TopMedTalk

"I think you're now famous in the CRNA community for being one of the first people in Fargo to receive the the COVID vaccine"

This piece sees us catching up with Certified Registered Nurse Anesthetists (CRNA's) who have just been vaccinated for COVID-19. Their story reminds us that even now some practitioners are facing their first real wave of the pandemic in their area: "We had a kind of trickle in, so to say, of COVID patients, and then this in this fall, the middle of November was really when it hit us pretty hard".

Presented by Desiree Chappell with Jordan Rohrich CRNA, Anesthesiology, Fargo, North Dakota and Jordi Idso MS, CRNA, Sanford Health in Fargo.

"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.

This piece is essential listening for any medical practitioner. The pathophysiology of COVID 19 is now being understood, although there are still a number of outstanding questions. This piece attempts to answer those questions; where does it come from, what do we know about it now, what would we like to know about it in the future?

Why is the disease more pronounced in men, how come obesity seems to be a factor, what's the mechanism which leaves children less at risk than adults and senior citizens?

This piece is a standout part of Evidence Based Perioperative Medicine's (EBPOM) Dingle 2020 conference. For more of the latest up to date information go now to www.ebpom.org

Presented by Hugh Montgomery, Professor of Cardiovascular Genetics and Critical Care University College London.

This piece is divided into two parts, the first being discussion between the panelists and the second, part 2, being questions from the online audience: What is your opinion about spinals and hip fractures for patients on clopidogrel? Do you use any near patient tests to confirm residual anticoagulation? Where are the best guidelines to be found?

We suggest you listen to this piece alongside part 1.

Presented by Sol Aronson, tenured Professor at Duke University, with his guests; 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 and Jeanna Blitz, Associate Professor of Anesthesiology, Director of the Preoperative Anesthesia and Surgery Screening Clinic, Director of Perioperative Medicine Fellowship at Duke University School of Medicine, Durham, North Carolina.

The conversation begins with "a day in the life" with respect to managing the anti coagulation questions that come up commonly. The contributors swap stories from their time in practice. The conversation moves to protocols, guidelines and also, when where and how to begin bridging.

This piece is divided into two parts, the first being discussion between the panelists and the second, part 2, being questions from the online audience.

Presented by Sol Aronson, tenured Professor at Duke University, with his guests; 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 and Jeanna Blitz, Associate Professor of Anesthesiology, Director of the Preoperative Anesthesia and Surgery Screening Clinic, Director of Perioperative Medicine Fellowship at Duke University School of Medicine, Durham, North Carolina.

How can enhanced recovery after surgery (ERAS) be applied to cardiac and what exciting opportunities are there for those who have made this their mission? This detail driven address contains more information on The Society for Enhanced Recovery After Cardiac Surgery (ERAS® Cardiac), more information can be found on their website: https://www.erascardiac.org/

Since this address was given at Evidence Based Perioperative Medicine (EBPOM) Chicago's 2020 meeting TopMedTalk has been proud to bring you coverage of ERAS® Cardiac's online meeting. For more on that start here: https://www.topmedtalk.com/the-eras-cardiac-society-conference-topmedtalk/

Presented by Daniel Engleman, the Medical Director of the Heart, Vascular and Critical Care Units at Baystate Medical Center. He is an Associate Professor of Surgery at The University of Massachusetts-Baystate. He started the ERAS® Cardiac Collaborative to internationally standardize best practices.

This piece looks at some of the latest research from a perioperative perspective regarding an essential question, when and how is surgery possible after a COVID-19 infection? How do we balance that ideal with the other pressures coming to bare on patients, practitioners and public health as a whole?

The paper "Timing of surgery following SARS‐CoV‐2 infection: an international prospective cohort study" is here: https://doi.org/10.1111/anae.15458

Presented by Desiree Chappell with Monty Mythen, Smiths Medical Professor of Anaesthesia and Critical Care at University College London, Sol Aronson, tenured Professor at Duke University and Mike Grocott, Professor of Anaesthesia and critical care at the University of Southampton.

This piece is the first of in a series of two, supported by Deltex Medical, for more information on their work please go here: www.deltexmedical.com

This piece focuses on iDelirium; The International Federation of Delirium Societies on world delirium day. As well as considering this difficult condition the conversation asks what the latest research shows us and how things could improve both for patients and practitioners. For more detail check out their website here: http://www.idelirium.org/

Presented by Desiree Chappell and Monty Mythen with their guests Heidi L. Lindroth, Senior Associate Consultant Nurse Scientist, Nursing Research Division Critical Care Nurse, Gideon Caplan, Director, Geriatric Medicine, Prince of Wales Hospital, Alasdair Macclullich, Professor of Geriatric Medicine, Honorary Consultant in Geriatric Medicine, Edinburgh, Delirium Research Group, Rakesh C. Arora, Co-Founder of IDelirium, Professor and Head of Cardiac Surgery and Cardiac Critical Care at Max Rady College of Medicine - University of Manitoba, Canada.

"You have to take the viewpoint that if the Nurses and the Physical Therapists and the Pharmacists are resisting the idea that you're putting forward, then there's probably something wrong with it, it doesn't work for them, for some reason, and you got to find out what that is..."

This long form conversation is a highlight for TopMedTalk's coverage of The Society for Enhanced Recovery After Cardiac Surgery (ERAS® Cardiac) conference. The conversation covers a wide range of interesting areas, including; the nature of leadership in medicine, the global nature of many of the questions we face, how the internet is changing what we do, what the phrase "better never stops" means, how to take and use feedback and why the patient has to be at the heart of what we do, the importance of "the growth mindset".

Also, discover how one of our guests has learned from his experience becoming a Lieutenant Colonel, US Army Reserves; what can a military mindset tell us about the task we face as advocates of perioperative medicine?

We wrap with a conversation about blood transfusion reduction.

This exclusive chat is only possible thanks to the support of the society, their excellent website is here: https://erasvirtual2021.com/

Presented by Desiree Chappell with her guests Kevin Lobdell, Professor and the Director of Regional Cardiovascular and Thoracic Quality, Education, and Research for Carolinas HealthCare System, Charlotte, NC, USA, as well as the Clinical Professor at the University of North Carolina-Chapel Hill, Chapel Hill, NC, USA and Rawn Salenger, Chief of Cardiac Surgery at University of Maryland St. Joseph Medical Center, Assistant Professor of Surgery at the University of Maryland School of Medicine.

"Critical Care has a moment in time, a moment where we can make some big changes, a moment of opportunity"

This uncompromising and informative talk from the technical lead for critical care in the Getting It Right First Time (GIRFT) project takes us through how services can improve and work alongside perioperative care to improve standards and outcomes for patients.

Sharing best practice between trusts GIRFT identifies changes that help improve and change an institution's procedures and cost savings, this is a vital talk and one of the highlights of the hugely successful EBPOM London 2020 virtual conference. For more details on up coming events from Evidence Based Perioperative Medicine EBPOM at www.ebpom.org

The GIRFT website is here – https://gettingitrightfirsttime.co.uk/

Further listening regarding GIRFT can be found here: https://www.topmedtalk.com/rcoa-13-the-girft-getting-it-right-first-time-project/

Presented by Anna Batchelor, MB ChB, FRCA, FFICM, Consultant Anaesthetist - Intensive Care Medicine, Newcastle upon Tyne. She is the technical lead for critical care in the 'Getting It Right First Time' (GIRFT) programme.