TopMedTalk

This piece is a question and answer session regarding the care of elderly patients undergoing surgery. Discussion topics include; The RELIEF trial, e health tools, gathering and accessing data, whether it is better to over estimate risks and which risk calculator is most appropriate to use where you are?

It features; Professor Jacqueline Close, Geriatrician, Prince Of Wales Hospital, Clinical Director, Falls, Balance and Injury Research Centre, David Storey, Head of Anaesthesia, Perioperative and Pain Medicine Unit (APPMU), Melbourne Medical School, University of Melbourne; Director, Melbourne Clinical and Translational Sciences (MCATS) research platform and Dr Doug Campbell, Anaesthesia Specialist at Auckland City Hospital.

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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 features a short informative presentation from our Editor in Chief Monty Mythen regarding Artificial Intelligence and the HPI Monitor developed by Edwards Life Sciences.

It is followed by question and answer session faciliated by both our online presence, studio audience and invited guests.

The "Perioperative Quality Initiative consensus statement on the physiology of arterial blood pressure control in perioperative medicine" piece mentioned is here: https://bjanaesthesia.org/article/S0007-0912(19)30047-9/fulltext

Presented by Desiree Chappell and Monty Mythen with, Feras Hatib, Phd, Director, Research and Development, Algorithms and Signal Processing at Edwards Lifesciences.

This piece gives you a wider perspective on perioperative medicine over the years. How have institutions risen to this challenge and what can we learn from them? How do systems and cultures change over time? When implimenting change have you asked the following questions; Is it scientifically rational? Is it clinically reasonable? What are the risks? What are the resource implications? Are there any ethical considerations? What does the evidence advise? What are the emotional and political issues? How are you going to evaluate change?

Presented by Ross Kerridge, John Hunter Hospital, Newcastle, Australia, often cited as 'the father of Modern Perioperative Medicine'.

The results of the Enhanced Peri-Operative Care for High-risk patients (EPOCH) trial are a huge talking point in the perioperative sphere; this stand alone piece follows on from "EBPOM Conference Highlight | Lessons on EPOCH in the UK".

To hear that click here: https://www.topmedtalk.com/ebpom-conference-highlight-1-21-lessons-on-epoch-in-the-uk/

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 Monty Mythen with Desiree Chappell and 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). Additional contributions from Sol Aronson, tenured professor at Duke University and Executive Vice Chairman in the Department of Anesthesiology as well as TopMedTalk listeners and conference delegates.

Preoperative risk stratification; what is are the risks and controversies behind preoperative exercise testing and the six minute walk test? This piece looks at the evidence behind both and some practical guidance for informing clinical care.

Does the six minute walk test predict complications? What is the true value for cardiopulminary exercise testing (CPET)?

For more on the METS study go here: https://www.topmedtalk.com/the-measurement-of-exercise-tolerance-before-surgery-mets-trial/

Presented by Duminda Wijeysundera, Professor in the Department of Anaesthesia and the Institute of Health Policy Management and Evaluation at the University of Toronto, and a Staff Anesthesiologist at St Michael's Hospital.

Preoperative optimisation and prehabilitation are key areas where your institution can increase value for patients. How do you negotiate the different pitfalls presented by the various core stakeholders?

Smoking cessation, nutrition, exercise; all are proven to help produce better outcomes for a patient. How do we express this in such a way that we get buy-in from everyone concerned?

When it comes to a deeper dive into preoperative optimisation, what's in it for the hospital, the practitioner and the fee payer?

This piece is moderated by Sol Aronson, tenured Professor at Duke University, it features a talk from Michael Englesbe, Professor of Surgery, Michigan followed by a panel discussion which also features Dan Engleman, President of the enhanced Recovery after Cardiac surgery society, Baystate Health in Massachusetts, Medical Director, Heart, Vascular & Critical Care Services, Baystate Medical Center and Associate Professor of Surgery University of Massachusetts Medical School-Baystate and Tim Miller, Duke University; further discussion is provided with questions from online listeners and conference delegates posed by Vicki Morton, Doctor of Nursing Practice and Director of Clinical and Quality Outcomes at Providence Anesthesiology Associates.

Can artificial intelligence drive new changes in care and the value of big data? We're already comfortable with using tools that help us to do our job better, what are the opportunities and pitfalls related to this new technology?

Are we ready yet for big data? The changes it may cause are staggering but equally; nuance is the friend of truth, do we have enough 'data literacy' to handle it all? Also - can the way you pronounce 'scone' give you an idea of your life expectancy?

How do we balance privacy concerns with the need for data to be accessible? Can such information be truly anonymised? Discussion moves here to 'Google flu tracker' and its, initially quite good, results.

Finally how do doctors adapt to the new world where they are being told in front of their patients what the right course of action is? Will patients retain trust in the Doctor's decisions?

Taken from day two of our coverage of the Royal College of Anaesthetists' annual conference at The British Museum in London.

Presented by Desiree Chappell, Monty Mythen and Joff Lacey, with their guest Professor Iain Moppett, Professor of Anaesthesia and Perioperative Medicine, University of Nottingham.

How do we convince patients that prehabilitation is safe? What forms of certification are available for the accreditation of a balanced multidisciplinary team? How do you monitor home based patients? How do we tap into the wider 'exercise industry' on behalf of perioperative prehabilitation?

Panel discussion, featuring; Daniel Santa Mina, Assistant Professor at University of Toronto & Scientist in ELLICSR at the Princess Margaret Cancer Centre; Stefan van Rooijen, surgical resident in Maxima Medical Center, The Netherlands, lecturer at the first Health Innovation School (Ministry of Health, Welfare and Sport and Reshape innovation), Surgical resident, Department of Surgery at Maxima Medical Center (ANIOS); Gerard Danjoux, Consultant in Anaesthesia and Sleep Medicine at South Tees Hospitals NHS Foundation Trust; Ken Van Someren, Director KvS Performance Ltd.

Why has 'prehabilitation' suddenly picked up pace in terms of both practice and interest? This piece takes a serious look at the widening interest in an idea familiar to many sportsmen.

Learn how the marginal gains we get through the application of science to optimise the moment of surgery as a real opportunity to apply everything we know.

Also; what are ketones and how can they be used to promote health?

Presented By Desire Chappell and Monty Mythen with their guests Gerard Danjoux, consultant in Anaesthesia and Sleep Medicine at South Tees Hospitals NHS Trust and Ken Van Someren, Director KvS Performance Ltd.

"Colloid vs Crystalloid - Goal Directed Therapy" - originally streamed live from The Institute of Engineering and Technology (IET) in London during EBPOM 2018 on www.topmedtalk.com

Hear this excellent talk, for free, on this podcast.

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 Monty Mythen, Smiths Medical Professor of Anaesthesia and Critical Care at University College London.