TopMedTalk

This piece focuses on the Preoperative Intravenous Iron To Treat Anaemia in major surgery (PREVENTT) trial; a randomized double-blind controlled phase III study to compare the efficacy and safety of intravenous ferric carboxymaltose with placebo in patients with anaemia undergoing major open abdominal surgery.

The main question is if we properly mobilize our patients, feed them and correct their anemia, do they do better? How can we get a patient fitter for surgery? Can we correct anemia before surgery? "We took people prior to major open abdominal surgery [...] and our question was, in two weeks prior to surgery, if we give them intravenous iron and treat the anemia, at operation do they receive less blood transfusion and post operatively recover without as many complications?".

Also, Are you a woman and anemic? Should you be taking iron supplements? Could you do with a dose of I.V. iron?

The Iron Clinic is here: https://www.theironclinic.com/

The PREVENTT website is here: https://preventt.lshtm.ac.uk/

Our guest also featured in the press where they dubbed him "Iron Man": https://www.dailymail.co.uk/femail/article-3932602/Hugely-popular-Australia-s-just-come-menopausal-women-benefit-iron-drip-stop-feeling-tired-time.html

Presented by Desiree Chappell with Monty Mythen and their guest Toby Richards, Professor, Anaesthesia Teaching & Research Faculty of Medicine, Nursing and Health Sciences Central Clinical School, Monash University.

This panel discussion includes questions such as: In a prehabilitation service what screening tools should we use to assess nutritional risk? What tools are there related to patient self management? What advice would you give a patient about cannabis smoking cessation? Should denial of surgical procedures be used as a motivator for lifestyle change? Can the questions used in interventions sometimes be open to misinterpretation by patients? How do we assess and treat sleep disorders? If not a psychologist, what team members might handle psychological behaviour change? Does immunonutrition work? Are there sensitive approaches to addressing weight loss, physical activity and diet that the panel reccomend?

Panel discussion chaired by Sandy Jack and Daniel Santa Mina, featuring, David Yates, Consultant in Anaesthesia and Critical Care Medicine at York Teaching Hospital, 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, Chris Snowden, Consultant Anaesthetist, Freeman Hospital, Newcastle upon Tyne and Senior lecturer at the Institute of Cellular Medicine at Newcastle University, Chelsia Gillis, Registered Dietitian, Canadian Vanier Scholar, and PhD Candidate in Epidemiology at the University of Calgary, Canada, she is leading the first prehabilitation program for colorectal surgery in Alberta.

"ERAS in Colorectal Surgery" - was originally streamed live from the Charles Sammons Cancer Center, Dallas, during EBPOM-USA 2019 on www.topmedtalk.com

If you'd like to attend an event like this ensure your next click is here: www.ebpom.org/meetings

If you have any comments or questions you'd like to send to the team email: [email protected]

Presented by Anthony Senagore, Professor and Vice Chair Western Michigan University-Homer Stryker MD School of Medicine Borgess Medical Center Kalamazoo, MI.

This piece focuses upon the African Surgical Outcomes Study (ASOS-2). More than a thousand people across Africa have combined forces to make this research into perioperative medicine in a resource limited environment happen. We know patients in Africa are twice as likely to die following surgery when compared to the global average, why is this? How does "failure to rescue" play into this?

The website mentioned in this piece for more details: https://www.asos.org.za

Presented by Desiree Chappell with Monty Mythen and their guest Bruce Biccard, consultant anaesthetist at the University of Kwazulu-Natal, Director, Perioperative Research Unit, Department of Anaesthetics, Nelson R Mandela School of Medicine from

"There seems to be a little extra buzz in the cardiac community".

This conversation focuses upon the psychology of change, specifically regarding the leadership role presented within perioperative medicine to anaesthesiologists. How can perfectionism, as a barrier to change, be overcome? How do practitioners build the confidence to make a difference? Furthermore, how do we engage in 'internal marketing' where we promote success within our own institutions?

More information on The Morpheus Consortium here: http://morpheusconsortium.org/

Check out the article here: https://jamanetwork.com/journals/jamasurgery/fullarticle/2732511

Find out more about NorthStar here: https://northstaranesthesia.com/

The "Masters of Scale" podcast is here: https://mastersofscale.com/

This piece was originally released live from "ERAS cardiac: Center of excellence training conference", an Edwards Life Sciences sponsored conference in North Carolina.

Presented by Monty Mythen and Desiree Chappell with their guest Bob Booth, Regional Chief Medical Officer, Vice President of Physician Operations at NorthStar Anesthesia, P.A.

Like this, want more?

Brian Woods from NorthStar features on TopMedTalk here: https://www.topmedtalk.com/topmedtalk-the-goal-is-more-important-than-the-role/

This hugely important talk was the centerpiece of EBPOM 2019 and, appropriately enough, it focuses on a big topic for us here at TopMedTalk; the future of fluid therapy.

Originally given as the EBPOM 2019 Ernest Henry Starling plenary lecture the talk is complimented by this piece which was recorded on the same day: https://www.topmedtalk.com/desirees-roundtable-fluids-in-the-2020s/

Where is the latest thinking on fluid therapy, what new evidence and understandings do we now have?

Presented by Dr Andrew Shaw, Chairman, Department of Anesthesiology and Pain Medicine at The University of Alberta, Edmonton, Alberta and Zone Clinical Department Head for Anesthesia, Alberta Health Services Edmonton Zone. He is also a Fellow of the Royal College of Anaesthetists (UK), the American College of Critical Care Medicine and the Faculty of Intensive Care Medicine (UK).

Dingle 2020 is now on! Make sure you check out www.ebpom.org for more details.

Today's TopMedTalk is another sampler from the conference, made available because this vital piece deals with a variety of issues related to COVID-19; what we know and what we know we do not know:

- Similarities and differences between COIVD-19 and Aqute Respiratory Distress Syndrome (ARDS) - The most useful information observed by practitioners at the bedside, conscious of the lack of Randomised Controlled Trials (RCTs) in this area - The controversy regrading early invasive ventilation versus non-invasive ventilation - What are the aerosolization risks? - Pragmatic patient prioritization - The role of anti-coagulation - The role of continuous positive airwave pressure (CPAP) - who benefits and why?

Presented by Professor Mervyn Singer, Intensive Care Medicine at University College London.

Don't miss out on our next conference, make sure you go now to www.ebpom.org

What are some of the major issues regarding billing? What are the most common mistakes when it comes to documentation? How do we keep the focus on great healthcare, as well as good book keeping? How does "the false claims act" impact on billing?

If you find a mistake or an issue in your note keeping the advice here is clear; deal with it the moment it is discovered. Also, under recording is an obvious issue, can the same be said of 'excessive documentation'?

The bottom line is that practitioners must remain educated, stay aware of what is going on and rely on the fact that patient care is crucial and has to remain at the heart of any healthcare practice.

This piece was part of our coverage of The American Association of Nurse Anesthetists (AANA) 2019 Annual Congress in Chicago, Illinois.

Check out the AANA here: https://www.aana.com/

If you would like to contact our guest he has allowed us to post his email here: [email protected]

Presented by Desiree Chappell and Monty Mythen with Sol Aronson, a tenured professor at Duke University and Executive Vice Chairman in the Department of Anesthesiology and their guest, Mark Silberman, Partner, Benesch Law Chair, White Collar, Government Investigations, & Regulatory Compliance Vice-Chair, Health Care.

This piece is a chance to hear more about the work of our guest, who made a big impact as a guest on a recent edition of TopMedTalk: https://www.topmedtalk.com/topmedtalk-computer-gamer-to-life-saver/

The Perioperative Quality Initiative (POQI) is here: www.poqi.org

This piece covers cerebral oximetry with near-infrared spectroscopy (NIRS), often used during the perioperative period of cardiovascular operations.

Article here:

"American Society for Enhanced Recovery and Perioperative Quality Initiative Joint Consensus Statement on the Role of Neuromonitoring in Perioperative Outcomes"

https://journals.lww.com/anesthesia-analgesia/Abstract/9000/American_Society_for_Enhanced_Recovery_and.95500.aspx

We're celebrating Evidence Based Perioperative Medicine's (EBPOM) Dingle conference which holds a special place in the hearts of TopMedTalk listeners. We've covered it for the last few years in detail, making many hours of valuable educational information accessible to a global audience of thousands of medical professionals each week. If you'd like to find out more about EBPOM's groundbreaking online proposition please checkout www.ebpom.org

Presented by Desiree Chappell and Monty Mythen with their guest Robert Thiele, Associate Professor, Departments of Anesthesiology and Biomedical Engineering, Division Chief, Critical Care Anesthesiology, Board of Directors, University Physicians Group, University of Virginia School of Medicine. He has a background in engineering and has been using technology to improve education since his residency in 2008. He is co-founder of www.OpenAnesthesia.org which lead to the development of Self-Study, and also authored one of the first iBooks focused on cardiac and critical care ultrasound.

The American Associaton of Retired People (AARP), an organisation with a membership almost equal to the entire voting population of the United Kingdom, are focusing on brain health, in response to the demands of their members.

Further conversation includes how practitioners both explain the risks of surgery and also calm possible misunderstandings or fears regarding them, as well as wider reflections on 'The Brain Health Initiative'.

Presented by Desiree Chappell with Mike Grocott and their guests Lee Fleisher, Professor of Anesthesiology and Critical Care, University of Pennsylvania and Sarah Lock, Senior Vice President for policy at the American Association of Retired People (AARP) and the director of 'The Global Council on Brain Health'.