TopMedTalk

"Shared decision making and risk prediction in the emergency setting: Can we achieve it?" is a talk originally given at the 8th Australian and New Zealand Symposium of Perioperative Medicine Special Interest Group: "Updates in Perioperative Medicine 360" which took place between November 7th-9th 2019.

This talk discusses survival after admission to intensive care. How do we incorporate concepts like shared decision making and value based care into this high stress, time limited environment?

Presented by Dr John Carlisle, anaesthetist, Torbay and South Devon NHS Foundation Trust. He also works as an intensivist in the intensive care unit, as well as the preoperative assessment clinic.

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EBPOM 2020 - Live from London - is on!

For those who have listened to Desiree's special announcement go now to: https://ebpom.org/EBPOM2020

If you liked this podcast and want more, our speaker mentions the excellent journal Anaesthesia, there's an interview with the editor here:

https://www.topmedtalk.com/topmedtalk-andy-klien-editor-in-chief-of-anaesthesia/

This piece is a fascinating discussion regarding research and safety in anaesthesia management; "in the past five or six years there's been a shift from high risk patients to all types of patients". How are we improving methods, evaluation and monitoring? What are some of the more essential elements of the process? Where is the latest research? What is a sensible policy when it comes to opioids?

Presented by Desiree Chappell and Monty Mythen with their guest Dan Longrois, Professor of Anaesthesia and Intensive Care Medicine, Department of Anaesthesia and Intensive care, Bichat Hospital.

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EBPOM 2020 - Live from London - is on!

For those who have listened to Desiree's special announcement go now to: https://ebpom.org/EBPOM2020

This piece dives into the latest thinking behind opioid-free anaesthesia; how can we improve? Is the challenge of the opioid crisis being met head on by perioperative medicine? Is it realistic to expect to reach a point where opioids are removed from the equation entirely?

Presented by Michael Manning, MD, PhD, Assistant Professor at Duke University Medical Center, Director of research for the Perioperative Medicine Fellowship at Duke.

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EBPOM 2020 - Live from London - is on!

For those who have listened to Desiree's special announcement go now to: https://ebpom.org/EBPOM2020

This piece tells the story of two different innovators in the field of an anesthesia. The first is, The Pediatric Device for Induction of Anesthesia (PeDIA), a mask-free anesthesia delivery system designed for kids. The second is the Error Recovery and Mitigation Aide (ERMA), a reworking of the traditional needle box whereby a clear reservoir is inserted between the re-entry proof top and opaque terminal disposal portion, allowing practitioners to have visualization of all the syringes and vials used during the course of a procedure. At the end of a single procedure, a trap door in the bottom of the reservoir is released to allow those sequestered vials and syringes to drop into the bottom of the needle box for terminal disposal. This allows providers to recognise, check and confirm possible errors in a timely fashion.

Also during this piece there is a wide ranging and fascinating discussion about patents and patenting. How does the process work, how can you patent your ideas and how does the advent of block chain technology potentially change this forever?

Google Patents is here: https://patents.google.com/

Check out the PeDIA website here: https://www.pediallc.com/

For more information about ERMA go here: https://ii4change.com/how-we-innovate/products/error-recovery-and-mitigation-aide/

The Facebook Group "CRNA Inventors and Innovators" mentioned in this piece is here: https://www.facebook.com/groups/2150893568464906/

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

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

Presented by Desiree Chappell and Monty Mythen with their guests Diane Miller, Pediatric Devices for Induction of Anesthesia | Product Development | PeDIA, LLC and Jean Snyder, CRNA Inc. Co-owner Goodwin and Snyder Anesthesia Associates, PLLC.

Doesn't the decision to delay surgery depend upon the type of cancer? Can you measure complications as an outcome? What's the cause of non cardiac complications that are related to lack of exercise? Can we change the mindset of prehabilitation by explaining that prehabilitation is the start of treatment? How do we convince patients and decision makers that delaying surgery is a good idea? How involved are oncologists in perioperative decisions?

Presented by Duminda Wijeysundera, Professor in the Department of Anaesthesia and the Institute of Health Policy Management and Evaluation at the University of Toronto, and a Staff Anesthesiologist at St Michael's Hospital and Gerrit Slooter, MD, PhD, Surgical Oncologist, Maxima Medical Centre, The Netherlands.

"We wanted to know if goal directed therpy using a (Hypotension Prediction Index) HPI monitor can prevent hypotension". This piece looks in detail at the HPI monitor in practice- what is the benefit of this piece of technology in relation to hypotensive episodes? Furthermore how else is it to be tested and when will these tests be carried out?

Presented by Desiree Chappell and Monty Mythen with their guest Marit Habicher, Specialist, Department of Anesthesia and Critical Care at UKGM Giessen.

Some practitioners habitually prescribe opioids, the consequences in America are now described as a national crisis. Essentially the focus here is "better opioid stewardship" and a "move away from the traditional fundamental principle of opioids first".

Presented by Michael Manning, MD, PhD, Assistant Professor at Duke University Medical Center, Director of Research for the Perioperative Medicine Fellowship at Duke.

After a short overview of the history of the Society of Cardiovascular Anesthesiologists (SCA) this conversation zones in on some of the hot topics that are being discussed in the field; devices and extracorporeal membrane oxygenation (ECMO) machines, as well as trans-esophageal echocardiography and how the practice has evolved. The conversation ends with a discussion about pre-habilitation in a resource stretched environment.

Presented by Desiree Chappell with Sol Aronson with Jamie Ramsey Medical Director Cardiac ICU at UCF and Gerald Levy, MD at Duke University.

The Centre for Perioperative Care (CPOC) is a cross-specialty centre dedicated to the promotion, advancement and development of perioperative care. Led by the Royal College of Anaesthetists to facilitate cross-organisational working on perioperative care for the benefit of patients. A partnership between patients and the public, other professional stakeholders including Medical Royal Colleges, NHS England and the equivalent bodies responsible for healthcare in the other UK devolved nations. The aim is to improve quality of care, support patients and professionals as well as influence policy, technology, research and innovation.

CPOC launched on 20 May 2019 at the Anaesthesia 2019 event.

Follow them on Twitter at @CPOC_News

There is a page on the Royal College of Anaesthetists' website here: https://www.rcoa.ac.uk/cpoc

Presented by Mike Grocott, Professor of Anaesthesia and critical care at the University of Southampton and frequent TopMedTalk contributor.

This piece focuses on The Centre for Perioperative Care (CPOC). How does it work, what are its goals and who is involved?

Also, what digital innovations will CPOC be looking towards?

For more information check out the website here: https://cpoc.org.uk/

Originally recorded live at Anaesthesia 2019; where world-renowned experts presented the latest advances in perioperative medicine, critical care and pain medicine.

Presented by Monty Mythen and Mike Grocott with their guest David Selwyn, Deputy Medical Director at Nottingham University Hospitals NHS Trust and Director of The Centre for Perioperative Care (CPOC).