TopMedTalk

This essential discussion covers total intravenous anaesthesia (TIVA) versus inhalation anesthesia, the pros, the cons, and the benefits of the process such as monitoring.

Included in this extended podcast are the two presentations (2:40mins in and 20:55mins in) and the question and answer session which followed (starts at 33:05mins in).

The Safe Brain Initiative is here: http://safebraininitiative.com/

Chaired by Desiree Chappell with her guests, Peter Kikegaard, Senior consultant and Medical Staff specialist at the Department of Anaesthesia and Intensive Care, Nykoebing Falster Hospital, University of Southern Denmark (SDU) and Anoushka Afonso, Assistant Professor of Anesthesia and critical care at Memorial Sloan Kettering Cancer Center, New York.

Ways to simplify the entire surgical encounter. This piece looks at the process of accepting patients into the surgical journey. Care coordination with a focus on the patient and the workflow associated with them; taking a fully integrated approach to the process from inception to preparation to completion and aftermath. More information about cloud-based Provation® SurgicalValet™ Perioperative Care Coordination can be found here: Provation® SurgicalValet™ Platform: Simplifying the Entire Surgical Encounter Presented by Desiree Chappell and Monty Mythen with their guests, Kari Beth Christie, Physician Anesthesiologist, NorthStar Anesthesia at Norton Healthcare in Louisville, KY and Tiffany Beatty, formerly the Director of Customer Success and now the Clinical Specialist Engineer at Provation.

Care home residents in South East London are to be the first in line to access remote examination technology.

Residents across 46 care homes in South East London are first in line to access innovative diagnostic technology from Arc Health ( www.archealth.io ), enabling doctors to remotely perform a clinical examination during a video call.

Where next for this sort of technology? Is a face to face meeting still the 'gold standard' of medical diagnosis?

Presented by Nick Margerrison with his guest Caroline Pilot, Honorary Professor of Algorithmic Medicine at DeMontfort University and Head of Clinical Product at Arc Health.

Perioperative enhancement teams have been a theme on TopMedTalk for years. This program, part two of two, goes into more detail around what could be the crucial next steps for your institution as it distinguishes itself from the pack with excellent value based care instead of excessive volume driven disasters.

In this program we cover the importance of prehabilitation, the need for respect in a multidisciplinary team, cardiopulmonary exercise testing (CPET), a centre for geriatric surgery and palliative care and perioperative smoking cessation clinics.

Further listening:

Olle Ljungqvist, Prof. of Surgery, MD, PhD, Surgeon, Örebro University Hospital & Karolinska Institute, Sweden and Franco Carli, Prof. MD, PhD, Anesthesiologist, McGill University, Canada can be found in their original form here: https://www.topmedtalk.com/the-second-annual-prehabilitation-world-congress-part-1/

Desiree Chappell and Monty Mythen with their guest Amir Jaffer, Chief Medical Officer, New York Presbyterian/ Queens feature here: https://www.topmedtalk.com/perioperative-medicine-summit-2019-1-02-amir-jaffer/

John Whittle, assistant Professor at Duke University Medical Centre provides some essential listening on the subject of CPET here: https://www.topmedtalk.com/topmedtalk-cpet-cardio-pulmonary-exercise-testing/

Angela Bader, Vice Chair of Perioperative Medicine at Brigham and Women's Hospital can be heard in full here: https://www.topmedtalk.com/perioperative-medicine-summit-2019-1-03-angela-bader/

James Davis, MD, Duke Smoking Cessation Program, presents and excellent talk here: https://www.topmedtalk.com/part-1-of-3-smoking-kills-more-than-all-addictive-substances-combined-plus-car-accidents/

This podcast is a look at some of the work done by practitioners who intend to take perioperative medicine to the next level; the "perioperative enhancement teams".

The program broadly follows a patient's surgical journey, we start with the UK's PREPWELL project, as explained by Gerard Danjoux, consultant in Anaesthesia and Sleep Medicine at South Tees Hospitals NHS Trust. For more information on that go to https://prepwell.co.uk/ - also, if you'd like to hear the original conversation you can find that here: https://www.topmedtalk.com/rcoa-03-adverse-outcomes-and-patient-optimisation/

Further discussion on the subject of psychological optimisation comes from, Chloe Grimmett, behavioural scientist and lead for Wesfit prehabilitation. If you'd like more details on the project go here: http://wesfit.org.uk/ - to hear the original presentation in full follow this link: https://www.topmedtalk.com/ebpom-2019-psychology-and-behavioural-change/

The fascinating debate which follows features Shawna Butler of the Singularity University in Exponential Medicine and Jennifer Brandon of the Hoag Orthopedic Institute in Irvine, California. That can be heard in full here: https://www.topmedtalk.com/using-new-technology-with-elderly-patients/

The essential contribution from Angela Coulter, a UK based health policy analyst and researcher, on the crucial area of "shared decision making" can be enjoyed in full here: https://www.topmedtalk.com/ebpom-2018-shared-decision-making-in-perioperative-care/

More wisdom from Steve Flanagan, Chair of Physical Medicine and Rehabilitation at NYU Langone can be found here: https://www.topmedtalk.com/rehabilitation-exercise-is-real-medicine/

Post EBPOM Monty and Desiree explain how TopMedTalk is building on the incredible success of the last few years. After producing a podcast every day for 3+ years we are now going to produce a new podcast each week with more focus on specific topics with bespoke documentary style pieces which will help us to present complicated content in a more digestible form. We will also continue to present the core principles of Enhance Recovery After Surgery alongside cutting edge talks we think need a wider audience.

It will continue to be essential listening each week for perioperative practitioners, students and people interested in how and why their forthcoming operations will work as well as what to do as a patient to prepare.

We look forward to continuing the journey with you, our audience, who have helped turn TopMedTalk into the success it is today.

Presented by Desiree Chappell, Monty Mythen and Nick Margerrison.

--ARCHIVE LINKS

Bruce Keogh's excellent talk: https://topmedtalk.libsyn.com/ebpom-highlight-the-nhs-over-70

Can Medicine be cured? https://topmedtalk.libsyn.com/dingle-highlight-can-medicine-be-cured

Paul Wischmeyer is here: https://topmedtalk.libsyn.com/topmedtalks-to-dr-paul-wischmeyer-0

In this piece we take a bit of time to speak with a newly graduated enhanced recovery after surgery (ERAS) enthusiast. How widely taught is ERAS in the US? Why is it such a game changing concept? How are people discovering and researching it?

Presented by Desiree Chappell and Vicki Morton and their guest Caroline Geary, critical care nurse residency, Novant Health Presbyterian Medical Center in Charlotte, North Carolina.

This piece is a listener generated question and answer session from EBPOM 2020. Although it works as a stand alone piece it relates directly to this talk here: https://www.topmedtalk.com/ebpom-2020-london-prediction-of-opioid-induced-respiratory-depression-on-the-general-care-floor-does-surveillance-monitoring-help/

Some of the questions considered include: How much do you think partial / inadequate neuromuscular blockade reversal, contributes to post pulmonary complications, perhaps in combination with opioids? Why as a group would we prefer to save money by avoiding sugammadex to reverse rocuronium to ensure complete reversal? Lack of reversal more than an issue? If you did a pre op sleep study on these patients, would you not find similar frequencies of desaturation? Is it just monitoring sleep? Should all wards have the capability for continuous monitoring?

Presented by Monty Mythen and Desiree Chappell with their guests, Ashish Khanna, Associate Professor, Section Head for Research, Department of Anesthesiology, Section on Critical Care Medicine,Wake Forest School of Medicine, Frank Overdyk, Professor of Anaesthesiology, Charleston, South Carolina, Leif Saager, Executive Vice Chair of the Department of anesthesiology in Germany at the University of Nottingham.

There's more from Frank Overdyk here: https://www.topmedtalk.com/11813-2/

"The delivery of good medical care is to do as much nothing as possible." - Samuel Shem.

The POCAPALOOZA (POC, perioperative care; apalooza - a celebration of) wraps up in true style with a look at Australia and their current situation. Lauded for their handling of COVID19 but not yet 'through the woods' the conversation looks at how doing the right thing can be innovative and why a good rapport with your patient is invaluable.

Presented by Desiree Chappell with her guest Ross Kerridge, Senior Staff Specialist Anaesthetist Clinician at the John Hunter Hospital, Newcastle, Australia and Associate Professor at the University of Newcastle.

Presenting 2021's POCApalooza West; the annual tradition continues in the wake of last year's hugely successful international gathering of perioperative practitioners; hear how the rest of the world is handling the COVID-19 crisis, how the connectivity between patients and practitioners is improving and how one of TopMedTalk's favourite contributors is now taking perioperative medicine to the heart of healthcare in the USA.

Featuring Desiree Chappell, Monty Mythen and their guests, Lee Fleisher, Emeritus Professor of Anesthesiology and Critical Care, University of Pennsylvania, Sol Aronson, Professor Emeritus, Duke University, Durham, North Carolina and Carol Peden, adjunct Professor at USC and Pennsylvania and current Chair of The American Society of Anesthesiology's Brain Health Initiative.