defined as: "the health outcomes of a group of individuals including the distribution of such outcomes within the group". Do the two compliment each other? Use this concise 15 minute presentation to help build the case for a perioperative care programme at your institution. Presented by Sol Aronson, tenured professor at Duke University and Executive Vice Chairman in the Department of Anesthesiology.

If we look at the evidence, is there a case for "vascular geriatrics"? Co-managed care in vascular surgery could be a way forward, this talk builds the case for change.

Readmission rates in this group are dissapointing, how do we reasonably tackle this issue? How do we balance questions regarding appropriateness and need for surgery in this area? What about the priorities of the patient, do they align with our aims?

Is it possible there are geriatiricans who are already doing co-management with vascular surgeons? Is it fair to say that vascular surgeons need help the most?

The talk is followed by a short case study regarding the model of care at Prince of Wales Hospital and Community Health Services, Department of Geriatrics.

Presented by Vasi Naganathan, Academic and Consultant Geriatrician at University of Sydney, Concord Repatriation Hospital, New South Wales, Australia; followed by a second brief 'case study' from Christina Norris, Prince of Wales Hospital and Community Health Services, Department of Geriatrics.

--

Brought to you by the Perioperative Medicine Special Interest Group (SIG) in association with the Australian and New Zealand Society for Geriatric Medicine and the Internal Medicine Society of Australia and New Zealand at the 7th annual Australasian Symposium of Perioperative Medicine.

The Perioperative Medicine Special Interest Group (SIG) has three aims; improve patient safety and outcomes, share knowledge and collaborate with specialty groups, develop the specialty of perioperative medicine with various craft groups.

For more information follow this link here: http://www.anzca.edu.au/fellows/special-interest-groups/perioperative-medicine

This piece is taken from the free papers presentations given at EBPOM 2019. Can two weeks of prehabilitation really make a difference for patients facing primary surgical resection of colorectal cancer? How feasable is it to recruit patients into such a programme? Can we make a real change in their objectively measured fitness? Is there patient buy in? What is the strain on an institution's resources?

Presented by Andrew Bates, Senior Research Nurse at Royal Bournemouth Hospital NIHR Intern.

Obstructive sleep apnea is important to identify in patients, this piece explains how; use the official STOP BANG website here: http://www.stopbang.ca/osa/screening.php

Opioids and pain management strategy is discussed, alongside reflections on the differences between the healthcare systems of Canada, the UK and America.

Finally, what is "the beard test" and "the upper lip bite test"?

Presented by Desiree Chappell and Monty Mythen with their guests, Frances Chung, Professor, Department of Anesthesiology and Pain Medicine, University of Toronto and Kurt J. Pfeifer, Professor of Medicine, General Internal Medicine, Medical Director, Preoperative Evaluation Clinic, Froedtert and Medical College Eye Institute, Medical College of Wisconsin, Milwaukee, WI.