TopMedTalk

This is the panel discussion which tackles emergency surgery. Discussion begins with more detail regarding the Enhanced Peri-Operative Care for High-risk patients (EPOCH) trial.

Featuring, Professor Carol Peden, Executive Director of the Center for Heath System Innovation and Professor of Anesthesiology at the Keck School of Medicine of the University of Southern California, Fellow of the Institute for Healthcare Improvement (IHI), Ben Griffiths, consultant anesthetist at Auckland City Hospital, anaesthetic lead for ANZELA-QI and Michael Cox, Professor of Surgery, Nepean Hospital.

Treating patients as people rather than 'jobs to be done' and 'boxes to be ticked' is the focus of this piece. What can Doctors do better when it comes to treating patients? Find out what happened when a perioperative care doctor became a patient.

A fascinating conversation streamed live from Atlanta Georgia during the second day of TopMedTalk's coverage of "EBPOM-USA Masters Course, A Perioperative Care Practicum".

Hosted by Desiree Chappell and Monty Mythen. Featuring Dr Paul Wischmeyer, Professor of Anaesthesiology and Surgery at Duke Anesthesiology and TopMedTalk's Henry Howe, a medical student at Bristol University.

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What should we think about issues regarding the Perioperative Ischemic Evaluation Study (POISE)? Is it time to treat men and women equally when it comes to haemoglobin levels? What advice should we give to clinicians who are managing change at a hospital? What should our approach to iron be and can interventions make a real difference?

Featuring; Bruce Waxman, Adjunct Associate Professor (Honorary) at Monash University Dept. of Surgery School of Clinical Sciences, Monash Health and Chief Medical Officer, Bass Coast Health, Wonthaggi Hospital, South Gippsland Coast, Victoria, Kate Burbury, Associate Professor, Deputy Chief Medical Officer, Peter MacCallum Cancer Centre and Toby Richards, Academic Professor of Surgery, Vascular Surgeon, University Western Australia.

Should we refuse surgery to those who won't change? What about pathological issues, such as smoking, should practitioners become more didactic in their approach? How do we effectively communicate risk, both to the patient and the institution you work for?

Professor Monty Mythen presents with Dr Joff Lacey and guests, Professor Sol Aronson, a tenured professor at Duke University and Executive Vice Chairman in the Department of Anesthesiology, and Dr Mike Irwin, Professor and Head, Department of Anaesthesiology, University of Hong Kon.

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Taken from a longer conversation to be found here: http://www.topmedtalk.com/ebpom-2017-pod-two-live-from-london/

This panel discussion provides a vital and thought provoking insight into frailty in a perioperative patient. Further, as perioperative medicine evolves, how do we know enhanced recovery after surgery (ERAS) works? Are there any large randomised controlled trials that prove it?

This piece is moderated by Dr Ming Loh, Staff Specialist Geriatrician and Clinical Lecturer at Westmead Hospital and the University of Sydney, Clinical Lead for the Orthogeriatric Service, Subacute Rehabilitation Ward and Falls Clinic, and features; Ruth E. Hubbard, Professor in Geriatric Medicine at the University of Queensland, Consultant Geriatrician at the Princess Alexandra Hospital and Head of School for PA-Southside Clinical Unit, with Bobbie Jean Sweitzer, Professor of Anesthesiology and Director of Perioperative Medicine at Northwestern University in Chicago, Illinois, and 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.

How important is it to triage the patient? Which triage tool should we use? How do we determine which of our surgical patients is most at risk? Which procedures carry the highest risks? What should our approach be towards managing patient deterioration? What about when it comes to acute clinical deterioration? What, in terms of research and technology, can we expect in the future to help us?

The slides for this piece are here: http://www.anzca.edu.au/documents/03-imogen-mitchell_how-do-we-minimise-failure.pdf

Presented by Imogen Mitchell, Senior Staff Specialist, ICU, the Canberra Hospital, Dean, ANU Medical School.

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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

An entertaining and informative discussion about the implementation process; how do you bring everyone to the table?

Desiree Chappell speaks with Robin Anderson, Enhanced Recovery (ERAS) program coordinator at Duke University, Bethany Sarosiek, Enhanced Recovery After Surgery (ERAS) Development Coordinator at UVA Health System, and Vicki Morton, Director of Clinical and Quality Outcomes at Providence Anesthesiology Associates. All of them are ASER nursing committee members.

Implementing better practice and "ERAS 2.0". The ground up approach of a 'council of nurses' sparks some fascinating debate and discussion. Can a roundtable approach sometimes work better than the traditional hierarchical power structure?

Presented by Desiree Chappell with her guests Dr Ruchir Gupta, medical lead for enhanced recovery at Stony Brook University and Joni Brady, Perianesthesia, Pain Management Nursing Consultant Alexandria, Virginia.

This piece is a chance to reflect upon the importance of new media within the sphere of medical education. As the run away success of TopMedTalk and other podcasts in this area shows people are hungry to use the unique potential of this medium. Also - how has social media, video casting and live streaming altered the way conferences are both organised, executed and received?

Finally, our team of experts tackle the eternal question; where to next?

Presented by Joff Lacey with his guests; David Lyness, Doctor in Anaesthetics and Intensive Care Medicine at Belfast Health and Social Care Trust, Segun Olusanyam Specialty Trainee in Intensive Care Medicine, Jamie Strachan, Intensive Care Medicine and Anaesthesia Registrar & Council Member of the Royal College of Anaesthetists and Dr Cian McDermott Consultant in Emergency Medicine at Mater Misericordiae University Hospital.

You can join IFAD for free online: www.fluidacademy.org

The Hypotension Prediction Index (HPI), which uses a machine learning algorithm to help predict intraoperative hypotension. Regular listeners to www.topmedtalk.com will be familiar with concerns about perioperative hypotension. For those who have just joined us, or anyone who fancies a quick refresher on this issue, it is covered in detail here: https://www.topmedtalk.com/live-from-boston-asa-2017-the-elephant-in-the-room-intraoperative-hypotension/

Many practitioners believe they can predict hypotension by observing trends in a patient's mean arterial blood pressure but data shows the machine learning artificial intelligence used by HPI delivers significantly better results. This piece was recorded during the first Morpheus Consortium Symposium, for more details on that look here: http://morpheusconsortium.org

Monty Mythen presents with Dr Tim Miller, anesthsiologist from Duke University Medical Centre and Thomas Scheeren, Chair Cardiovascular Dynamics Section at European Society of Intensive Care Medicine - ESICM.