TopMedTalk

This piece is a two part conversation about the essence of what many of TopMedTalk's listeners do; Enhanced Recovery. A fascinating conversation between a number of experts in the field the conversation presented here was part of the hugely popular EBPOM Chicago 2020 meeting. For more on Evidence Based Perioperative Medicine (EBPOM) go to www.ebpom.org

This first part of the conversation covers what the main elements of an Enhanced Recovery After Surgery program entail, what literature our contributors favor and what service lines include enhanced recovery at their practice.

Presented by Desiree Chappell with Vicki Morton, Director of Clinical and Quality Outcomes at Providence Anesthesiology Associates, P.A, Cheryl Crisafi, Cardiac Surgery Care Coordinator Nurse at Baystate Medical Center in Springfield, MA and Gina McConnell, ERAS Coordinator for all WakeMed health systems.

What are the aims of The International Prehabilitation Society? Its vision is about "bringing together international multidisciplinary expertise, across healthcare and beyond, creating a platform of shared learning, research and education for the benefit of patients".

This piece updates you on the current board members, the roles of committee members, conferences that the society has previously supported alongside those being planned for the future. Also there's an update on some exciting new sponsorship news and a brief overview of future plans.

The society's website is here: https://prehabsociety.com/

Presented by Gerard Danjoux, consultant in Anaesthesia and Sleep Medicine at South Tees Hospitals NHS Trust.

"The people of Wales are particularly unfit", there is a high incidence of smoking, physical inactivity, and alcohol intake. Grim news from one angle but on the other hand it's a huge opportunity to make a massive difference in the prehabilitation stage of the perioperative process. Hear how cancer outcomes are being dramatically improved as a clear pathway of optimisation is rolled out.

Presented by Rachael Barlow, National Lead, Enhanced Recovery, Prehabilitation and Optimisation, at Cardiff and Vale health board, Wales.

This piece focuses on the great work done by The Anesthesia Patient Safety Foundation. We turn to their specific focus on COVID 19 and then look at the wider benefits of a network dedicated to patient safety in our field.

Their section on COVID 19 is here: https://www.apsf.org/news-updates/perioperative-considerations-for-the-2019-novel-coronavirus-covid-19/

Furthermore there is a remarkably prescient article by Mike Grocott and Monty Mythen on there in which we discuss, Perioperative Fluid Management: Cheers to the Dream of Moderation: https://www.apsf.org/article/perioperative-fluid-management-cheers-to-the-dream-of-moderation/

Presented by Desiree Chappell and Monty Mythen with their guest Steven Greenberg, MD, FCCP, FCCM, Editor-in-Chief, Anesthesia Patient Safety Foundation (APSF) Newsletter, Vice Chairperson, Education, Department of Anesthesiology, Director of Critical Care Services, Evanston Hospital NorthShore University HealthSystem, Clinical Professor, Department of Anesthesiology Critical Care, University of Chicago, Pritzker School of Medicine.

"Accelerated surgery is not a panacea"

This piece, presented in two parts, is a discussion about enabling enhanced recovery. Originally part of EBPOM London this is an 'as live' discussion with four of the main presenters from the conference.

Get more detail on nutrition, hip fractures, psychological optimisation and discover both where the difficulties are and what opportunities they provide. For more of this sort of content go now to www.ebpom.org to find out more about how you can be part of Evidence Based Perioperative Medicine.

Presented by Professor Denny Levett and Jugdeep Dhesi with their guests P.J. Devereaux, cardiologist, clinical epidemiologist, and perioperative care physician, Professor in the Departments of Health Research Methods, Evidence, and Impact (HEI) and Medicine, Director of the Division of Perioperative Care, McMaster University, Associate Deputy Director of the Population Health Research Institute, President of the Society of Perioperative Research and Care, Chloe Grimmett, National Institute of Health Research (NIHR) post-doctoral Research Fellow and Senior Research Fellow for the Macmillan Survivorship Research Group at the University of Southampton, Dr Paul Wischmeyer, Professor of Anaesthesiology and Surgery at Duke Anesthesiology.

"Accelerated surgery is not a panacea"

This piece, presented in two parts, is a discussion about enabling enhanced recovery. Originally part of EBPOM London this is an 'as live' discussion with four of the main presenters from the conference.

Get more detail on nutrition, hip fractures, psychological optimisation and discover both where the difficulties are and what opportunities they provide. For more of this sort of content go now to www.ebpom.org to find out more about how you can be part of Evidence Based Perioperative Medicine.

Presented by Professor Denny Levett and Jugdeep Dhesi with their guests P.J. Devereaux, cardiologist, clinical epidemiologist, and perioperative care physician, Professor in the Departments of Health Research Methods, Evidence, and Impact (HEI) and Medicine, Director of the Division of Perioperative Care, McMaster University, Associate Deputy Director of the Population Health Research Institute, President of the Society of Perioperative Research and Care, Chloe Grimmett, National Institute of Health Research (NIHR) post-doctoral Research Fellow and Senior Research Fellow for the Macmillan Survivorship Research Group at the University of Southampton, Dr Paul Wischmeyer, Professor of Anaesthesiology and Surgery at Duke Anesthesiology.

This piece is an informative conversation about the models of prehabilitation from a number of different angles. Questions come in from an online audience as our panelists tackle the topic from their respective areas.

What are the risks and how are they mitigated? Where does your funding come from and why? How safe is iron for cancer patients?

The link to Safe Fit self referal is here: https://www.macmillan.org.uk/cancer-information-and-support/get-help/physical-help/safefit%20#refer_yourself_to_this_service

Presented by Denny Levett, Professor in Perioperative Medicine and Critical Care at Southampton University Hospital NHS Foundation trust and Honorary Associate Professor at the University of Southampton and Gerard Danjoux, consultant in Anaesthesia and Sleep Medicine at South Tees Hospitals NHS Foundation Trust with their guests John Moore, Clinical Director for Intensive Care at Manchester Royal Infirmary and Medical Lead for Enhanced Recovery After Surgery, Professor Sandy Jack, PhD, Consultant Clinician Scientist in The Anaesthesia and Critical Care Research Unit at University Hospital Southampton NHS Foundation Trust, Honorary Senior Lecturer at the University of Liverpool, University of Southampton and University College London and Rachel Barlow, National Lead, Enhanced Recovery, Prehabilitation and Optimisation, at Cardiff and Vale health board, Wales.

"I hope to impress upon you that this is a topic that we can and must do better at ... no malnourished patient should ever have elective surgery without having a nutrition assessment done"

This piece is presented in two parts; this is part 2.

Using perioperative nutrition to optimize our patients outcomes; data shows us that nutrition therapy or nutrition optimization is literally life saving. Anyone who uses evidence as their guide know it has to be part of their practice.

Enhanced Recovery After surgery, sometimes called "fast track surgery" is about ensuring we apply the best information we have to the process. This talk focuses on how and why this ties into a sensible attitude towards nutrition and nutritional assessment.

This talk pulls no punches and yet is powerfully optimistic in its message. We implore TopMedTalk listeners to share it with colleagues.

The entertaining audio clips used in this piece are available, with video and in full here: https://www.youtube.com/watch?v=zHEincgSm1k&t=190s

Our speaker kindly shares his email address for further correspondence and questions: [email protected]

Presented by Paul Wischmeyer, Professor of Anaesthesiology and Surgery at Duke Anesthesiology.

"I hope to impress upon you that this is a topic that we can and must do better at ... no malnourished patient should ever have elective surgery without having a nutrition assessment done"

This piece is presented in two parts; this is part 1.

Using perioperative nutrition to optimize our patients outcomes; data shows us that nutrition therapy or nutrition optimization is literally life saving. Anyone who uses evidence as their guide know it has to be part of their practice.

Enhanced Recovery After surgery, sometimes called "fast track surgery" is about ensuring we apply the best information we have to the process. This talk focuses on how and why this ties into a sensible attitude towards nutrition and nutritional assessment.

This talk pulls no punches and yet is powerfully optimistic in its message. We implore TopMedTalk listeners to share it with colleagues.

The entertaining audio clips used in this piece are available, with video and in full here: https://www.youtube.com/watch?v=zHEincgSm1k&t=190s

Our speaker kindly shares his email address for further correspondence and questions: [email protected]

Presented by Paul Wischmeyer, Professor of Anaesthesiology and Surgery at Duke Anesthesiology.

"In the United States approximately 112,000 patients annually are at risk for adverse events associated with discharge from the operating room with residual neuromuscular blockade"

This talk highlights the latest thinking on both monitoring and management of neuromuscular blockade. Where does the data lead us to? How big a problem do they suggest poor efficiency in this area is? What are the realities behind postoperative pulmonary complications? How can we reduce the risk of residual block?

Presented by Glenn Murphy, Jeffery S. Vender Chair of Anesthesiology Research and Education and Director of Cardiac Anesthesia and Clinical Research at NorthShore University HealthSystem, a hospital affiliated with the University of Chicago Pritzker School of Medicine.