TopMedTalk was at the American Society of Anesthesiologists (ASA) Annual General Meeting, Anesthesiology 2024. We’re bringing you a series of podcasts from the conference.

In this episode, we share insights into patient care, emphasizing the importance of empathy, trust, and tailored communication, especially for patients from communities with healthcare inequities. How do we handle different patient responses to monitoring technology? While remote monitoring offers potential benefits—such as allowing patients to recover at home—it raises questions about who will oversee this data and how to ensure it remains safe and effective.

Presented by Desiree Chappell and Mike Grocott with their guest Ashley P. Oliver, MD MA, HS Clinical Assistant Professor, Division of Cardiothoracic Anesthesia, UCLA Department of Anesthesiology and Perioperative Medicine.

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We've been releasing more podcasts than usual here recently. Make sure you keep an eye on the TopMedTalk feed as we head towards the holidays.

Like this, want more?

Here's a great piece we did from the same conference:

"Challenging The Big Insurance Companies"

 https://topmedtalk.libsyn.com/challenging-the-big-insurance-companies-anes24

TopMedTalk was at The American Society of Anesthesiologists (ASA)'s annual general meeting; Anesthesiology 2024. We’re bringing you a series of podcasts from the conference.

Make sure you check our podcast feed and are subscribed to TopMedTalk, as we’re currently releasing episodes more than usual to accommodate high demand.

What's the impact of a remote patient monitoring device, or wearable, on a patient and how does this compare with the potential consequences of not having one? This personal story from our guest should force you to consider where patient care is and where it should be.

Presented by Desiree Chappell and Monty Mythen with their guest, LaToya Mason, Anesthesiologist, Director of Obstetric Anesthesia Education at The University of Mississippi Medical Center, Chair of the SOAP Membership Committee, member of the ASA Educational Track Committee for Obstetric Anesthesia, and member of the SOAP Trainee Curriculum Committee.

More from Anesthesia '24:

https://topmedtalk.libsyn.com/top-7-ways-to-drive-success-for-independent-anesthesia-groups-anes24

https://topmedtalk.libsyn.com/the-anesthesia-toolbox-anes24

TopMedTalk brings you exclusive, cutting-edge conversations from Anesthesiology 2024, the American Society of Anesthesiologists (ASA) annual general meeting; as is traditional, we always speak with the outgoing and incoming Presidents of the ASA.

This podcast is taken from the final day of our coverage. Make sure you are subscribed to TopMedTalk so you can hear all of our coverage -as we release it- over the next few months.

Presented by Desiree Chappell and Mike Grocott with their guests, Donald Arnold, MD, FACHE, FASA, Incoming ASA President president of Western Anesthesiology Associates, Inc., chair of anesthesiology at Mercy Hospital St. Louis and Ronald Harter, MD, FASA, Outgoing ASA President, Jay J. Jacoby professor and chair of the Department of Anesthesiology at The Ohio State University College of Medicine in Columbus, and physician anesthesiologist at the University’s Wexner Medical Center.

“What is prehabilitation?” is presented by Mike Grocott, TopMedTalk’s co-editor in Chief and Professor of Anaesthesia and Critical Care Medicine at the University of Southampton, as well as an NIHR Senior Investigator.

Originally presented at The World Congress of Prehabilitation, this challenging and exciting talk sets the tone for those of us who advocate for Prehabilitation; how do we define it and where is the evidence that it works? The intention here is to start a stimulating conversation with the audience and the prestigious panel who are assembled for the question and answer session that follows.

That discussion is scheduled to be released here on TopMedTalk in the near future, make sure you are subscribed to us through whichever channel you found us on to ensure you hear it.

TopMedTalk is the broadcasting arm of Evidence Based Perioperative Medicine (EBPOM), if you’d like to attend one of our forthcoming conferences go now to www.ebpom.org

How do the insights from experience in Enhanced Recovery apply to critical care patients and postoperative care pathways? We also discuss utilization of advanced monitoring technology for the critically ill patient postoperatively.

Presented by Desiree Chappell with her guests Philip Corvo, Chairman of Surgery Stanley J Dudrick Dept of Surgery at Saint Mary's Hospital and Vicki Morton, DNP and Director of Clinical and Quality Outcomes at Providence Anesthesiology Associates University of South Carolina.

This piece argues that troponin screening might be overused, "it's not all about the heart". Myocardial injury after noncardiac surgery (MINS) is seen as a relatively common issue driving post-operative harm. This piece gets into the detail and asks some important questions as to how focused practitioners should be upon troponin screening.

It's part 2 of 3 from The EBPOM 2019 TopMedTalk session which debated the issue.

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

This is the panel discussion which followed the address at EBPOM 2018 by Professor Sir Bruce Keogh on the eve of the 70th anniversary of the NHS.

Various questions from the audience are considered; where should we be in ten years from now, what are the disruptive forces headed our way?

The panel features; Sir Bruce Keogh, Professor Monty Mythen, University College London, Carol Peden, Professor of Anesthesiology and Exec. Director of the Center for Health System Innovation, University of Southern California, University of Bath and the Institute for Healthcare Improvement (IHI), Professor Sol Aronson, tenured professor at Duke University and Executive Vice Chairman in the Department of Anesthesiology, Mike Grocott, Professor of Anaesthesia and Critical Care Medicine, University of Southampton, NIHR Senior Investigator and Dr Ramani Moonesinghe, Director of the UK National Institute of Academic Anaesthesia Health Services Research Centre.

The full lecture from Sir Bruce Keogh 'Ernest Henry Starling Plenary Lecture 2018 “70 Years on: our NHS”' is available in full here: https://www.topmedtalk.com/ebpom-2018-3-sir-bruce-keogh-the-nhs-at-70/

On the last occasion we spoke with our guest she was a Perioperative Medicine Fellow at Duke University; learn now how her experiences have helped change her practice and the edge she has dealing with healthcare.
 
The conference is producing a number of talking points, the Measurement of Exercise Tolerance before Surgery (METS) Trial seems to have shifted opinions, does a genuine 'perioptimist' have a deeper insight into the issues there?
 
Also - does North America really lack the resources, expertise and money to adpot Cardiopulmonary Exercise Testing (CPET)?
 
Presented by Desiree Chappell and Monty Mythen with their guest Dr Elena Koepke, Assistant Professor at Moffitt Cancer Center/USF, Physician Anesthesiologist, Perioperative Medicine Specialist.
 
You can find POETTS here: https://www.poetts.co.uk

How do new technologies impact the postoperative elements of Enhanced Recovery? Here we discuss "ward monitoring 3.0" and new technologies which are now available, or in the pipeline, to improve outcomes. How do we best use this information and these innovations?

The website mentioned in the podcast is here: https://www.michardconsulting.com/

Presented by Desiree Chappell with Monty Mythen and their guest Frederic Michard of MiCo Consulting.

This panel discussion provides a vital and thought provoking insight into frailty in a perioperative patient. Further, as perioperative medicine evolves, how do we know enhanced recovery after surgery (ERAS) works? Are there any large randomised controlled trials that prove it?

This piece is moderated by Dr Ming Loh, Staff Specialist Geriatrician and Clinical Lecturer at Westmead Hospital and the University of Sydney, Clinical Lead for the Orthogeriatric Service, Subacute Rehabilitation Ward and Falls Clinic, and features; Ruth E. Hubbard, Professor in Geriatric Medicine at the University of Queensland, Consultant Geriatrician at the Princess Alexandra Hospital and Head of School for PA-Southside Clinical Unit, with Bobbie Jean Sweitzer, Professor of Anesthesiology and Director of Perioperative Medicine at Northwestern University in Chicago, Illinois, and 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.

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.

This question and answer session is a valuable insight into where the latest thinking is as regards tackling the opioid crisis. How do we get to an understanding where the entire continuum of care is on the same page as regards pain relief? What's the level of adoption for opioid free anaesthesia? Can re-languaging pain or "re-writing the narrative" help, for example is it better to speak of 'comfort levels' as opposed to pain? What's the latest thinking as regards caffeine as an aid to comfort? Should we be worried about post operative delerium as regards ketamine use? What about gabapentinoids in the elderly? What about Midazolam? What should we send patients home with afterwards?

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

This piece argues that troponin screening is useful, if used appropriately. Is it the case that this test has been 'over sold' and as a result has provoked unhelpful pushback from practitioners?

It's part 1 of 3 from The EBPOM 2019 TopMedTalk session which debated the issue.

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.

A special edition of TopMedTalk recorded at The Institute of Sport Exercise and Health (ISEH) live from an Enhanced Recovery After Surgery (ERAS) leadership forum.

How can cold water adaption help people deal with medical issues? There's evidence to suggest that cold water adaption reduces inflamation, can open water swimming help with issues such as chrohn's disease? On the other hand how important is it to ensure patients do not become cold while in our care? Hypothermia is never good, how important is it to keep patients warm? Keeping patients and their environments warm is discussed, as is pre-warming, going beyond the standard blankets and patient insulation to include active warming and even patients exercising as a method of warming up. Further to this conversation, how do you measure a patient's temperature?

How do we drive change in our institutions towards enhanced recovery after surgery? The GIRFT (Getting It Right First Time) project is explained. The Health Foundation is also mentioned. The piece also includes patient communication and the question of 'how much is too much?', when administering a dose of morphine. Also, is there a hierarchy on the pathway of enhanced recovery after surgery?

The conversation features Professor Monty Mythen and his two guests; Dr Simeon West, consultant anaethetist at (University College London Hospitals) UCLH who sits on the board at Regional Anaesthesia UK (RAUK) and Mark Harper Consultant Anaesthetist at Brighton and Sussex University Hospitals, with a research interest in the prevention of perioperative hypothermia and the use of cold water adaptation for theraputic purposes. There are also attributed questions from the audience.

In this essential piece we discuss, anesthesiology and its global impact with experts, empathy with patients, emotional expression in medicine, improving anesthesia care globally and standardisation in anaesthesiology.

Direct from the 18th WFSA World Congress of Anaesthesiologists in Singapore, Desiree Chappell and Monty Mythen speak with their guest Jannicke Mellin-Olsen, Knight 1st Class of the Order of St.Olav (for services to medicine), past president of the World Federation of Societies of Anaesthesiologists, a member of the Board of Directors of the Patient Safety Movement Foundation, she practices at Baerum Hospital, Oslo, Norway.

Post op respiratory complications are the focus of this piece. How can they be anticipated, detected early and dealt with appropriately? What about objective neuromuscular monitoring? Should you revese every single patient? If so, how do you do it? What about the risk of pulmonary complications?
 
Presented by Desiree Chappell with her guest Frances Chung, Professor, Department of Anesthesiology and Pain Medicine, University of Toronto. 

Learn about the Perioperative Anesthesia and Surgical Screening Clinic (PASS Clinic), do you need one at your practice? What is pain control for a perioperative patient? Hear also about the 'subacute period' and how you can incorporate it into your practice. Also, how do we keep patients 'opioid free' once they leave our care? Finally, how does individualised pain management and pain education fit into this picture?

Presented by Desiree Chappell and Vicki Morton, with their guests; Professor Padma Gulur, Anaesthesia and Executive Vice-Chair at Duke University and Dr Natasha Curran, pain medicine University College London Hospital (UCLH) and Medical Director at the Health Innovation Network.

The fuller version of this conversation is available here: https://www.topmedtalk.com/ebpom-2018-14-the-realities-of-pain-management/

Our Holiday Special, part 3 of 3, is a sampling of our favorite conversations and lectures from 2019. It is a chance for new listeners to the hear the outstanding content that has made TopMedTalk the success it is after 2 amazing years. And for our regular listeners, a check in to make sure they've not missed some of the crucial pieces of the last year.

🙏🙏 All of us at TopMedTalk want to send a BIG thank you to ALL of our amazing fans and listeners. The support these past 2 years is inspiring and much appreciated. We want to thank our guests and lecturers from this past year as well. Your contribution to the show is what makes TopMedTalk so special. And a final THANK YOU to our Sponsors. Your generous support keeps TopMedTalk free open access to the world! Happy Holidays and Cheers to the New Year!! 🥂🥂🎉

More about caring for the transgender patient is here: https://www.topmedtalk.com/aana-2019-caring-for-the-transgender-patient/

Emotional intelligence is explored further here: https://www.topmedtalk.com/aana-2019-emotional-intelligence-and-occupational-stress/

Paul Myles is here: https://www.topmedtalk.com/live-from-asa-2017-paul-myles-3000-patients-in-study-of-fluid-restriction/

Joan Mythen may feature in the future on TopMedTalk.

The Grenfell fire episode is here: https://www.topmedtalk.com/topmedtalk-the-grenfell-inquiry-2/

The Dingle conference for 2020 is here: https://www.ebpom.org/Dingle2020

Carol Peden is here: https://www.topmedtalk.com/anes19-carol-peden-robin-cresner-shane-dickinson-snow-shoo-son/

Mike Scott is here: https://www.topmedtalk.com/anes19-michael-scott/

The interview with Andrew Shaw is here: https://www.topmedtalk.com/anes19-andrew-shaw/

Presented by Desiree Chappell with Monty Mythen alongside a selection of clips from the last year.

Our Holiday Special, part 2 of 3, is a sampling of our favorite conversations and lectures from 2019. It is a chance for new listeners to the hear the outstanding content that has made TopMedTalk the success it is after 2 amazing years. And for our regular listeners, a check in to make sure they've not missed some of the crucial pieces of the last year.

🙏🙏 All of us at TopMedTalk want to send a BIG thank you to ALL of our amazing fans and listeners. The support these past 2 years is inspiring and much appreciated. We want to thank our guests and lecturers from this past year as well. Your contribution to the show is what makes TopMedTalk so special. And a final THANK YOU to our Sponsors. Your generous support keeps TopMedTalk free open access to the world! Happy Holidays and Cheers to the New Year!! 🥂🥂🎉

Sol Aronson's inimitable style is on display here: https://www.topmedtalk.com/sca-poster-presenters/

Sasha Shillcut gets a mention, her piece is here: https://www.topmedtalk.com/topmedtalks-to-sasha-shillcutt/

The piece with Tjorvi Perry will be available next year.

Charles Brown gets a mention, his piece is here: https://www.topmedtalk.com/topmedtalks-to-charles-brown/

The piece regarding emergency laparotomys is here: https://www.topmedtalk.com/anaesthesia-2019-tim-cook-and-paul-wischmeyer/

The Fitter Better Sooner initiative is outlined here: https://www.topmedtalk.com/sunday-special-fitter-better-sooner/

Anaesthesia 2019 | Developmental neurotoxicity: https://www.topmedtalk.com/anaesthesia-2019-developmental-neurotoxicity/

Linda Mason's full interview is here: https://www.topmedtalk.com/euroanaes2019-linda-mason/

Paul Pomerance is here: https://www.topmedtalk.com/euroanaes2019-paul-pomerance/

Maurizio Cecconi is here: https://www.topmedtalk.com/euroanaes2019-maurizio-cecconi/

The piece featuring Dan Longrois is here: https://www.topmedtalk.com/euroanaes2019-dan-longrois/

The fascinating Paul Myles piece is here: https://www.topmedtalk.com/prato-2019-paul-myles/

Discover more about Bruce Biccard's work here: https://www.topmedtalk.com/prato-2019-bruce-biccard/

Find out more about WakeMed here: https://www.topmedtalk.com/eras-cardiac-2019-judson-williams-and-gina-mcconnell/

Ken Van Someren is here: https://www.topmedtalk.com/prehab-periop-world-congress-gerard-danjoux-ken-van-someren/

Find out more about our "forgotten friend" from Evan Karesh here: https://www.topmedtalk.com/topmedtalk-methadone-a-forgotten-friend/

Presented by Desiree Chappell with Monty Mythen alongside a selection of clips from the last year.

Our Holiday Special, part 1 of 3, is a sampling of our favorite conversations and lectures from 2019. It is a chance for new listeners to the hear the outstanding content that has made TopMedTalk the success it is after 2 amazing years. And for our regular listeners, a check in to make sure they've not missed some of the crucial pieces of the last year.

🙏🙏 All of us at TopMedTalk want to send a BIG thank you to ALL of our amazing fans and listeners. The support these past 2 years is inspiring and much appreciated. We want to thank our guests and lecturers from this past year as well. Your contribution to the show is what makes TopMedTalk so special. And a final THANK YOU to our Sponsors. Your generous support keeps TopMedTalk free open access to the world! Happy Holidays and Cheers to the New Year!! 🥂🥂🎉

In the order discussed on the podcast here are the pieces mentioned:

President Bill Clinton features on TopMedTalk here: https://www.topmedtalk.com/sunday-special-bill-clinton-at-the-world-patient-safety-science-technology-summit/

Joe Kiani from the Patient Safety Movement Foundation link: https://www.topmedtalk.com/topmedtalks-to-joe-kiani/

Angela Bader is here: https://www.topmedtalk.com/perioperative-medicine-summit-2019-1-03-angela-bader/

Periperative Cognition workshop: https://www.topmedtalk.com/sunday-special-the-perioperative-cognition-workshop-part-4-2/

Our discussion regarding muscle quality is here: https://www.topmedtalk.com/desirees-roundtable-the-malnourished-surgery-patient/

Our discussion with Rick Dutton is here: https://www.topmedtalk.com/topmedtalks-to-rick-dutton-2/

The TRIPOM series is here: https://www.topmedtalk.com/?s=tripom

Liz Pratt's interview is here: https://www.topmedtalk.com/desirees-roundtable-changing-the-culture-around-surgical-recovery/

Jamie Harris is here: https://www.topmedtalk.com/desirees-roundtable-aser-2019-jamie-harris-and-carol-schmidt/

Presented by Desiree Chappell with Monty Mythen alongside a collection of highlights from the last twelve months of TopMedTalk.

This piece discusses The Brain Health Initiative and the sixth Peri-Operative Quality Initiative which focused upon delirium. How can progress in these areas be built upon and encouraged? Where is the data in regards to detecting and dealing with delirium?

Beers Criteria Medication List; Potentially Inappropriate Medications for the Elderly According to the Revised Beers Criteria is here: https://dcri.org/beers-criteria-medication-list/

The website for the AARP is here: https://www.aarp.org/

Presented by Lee A. Fleisher Professor and Chair of Anesthesiology and Critical Care, University of Pennsylvania. There is a short question and answer session at the end hosted by Desiree Chappell and Monty Mythen.

Twitter is ablaze with talk of the Society for Perioperative Assessment and Quality Improvement (SPAQI). How did they do it?

This piece is a thought provoking discussion about new media and the consequences of our online world for medicine. 'The democratisation of education' is a phrase we've heard here on TopMedTalk in the past. How does direct access to information and experts in our field alter the state of play in the perioperative field?

Desiree Chappell and Monty Mythen are presenting with their guest Avital O'Glasser, Assistant Professor of Medicine at OHSU, Oregon Health & Science University and member of the communications committee for SPAQI.

If you enjoyed this, carry on listening with this piece here:

Sunday Special | Social Media
http://topmedtalk.libsyn.com/sunday-special-social-media

What is a "Respect Officer"? Why is respect so important in perioperative care? How does improving 'the culture of safety' also help to improve outcomes? Should we be overly concerned about high cancelation rates for surgery? And what are the advantages of a preoperative risk assessment clinic (PRAC)?

Presented by Desiree Chappell and Monty Mythen with their guest Amir Jaffer, Chief Medical Officer, New York Presbyterian / Queens.

Shared decision making is key to any perioperative enhancement team, this piece is a fascinating debate between various interesting positions.

For more on the (Perioperative Optimization of Senior Health) POSH clinic mentioned in this piece look here: https://medicine.duke.edu/divisions/geriatrics/patient-care/duke-perioperative-optimization-senior-health

Presented by Monty Mythen with his guest Mike Grocott, Professor of Anaesthesia and Critical Care Medicine, University of Southampton and contributions from Lee Fleisher, Professor of Anesthesiology and Critical Care, University of Pennsylvania and Sol Aronson, tenured Professor at Duke University, Dr Tim Miller, Duke University and Dr Attilla Kett, St Peter's University Hospital at New Jersey.

This exciting panel discussion covers a wide variety of questions, including; what is the definition of high risk patients in your clinic? What is your criteria for referal regarding pre-op patients? Who is in the multidisciplinary pre-op team? How long does each patient appointment last? How should we prioritise antihypertensives? Should anaesthetists be more involved in the postoperative care of patients?

This piece is chaired by Dr Ar Kar Aun and features; Imogen Mitchell, Senior Staff Specialist, ICU, the Canberra HospitalDean, ANU Medical School, Vincent D'Intini, Senior staff specialist, Nephrologist, Alfred Hospital Melbourne, and Bobbie Jean Switzer, Professor of Anesthesiology and Director of Perioperative Medicine at Northwestern University in Chicago, Illinois.

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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

Direct from the 18th WFSA World Congress of Anaesthesiologists in Singapore Desiree Chappell and Monty Mythen catch up with Andy Shaw, Chairman, Department of Intensive Care and Resuscitation at The Cleveland Clinic, Cleveland, Ohio.

This discussion touches on the topics of; cardiac anesthesia and care, temporary circulatory support in cardiac surgery, professional development and 'task shifting' in healthcare. We also focus upon The Perioperative Quality Initiative (POQI) and health economics, global access to cardiac surgery technology and global anesthesia and perioperative care.

The Perioperative Quality Initiative (POQI) - a wealth of free resources - is here: https://thepoqi.org/

We last heard from Andy Shaw here: https://topmedtalk.libsyn.com/the-perioperative-quality-initiative-ebpom-2023

And our YouTube audio channel is here: https://www.youtube.com/watch?v=VH0zX19sScE

"POETTS 2018 | Psychological Behavioural Change Interventions in Cancer Patients" - originally streamed live from The Institute of Engineering and Technology (IET) in London during EBPOM 2018 on www.topmedtalk.com

Hear this excellent talk, for free, on this podcast.

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: contact@topmedtalk.com

Presented by Chloe Grimmett, behavioural scientist from Southampton University. She works closely alongside the 'Fit for Surgery Team', providing the behavioural intervention which is part of the on-going WestFit prehabilitation trial.

"What drove enhanced recovery for us was not the short lengths of stay but the cancer outcomes" - this conversation explains how enhanced recovery gains traction in practice. Even after a relatively short period of application an evidence based approach is hard to refute.

Desiree Chappell presents 'The Roundtable blog'; in this piece she’s in conversation with Dr Michael Scott, Professor of Anesthesiology at Virginia Commonwealth University and Professor at The University of Pennsylvania, Dr Neil Seeley, Chief of Anesthesia for the Cancer Treatment Centres of America and Dr Kevin Watkins, Surgical Oncologist for the Cancer Treatment Centres of America.

As a general rule, should ward monitoring be increased? Should continuous blood pressure monitoring be more frequent?

This short piece follows on from Tim Miller's talk "Perioperative Blood Pressure (PeriOperative Quality Initiative: POQI 3) how low can you safely go?".

Presented by Desiree Chappell and Monty Mythen with Tim Miller, Associate Professor of Anesthesiology from Duke University Medical Centre.

Pets as Therapy are a fantastic charity who have provided a practical theraputic service to various people in assorted contexts, here you can hear them work their magic on the TopMedTalk team.

What are the advantages of taking pets into the ward? Can patients benefit from some therapy from our 'hairy friends'? Meet the volunteers and practitioners who have a dogged determination to cheer up our patients.

Presented by Desiree Chappell and Monty Mythen with their guests; Hillary Burbage, with Matlock, Pamela Pearl, with Frankie, Suzy Emsden with Alfie the therapy dog and Matthew Robinson, national project co-ordinator for Pets as Therapy.

Most people are familiar with ultrasound these days, next to the stethoscope and thanks largely to baby photographs, it's one of the most frequent public facing technologies in medicine.

New developments in transesophageal echocardiography have brought about huge advancements in its use as a technology; not to mention the incredible images now available from three dimensional echocardiography. As ultrasound becomes more available and more portable this conversation gives you an idea of where, when, why and how you can use this incredible tool. Is it really a piece of bedside assessment equipment which is about to become as ubiquitous as a doctor's thermometer?

It's difficult not to get excited about the ability to take a quick look at a patient's cardiac function, at the bedside, with a handheld piece of kit. Scanning a patient's abdomen, seeing how to apply appropriate measures of care rapidly on the spot, these are just some of the advantages discussed in this piece.

See more here:

Acute Care and Perioperative Ultrasound Workshop Co-sponsored by the Departments of Anesthesiology at Loma Linda and UCLA Medical Centers.

www.pocusededucation.com

Evidence-Based Perioperative Ultrasound Educational Curriculum (created as a free, open-source, platform for point of care ultrasound education)

www.foresightultrasound.com

Professor Monty Mythen is presenting, with his guest, Davinder Ramsingh MD, Director of Research and Perioperative Ultrasound at Loma Linda University Medical Center - Dept. of Anesthesiology.

The need for patient education is a constant theme on TopMedTalk, many are keen to soak up information and become and active team player in their operation, how can we make the most of their patricipation? For example, do you let your patients go to "surgery school"?

Presented by John Moore, Adult Critical Care Clinical Director and Consultant Critical Care & Anaesthesia at Manchester.

The fuller version of the original talk is here: http://topmedtalk.libsyn.com/poetts-2018-pre-operative-inspiratory-muscle-training

Australia has an interesting history both generally and with perioperative medicine specifically. Here the story is told and their current progress is revealed. How do comparisons between various countries help us to understand where improvements can be made? How do the differences between the way in which healthcare is funded impact patients and providers?

Moderated by Dr Mark Edwards, University College London Hospital, with his guests Ross Kerridge, John Hunter Hospital, Newcastle, Australia, often cited as 'the father of Modern Perioperative Medicine', Sol Aronson, tenured professor at Duke University and Executive Vice Chairman in the Department of Anesthesiology, Mike Grocott, Professor of Anaesthesia and critical care at the University of Southampton.

"POETTS 2018 | Pre-operative Inspiratory Muscle Training" - originally streamed live from The Institute of Engineering and Technology (IET) in London during EBPOM 2018 on www.topmedtalk.com

Hear this excellent talk, for free, on this podcast.

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: contact@topmedtalk.com

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.

We learn more about what the Perioperative medicine summit is and have a quick fire review of the current literature related to Perioperative Medicine. Discussions in this piece include the use of ACE inhibitors and ARBs, Hypotension, the Measurement of Exercise Tolerance before Surgery (METS) Trial and the improving fortunes of asprin.

The SPAQI website is here: https://www.spaqi.org

Presented by Desiree Chappell with Monty Mythen and their guests Barbara Slawski, Professor of Medicine and Orthopaedic Surgery; Chief, Section of Perioperative and Consultative Medicine; Froedtert and Medical College of Wisconsin and Steven L. Cohn, Professor Emeritus, Director – Medical Consultation Service, Jackson Memorial Hospital University of Miami Miller School of Medicine.

This piece outlines some of the topics related to the third Perioperative Quality Initiative (POQI). What is 'perioperative blood pressure'? What have been the major developments in this area? Also, should we be looking at increasing monitoring of patients, particularly regarding their blood pressure, in hospital?

The Perioperative Quality Initiative (POQI) is discussed here: https://www.topmedtalk.com/anesthesia-and-analgesia-go-big-on-poqi/

The POQI website is here: http://poqi.org/

The INPRESS Trial is discussed here: https://www.topmedtalk.com/ebpom-london-2018-any-answers-part-3-the-big-trials/

We speak with Dan Sessler here: https://www.topmedtalk.com/topmedtalks-to-dan-sessler-2/

Presented by Tim Miller, Associate Professor of Anesthesiology from Duke University Medical Centre.

Our coverage of the 18th World Congress of Anaesthesiologists (WCA 2024) continues.

In this piece we cover assisted fluid management in anesthesia. Using AI in anesthesia and its potential impact on anesthesiologists. The validity of the hypotension prediction index in academic debate. Reducing hypertension in surgical patients using HPI.

Desiree Chappell and Monty Mythen speak with Thomas Scheeren, Senior Director Medical Affairs, Edwards Lifesciences and Paul Van Beest, Anaesthesiologist, Medical Center Leeuwarden, University Medical Center Groningen.

This invaluable piece is a chance to attend a workshop which looks at the latest thinking on "perioperative cognition" and 'post-operative cognitive dysfuntion'.

We advise you use this link here to find the PDF of the paper being discussed: https://bjanaesthesia.org/article/S0007-0912(17)54082-9/fulltext

Presented by David Scott, Professor, University of Melbourne, Director, Anaesthesia and Acute Pain Medicine, St Vincent’s Hospital, Melbourne and Lis Evered, Scientific Head of Research, Department of Anaesthesia, St. Vincent's Hospital, Melbourne.

This is Part 4, to find Part 1 follow this link here: https://www.topmedtalk.com/sunday-special-the-perioperative-cognition-workshop-part-1/

Part 2 is here:

https://www.topmedtalk.com/sunday-special-the-perioperative-cognition-workshop-part-2/

Part 3 is here:

https://www.topmedtalk.com/sunday-special-the-perioperative-cognition-workshop-part-3/

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

Does perioperative medicine alow institutions to take a broader view? Population health has been a theme on TopMedTalk, is it a logical extension of the perioperative process? How do we manage specialist care for the elderly and ensure high quality shared decision making? What lies behind the mindset change needed for some to accept surgery is not always the answer? Should we expect medical students to be taught the principles of perioperative medicine?

What are some of the unique tensions in the US system that can frustrate the adoption of a truly perioperative practice?

Presented by Desiree Chappell and Monty Mythen with their guest Angela Bader, Vice Chair of Perioperative Medicine at Brigham and Women's Hospital.

When it comes to breathlessness how do we better diagnose and apply treatment? How do we overcome the fact that referring to a specialist can sometimes take a patient 'down the wrong route' with a condition that might not be just heart or lung related? Should we take a more perioperative approach to treatment and diagnosis?

"Nick, the patient" asks a few questions and demonstrates the misunderstanding that many sufferers might have; breathlessness is not always connected to your lungs.

"Johnny, the concerned family member" then speaks about his Mother, 84, who has recently experienced breathlessness; she didn't want to complain about it, how can we pick these issues up earlier?

This podcast is presented by Professor Monty Mythen and features contributions from; Ronan Astin, clinical consultant in respiratory medicine at UCL Hospital and finally 'the patients' Nick Margerrison and Johnny Themans.

"Increasing the richness and the reach of what we do" is the mantra of 'Anesthesiology'; hear from its Editor in Chief how it managed to self study and discover the essential idea behind the journal: "trusted evidence, from discovery to practice".

Conversation then moves on to methadone, the overlooked opiate; where do you use it and what sort of dose is appropriate? What are the benefits of including this in your practice and should it really be considered in the same category as most other opioids?

The podcasts mentioned are here: https://anesthesiology.pubs.asahq.org/multimedia.aspx?mediaType=Podcasts

Presented by Desiree Chappell and Monty Mythen with Korey Springman and their guest Evan Kharasch, Professor of Anesthesiology, Vice Chair for Innovation, Director, Academic Entrepreneurship, Duke University School of Medicine and Editor-in- Chief, Anesthesiology.

The results of the Enhanced Peri-Operative Care for High-risk patients (EPOCH) trial; where does it put perioperative practice in 2019? What have we learned?

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: contact@topmedtalk.com

Presented by Carol Peden, Professor of Anesthesiology and Exec. Director of the Center for Health System Innovation, University of Southern California, University of Bath and the Institute for Healthcare Improvement (IHI).

How does one go about becoming a Master of Perioperative Medicine? This piece takes a look at the growing movement which all TopMedTalk listeners are at the forefront of. Further debate covers, "NPO after midnight", getting buy in from the institution to practice perioperatively and keeping the momentum going after one leaves a conference.

Presented by Desiree Chappell and Monty Mythen with their guests, Marc Koch President & CEO of Somnia Inc and Gregory Pato, internal medicine physician assistant, New York Presbyterian/Weill Cornell.

When it comes to blood pressure, hypotension is associated with poor outcomes for patients, how do we react to this? How do we manage and avoid hypotension where possible? How has technology caught up with this challenge? Could automated closed loop systems be helpful here? The bottom line is simple; "If we measure blood pressure properly, we can predict it".

Presented by Dr Simon Davies, Consultant Anaesthetist at York Teaching Hospital NHS Foundation Trust.

This invaluable piece is a chance to attend a workshop which looks at the latest thinking on "perioperative cognition" and 'post-operative cognitive dysfuntion'.

We advise you use this link here to find the PDF of the paper being discussed: https://bjanaesthesia.org/article/S0007-0912(17)54082-9/fulltext

Presented by David Scott, Professor, University of Melbourne, Director, Anaesthesia and Acute Pain Medicine, St Vincent’s Hospital, Melbourne and Lis Evered, Scientific Head of Research, Department of Anaesthesia, St. Vincent's Hospital, Melbourne.

This is Part 3, to find Part 1 follow this link here: https://www.topmedtalk.com/sunday-special-the-perioperative-cognition-workshop-part-1/

Part 2 is here:

https://www.topmedtalk.com/sunday-special-the-perioperative-cognition-workshop-part-2/

Part 4 is here:

https://www.topmedtalk.com/sunday-special-the-perioperative-cognition-workshop-part-4/

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

More of our coverage of the American Society of Enhanced Recovery (ASER) annual general meeting. Reflections regarding the rise of Cardiopulmonary Exercise Testing (CPET); a growing field, particularly in the US.

The "Prehabilitation World Congress in association with POETTS & EBPOM" meeting discussed in this podcast is here: https://ebpomusa.org/Prehab-2019

If you are interested in hearing more about the Measurement of Exercise Tolerance before Surgery (METS) trial: https://www.topmedtalk.com/journal-club-1-03-the-mets-trial/

Presented by Desiree Chappell and Monty Mythen with their guest Mike Grocott, Professor of Anaesthesia and critical care at the University of Southampton.

Perioperative medicine is defined here as: "the practice of patient centred multidisciplinary and integrated medical care of patients from the moment of contemplation of surgery until full recovery". Population health is defined as: "the health outcomes of a group of individuals including the distribution of such outcomes within the group".

Do the two compliment each other?

Use this concise 15 minute presentation to help build the case for a perioperative care programme at your institution.

Presented by Sol Aronson, tenured professor at Duke University and Executive Vice Chairman in the Department of Anesthesiology.

Our coverage of the 18th World Congress of Anaesthesiologists (WCA 2024) continues. This conversation focuses upon The National Audit Projects, https://www.rcoa.ac.uk/research/research-projects/national-audit-projects-naps Patient safety and event reporting in healthcare. Anesthesia trends and patient outcomes in the UK. Cardiac arrest causes and preparedness in medical departments. Cardiac arrest outcomes and quality of care. Anesthesia patient safety and risk management.

Presented by Desiree Chappell and Mike Grocott with their guest, Tim Cook, Consultant in Anaesthesia and Intensive Care Medicine, Royal United Hospital, Bath, Honorary Professor of Anaesthesia University of Bristol and Director of National Audit Projects.

If we look at the evidence, is there a case for "vascular geriatrics"? Co-managed care in vascular surgery could be a way forward, this talk builds the case for change.

Readmission rates in this group are dissapointing, how do we reasonably tackle this issue? How do we balance questions regarding appropriateness and need for surgery in this area? What about the priorities of the patient, do they align with our aims?

Is it possible there are geriatiricans who are already doing co-management with vascular surgeons? Is it fair to say that vascular surgeons need help the most?

The talk is followed by a short case study regarding the model of care at Prince of Wales Hospital and Community Health Services, Department of Geriatrics.

Presented by Vasi Naganathan, Academic and Consultant Geriatrician at University of Sydney, Concord Repatriation Hospital, New South Wales, Australia; followed by a second brief 'case study' from Christina Norris, Prince of Wales Hospital and Community Health Services, Department of Geriatrics.

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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

This piece is taken from the free papers presentations given at EBPOM 2019. Can two weeks of prehabilitation really make a difference for patients facing primary surgical resection of colorectal cancer? How feasable is it to recruit patients into such a programme? Can we make a real change in their objectively measured fitness? Is there patient buy in? What is the strain on an institution's resources?

Presented by Andrew Bates, Senior Research Nurse at Royal Bournemouth Hospital NIHR Intern.