TopMedTalk

Presenting 2021's POCApalooza East. The now 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 vaccines are getting on and why perioperative medicine is primed to help in the near and necessary journey to be taken out of this current situation.

Featuring Desiree Chappell, Monty Mythen and their guests, Bruce Biccard, consultant anaesthetist at the University of Kwazulu-Natal, Director, Perioperative Research Unit, Department of Anaesthetics, Nelson R Mandela School of Medicine, Paul Myles, Director, Anaesthesiology and Perioperative Medicine, Alfred Hospital and Monash University and Mike Irwin, Professor, Head and Chief of Service, Anaesthesiology Hong Kong University, Gleneagles Hospital.

"Perioperative medicine ... I always think of a Venn diagram where there's truly an intersection between surgery anesthesia and medicine, and perhaps even a subset of medicine called geriatrics, that really create this convergence of what we're now creating as a novel science ... Perioperative medicine, I would say is a new clinical science that really incorporates all that"

This piece is a fascinating debate, it follows on from Part 1 of the same name; the panel discuss ways forward for perioperative medicine and the new opportunities being presented by a recent focus on both population health and the wider needs of a national healthcare system.

Presented by Desiree Chappell and Sol Aronson with panelists; Angela Bader, Harvard Medical School and Vice Chair of Perioperative Medicine at Mass General Brigham, BobbieJean Sweitzer, Professor of Anesthesiology and Director of Perioperative Medicine at Northwestern University in Chicago, Illinois, Rob Shakar, Medical Director of a 32-physician group in Wilmington, NC he oversees the Perioperative Surgical Home Project for New Hanover Regional Medical Center, Thomas Vetter, Director of Perioperative Care and Director of Comprehensive Pain Management and Professor of Surgery and Perioperative Care and Professor of Population Health, at the Dell Medical School at The University of Texas, Austin.

"Data is key and having champions is key"

This piece provides a truly transatlantic in-depth perspective on an area of opportunity highlighted by our needs in the wake of COVID 19; now more than ever true enhanced recovery after surgery (ERAS) is essential. Optimising value, reducing the need for return visits, decreased length of stay, there is almost no aspect of perioperative medicine and enhanced recovery that is not going to be crucial for our institutions in the near and present future. A data driven approach makes it clear, there is no other way forward.

Also in this podcast a fascinating dive into one of our favorite topics, goal directed fluid management. How have the terms "restricted" and "liberal" evolved over the years? What should we make of the new evidence that ha come in over the last few years?

Hear how these challenges are being met in this exclusive conversation, generously supported by Deltex Medical.

Presented by Desiree Chappell and Monty Mythen with their guest Michael Scott, M.B., Ch.B. Professor of Anesthesiology at the University of Pennsylvania

"Connected care is a combination of the right tech, to monitor the patient, that's human factor friendly and easy to use"

This piece is an in-depth look at how remote patient monitoring is evolving to suit a need that's growing as patients require more from their healthcare. The COVID-19 crisis has pushed these issues to the forefront, how can your institution modernize and evolve in this direction?

Presented by Desiree Chappell with Monty Mythen and their guest Sam Ajizian CMO Patient monitoring at Medtronic.

"We've been doing cryoneurolysis for total knees now for three years... people gravitate to practices that that practice this technology"

This piece focuses upon two 'early adopter' orthopedic surgeons changing up the way we treat joint pain for surgical patients.

We mention Iovera, a provider at the forefront of this technology: https://www.iovera.com/

The Doc Social website is here: www.doc.social/

The Evidence Based Perioperative Medicine (EBPOM) website is here: www.ebpom.org

This piece also features important news for TopMedTalk fans as, towards the end, we explain how your favorite perioperative podcast is asking listeners for feedback and thoughts. Email [email protected]

Presented by Desiree Chappell and Monty Mythen with their guests Vinod Dasa, Vice Chairman of Academic Affairs, Irv Cahen Chair of Orthopaedic Surgery and Research, Co-Director LSU Musculoskeletal Research Consortium and Josh Urban, board-certified orthopedic surgeon, OrthoNebraska, Omaha, Nebraska.

This piece is a worthwhile deep dive into this perioperative medicine and how we go forward with it. Hear the panel speak about what it is they want for the future and what it is they are doing now. With questions submitted from the online audience the panel get into the detail. Essential listening for any student of perioperative medicine.

It includes a mention for the Welsh Perioperative Medicine Society, their website is here: https://www.welshpoms.com/

This is part two of a two part piece of the same name.

Presented by David Walker, Professor in Anaesthesia and Critical Care Medicine, University College London Hospitals, Honorary Senior Lecturer UCL, Kim Caulfield, Perioperative Medicine Fellow, University College London Hospitals NHS Foundation Trust, Mike Grocott Professor of Anaesthesia and critical care at the University of Southampton, Aislinn Sherwin, a Fellow in Perioperative Medicine and Onco-Anaesthesia at the Peter MacCallum Cancer Centre, Melbourne, Roisin Coary, final year SpR in Geriatric and General Internal Medicine, with a specialist interest in Peri-operative Medicine, Dublin Ireland and Isra Hassan, a post-CCT Perioperative Medicine Fellow at the University College of London Hospital she co-founded the Welsh Perioperative Medicine Society in 2018 which now has over 100 members, and to date has delivered two national conferences, Andrea Haren, perioperative medicine fellow at UCLH she worked with Guys and St Thomas' working with the POPS Clinic she is currently a locum consultant anaesthetist at St. Vincent's Hospital in Dublin and Pádraig Ó Scanaill, Locum Consultant Anaesthetist at the Mater Misericordiae University Hospital, Dublin.

This is a story that starts with some of the challenges faced in our world outside the operating theatre and it's about how we might address some of these problems systematically. Healthcare organizations have to deliver high quality, competitive and sustainable results and costs. Good quality perioperative surgery is absolutely critical to maintain the health and well being of our population going forwards; this talk is a step in that direction.

Presented by Guy Ludbrook Professor of Anaesthesia at the University of Adelaide and Royal Adelaide Hospital.

This piece is a worthwhile deep dive into this perioperative medicine and how we go forward with it. Hear the panel speak about what it is they want for the future and what it is they are doing now. With questions submitted from the online audience the panel get into the detail. Essential listening for any student of perioperative medicine.

When should we pre-assess patients? Should all anaesthetists be doing pre-operative sessions? What is it about the role of the anaesthestist that makes it uniquely suited to the discipline of perioperative medicine?

This is part one of a two part piece of the same name.

Presented by David Walker, Professor in Anaesthesia and Critical Care Medicine, University College London Hospitals, Honorary Senior Lecturer UCL, Kim Caulfield, Perioperative Medicine Fellow, University College London Hospitals NHS Foundation Trust, Mike Grocott Professor of Anaesthesia and critical care at the University of Southampton, Aislinn Sherwin, a Fellow in Perioperative Medicine and Onco-Anaesthesia at the Peter MacCallum Cancer Centre, Melbourne, Roisin Coary, final year SpR in Geriatric and General Internal Medicine, with a specialist interest in Peri-operative Medicine, Dublin Ireland and Isra Hassan, a post-CCT Perioperative Medicine Fellow at the University College of London Hospital she co-founded the Welsh Perioperative Medicine Society in 2018 which now has over 100 members, and to date has delivered two national conferences, Andrea Haren, perioperative medicine fellow at UCLH she worked with Guys and St Thomas' working with the POPS Clinic she is currently a locum consultant anaesthetist at St. Vincent's Hospital in Dublin and Pádraig Ó Scanaill, Locum Consultant Anaesthetist at the Mater Misericordiae University Hospital, Dublin.

"More than 300 million patients have surgery annually worldwide and an increasing proportion of them are elderly and at risk of perioperative adverse events. There's very few proven primary or secondary prevention measures, and the resources for monitoring and trading complications are inadequate. So - more action is required".

This piece looks at the evidence as regards perioperative outcomes for the elderly, depth of anesthesia and mortality. Also, what's the latest on depth of anesthesia and delirium?

Presented by Kate Leslie, Honorary Professor, Monash University, Melbourne, VIC, Australia, Specialist Anaesthetist, The Royal Melbourne Hospital & North Western Mental Health and Non-Executive Director, Australian Medical Council.

"The song remains the same"

The story picks up toward the end of the 1970's; "interesting stuff was going on ... Professor William Shoemaker, a surgeon and intensive care doctor one of the founding members of the American critical care society ... fiddling around with pulmonary artery catheters in his high risk surgical patients in South Los Angeles, and identified that those patients that were surviving tended to have higher cardiac indexes higher option deliveries than the non survivors".

This piece was Dingle 2020's Inaugural Siobhan Mythen Visiting Lecturer. For more content from that meeting check TopMedTalk's archive or go to www.ebpom.org for video presentations.

Presented by Jonathan Wilson, retired Consultant Anaesthetist, York Hospital, York.