TopMedTalk are proud to present The Siobhan Mythen Plenary Lecture, taken from our coverage of Evidence Based Perioperative Medicine (EBPOM) Ireland 2025.

Professor Ellen O'Sullivan trained in anaesthesiology and intensive care in UK and USA and is now a Consultant Anaesthesiologist at St James's Hospital Dublin, Ireland, affiliated to Trinity College Dublin. She specializes in airway management and is Director of the Fellowship in Advanced Airway Management and Simulation. She is Past President of the Difficult Airway Society, DAS, and was appointed DAS Professor of Anaesthesia & Airway Management.

She outlines the "The difficult anatomical airway" and introduces the Siobhan Mythen plenary lecturer Professor John Laffey.

John Laffey is Professor of Anaesthesia and Intensive Care Medicine at the University of Galway (formerly National University of Ireland, Galway), where he also serves in clinical and research leadership roles. His work focuses on critical illnesses, particularly Acute Respiratory Distress Syndrome (ARDS), sepsis, mechanical ventilation strategies, and translational research including cell/gene therapies for these conditions.

He discusses, "The Difficult Physiology Airway"

--

Join us at Evidence Based Perioperative Medicine (EBPOM) World Congress 2026 in London. Be part of a global conversation as clinicians from around the world gather between 7-9th July at the British Library in London. Three days of evidence-based perioperative medicine, global insights, and expert debate—featuring speakers including Michael Marmot and Ken Rockwood.

Register here -

https://ebpom.org/product/ebpom-world-congress-2026/

At the Royal College of Anaesthetists' Centre for Perioperative Care (CPOC) Perioperative Leads Day in London, host Andy Cumpstey speaks with James White, a perioperative medicine clinician (and qualified general practitioner) working within the NHS in Cheshire and Merseyside, serving as Clinical Lead for Perioperative Medicine and contributing to national improvement work with the Centre for Perioperative Care, Simon Rang, consultant anaesthetist at East Kent Hospitals University NHS Trust who also contributes to national healthcare improvement work including with the Centre for Perioperative Care, and Denny Levett, Director of the Centre for Perioperative Care, and a Professor of Perioperative Medicine and Critical Care and Consultant at University Hospital Southampton NHS Foundation Trust and the University of Southampton.

The conversation covers how UK perioperative medicine policy is implemented through evolving NHS structures. They explain the relationship between national policy (Department of Health, NHS England) and delivery via regions, integrated care boards (ICBs), and local trusts, emphasizing integrated pathways spanning primary and secondary care, particularly post-COVID. James outlines five core requirements: early perioperative screening, proactive optimization/prehabilitation, maintaining health while waiting, listing patients only when medically fit, and shared decision-making. The guests discuss how regional and ICB networks share solutions, address variation and barriers (including finances and culture), and use CPOC guidance and resources alongside initiatives like GIRFT to support consistent implementation.

--

Join us at Evidence Based Perioperative Medicine (EBPOM) World Congress 2026 in London. Be part of a global conversation as clinicians from around the world gather between 7-9th July at the British Library in London. Three days of evidence-based perioperative medicine, global insights, and expert debate—featuring speakers including Michael Marmot and Ken Rockwood.

Register here -

https://ebpom.org/product/ebpom-world-congress-2026/

Kate Leslie and Andy Cumpstey join special guests at the British Journal of Anaesthesia's annual meeting in Dublin, Ireland. The discussion focuses on the experiences and motivations of three BJA editorial fellows; Allison Janda, Anesthesiologist and Assistant Professor at the University of Michigan; Brett Doleman, clinical academic and anaesthetist from the University of Nottingham; and Christina Boncyk, critical care anesthesiologist and Associate Professor at Vanderbilt University Medical Center in Nashville, Tennessee.

The conversation delves into their roles, the peer review process, and the mentorship that shapes their contributions to medical science. They emphasize the importance of constructive feedback, scientific rigor, and encouraging participation from new reviewers.

The episode underscores the professional growth afforded by editorial roles and highlights ways to enhance the author and reviewer experience in academic publishing.

Euroanaesthesia is recognised worldwide as one of the most important and influential annual congresses in anaesthesiology and intensive care. Organised by The European Society of Intensive Care Medicine (ESICM). This year, TopMedTalk is there in Munich, Germany, bringing you exclusive coverage.

This piece focuses upon bringing education to a wider selection of people and new ways of disseminating information.

Presented by Desiree Chappell and Kate Leslie with their guests, Markus Klimek, Director, Residency Training Program, Vice-Chairman, Associate Professor, Erasmus MC, Department of Anesthesiology and Joana Berger-Estilita, Consultant in Anaesthesiology and Intensive Care at Bern University Hospital Inselspital, University of Bern, Switzerland, co-Director of the ESICM European Perioperative Intensive Care Curriculum e-course.

The team aspect of perioperative care is an essential element, this piece gets into the details as thought leaders and key opinion makers engage with the debate regarding how that actually works in practice.

Moderated by Ross Kerridge, John Hunter Hospital, Newcastle, Australia, often cited as 'the father of Modern Perioperative Medicine'; the panel consists of, Charlie Corke, Associate Professor, Senior Intensive Care Specialist, Barwon Health, Kerin Fielding, Associate Professor, University of Notre Dame, Australia School of Medicine, Sydney and Don Campbell, Professor of Medicine at Monash University and Head of General Medicine at Southern Health.

This piece dives into "The new www revolution?: Wireless Wearables on the Ward". Improving the monitoring of patients on the wards is an exciting prospect for any modern practitioner and as personal health monitoring technology becomes mainstream for the public it's surely an inevitable part of the future of medicine.

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

The Global burden of postoperative death - The Lancet is here: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(18)33139-8/fulltext?rss=yes

This paper in The Lancet is also mentioned: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(12)61148-9/fulltext

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

Like this, want more?

Our guest previously featured on TopMedTalk here:

https://www.topmedtalk.com/asa-2018-san-francisco-the-practical-applications-of-innovation/

This piece takes a look at the frontline fight against COVID 19 at Penn Medicine Princeton Medical Center in New Jersey, USA. Details of airway, ventilation and hemodynamic management are discussed with the director of Critical care and Anesthesiology. Resource management is a clear front runner as the virus creates a public health emergency for medics to try to battle. Additional beds and treatment facilities are being prepared, what other innovations are being brought to the fore.

Presented by Desiree Chappell with Monty Mythen and their guests Michael Scott, M.B., Ch.B. Professor of Anesthesiology at the University of Pennsylvania, Jasmeet Bajaj, MD, Chief of Critical Care and Bridget Ruscito, MD Chair of the Dept of Anesthesiology at the Penn Medicine Princeton Medical Center and Jesse James Kiefer, MD, Anesthesiologist Assistant Professor of Clinical Anesthesiology and Critical Care at the University of Pennsylvania.

If you found this interesting listen to more on the topic here: https://www.topmedtalk.com/covid-19-epidemiology-revisited-a-case-for-virtual-meetings/

Thank you to our sponsor Edwards Lifesciences.

Edwards clinical education (ECE): https://www.edwards.com/clinicaleducation

Extended periods of intraoperative hypotension are firmly associated with harm. This piece looks into the detail behind concerns regarding hypotension. Are we now in a position where we can eliminate it entirely?

The paper mentioned in this piece, "Ability of an Arterial Waveform Analysis–Derived Hypotension Prediction Index to Predict Future Hypotensive Events in Surgical Patients", is here: https://journals.lww.com/anesthesia-analgesia/Abstract/publishahead/Ability_of_an_Arterial_Waveform_Analysis_Derived.96240.aspx

Presented by Desiree Chappell and Monty Mythen with their guest Thomas Scheeren, Chair Cardiovascular Dynamics Section at European Society of Intensive Care Medicine (ESICM).

Like this, want more?

Our work regarding hypotension is here: https://www.topmedtalk.com/?s=Hypotension

In this piece we look at how Australia is dealing with the COVID 19 crisis. What restrictions are being placed upon people and how strict are they? How does "the father of perioperative medicine" see the world which is now being asked to face one of its most urgent medical emergencies? Has the time come to honour 'the whole team' in the institutions where we work? How can medics help to rebuild our societies after the already devastating consequences of a global pandemic?

Presented by Desiree Chappell with her guest Ross Kerridge, Senior Staff Specialist Anaesthetist Clinician at the John Hunter Hospital, Newcastle, Australia and Associate Professor at the University of Newcastle.

The article mentioned is here: https://www.newcastleherald.com.au/story/6699930/honouring-our-courageous-frontline-force-in-the-fight-against-covid-19/

Thank you to our sponsor Edwards Lifesciences.

Edwards clinical education (ECE): https://www.edwards.com/clinicaleducation

Preoperative risk stratification; what is are the risks and controversies behind preoperative exercise testing and the six minute walk test? This piece looks at the evidence behind both and some practical guidance for informing clinical care.

Does the six minute walk test predict complications? What is the true value for cardiopulminary exercise testing (CPET)?

For more on the METS study go here: https://www.topmedtalk.com/the-measurement-of-exercise-tolerance-before-surgery-mets-trial/

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.

This piece takes a look at the San Diego front line of the global fight against COVID 19. What unique pressures are there here; the large homeless population is a particular challenge, how do psychiatric patients further the conundrum. Also, what about the assumption that patients are likely to be carrying the virus so should all be treated as if that is the case, does that apply here?

There is also a short update on our Editor in Chief, another front line medical provider, who tested positive for Corona Virus last week.

Presented by Desiree Chappell with Roneet Lev, MD FACEP, Chief Medical Officer, White House Office of National Drug Control Policy Director of Operations, Scripps Mercy Hospital Emergency Department San Diego.

Thank you to our sponsor Edwards Lifesciences.

Edwards clinical education (ECE): https://www.edwards.com/clinicaleducation

"We keep being told we're one to two weeks away from the peak..."

This piece takes a look at how Monty is getting on with his diagnosis, COVID 19 symptoms infamously vary in severity throughout the infection. Now he has been diagnosed how, if at all, will his behaviour change? What is the UK's policy on practitioners who are COVID 19 positive? Further discussion includes the news that 'rapid tests' are being introduced in the battle against the global pandemic as well as 'drive through' testing. How reliable are they, how might they work?

Presented by Desiree Chappell and Monty Mythen.

Thank you for your emails, if you would like to contribute to the discussion please do: contact@topmedtalk.com

Thank you to our sponsor Edwards Lifesciences.

Edwards clinical education (ECE): https://www.edwards.com/clinicaleducation

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.

"About a year ago our chief CRNA sent me a podcast from TopMedTalk about fluid management" - this podcast is a fascinating insight into how Enhanced Recovery continues to reach out across the world to the bedside of patients.

How do you take your institution from where you're at now to where you need to be tomorrow? What are the essential ingredients? How do you work, through education, towards real patient engagement and empowerment? How do you manage a sensible quality improvement programme?

Presented by Desiree Chappell with co-host Korey Sprigman and their guests, Jamie Harris, CRNA, Hillcrest Hospital, Tulsa, Oklahoma and Carol Schmidt, CRNA, Royal Oak, Michigan.

The British Journal of Anaesthesia article, which inspired this series, is here: https://bjanaesthesia.org/article/S0007-0912(20)30003-9/fulltext

This piece was recorded at the The 7th Collaborative Clinical Trials in Anaesthesiology Conference, Prato, Italy. The discussion centers around the roles and contributions of bio statisticians in clinical trials.

Presented by Kate Leslie and Andy Cumpstey with their guests, Jessica Kasza, Professor of Biostatistics, Data Analytics/Modelling and Health Economics at Monash University and Elizabeth Ryan, Research Fellow at Monash University.

This piece focuses on the SuperNO2VA mask, which delivers positive airway pressure to stent open the upper airway, allowing for the preoperative delivery of positive pressure ventilation and oxygen for patients with a decreased level of consciousness.

The website mentioned in the piece is here: https://www.vyaire.com/

Presented by Desiree Chappell with Monty Mythen and Michael Pedro, VP, Medical Director at Vyaire Medical.

"It is interesting how well you can feel, compared to the night time [...] it gives you this real false sense of wellness for a period of time and then it hits you, man it hits you hard, when it hits you."

The UK Prime Minister has tested positive for COVID 19 as has The UK's Health Secretary, Matt Hancock, MP. Yesterday we revealed there were concerns our Editor in Chief Monty Mythen had some of the symptoms, only days before he was set to return to active duty in Critical Care. Acting responsibly precautions were already being taken and the assumption was that it was likely, given its profusion in London where he lives, that he had the new virus. The test results confirmed that last night.

Also on this podcast we get into further discussion regarding Continuous Positive Airway Pressure (CPAP), something which we have discussed a lot in this series, see links below.

There is also an assortment of questions from the audience, if you'd like to add your thoughts to one of next week's podcasts email us now: contact@topmedtalk.com

Presented by Desiree Chappell with Monty Mythen, Editor in Chief of TopMedTalk.

The European Society of Anaesthesiology (ESA) webinar was here: https://www.esahq.org/event/webinar-on-covid-19/

Thank you to our sponsor Edwards Lifesciences.

Edwards clinical education (ECE): https://www.edwards.com/clinicaleducation

"When you start to think about how we can protect ourselves; we have some reasonably robust literature for a few interventions [..] that do seem to associate with the prevention of viral infections..."; maintain a normal vitamin D level, probiotics, vitamin C.

This piece is a fascinating conversation with a TopMedTalk favorite. How are preparations going at Duke University? How can we optimise ourselves for an oncoming viral attack? How can we make sure our patients get the best possible care and are as informed as they can be? What research is being carried out into COVID 19?

Presented by Desiree Chappell with her guest Paul Wischmeyer, Professor of the Department of Anesthesiology and Critical Care, Duke University.

Thank you to our sponsor Edwards Lifesciences.

Edwards clinical education (ECE): https://www.edwards.com/clinicaleducation

The historical focus in prehabilitation has been on exercise, how can the insights of psychology and behaviour change techniques be applied to the field? Should psychosocial outcomes and behaviour change be factored into your practice?

There's consistent evidence that anxiety around the time of diagnosis is predictive of post operative pain; depression increases the risk of chronic pain; psychological factors also impact on wound healing and functional recovery. Meanwhile low confidence and depression have been shown to effect outcomes.

How can psychological behaviour change techniques be embedded into encouragement to involve themselves in exercise training in advance of their operation?

For more on the Wesfit trial go here: http://www.wesfit.org.uk/

Presented by 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; behavioural science lead for Wessex-Fit-for Surgery (WesFit) trial, a large randomised controlled trial of physical and psychological prehabilitation prior to cancer surgery and is a member of the National Cancer Research Institute clinical studies Lifestyle and Behaviour Change Group and the NIHR Cancer and Nutrition Collaborative.

The UK's fight back is now underway; the 'lockdown' is being largely adhered to and the efforts to support the National Health Service (NHS) from the public, medical students and retired professionals is inspiring to many.

This piece takes a look at the realities of students being given the chance to graduate and practice their skills a little earlier than previously planned.

Presented by Desiree Chappell with her guest, Henry Howe, a medical student at Bristol University, a frequent contributor and partner to TopMedTalk.

Thank you to our sponsor Edwards Lifesciences.

Edwards clinical education (ECE): https://www.edwards.com/clinicaleducation

"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/

"I work in a houshold where my wife was working at a school and my student children have come home so, it's highly likely that I would get COVID 19"; the conversation begins with a discussion about the fact our Editor in Chief Monty Mythen has had some of the symptoms over the last few days. "For us as healthcare workers what we need to do is filter out the true head colds from the COVID 19s"; the symptoms could be caused by a number of factors but until a clear test result is available he is taking precautions.

It underlines the need for practitioners to adhere to distancing guidelines as the conversation moves to an update on the UK's measures to tackle the pandemic and how the global fight continues.

The "Nightingale Hospital" is covered in more detail here: https://www.telegraph.co.uk/global-health/science-and-disease/coronavirus-uk-lockdown-latest-news-non-essential-shops-close/

Presented by Desiree Chappell with Monty Mythen.

How is the fight against COVID 19 going where you are? We are very grateful to everyone who has emailed us since the crisis began. If you would like to reach out to TopMedTalk email contact@topedtalk.com

The clip of Professor Hugh Montgomery was taken from Coronavirus: How to Isolate Yourself, Channel 4. Find the full programme here: https://www.channel4.com/programmes/coronavirus-how-to-isolate-yourself

The UK Prime Minister's statement is available in full here: https://www.youtube.com/watch?v=iF5gpoj1lwg

Thank you to our sponsor Edwards Lifesciences.

Edwards clinical education (ECE): https://www.edwards.com/clinicaleducation

This piece focuses in upon the important work being done by The Enhanced Recovery After Cardiac Surgery Society, specifically the new guidelines which were published in May 2019. Furthermore, how is the society going to move forward, will it continue to push for a sensible combination of both care providers and academics and what areas of focus are most impactful when it comes to improving care and helping implementation?

The article discussed in this piece "Guidelines for Perioperative Care in Cardiac Surgery, Enhanced Recovery After Surgery Society Recommendations" is here: https://jamanetwork.com/journals/jamasurgery/fullarticle/2732511?guestAccessKey=04f7090d-122c-4e94-a46f-22e49dab7c51

The Enhanced Recovery After Cardiac Surgery website is here: https://www.erascardiac.org/

Presented by Desiree Chappell with her guest Kevin Lobdell, Director of Regional CVT Quality, Education, and Research.

"The guidelines, in fact, I found most useful were the Royal College's guidelines, all those info graphics and all those protocols"

This piece is an emotional conversation with a TopMedTalk favourite; how are things going in New Jersey? Has elective surgery come to a halt yet? What innovations are being deployed by medics are they face a global pandemic? What are the unique pressures which medics are being called upon to deal with in this crisis?

The collaborative resource from the UK
https://icmanaesthesiacovid-19.org/

The Royal College of Nursing's webpage regarding Personal Protection Equipment (PPE) is here: https://rcni.com/hosted-content/rcn/first-steps/personal-protective-equipment

Also, the recently released useful conversation about Oxygen shortages Dr Kett mentions - which featured Mike Grocott - can be found here: https://www.topmedtalk.com/covid-19-uk-southampton-and-london-mike-grocott-and-monty/

Presented by Desiree Chappell with Attilla Kett, Chair of Anesthesia at St Peter's University Hospital, New Brunswick, New Jersey.

Thank you to our sponsor Edwards Lifesciences.

Edwards clinical education (ECE): https://www.edwards.com/clinicaleducation

"The first case of COVID in China was the 8th of December…" this piece looks at the outbreak of the disease from the perspective of healthcare workers in Italy. Focusing on the community health approach to controlling this pandemic, our guest emphasizes the importance of understanding the epidemiology of COVID- 19.

Mirco Nacoti, Department of Anesthesia and Intensive Care, Pediatric Intensive Care Unit, Papa Giovanni XXIII Hospital, Bergamo, Italy, was subsequently featured in the New England Journal of Medicine where he along with Andrea Ciocca and Maurizio Cereda wrote this excellent article: https://catalyst.nejm.org/doi/full/10.1056/CAT.20.0080

Please share this information with as many colleagues and friends as you can. TopMedTalk is working with you, our listeners, to raise awareness at this crucial time.

REMINDER: PLEASE stop having in person meetings with administrators and departments to help stop the spread of CV19.

Presented by Monty Mythen and Desiree Chappell.

This podcast was originally released as part of a longer podcast which you can listen to here: https://www.topmedtalk.com/covid-19-you-must-learn-the-epidemiology/

Thank you to our sponsor Edwards Lifesciences.

Edwards clinical education (ECE): https://www.edwards.com/clinicaleducation

This important piece shines a light on the evolution and challenges of Enhanced Recovery After Surgery (ERAS).

If you've never listened to TopMedTalk, this is a great place to start. If you've listened before it's possible you've heard us talking with excitement about today's guest, we hope you find this session to be worth the wait.

Hear how our guest's insights on the need for an understanding of the pathophysiological basis and integrated pre-, intra- and post-operative care for the best patient centered outcomes.

We cover the concept of "DReaMing" (Drinking, Eating, Mobilizing) as both a goal and measure of recovery; it simplifies complex pathways, encouraging a focus on practical, patient-centered outcomes while reminding us to investigate barriers when these aren't achieved. Also, listen to our timely discussion regarding the misinterpretation of fluid management—shifting from avoiding overload to outright restriction—reiterating the importance of precision and nuance in applying guidelines. Can these approaches then be turned into individualized risk assessments, which bridge the gap between protocolization and personalization?

Finally there's a powerful call for increased post-discharge research, to monitor and mitigate challenges like fatigue and pain. Recovery does not stop at hospital discharge.

Presented by Desiree Chappell, Mike Grocott and Monty Mythen with their guest, Henrik Kehlet, Professor of Surgery at Copenhagen University and Professor of Perioperative Therapy at Rigshospitalet, Copenhagen University, Denmark.  He is also an Honorary Fellow of the Royal College of Anaesthetists, UK, the American College of Surgeons, the American Surgical Association, the German Surgical Society, the German Anaesthesiological Society and American Society of Anesthesiology.

Professor Kehlet has published more than 1,250 scientific articles and has given more than 300 invited lectures at international scientific meetings, several honorary lectures including the ASA Excellence in Research Award 2014. He was the first recipient of the BJS Society Award 2023.

Like this? Want more?

https://topmedtalk.libsyn.com/topmedtalk-henrik-kehlet-and-nick-scott-0

https://topmedtalk.libsyn.com/asa-2018-san-francisco-exclusive-professor-henrik-kehlet

"'The disease is not complicated, the biology is not complicated, the treatment is not that complicated; our behavior patterns and our understanding of what it is truly like to be in a pandemic is the complicated bit' ... 'Yeah, this is not a drill'": the firm message in this piece is clear, use the internet and stop your face to face departmental meetings now.

More broadly we ask; how are things going in North Carolina, Louisville and London? Has elective surgery been cancelled yet? How are people facing the issue of personal protective equipment (PPE)? London practitioners are assuming they themselves have the virus, is this the case everywhere else? How are staff roles being changed in anticipation of the problem?

There's also a very frank conversation about the personal risks practitioners are being asked and deciding to take. Should they acknowledge and talk about their safety for both themselves and their loved ones? We wrap on a conversation about the reported interest in smoking cessation that has grown in the last few days.

Presented by Desiree Chappell and Monty Mythen with TopMedTalk regular and occasional co-host, Sol Aronson, tenured Professor at Duke University.

Thank you to our sponsor Edwards Lifesciences.

Edwards clinical education (ECE): https://www.edwards.com/clinicaleducation

This conversation sets the scene for the UK. London now having some hospitals which are overwhelmed, other parts of the UK still in the anticipation period. The conversation moves to the importance of enhanced recovery after surgery and its immediate relevance to the COVID 19 crisis. Then the topic of Personal Protection Equipment (PPE) is raised, possible shortages are discussed. The debate about non invasive ventilation, continuous positive airwave pressure (CPAP) and optiflow techniques. Oxygen economy is one thing to consider, service providers may face issues over this vital resource.

Presented by Monty Mythen with his guest Mike Grocott, occasional TopMedTalk anchor and Professor of Anaesthesia and critical care at the University of Southampton.

Thank you to our sponsor Edwards Lifesciences.

Edwards clinical education (ECE): https://www.edwards.com/clinicaleducation

This remarkably prescient conversation was recorded at an Australian National Summit in Adelaide regarding the 'hidden pandemic of postoperative complications'. The dangers presented by them certainly suggest this area needs to be taken more seriously. Although staged in Australia this conversation is of global concern, particularly at a time when the world is realising the benefits of proper perioperative care.

For more about the National Emergency Laparotomy Audit go here: https://www.topmedtalk.com/ebpom-2018-12-the-importance-of-cpet-and-nela/

The article mentioned in this piece is here: https://bjanaesthesia.org/article/S0007-0912(18)30654-8/abstract

There's a good piece about the summit here: http://theleadsouthaustralia.com.au/industries/health-and-medical/summit-targets-post-op-pandemic/

Presented by Monty Mythen and Mike Grocott with their guest Guy Ludbrook Professor of Anaesthesia at the University of Adelaide and Royal Adelaide Hospital.

What are the benefits of Cardio Pulmonary Exercise Testing (CPET) in cancer patients? What is the evidence that suggests prehabilitation changes outcomes? Furthermore, what is the National Emergency Laparotomy Audit (NELA) and what are its benefits?

Presented by Joff Lacey and Desiree Chappell with their guests; Carolyn Johnston, consultant Anaesthetist in St Georges hospital in London and Improvement lead for the National Emergency Laparotomy Network (NELA.org.uk) and Malcolm West, National Institute for Health Research (NIHR) funded clinical lecturer in surgery and honorary colorectal surgical specialist registrar at the University of Southampton, United Kingdom.

Join in the debate: contact@topmedtalk.com

The British Journal of Anaesthesia article, which inspired this series, is here: https://bjanaesthesia.org/article/S0007-0912(20)30003-9/fulltext

"Enhanced Recovery After Cardiac Surgery" - was originally streamed live from the Charles Sammons Cancer Center, Dallas, during EBPOM-USA 2019 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

Daniel Engelman is the Medical Director of the Heart, Vascular and Critical Care Units at Baystate Medical Center. He is an Associate Professor of Surgery at The University of Massachusetts-Baystate. He started the ERAS® Cardiac Collaborative to internationally standardize best practices.

This piece is a detailed and reassuring look at how preparations are being made in North Carolina by our occasional host and regular contributor Vicki Morton. "I was told a few weeks ago [that] my focus was shifting to Covid preparedness"; hear how a taskforce was put together to prepare for the global pandemic. "Various different countries have been in denial" but now the fight back has begun in ernest. Will testing kits be made more widely available soon?

Questions for our listeners: Could a 'remote buddy system' - facilitated by online facetime or video communication - help practitioners to put on personal protection equipment in your practice? Do you have creative ways of dealing with children off school and the current pressures other providers like you might face? Are you prepared for more patients were you work? Do you consider cohorting to be the way forward? What are your thoughts on the plans where you work? Please email us: contact@topmedtalk.com and we will share them with the audience.

Presented by Monty Mythen and Desiree Chappell with Vicki Morton, Director of Clinical and Quality Outcomes at Providence Anesthesiology Associates, P.A.

Our conversation with Dan Martin is here: https://www.topmedtalk.com/covid-19-oxygen-economy-cpap-and-ventilators/

Our guest kindly shared her email with us: Vicki.Morton@provanesthesiology.com

Thank you to our sponsor Edwards Lifesciences.

Edwards clinical education (ECE): https://www.edwards.com/clinicaleducation

Our guest is an intensivist and specialist in dangerous transmissible diseases as well as being one of the scientists who took part in the Xtreme Everest expedition which investigated the effects of human tolerance of hypoxia.

What about continuous positive airway pressure (CPAP)? Information suggests this may be more useful as we head into the pandemic stage "based on the experience the Italians are describing to us".

This piece looks at how the UK is preparing to tackle the global pandemic before asking some important questions about oxygen supplies. There's a tendency for people to use more rather than less, should we look to reverse this? "We give people a range to put their oxygen saturation between and people naturally want to go for the higher end of that target," in this time of crisis and potential shortages is it important to change that habit?

"The whole National Health Service has changed its thinking..." the piece wraps with some thoughts about how enticing it is to see the UK's Government and health service move to stop medics being bound by red tape and overly strict guidelines.

Presented by Monty Mythen with his guest Dan Martin, OBE, Anaesthetist and Intensivist at the Royal Free Hospital and Reader at University College London (UCL).

Link to the story about the Critical Care Nurse who attracted the nation's sympathy in the press recently: https://www.standard.co.uk/news/uk/nurse-urges-public-stop-panic-buying-dawn-bilbrough-a4392596.html

For more of our COVID 19 coverage go here: https://www.topmedtalk.com/covid-19/

Thank you to our sponsor Edwards Lifesciences.

Edwards clinical education (ECE): https://www.edwards.com/clinicaleducation

Can delirium, the most frequent complication in an elderly patient, be tackled with multimodal prehabilitation? This piece explains how that challenge is being investigated at the moment. A link to the paper is here: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6564537/

Presented by Ties Lukas Janssen, General Surgery Resident at Amphia Ziekenhuis.

Desiree and Monty update each other on how it's going as both the US and UK healthcare services prepare for, and begin battle with, COVID 19. School closures in both the UK and the US; how do the practicalities of cancelling school attendance impact upon frontline providers? What do comparisons with other countries tell us about the oncoming tsunami?

Presented by Monty Mythen and Desiree Chappell.

Link to Hugh Montgomery's piece: https://www.topmedtalk.com/covid-19-hugh-montgomery-north-london-uk/

Link to NEJM: https://www.nejm.org/coronavirus

How to use PPE by The Center for Disease Control: https://www.youtube.com/watch?v=Ca66dpjPWZc

Desiree's tweet: https://twitter.com/ChappellDesiree/status/1240480154117451776

Thank you to our sponsor Edwards Lifesciences.

Edwards clinical education (ECE): https://www.edwards.com/clinicaleducation

A large part of the journey towards enhanced recovery, better outcomes and fewer complications, is to do with educating patients. How do we explain to patients that an operation is something which is ideally a collaboration between both practitioner and patient?

The "Fitter, Better, Sooner" toolkit, which this piece focuses on, can be found here: https://www.rcoa.ac.uk/fitterbettersooner

The excellent video we mention is here: https://www.youtube.com/watch?v=0NMHMX-nFgY

Presented by Nick Margerrison with his guest Dr Hilary Swales, lead for Patient Information at The Royal College of Anaesthetists.

Go here for some of TopMedTalk's COVID-19 coverage: https://www.topmedtalk.com/covid-19-you-must-learn-the-epidemiology/

TopMedTalk 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 are currently releasing episodes more often than usual to accommodate high demand.

This piece provides much needed focus on the topic of pediatrics and hemodynamics. Is it true to say that children are completely different to adults? What information do we need and what should the considerations around this topic really be?

Presented by Desiree Chappell and Mike Grocott with their guests Dwight Bailey, Chief, Division of Pediatric Critical Care Medicine at Atrium Health, Levine Children's Hospital and Jonathan Tan, Vice Chair of Analytics and Clinical Effectiveness, Department of Anesthesiology Critical Care Medicine, Assistant Professor of Clinical Anesthesiology and Spatial Sciences, Children's Hospital Los Angeles, Keck School of Medicine of the University of Southern California, Spatial Sciences Institute of the University of Southern California

"Thank you for taking this meeting beyond these walls" - this piece was the final part of our coverage of The American Association of Nurse Anesthetists (AANA) 2019 Annual Congress in Chicago, Illinois. We begin with the global audience in mind and break down what it is to be a Nurse Anesthetist. It's a role which is expanding in scope, our guest walks us through how and why that's the case.

This wide ranging conversation then moves to the future of enhanced recovery and the AANA's future development.

For more on the Drink Eat Mobilise topic go here: https://www.topmedtalk.com/periop-coach-2-02-eras-whats-the-secret-sauce/

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

Presented by Desiree Chappell and Monty Mythen with their guest Lynn Reede, Associate Clinical Professor, Northeastern University Nurse Anesthesia Program.

"The parade here in Dingle is usually the first in Ireland..." but this year it is postponed. We speak to a Councillor in Dingle, a place much loved by many TopMedTalk listeners who attend the annual Evidence Based Perioperative Medicine (EBPOM) conference there.

Monty Mythen is joined by Cllr. Breandán Fitzgerald, County Councillor on Kerry County Council.

Thank you to our sponsor Edwards Lifesciences.

Edwards clinical education (ECE): https://www.edwards.com/clinicaleducation

"Maintaining your staffing is key"; this piece is a conversation recorded immediately after a deeply concerning report regarding the situation in Bergamo, Italy. The risk of overwhelm at our institutions is present as the understanding sinks in regarding the fact this is a massive population health issue.

Presented by Desiree Chappell and Monty Mythen with their guests Dr Michael Scott, Professor of Anesthesiology at Virginia Commonwealth University, Maurizio Cereda, Associate Professor at Hospital of the University of Pennsylvania.

The conversation which preceded this is here: https://www.topmedtalk.com/covid-19-you-must-learn-the-epidemiology/

Thank you to our sponsor Edwards Lifesciences.

Edwards clinical education (ECE): https://www.edwards.com/clinicaleducation

 

Preparations in London and the US are discussed before a frontline report regarding Italy and the consequences of the pandemic there.

Presented by Desiree Chappell and Monty Mythen with, Dr Michael Scott, Professor of Anesthesiology at Virginia Commonwealth University, Maurizio Cereda, Associate Professor at Hospital of the University of Pennsylvania and Andrea Ciocca from Naples.

This conversation preceeded the one in this piece here: https://www.topmedtalk.com/covid-19-you-must-learn-the-epidemiology/

Thank you to our sponsor Edwards Lifesciences.

Edwards clinical education (ECE): https://www.edwards.com/clinicaleducation

This piece focuses upon the increasing development of artificial intelligence and automation within the medical profession. Can automated monitoring actually allow practitioners to live more "in the moment" while in the operating theater? How do we use algorithms to avoid information overload?

The book "Deep Medicine: How Artificial Intelligence Can Make Healthcare Human Again", your "anxiety antidote" to the AI discussion, is here: https://www.amazon.co.uk/Deep-Medicine-Artificial-Intelligence-Healthcare/dp/1541644638

This piece was originally streamed from 'The Society of Cardiovascular Anesthesiologists' (SCA) annual conference, 2019.

Presented by Desiree Chappell and Monty Mythen with Sol Aronson, Tenured Professor, Duke University and Executive Vice Chairman in the Department of Anesthesiology, and their guest Tjorvi Perry, Assistant Professor, Department of Anesthesiology, University Minnesota.

"There hasn't been any griping, there hasn't been any ill temper and people are coming in to help out in any way..." this piece gives us an idea of how things are going in the UK, in this instance in Whittington, North London. A sense of preparation is in the air. Looking at other countries and the epidemiology "we're about to reach the inflection point when a little trickle of cases [become] a flood".

How can lessons from other nations help our preparation process? Should 'social isolation' be adopted by more potential service users? Why is this crisis so important for the UK to handle correctly? Is it currently more of a 'population health' issue than anything else?

Also, what about healthcare professionals, how should the care both for themselves and their patients? Will lessons learned regarding 'burn out' and self-care be learned and applied at this crucial time?

Presented by Monty Mythen with his guest Hugh Montgomery, Intensive Care Society Board Member and, Professor of Cardiovascular Genetics and Critical Care University College London.

There's a useful information hub referenced in this interview here: https://icmanaesthesiacovid-19.org/

Information Hub for the Intensive Care Society regarding COVID19: https://www.ics.ac.uk/COVID19.aspx?hkey=d176e2cf-d3ba-4bc7-8435-49bc618c345a&WebsiteKey=10967510-ae0c-4d85-8143-a62bf0ca5f3c

If you would like to contribute to TopMedTalk's ongoing coverage of the global crisis presented by COVID-19 please email: contact@topmedtalk.com

Thank you to our sponsor Edwards Lifesciences.

Edwards clinical education (ECE): https://www.edwards.com/clinicaleducation

"The first case of COVID in China was the 8th of December..." this piece looks at the outbreak of the disease from the perspective of healthcare workers in both Hong Kong and Italy. It starts with a summary of a conversation with Professor Mike Irwin, University of Hong Kong. We then move to a conversation with Mirco Nacoti, specialist intensivist at Bergamo, Italy.

Presented by Monty Mythen and Desiree Chappell.

This piece is part of a longer conversation, which will be available in full soon.

Thank you to our sponsor Edwards Lifesciences.

Edwards clinical education (ECE): https://www.edwards.com/clinicaleducation

This piece is the first in a new series of programs we are making in response to COVID-19, now described by The World Health Organisation as a global pandemic.

How can we, the TopMedTalk community, rise to this challenge and help each other as we share information and experiences? Where can people look for the sort of information they would ordinarily have gained from the conference circuit this year? How can listeners to TopMedTalk get involved directly with us?

Presented by Desiree Chappell and Monty Mythen.

Thank you to our sponsor Edwards Lifesciences.

Edwards clinical education (ECE): https://www.edwards.com/clinicaleducation

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.   The British Journal of Anaesthesia article, which inspired this series, is here: https://bjanaesthesia.org/article/S0007-0912(20)30003-9/fulltext

 

The concern for patient safety naturally flows throughout the healthcare continuum. In our discussion with Masimo Founder, Joe Kiani, we discuss the 'planning for zero' initiative and how we can realistically reach perfection in this area.

The Patient Safety Movement Foundation is an organization dedicated to a goal of ZERO in-hospital preventable deaths by 2020. They request that you and your organization get involved and commit to this goal.

Find out more at www.patientsafetymovement.org

Presented by Desiree Chappell and Monty Mythen with their guest Joe Kiani, Founder, Chairman & CEO of Masimo, Cercacor & Patient Safety Movement Foundation.

This piece addresses challenges in anesthesiology, workforce dynamics, leadership development, and operational efficiency. Flexible employment models, such as part-time roles and tailored schedules, are helping attract and retain talent while reducing burnout and reliance on locum tenens.

Are we seeing a shift from crisis management to long-term strategic planning? How can organizations, focused on innovation, leadership training, and fostering professional satisfaction, create a more stable and collaborative environment for clinicians and patients alike?

Presented by Desiree Chappell and her guests, Adam Spiegel, CEO, NorthStar Anesthesia and Jim Roberts, Chief Medical Officer of NorthStar Anesthesia and Meagan Barkett, Chief Operating Officer, NorthStar Anesthesia.

--

TopMedTalk on location at the American Society of Anesthesiologists (ASA) annual meeting, Anesthesiology 2024.

In the last week we have released various pieces from Anesthesiology 2024.

The Anesthesia Quality Institute (AQI) - https://topmedtalk.libsyn.com/the-anesthesia-quality-institute-aqi-anes24

Remote Patient Monitoring: reducing risk & improving patient outcomes - https://topmedtalk.libsyn.com/remote-patient-monitoring-reducing-risk-improving-patient-outcomes-anes24

Ensure you check TopMedTalk regularly during this time as our conference coverage continues to be released.

 

"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: contact@topmedtalk.com

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

Learn how and why the benefits of real-life health care simulation situations are used by institutions such as Northern Kentucky University. Interviewing a patient, reading an X-ray, or administering an injection, in a convincing virutal environment. The St. Elizabeth Healthcare Simulation Center features seven simulation rooms including an operating room and intensive care unit.

What are the future applications we can look forward to? Furthermore how is the AANA developing the way in which simulation is used to train anesthesia providers?

Checkout the Simulation Centre here: https://nku.edu/ihi/health-innovation-center-2/simulation-center.html

Our guest kindly shares their email: Kendonb1@nku.edu

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/

Presented by Desiree Chappell with Monty Mythen and their guest Brett Kendon, DNP, CRNA, CHSE, Assistant Clinical Professor, Assistant Program Director, Nurse Anesthesia Program, Northern Kentucky University.