TopMedTalk

The NHS has helped to put the UK into a leading position in perioperative medicine, elsewhere there have been pioneers and innovators pushing it forward. How has this leadership in perioperative medicine become a force for change and improvement worldwide and what are the common themes that emerge as we take a global perspective on the discipline?

This piece is taken from a longer conversation to be found here: https://www.topmedtalk.com/rcoa-04-the-royal-college-of-anaesthetists-world-leading-healthcare/

Presented by Monty Mythen with their guests Dr Liam Brennan, President of The Royal College of Anaesthetists (RCoA) and Professor Paul Myles, Director, Department of Anaesthesia and Perioperative Medicine, Alfred Hospital and Monash University, Melbourne, Australia.

Join the debate: [email protected]

The NHS has helped to put the UK into a leading position in perioperative medicine, elsewhere there have been pioneers and innovators pushing it forward. How has this leadership in perioperative medicine become a force for change and improvement worldwide and what are the common themes that emerge as we take a global perspective on the discipline?

This piece is taken from a longer conversation to be found here: https://www.topmedtalk.com/rcoa-04-the-royal-college-of-anaesthetists-world-leading-healthcare/

Presented by Monty Mythen with their guests Dr Liam Brennan, President of The Royal College of Anaesthetists (RCoA) and Professor Paul Myles, Director, Department of Anaesthesia and Perioperative Medicine, Alfred Hospital and Monash University, Melbourne, Australia.

Join the debate: [email protected]

TopMedTalk set itself a target of over 10,000 downloads in the first year. Much to everyone's delight and surprise, we've smashed that target already!

This piece is a chance to hear how you can become a bigger part of what we are doing here; it could be as simple as you connecting with us online, sharing some of our content on your social media feed, emailing us your feedback ([email protected]), or even coming to one of the many meetings we're scheduled to attend: www.ebpom.org/meetings

It's also a sincere thanks to everyone who has taken one or more of these steps, we could not have managed to have the success we've had without you.

Featuring on this podcast are some of the main TopMedTalk team members; Monty Mythen, Desiree Chappell, Nick Margerrison and Henry Howe.

In this piece Monty Mythen speaks to Professor Paul Wischmeyer from the Department of Anesthesiology, Duke University, about the recently published American Society of Enhanced Recovery (ASER) and Perioperative Quality Initiative (POQI) joint consensus statement on Nutrition and Screening Therapy within an Surgical Enhanced Program, which has just been print published.

In this piece Monty Mythen speaks to Professor Paul Wischmeyer from the Department of Anesthesiology, Duke University, about the recently published American Society of Enhanced Recovery (ASER)  and Perioperative Quality Initiative (POQI) joint consensus statement on Nutrition and Screening Therapy within an Surgical Enhanced Program, which has just been print published.

A highlights RCoA's Anaesthesia 2018

A fascinating conversation about the anti-inflammatory effects of exercise. The theory is floated that this could be part of the reason why exercise as a form a prehabilitation might be so effective as part of an enhanced recovery pathway.

This is part of a longer piece which you can enjoy in full here:

https://www.topmedtalk.com/rcoa-03-adverse-outcomes-and-patient-optimisation/

Featuring Joff Lacey speaking to Dr Mark Edwards, Consultant in Anaesthesia and Perioperative Medicine at The University Hospital Southampton NHS Foundation Trust and Professor Gerard Danjoux, Consultant in Anaesthesia and Sleep Medicine at South Tees Hospitals NHS Foundation Trust.

Join the debate: [email protected]

A highlights RCoA’s Anaesthesia 2018

A fascinating conversation about the anti-inflammatory effects of exercise. The theory is floated that this could be part of the reason why exercise as a form a prehabilitation might be so effective as part of an enhanced recovery pathway.

This is part of a longer piece which you can enjoy in full here:

https://www.topmedtalk.com/rcoa-03-adverse-outcomes-and-patient-optimisation/

Featuring Joff Lacey speaking to Dr Mark Edwards, Consultant in Anaesthesia and Perioperative Medicine at The University Hospital Southampton NHS Foundation Trust and Professor Gerard Danjoux, Consultant in Anaesthesia and Sleep Medicine at South Tees Hospitals NHS Foundation Trust.

Join the debate: [email protected]

Effect of Use of a Bougie vs Endotracheal Tube and Stylet on First-Attempt Intubation Success Among Patients With Difficult Airways Undergoing Emergency Intubation

Brian E. Driver, MD1; Matthew E. Prekker, MD1,2; Lauren R. Klein, MD1; et al

Key Points

Question

In patients admitted to the emergency department with difficult airway characteristics undergoing orotracheal intubation with a Macintosh laryngoscope blade, does a bougie facilitate higher first-attempt intubation success than an endotracheal tube + stylet?

Findings

In this randomized clinical trial that included 757 adults, bougie use resulted in significantly higher first-attempt intubation success than an endotracheal tube + stylet (96% vs 82%) for those with a difficult airway characteristic.

Meaning

Although bougie use led to a higher likelihood of first-attempt intubation success, further research is needed to assess generalizability to other institutions and settings.

DOI: 10.1001/jama.2018.6496

Effect of Use of a Bougie vs Endotracheal Tube and Stylet on First-Attempt Intubation Success Among Patients With Difficult Airways Undergoing Emergency Intubation

Brian E. Driver, MD1; Matthew E. Prekker, MD1,2; Lauren R. Klein, MD1; et al

Key Points

Question

In patients admitted to the emergency department with difficult airway characteristics undergoing orotracheal intubation with a Macintosh laryngoscope blade, does a bougie facilitate higher first-attempt intubation success than an endotracheal tube + stylet?

Findings

In this randomized clinical trial that included 757 adults, bougie use resulted in significantly higher first-attempt intubation success than an endotracheal tube + stylet (96% vs 82%) for those with a difficult airway characteristic.

Meaning

Although bougie use led to a higher likelihood of first-attempt intubation success, further research is needed to assess generalizability to other institutions and settings.

DOI: 10.1001/jama.2018.6496

How do we develop an agreed curriculum that speaks to what perioperative medicine should be? Once that's in place, how should it be overseen? What sort of official endorsements would it need?

Running in parallel to this are the MOOCs - Massive Online Open Courses - that are being developed.

Developing a broad knowledge of the process is distinct from being a perioperative specialist, how do we develop that even further - without developing a schism? These complicated topics are discussed alongside more detail regarding the future of teaching this speciality.

Presented by Monty Mythen and Mike Grocott with their guests; Joel Symmons, Staff Consultant Anaesthetist in the Department of Anaesthesia and Perioperative Medicine at the Alfred Hospital, Perioperative Medicine Short Course Convenor, and a Senior Lecturer in Anaesthesia at Monash University, and Paul Myles, Head of Alfred Health's and Monash University's Department of Anaesthesia and Perioperative Medicine.