TopMedTalk

The Royal College of Anaesthetist's National Audit Projects (NAP) are frequently fascinating and always important, here we get a look at NAP7, which will examine Perioperative Cardiac Arrest. The conversation also explores the Sprint National Anaesthesia Projects (SNAP) organised by the National Institute of Academic Anaesthesia. There's also discussion regarding muscle quality, malnourishment and ultrasound.

The conversation progresses to Quality Improvement and the latest evidence there. This includes discussion of The National Emergency Laparotomy Audit (NELA). Their website is here: https://www.nela.org.uk/

Find out more about Emergency Laparotomy Quality Improvement Care Bundle - ELPQuiC - here: https://www.ncbi.nlm.nih.gov/pubmed/25384994

Find out more about the Emergency Laparotomy Collaborative here: https://wessexahsn.org.uk/projects/95/emergency-laparotomy-collaborative

If you're looking for the hugely popular debate regarding direct laryngoscopy we mention in the podcast go here: https://www.topmedtalk.com/sunday-special-should-direct-laryngoscopy-be-consigned-to-the-history-books/

Finally Carol Peden gets mentioned frequently in this talk, she appears on TopMedTalk here: https://www.topmedtalk.com/desirees-roundtable-carol-peden-epoch-qa-2/

Live from Anaesthesia 2019, on day two of the conference; a 'must-attend event' for the specialty where world-renowned experts present the latest advances in perioperative medicine, critical care and pain medicine.

Presented by Monty Mythen with Tim Cook, Consultant in Anaesthesia and ICM, Royal United Hospitals, Bath and Paul Wischmeyer, Professor of the Department of Anesthesiology, Duke University.

Developmental neurotoxicity; can human infants exposed to anaesthesia early in their early development really be facing risks which we were previously unaware of? There's a lack of evidence at the moment but outcomes for young animals have raised concern. Given the complexities of human neurodevelopment how can such issues be reliably detected?

Presented by Joff Lacey with his guest Hugh Hemmings Senior Associate Dean for Research, Professor and Chair of Anesthesiology at Weill Cornell Medicine.

This excellent conversation explores how Anaesthesia as a profession will the profession evolve as the years pass; change is inevitable and the direction of it is becoming clearer but what it's pace will be is still uncertain. How will we adapt to the new roles and requirements we can see coming towards us in the near future? Will "the computers take over" or do we see a future where roles will be made simpler and more automated? Should Anaesthetists expect to tackle more of a leadership role in the future?

Also, what is the "technological singularity"? Should we be concerned about it? Finally, some thoughts on what it really means to work in healthcare, how are we different to the super computers we imagine doing our work in years to come and might these differences be unique advantages that can never be emulated?

Originally broadcast live from Anaesthesia 2019; a 'must-attend event' for the specialty where world-renowned experts present the latest advances in perioperative medicine, critical care and pain medicine.

Presented by Joff Lacey with Mike Swart, Consultant in Anaesthesia and Critical Care Medicine at Torbay Hospital and advisor to the UK Department of Health for the Enhanced Recovery Programme.

"Keeping the care in healthcare", is the agenda for this powerful and wide ranging conversation with one of our most popular contributors. How do we keep the priority of what we do at the forefront of our minds? Does the information we've learned recently on TopMedTalk about "burn out" impact on our understanding of poor levels of care in healthcare? Is it possible to rate providers on how much care they display?

Also; "what is a microbiome"? The second half of this conversation is a deep dive into "the bugs that make us whole". How can this remarkable area of research help to improve our overall well being and health? How does it impact upon our understanding of cesarean delivery (c section)?

Live from Anaesthesia 2019, on day two of the conference; a 'must-attend event' for the specialty where world-renowned experts present the latest advances in perioperative medicine, critical care and pain medicine.

A fascinating conversation about "burn out" is here: https://www.topmedtalk.com/topmedtalks-to-sasha-shillcutt/

We mention this piece here, one of TopMedTalk's most downloaded podcasts: https://www.topmedtalk.com/topmedtalks-to-dr-paul-wischmeyer/

Presented by Monty Mythen with Paul Wischmeyer, Professor of the Department of Anesthesiology, Duke University.

This piece focuses on intensive care, the use of data and the future of fluid therapy research and its related physiological outcomes.

The article mentioned in this podcast is here: "Perioperative haemodynamic therapy for major gastrointestinal surgery: the effect of a Bayesian approach to interpreting the findings of a randomised controlled trial" https://bmjopen.bmj.com/content/9/3/e024256

Presented by Desiree Chappell and Monty Mythen with their guest Maurizio Cecconi, Head of the Anaesthesia and Intensive Care Department at Humanitas Research Hospital; President-elect of the European Society of Intensive Care Medicine (ESICM) for 2020-2021, Chair Division of Scientific Affairs at ESICM; Director of the Master in Patient Blood Management at Humanitas University.

--

Like this, want more?

Rupert Pearse, one of the co-authors of the above article, was interviewed on TopMedTalk here: https://www.topmedtalk.com/anaesthesia-2019-rupert-pearse/

The 2nd Sprint National Anaesthesia Project: Epidemiology of Critical Care after Surgery (SNAP-2 - EPICCS) study launched in March 2017 around the UK. More than 2,200 investigators at more than 250 sites across the UK were signed up to take part. The observational study collected data on all patients undergoing inpatient surgery during a one-week period (21 March to 27 March) in UK NHS hospitals.

The website is here: https://www.niaa-hsrc.org.uk/SNAP-2-EpiCCS?newsid=1710

This talk explains the study and its far reaching implications.

Another talk on SNAP-2 is available here: https://www.topmedtalk.com/what-is-snap-2/

Presented by Ramani Moonesinghe, Professor of Perioperative Medicine at University College London (UCL).

This piece is a question and answer session regarding the care of elderly patients undergoing surgery. Discussion topics include; The RELIEF trial, e health tools, gathering and accessing data, whether it is better to over estimate risks and which risk calculator is most appropriate to use where you are?

It features; Professor Jacqueline Close, Geriatrician, Prince Of Wales Hospital, Clinical Director, Falls, Balance and Injury Research Centre, David Storey, Head of Anaesthesia, Perioperative and Pain Medicine Unit (APPMU), Melbourne Medical School, University of Melbourne; Director, Melbourne Clinical and Translational Sciences (MCATS) research platform and Dr Doug Campbell, Anaesthesia Specialist at Auckland City Hospital.

--

Brought to you by the Perioperative Medicine Special Interest Group (SIG) in association with the Australian and New Zealand Society for Geriatric Medicine and the Internal Medicine Society of Australia and New Zealand at the 7th annual Australasian Symposium of Perioperative Medicine.

The Perioperative Medicine Special Interest Group (SIG) has three aims; improve patient safety and outcomes, share knowledge and collaborate with specialty groups, develop the specialty of perioperative medicine with various craft groups.

For more information follow this link here: http://www.anzca.edu.au/fellows/special-interest-groups/perioperative-medicine

We begin with a conversation about The UK Perioperative Medicine Clinical Trials Network, their website is here: https://www.pomctn.org.uk/

This piece focuses on the Optimising Shared decision-makIng for high-RIsk major Surgery (OSIRIS) programme. Shared decision making can be very challenging when we're not sure what the risks are and older patients with chronic diseases often make very different decisions when informed. How do we make this process more evidence based? How do we better understand this group and communicate with them? Are there technological answers to these questions?

If you'd like to see the OSIRIS section there here's the link: https://www.pomctn.org.uk/OSIRIS

You can find the OSIRIS website here: https://osiris-programme.org/

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

Presented by Monty Mythen with Mike Grocott, Professor of Anaesthesia and Critical Care Medicine, University of Southampton and Rupert Pearse, Professor of Intensive Care Medicine at Queen Mary, University of London.

Mentorship, diversity and inclusion are key parts of any socially responsible institution's practice. This piece speaks to how we make medicine more diverse and inclusive overall, there is much work to be done but an active focus coupled with mentorship programes is shown here to be an effective way forward.

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/

Check out the AANA's page on diversity here: https://www.aana.com/about-us/aana-diversity-and-inclusion

Presented by Desiree Chappell and Monty Mythen with their guests Debra Diaz, DNP, CRNA, APRN, CDR, AANA Board of Directors, Lena Gould, CRNA, Founder, Diversity in Nurse Anesthesia Mentorship Program, John Bing, Owner, JBing and Assoc Anesthesia Services, AANA Board of Directors.

How do we best negotiate working in a multidisciplinary team? Generalisations regarding surgeons and anaesthetists only ever work generally, the specifics of each practitioner and their priorities inevitably contrast. How do we keep sight of these broad differences without falling foul of stereotypes?

The conversation evolves; how does the surgical journey fully utilise the team based perioperative approach? With specific focus on geriatric care there is further discussion regarding shared decision making, something which has been part of that discipline for many years.

The debate regarding when a patient becomes geriatric is explored. Is it age which defines that or do symptoms and comorbidities qualify the term?

Recorded on the first day of the Royal College of Anaesthetists' annual conference at The British Museum.

Desiree Chappell and Monty Mythen interview their guests Professor Jenifer Weller, Head of the Centre for Medical and Health Sciences Education, University of Auckland and Dr Jugdeep Dhesi, Clinical Lead, POPS and Consultant Geriatrician, Guys and St Thomas' NHS Trust.