This piece presents two short talks both of which sit under the headline, “Standardisation of Screening, Assessment, Interventions and Outcomes” and they were given at the recent Prehabilitation World Congress, held in London. The first talk “Standardising prehabilitation outcomes” was presented on behalf of John Moore, a consultant in anaesthetics and critical care medicine from Manchester by Liam Humphries, Senior Research Fellow and lead of the Living Well with Chronic Disease research theme at the Advanced Wellbeing Research Centre. The second talk “Standardising prehabilitation Intervention reporting” is presented by Chelsia Gillis, Assistant Professor in the School of Human Nutrition in the Faculty of Agricultural and Environmental Sciences at McGill University.

This talk “Behavioural change vs Psychological interventions: which is key in prehabilitation?” was given at the Prehabilitation World Congress as part of a series of presentations under the heading; “Controversies and Standardisation in Prehabilitation”. It was preceded by “Should we delay surgery for prehabilitation?” which is available for you to listen to here: https://topmedtalk.libsyn.com/should-we-delay-surgery-for-prehabilitation-prehabilitation-world-congress Presented by Liam Humphries, Senior Research Fellow and lead of the Living Well with Chronic Disease research theme at the Advanced Wellbeing Research Centre.

This piece is a discussion which followed three presentations at the Evidence Based Perioperaive Medicine (EBPOM) World Congress in London on artificial intelligence in perioperative medicine. Although, for an informed listener, it will work as a standalone piece the presentations which it is in part a response to are here: Part one is here: https://topmedtalk.libsyn.com/ai-in-perioperative-care-part-1-ebpom-london-2023 Part two is here: https://topmedtalk.libsyn.com/artificial-intelligence-in-perioperative-care-part-2-ebpom-2023 Part three is here: https://topmedtalk.libsyn.com/ai-predictive-monitoring-to-prevent-hemodynamic-instability-and-deterioration-in-perioperative-and-acute-care-patients-ebpom-world-congress On the panel are; Feras Hatib, Vice President of the R&D Algorithms and Signal Processing organization for Critical Care and Vascular at Edwards Lifesciences in Irvine California, Adriane Chapman, Professor at University of Southampton, Head of Digital Health Research Group, Director for the Centre for Health Technologies and Sandy (Alexander) Jackson, specialty trainee in anaesthetics and intensive care medicine and a National Institute for Health and Care Research (NIHR) Doctoral Fellow at the University of Southampton. This piece is chaired by TopMedTalk’s co-editor in Chief Mike Grocott, Professor of Anaesthesia and Critical Care Medicine at the University of Southampton.

“AI Predictive Monitoring to prevent Hemodynamic Instability and Deterioration in Perioperative and Acute Care Patients” was a talk given at the Evidence Based Perioperative Medicine (EBPOM) World Congress. For more on their conferences check out www.ebpom.org Presented by Feras Hatib, Vice President of the R&D Algorithms and Signal Processing organization for Critical Care and Vascular at Edwards Lifesciences in Irvine California. This piece works as a standalone talk but it is part 3 of a 4 part series. Part one is here: https://topmedtalk.libsyn.com/ai-in-perioperative-care-part-1-ebpom-london-2023 Part two is here: https://topmedtalk.libsyn.com/artificial-intelligence-in-perioperative-care-part-2-ebpom-2023 And, still to come, a fascinating panel discussion. Make sure you like and subscribe to TopMedTalk so you hear it first.

Should we delay surgery for prehabilitation? A short dissection of a perennial topic for anyone interested in perioparative medicine and enhanced recovery after surgery. This piece was originally part of the Prehabilitation World Congress in London. For more on this year’s conferences, organised by Evidence Based Perioperative Medicine (EBPOM), check out www.ebpom.org Presented by Andrew Davies, consultant in upper gastro-intestinal surgery at Guy’s and St Thomas’ NHS Hospital Trust.

This conversation comes from the American Association of Nurse Anesthesiology conference 2023. It gets right to the business end of our profession and discusses industry trends and challenges in anesthesia; payment cuts, healthcare pricing, reimbursement, staffing and leadership. Presented by Desiree Chappell, TopMedTalk Co-Editor in Chief, Vice President of Clinical Quality at NorthStar Anesthesia, with her guests Adam Spiegel, CEO, NorthStar Anesthesia and Randy Moore, Chief Anesthetists Officer of NorthStar Anesthesia.

“It's evolution, not revolution, we've got a long way to go. But I'm certainly really excited to be on this journey. And I hope some of you will want to come on that journey with us.” This piece looks at artificial intelligence (AI) in perioperative care. How and why can this new technology help? Presented by Sandy (Alexander) Jackson, specialty trainee in anaesthetics and intensive care medicine and an NIHR Doctoral Fellow at the University of Southampton.

“Every single one of you can and should go build an AI model. It's actually pretty simple these days. But then think about; what actually is the problem here? And where could the system go wrong?” This podcast opens up the first in a four part series here on TopMedTalk about a topic which has defined the last few years; what does the development of artificial intelligence (AI) systems mean for perioperative medicine, what will the benefits be and where do we already see potential challenges? This first part “An Introduction to AI” gets the conversation going. With a short introduction from Mike Grocott this piece is presented by Adriane Chapman, Professor at University of Southampton, Head of Digital Health Research Group, Director for the Centre for Health Technologies. This piece is taken from a four part presentation, three talks and a discussion, first given at Evidence Based Perioperative Medicine (EBPOM) 2023.

Anesthesiology 2023, a huge event in the perioperative calendar for us here at TopMedTalk; the annual general meeting of the American Society of Anesthesiologists (ASA). Part one of this podcast is here: https://topmedtalk.libsyn.com/anesthesiology-2023-digest-part-1-topmedtalk The pieces linked to in this podcast are here: Opportunities in Anesthesiology | #ANES23 https://topmedtalk.libsyn.com/opportunities-in-anesthesiology-anes23 The GAP study: Gabapentin and perioperative pain, results and analysis | #ANES23 https://topmedtalk.libsyn.com/the-gap-study-gabapentin-and-perioperative-pain-results-and-analysis-anes23 Artificial Intelligence in your practice | #ANES23 https://topmedtalk.libsyn.com/artificial-intelligence-in-your-practice-anes23 TopMedTalks to… the Chief Executive Officer and Chief Quality Officer of NorthStar Anesthesia | #ANES23 https://topmedtalk.libsyn.com/topmedtalks-to-the-chief-executive-officer-and-chief-quality-officer-of-northstar-anesthesia-anes23 Patient Safety in Anesthesiology | #ANES23 https://topmedtalk.libsyn.com/patient-safety-in-anesthesiology-anes23 Anesthesia Patient Safety Foundation; Intraoperative Hypotension and Hemodynamic Stability | #ANES23 https://topmedtalk.libsyn.com/anesthesia-patient-safety-foundation-intraoperative-hypotension-and-hemodynamic-stability-anes23 Alternative study designs for the future | #ANES23 https://topmedtalk.libsyn.com/alternative-study-designs-for-the-future-anes23 TopMedTalks to ... BobbieJean Sweitzer | #ANES23 https://topmedtalk.libsyn.com/topmedtalks-to-bobbiejean-sweitzer-anes23

Anesthesiology 2023, a huge event in the perioperative calendar for us here at TopMedTalk; the annual general meeting of the American Society of Anesthesiologists (ASA). This piece includes clips from the following podcasts: Mani Vindhya, Chief Medical Officer at Provation iProcedures | #ANES23 https://topmedtalk.libsyn.com/mani-vindhya-chief-medical-officer-at-provation-iprocedures-anes23 O.R. Sustainability & End-tidal Control | #ANES23 https://topmedtalk.libsyn.com/or-sustainability-end-tidal-control-anes23 Anesthesiology as a career in the 2020's | #ANES23 https://topmedtalk.libsyn.com/anesthesiology-as-a-career-in-the-2020s-anes23 Physician payments and Medicare | #ANES23 https://topmedtalk.libsyn.com/physician-payments-and-medicare-anes23 Updates on Neuromuscular Transmission (NMT) monitoring | #ANES23 https://topmedtalk.libsyn.com/updates-on-neuromuscular-transmission-nmt-monitoring-anes23 TopMedTalks to Michael W. Champeau and Ronald L. Harter | #ANES23 https://topmedtalk.libsyn.com/topmedtalks-to-michael-w-champeau-and-ronald-l-harter-anes23

This wide ranging conversation gets into the thorny subject of reimbursement; how and why can practitioners advocate for a fairer rates? Also, what is the role of the American Association of Nurse Anesthesiology in this debate? Further, what are some of the realities of the ‘no surprises’ billing act? Presented by Desiree Chappell and Randy Moore, Chief Anesthetists Officer of NorthStar Anesthesia with their guest Dru Riddle, PhD, DNP, CRNA, FAAN,American Association of Nurse Anesthesiology President, Anesthesia Patient Safety Foundation (APSF) board member.

“We do need to give ourselves credit for the sacrifices we made along the way…” This entertaining piece is a conversation about blood pressure, swimming, extreme physiology and the joy of exercise. You will hear Desiree Chappell and Monty Mythen chatting with Nuala Moore, an Irish swimmer known for open water swimming and ice swimming. She was the 2011 winner of the Margaret Smith Award of the Irish Long Distance Swimming Association, given for increasing the profile of open water swimming; in 2006, she was one of six swimmers to swim around the coast of Ireland in a relay, the first-ever swim of over 1300 km around the coast. Then in 2008 she did a double relay crossing of the English Channel. Her book “Limitless: From Dingle to Cape Horn, finding my true north in the earth’s vastest oceans” is available to buy in Dingle, or on Amazon: https://amzn.eu/d/bTEBKNS

The American Association of Nurse Anesthesiology (AANA) annual conference, here we speak with the outgoing and incoming Presidents of the organization. What can we expect in the year to come and what have been the highlights of the year past? Desiree Chappell and her co-host Randy Moore, CRNA and Chief Anesthetist Officer of Northstar Anesthesia, Irving, Texas, speak with outgoing AANA president Angie Mund, DNP, CRNA, Department Chair, Clinical Sciences MUSC College of Health Professions Charleston, South Carolina and the AANA President- Elect, Janet Setnor, MSN, CRNA, Col. (Ret), USAFR, NC and practicing Certified Registered Nurse Anesthesiologist, Springfield, Virginia.

Intraoperative hypotension is now firmly associated with harm and poor outcomes, this conversation should get you thinking about what this means to you as a practitioner. Here Desiree Chappell speaks with Amy Yerdon, Assistant Professor of Nursing, Nursing Acute, Chronic & Continuing Care, University of Alabama, Birmingham and Bradley Steg, CRNA is a Nurse Anesthetist in Jackson, Tennessee.

This talk “Advancing POM in New Zealand and Australia” was originally the EBPOM Visiting Professor Plenary Lecture given at the Evidence Based Perioperative Medicine (EBPOM) 2023 World Congress. Our visiting Professor is Vanessa Beavis, the Immediate Past President of The Australian and New Zealand College of Anaesthetists (ANZCA), having just completed her 2 year term, she is a specialist anaesthetist at Auckland City Hospital, New Zealand and also an Honorary Senior Lecturer at the Department of Anaesthesiology, Auckland University. She is introduced by Monty Mythen, Senior Vice President Medical Affairs, Edwards Lifesciences, Critical Care and Emeritus Professor of Anaesthesia and Critical Care, University College London. Find out more about the ANZCA Diploma of Perioperative Medicine here: https://www.anzca.edu.au/education-training/perioperative-medicine-qualification/dip-pom

This valuable conversation took place at the annual Evidence Based Perioperative Medicine (EBPOM) Ireland conference. One of our most loved conference settings we’d love you, a TopMedTalk listener, to join us next year. Go now ot www.ebpom.org to find out more. Hear Desiree Chappell in conversation with Anoushka Alfonso, Associate Professor of Clinical Anesthesiology at Memorial Sloan Kettering Cancer Center (MSK), where she is the Director of Enhanced Recovery Program, BobbieJean Sweitzer, Systems Director of Perioperative Practices at Inova Health, Falls Church, Virginia and Kate Leslie, specialist anaesthetist and head of research in the Department of Anaesthesia and Pain Management, Royal Melbourne Hospital and honorary professorial fellow at the University of Melbourne and Monash University in Australia.

This week’s podcast is another “from the TopMedTalk table” at the recent World Prehabilitation Society annual conference held this year in London. We’ve been getting a feel for the issues people were discussing by listening to some of the people who took time to pop over and say hello. This week sees us speaking to Imogen Fecher-Jones, lead nurse and project manager for the Perioperative Medicine Service and Preassessment at University Hospital Southampton and Nicholas Tetlow, exercise physiologist at UCLH and an honorary research fellow at UCL.

This discussion covers many topics including; preoperative medicine and its evolution, frailty in various age groups, brain health and anesthesia in older adults, cognitive decline and executive function testing. It is presented by Desiree Chappell and Guy Ludbrook with their guest, BobbieJean Sweitzer, Systems Director, Preoperative Medicine, Inova Health, Falls Church, Virginia, and Professor of Medical Education, University of Virginia and the author and editor of 'Preoperative Assessment and Management' (currently 3rd edition). -- Originally streamed live as part of our coverage of Anesthesiology 2023; the annual meeting of the American Society of Anesthesiologists, the largest and most important gathering of anesthesiologists in the world. We're your free front row seat. For more on the ASA go here: https://www.asahq.org/ Check out our YouTube page for a record of the live stream video of this podcast: https://www.youtube.com/@topmedtalk7687/streams

Looking this week at one of the highlights of Anesthesiology 2022 for us here on TopMedTalk; Desiree Chappell and Monty Mythen in conversation with the always interesting Bernd Saugel, Professor and Vice Chair of the Department of Anesthesiology, Center of Anesthesiology and Intensive Care Medicine at the University Medical Center Hamburg-Eppendorf, Germany. The study is here: https://pubmed.ncbi.nlm.nih.gov/37265355/ Bernd is a popular figure here on TopMedTalk, we featured him recently during our coverage of The Euroanesthesia 2023 conference: https://topmedtalk.libsyn.com/topmedtalks-to-bernd-saugel-and-thomas-scheeren-esaic-2023 We also reference an earlier appearance in the conversation here: https://topmedtalk.libsyn.com/bernd-saugel-at-euroanesthesia-2022-topmedtalk The original unedited conversation is here:https://topmedtalk.libsyn.com/the-detect-study-anesthesiology-2022

This informative conversation takes a broad look at the field of anesthesiology, the staffing crisis and opportunities arising from that, leadership in medicine, as well as the recent past and long term future of the American Society of Anesthsiologists (ASA). Presented by Desiree Chappell and Monty Mythen witn their guests Michael W. Champeau, outgoing President of The American Society of Anesthesiologists, President of the Associated Anesthesiologists Medical Group and Ronald L. Harter, incoming President of The American Society of Anesthesiologists, Professor of anesthesiology, Department of Anesthesiology at The Ohio State University Wexner Medical Center in Columbus. -- Originally streamed live as part of our coverage of Anesthesiology 2023; the annual meeting of the American Society of Anesthesiologists, the largest and most important gathering of anesthesiologists in the world. We're your free front row seat. For more on the ASA go here: https://www.asahq.org/ Check out our YouTube page for a record of the live stream video of this podcast: https://www.youtube.com/@topmedtalk7687/streams

"How do you know how much anesthesia your patient needs? Brain monitoring to optimize neurohealth." This piece dives into the details with an important subject for anyone working in surgery at the moment. Desiree Chappell and Guy Ludbrook talk to Jiapeng Huang, Tenured Professor and Vice Chairman of the Department of Anesthesiology and Perioperative Medicine at the University of Louisville, ASA Board of Directors. -- Originally streamed live as part of our coverage of Anesthesiology 2023; the annual meeting of the American Society of Anesthesiologists (ASA), the largest and most important gathering of anesthesiologists in the world. We're your free front row seat. For more on the ASA go here: https://www.asahq.org/ Check out our YouTube page for a record of the live stream video of this podcast: https://www.youtube.com/@topmedtalk7687/streams

This engaging conversation gets into how and why trials and research are moving forward. Find out more about the conference we discuss here: https://euroanaesthesia.org Presented by Desiree Chappell and Monty Mythen with their guests Wolfgang Buhre, Professor and Chair, Department of Anesthesiology, Division of Vital Functions, University Medical Center, Utrecht, The Netherlands and Thomas Sheeren, Senior Director Medical Affairs CC EMEACLA, Edwards Lifesciences. -- Originally streamed live as part of our coverage of Anesthesiology 2023; the annual meeting of the American Society of Anesthesiologists (ASA), the largest and most important gathering of anesthesiologists in the world. We're your free front row seat. For more on the ASA go here: https://www.asahq.org/ Check out our YouTube page for a record of the live stream video of this podcast: https://www.youtube.com/@topmedtalk7687/streams

This piece focuses upon The World Congress of Anesthesiologists 2024: https://www.wca2024.org/ Presented by Desiree Chappell and Mike Grocott with their guests Wayne Morriss, President, WFSA (World Federation of Societies of Anaesthesiologists), Clinical Associate Professor, University of Otago, Specialist Anaesthetist, Canterbury District Health Board, New Zealand, Adrian Gelb, Immediate Past President at WFSA (World Federation of Societies of Anaesthesiologists), Anesthesiologist, University of California and Tony Gin, WFSA, Scientific Programme Committee Co-Chair. -- Originally streamed live as part of our coverage of Anesthesiology 2023; the annual meeting of the American Society of Anesthesiologists (ASA), the largest and most important gathering of anesthesiologists in the world. We're your free front row seat. For more on the ASA go here: https://www.asahq.org/ Check out our YouTube page for a record of the live stream video of this podcast: https://www.youtube.com/@topmedtalk7687/streams  

This important piece covers the recent Anestheia Patient Safety Foundation (APSF) conference on perioperative hemodynamic instability, and the recent recommendations that they have just launched. The Anestheia Patient Safety Foundation is here: https://www.apsf.org/ Presented by Desiree Chappell and Mike Grocott with their guests, Daniel Cole MD, APSF President, Louise Y. Sun MD, SM, FRCPC , FAHA Professor of Anesthesiology at Stanford University, Michael Scott MB, ChB, FRCP, FRCA, FFICM Professor of Anesthesiology at the University of Pennsylvania. -- Originally streamed live as part of our coverage of Anesthesiology 2023; the annual meeting of the American Society of Anesthesiologists (ASA), the largest and most important gathering of anesthesiologists in the world. We're your free front row seat. For more on the ASA go here: https://www.asahq.org/ Check out our YouTube page for a record of the live stream video of this podcast: https://www.youtube.com/@topmedtalk7687/streams

The American Association of Nurse Anesthesiology (AANA) welcomes TopMedTalk to its annual conference with an array of great guests and healthy conversation. Recorded at the conference this series takes you right to the stories that mattered. This piece sees Desiree Chappell speaking with Tim Jones, NorthStar Anesthesia’s Vice President of Academic Affairs and Lois Stewart, co director of the South College, Nurse Anesthesia program, Knoxville, Tennessee.

TopMedTalk continues to bring you our coverage of Anesthesiology 2023; the annual meeting of the American Society of Anesthesiologists (ASA), the largest and most important gathering of anesthesiologists in the world. We're your free front row seat. For more on the ASA go here: https://www.asahq.org/ Check out our YouTube page for a record of the live stream video of this podcast: https://www.youtube.com/@topmedtalk7687/streams This essential conversation contains a look at anesthesia leadership and quality management, medication safety and a look forward to conferences to come. We mention the Anesthesia Patient Safety Foundation, an organisation we have profiled in the past. If you'd like more information about them go here: https://www.apsf.org/ Presented by Desiree Chappell, Mike Grocott and Monty Mythen with their guest Elizabeth Rebello, Executive Director, Anesthesiology, Critical Care, and Pain Medicine, Cancer Network; Professor, Department of Anesthesiology and Perioperative Medicine, MD Anderson Cancer Center.

Welcome to our coverage of Anesthesiology 2023; the annual meeting of the American Society of Anesthesiologists (ASA); it's the largest and most important gathering of anesthesiologists in the world and we're your free front row seat. For more on the ASA go here: https://www.asahq.org/ Check out our YouTube page for a record of the live stream video of this podcast: https://www.youtube.com/@topmedtalk7687/streams This piece looks at the management of anesthesiology in the US, what are the challenges and solutions, the realities of 'provider squeeze', broader market trends and the opportunities for long term growth? Presented by Desiree Chappell and Mike Grocott with their guests Adam Spiegel, CEO, NorthStar Anesthesia and Josh Lumbley, Chief Quality Officer, NorthStar Anesthesia.

Welcome to our coverage of Anesthesiology 2023; the annual meeting of the American Society of Anesthesiologists (ASA); it's the largest and most important gathering of anesthesiologists in the world and we're your free front row seat. For more on the ASA go here: https://www.asahq.org/ Check out our YouTube page for a record of the live stream video of this podcast: https://www.youtube.com/@topmedtalk7687/streams Presented by Desiree Chappell, Mike Grocott and Guy Ludbrook with their guest Rick Dutton, Chief Quality Officer US Anesthesia Partners, Anesthesiologist, Baylor University Medical Center, Dallas, and is an adjunct professor in the Department of Anesthesiology at Texas A&M School of Medicine. Rick has appeared on TopMedTalk multiple times, here are some of his most listened to podcast appearances: Rick Dutton Chief Quality Officer US Anesthesia Partners | TopMedTalk at the ASA: https://topmedtalk.libsyn.com/rick-dutton-chief-quality-officer-us-anesthesia-partners-topmedtalk-at-the-asa Interoperative hypotension study group; USAP and NorthStar Anesthesia | TopMedTalk: https://topmedtalk.libsyn.com/interoperative-hypotension-study-group-usap-and-northstar-anesthesia-topmedtalk Desiree's Roundtable | Rick Dutton Q&A Session: https://topmedtalk.libsyn.com/desirees-roundtable-rick-dutton-qa-session  

Our coverage of Anesthesiology 2023, continues. It's the annual meeting of the American Society of Anesthesiologists (ASA); it's the largest and most important gathering of anesthesiologists in the world and we're your free front row seat. For more on the ASA go here: https://www.asahq.org/ Check out our YouTube page for a record of the live stream video of this podcast: https://www.youtube.com/@topmedtalk7687/streams This year's conference was buzzing with discussion about artificial intelligence (AI) and in this conversation we get into the nuts and bolts of it. How will AI change our practice in the next 5 years? Who will AI replace, or will it instead become a tool which all healthcare providers welcome? Where are we in now the "hype cycle" of this new technology? Featuring Desiree Chappell and Mike Grocott with their guests; Ronald G. Pearl, ASA committee on Innovation, Professor and Chair, Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine and Peter V. Killoran, ASA Committee on Informatics and Information Technologies, Associate Professor of Anesthesiology, Assistant Professor, Biomedical Informatics at The University of Texas Health Science Center, Houston.

Our coverage of Anesthesiology 2023, continues. It's the annual meeting of the American Society of Anesthesiologists (ASA); it's the largest and most important gathering of anesthesiologists in the world and we're your free front row seat. For more on the ASA go here: https://www.asahq.org/ Check out our YouTube page for a record of the live stream video of this podcast: https://www.youtube.com/@topmedtalk7687/streams For more on the Gabapentin and perioperative pain (GAP) study go here: https://bristoltrialscentre.blogs.bristol.ac.uk/details-of-studies/gap/ We get into an important conversation about The Opioid Crisis, there's a powerful conversation about it in our archive here: https://topmedtalk.libsyn.com/topmedtalk-tackling-the-pain-of-the-opioid-crisis-0 Presented by Desiree Chappell, Mike Grocott and Guy Ludbrook with their guest Ben Gibbison Consultant Anaesthetist at University Hospitals Bristol NHS Foundation Trust.

This piece works as a summary of our coverage of Anesthesiology 2023, so far. It's the annual meeting of the American Society of Anesthesiologists (ASA); it's the largest and most important gathering of anesthesiologists in the world and we're your free front row seat. For more on the ASA go here: https://www.asahq.org/ Check out our YouTube page for a record of the live stream video of this podcast: https://www.youtube.com/@topmedtalk7687/streams Presented by Desiree Chappell, our lead US presenter, a Certified Registered Nurse Anesthetist (CRNA) and Vice President of Clinical Quality for NorthStar Anesthesia, Mike Grocott, Professor of Anaesthesia and Critical Care Medicine at the University of Southampton and an NIHR Senior Investigator, and Guy Ludbrook, Professor of Anaesthesia at the University of Adelaide and Royal Adelaide Hospital. The team take a minute to review some of this year's coverage of Anesthesiology 2023 and look forward to some of the conversations still to come here on TopMedTalk's podcast feed. Some of the highlights mentioned in this piece include: Anesthesiology as a career, "the future of the profession"; https://topmedtalk.libsyn.com/anesthesiology-as-a-career-in-the-2020s-anes23 The piece on Howard University; https://topmedtalk.libsyn.com/opportunities-in-anesthesiology-anes23 The discussion about pricing; https://topmedtalk.libsyn.com/physician-payments-and-medicare-anes23 The conversation about sustainability; https://topmedtalk.libsyn.com/or-sustainability-end-tidal-control-anes23    

Our coverage of Anesthesiology 2023, continues. It's the annual meeting of the American Society of Anesthesiologists (ASA); it's the largest and most important gathering of anesthesiologists in the world and we're your free front row seat. For more on the ASA go here: https://www.asahq.org/ Check out our YouTube page for a record of the live stream video of this podcast: https://www.youtube.com/@topmedtalk7687/streams This piece looks into equal opportunities in anesthesiology. Presented by Desiree Chappell, and Guy Ludbrook with Elijah McMillan, MD Candidate at Howard University College of Medicine and Majesty Greer, MD Candidate at Howard University College of Medicine.

Our coverage of Anesthesiology 2023, continues. It's the annual meeting of the American Society of Anesthesiologists (ASA); it's the largest and most important gathering of anesthesiologists in the world and we're your free front row seat. For more on the ASA go here: https://www.asahq.org/ Check out our YouTube page for a record of the live stream video of this podcast: https://www.youtube.com/@topmedtalk7687/streams This piece focuses in on physician payments and Medicare. Presented by Desiree Chappell and Mike Grocott with their guests Lois Connolly, ASA Vice President for Professional Affairs, Professor, Department of Anesthesiology, Medical College of Wisconsin and Jonathan Gal, Chair of ASA Committee on Economics, Professor, Anesthesiology, Ichan School of Medicine, Medical Director for Offsite Ambulatory Surgery Centers Anesthesia, Director of Governmental and Reimbursment Affairs.

"What is anestheiology going to look like in the next ten years?" This is a no holds barred conversation about the future of our profession, as a career, particularly for those who are looking at how and why they should embrace some of the seismic changes we currently face. Presented by Desiree Chappell, Mike Grocott, and Guy Ludbrook, Professor of Anaesthesia at the University of Adelaide and Royal Adelaide Hospital with their guest George W. Williams II, Chair of the ASA Comittee on Critical Care Medicine, and Professor of Anesthesiology at The University of Texas Health Science in Houston. -- Our coverage of Anesthesiology 2023, continues. It's the annual meeting of the American Society of Anesthesiologists (ASA); it's the largest and most important gathering of anesthesiologists in the world and we're your free front row seat. For more on the ASA go here: https://www.asahq.org/ Check out our YouTube page for the live stream video of this podcast: https://www.youtube.com/@topmedtalk7687/streams

Our coverage of Anesthesiology 2023, continues. It's the annual meeting of the American Society of Anesthesiologists (ASA); it's the largest and most important gathering of anesthesiologists in the world and we're your free front row seat. For more on the ASA go here: https://www.asahq.org/ Check out our YouTube page for the live stream video of this podcast: https://www.youtube.com/@topmedtalk7687/streams Presented by Desiree Chappell, Mike Grocott, and Guy Ludbrook, Professor of Anaesthesia at the University of Adelaide and Royal Adelaide Hospital with their guest John W Beard, Chief Medical Officer at GE Healthcare - Patient Care Solutions. with their guest David Hovord GE Healthcare Consultant, Clinical Assistant Professor, Michigan Medicine.

Our coverage of Anesthesiology 2023, continues. It's the annual meeting of the American Society of Anesthesiologists (ASA); it's the largest and most important gathering of anesthesiologists in the world and we're your free front row seat. For more on the ASA go here: https://www.asahq.org/ Check out our YouTube page for the live stream video of this podcast: https://www.youtube.com/@topmedtalk7687/streams This piece is presented by Desiree Chappell, our lead US presenter, a Certified Registered Nurse Anesthetist (CRNA) and Vice President of Clinical Quality for NorthStar Anesthesia, Mike Grocott, our Editor in Chief, Professor of Anaesthesia and Critical Care Medicine at the University of Southampton and an NIHR Senior Investigator, and Guy Ludbrook, Professor of Anaesthesia at the University of Adelaide and Royal Adelaide Hospital with their guest John W Beard, Chief Medical Officer at GE Healthcare - Patient Care Solutions. We mention 'The Portrait Mobile product launch, live from the ESAIC' piece, which you can find here: https://topmedtalk.libsyn.com/the-portrait-mobile-product-launch-at-the-esaic-topmedtalk The paper referenced in this piece, "Cost savings through continuous vital sign monitoring in the medical-surgical unit" is here: https://www.tandfonline.com/doi/full/10.1080/13696998.2023.2219156

The annual meeting of the American Society of Anesthesiologists; Anesthesiology 2023, it's the largest and most important gathering of anesthesiologists in the world and we're your free front row seat. For more on the ASA go here: https://www.asahq.org/ Make sure you subscribe to TopMedTalk and follow along as all our conversations from the conference make their way to you. In this piece we're getting a feel for the conference on our second day there, featuring Desiree Chappell, our lead US presenter, a Certified Registered Nurse Anesthetist (CRNA) and Vice President of Clinical Quality for NorthStar Anesthesia, Mike Grocott, Professor of Anaesthesia and Critical Care Medicine at the University of Southampton and an NIHR Senior Investigator, Monty Mythen, Senior Vice President Medical Affairs, Edwards Lifesciences, Critical Care, Emeritus Professor of Anaesthesia and Critical Care, University College London, and Guy Ludbrook, Professor of Anaesthesia at the University of Adelaide and Royal Adelaide Hospital.

Our coverage of the annual meeting of the American Society of Anesthesiologists; Anesthesiology 2023, continues. The largest and most important gathering of anesthesiologists in the world and we're your free front row seat. For more on the ASA go here: https://www.asahq.org/ Presented by Desiree Chappell, Guy Ludbrook and Monty Mythen with Mani Vindhya, Chief Medical Officer at Provation® iProcedures, Assistant Professor of Anesthesiology, Nova Southeastern University and Attending Anesthesiologist at St Josephs Hospital. NB// If you would like to watch these podcasts LIVE go here: https://www.youtube.com/watch?v=JPpwNqaVXP8

Our coverage of the annual meeting of the American Society of Anesthesiologists; Anesthesiology 2023, continues. The largest and most important gathering of anesthesiologists in the world and we're your free front row seat. Hear how and why both local and state level advocacy has recently helped move our discipline forward. For more on the ASA go here: https://www.asahq.org/ Presented by Mike Grocott, TopMedTalk's Editor in Chief and Guy Ludbrook, Professor of Anaesthesia at the University of Adelaide and Royal Adelaide Hospital with their guest Michael M. Beck, ASA Committee on Governmental Affairs, Chair, ASA Committee on Governmental Affairs Task Force on State Advocacy, Managing Board Member, Mountain West Anesthesia, Intermountain Healthcare – Riverton Hospital, The Orthopedic Specialty Hospital, Salt Lake City, Utah.

What is the future of TopMedTalk, where will we find our new Editor in Chief? This podcast has all the answers. Make sure you are subscribed to this podcast so you don't miss a minute of our coverage of the annual meeting of the American Society of Anesthesiologists; Anesthesiology 2023. It's the largest and most important gathering of anesthesiologists in the world and we're your free front row seat. For more on the ASA go here: https://www.asahq.org/ Also, check out our LIVE FREE VIDEO STREAM here: https://www.youtube.com/watch?v=JPpwNqaVXP8 This podcast features Desiree Chappell, our lead US presenter, a Certified Registered Nurse Anesthetist (CRNA) and Vice President of Clinical Quality for NorthStar Anesthesia, Monty Mythen, Senior Vice President Medical Affairs, Edwards Lifesciences, Critical Care, Emeritus Professor of Anaesthesia and Critical Care, University College London, Mike Grocott, Professor of Anaesthesia and Critical Care Medicine at the University of Southampton and an NIHR Senior Investigator and Guy Ludbrook, Professor of Anaesthesia at the University of Adelaide and Royal Adelaide Hospital.

This is a huge moment in the calendar for us here at TopMedTalk, the annual meeting of the American Society of Anesthesiologists; Anesthesiology 2023. TopMedTalk will be bringing you the best of our coverage on this podcast stream. We also invite you to join us on our free live video stream, here: https://www.youtube.com/watch?v=c0-b3WagONQ This piece features Desiree Chappell, our lead US presenter, a Certified Registered Nurse Anesthetist (CRNA) and Vice President of Clinical Quality for NorthStar Anesthesia, Mike Grocott, Professor of Anaesthesia and Critical Care Medicine at the University of Southampton and an NIHR Senior Investigator and Guy Ludbrook, Professor of Anaesthesia at the University of Adelaide and Royal Adelaide Hospital.

This piece is a guide to the importance behind drinking, eating and mobilising as part of an enhanced recovery after surgery programme (ERAS). It comprises clips from previous conversations, linked to below, along with a as yet to be released piece on the topic featuring Vicki Morton, Director of Clinical and Quality Outcomes at Providence Anesthesiology Associates in Charlotte, NC. Henrik Kehlet, gastrointestinal surgeon and former professor of surgery, Copenhagen University, and now professor of perioperative therapy and Head of Section of Surgical Pathophysiology, Rigshospitalet, Copenhagen University, spoke to us in more detail here: https://topmedtalk.libsyn.com/asa-henrik-kehlet-recovery-is-all-about-inflammation We speak with Ramani Moonesinghe, OBE, Professor of Perioperative Medicine at University College London and Honorary Consultant in Anaesthesia and Perioperative Medicine at University College London Hospital here: https://topmedtalk.libsyn.com/perioperative-quality-improvement-and-the-dreaming-question-ebpom-2023 We mention this paper “Is the pursuit of DREAMing (drinking, eating and mobilising) the ultimate goal of anaesthesia?” here: https://pubmed.ncbi.nlm.nih.gov/27079158/

Desiree Chappell, Monty Mythen and Andrew Cumpstey sit down with Cory Stahl, Global Marketing Manager at GE Healthcare to talk about “Portrait Mobile”. This piece was recorded while TopMedTalk were at this year’s annual conference of The European Society of Anaesthesiology and Intensive Care (ESAIC); Euroanesthesia 2023. We had a presence there at the GE Healthcare stand. ESAIC is the leading European Organisation for Anaesthesia, Intensive Care, Pain and Perioperative Medicine. TopMedTalk is proud to continue to bring you coverage of their annual conference. For more information on the work ESIAC do check out their website here: https://www.esaic.org/event/euroanaesthesia-2023/

TopMedTalk were at this year’s annual conference of The European Society of Anaesthesiology and Intensive Care (ESAIC); Euroanesthesia 2023. ESAIC is the leading European Organisation for Anaesthesia, Intensive Care, Pain and Perioperative Medicine. TopMedTalk is proud to continue to bring you coverage of their annual conference. For more information on the work ESIAC do check out their website here https://euroanaesthesia.org/ We previously featured the GE Healthcare portrait mobile launch, as mentioned in this piece, you can hear that here: https://topmedtalk.libsyn.com/the-portrait-mobile-product-launch-at-the-esaic-topmedtalk Here Desiree Chappell and Monty Mythen pick up a conversation with Chris Lawman Senior Modality Leader for GE Healthcare and Peter van Heezik Anesthesia Digital Leader for GE Healthcare.

TopMedTalk continues tracking the incredibly important work done by Perioperative Quality Initiative (POQI), check out their website here: http://thepoqi.org/ This piece acts as an introduction to this year’s POQI - 12. Recorded at the Evidence Based Perioperative Medicine (EBPOM) Ireland conference this piece features an exclusive conversation between Desiree Chappell and Mike Grocott speaking with Guy Ludbrook, Professor of Anaesthesia at the University of Adelaide and Royal Adelaide Hospital and Andrew Shaw, Chairman, Department of Intensive Care and Resuscitation at The Cleveland Clinic, Cleveland, Ohio.

The Perioperative Quality Initiative (POQI) is an international, multidisciplinary non-profit organization that organizes consensus conferences on topics of interest related to perioperative medicine with the aim of improving patient care. This piece is an exclusive chance to hear how and why The POQI strives towards a broader perspective and the value of not existing within an echo chamber. It was originally part of The Evidence Based Perioperative Medicine (EBPOM 2023) World Congress in London. With questions from the audience Desiree Chappell hosts a conversation with the chairs Mike Grocott, Professor of Anaesthesia and Critical Care Medicine at the University of Southampton and Andy Shaw, Chairman, Department of Intensive Care and Resuscitation at The Cleveland Clinic, Cleveland, Ohio. Find out more about The POQI and to read their publications go here: http://thepoqi.org/ Publications: http://thepoqi.org/Publications  

Here John Koncelik, Regional Medical Director HCA Healthcare Physician Services Group, West Florida comes to the TopMedTalk table to share his thoughts on the need for prehabilitaiton and the way in which it relates to the wider question of “population health management”. He also chooses to share his recent experiences as a patient in the healthcare system, how that has changed his view and why he’s so proud to work in the industry. If you enjoyed this piece it may interest you to know that John will be sharing more of his personal story with us at the forthcoming Evidence Based Perioperative Medicine (EBPOM) Dingle Conference, tickets are available now: https://ebpom.org/product/ebpom-ireland-2023/

Desiree Chappell and Monty Mythen in conversation with Seenu Reddy, Cardiothoracic Surgeon at HCA‘s TriStar Cardiovascular Surgery in Nashville, National Physician Director, HCA Healthcare's CV Service line. We start with discussion about the ERAS Cardiac society, more about them here: https://www.erascardiac.org/ The paper discussed in this piece (10 minutes in) “Advanced artificial intelligence–guided hemodynamic management within cardiac enhanced recovery after surgery pathways: A multi-institution review” is available here: https://doi.org/10.1016/j.xjon.2023.06.023 TopMedTalk is the broadcasting arm of Evidence Based Perioperative Medicine (EBPOM). For more information on EBPOM Ireland go here: https://ebpom.org/ As mentioned in the piece we’ve enjoyed conversations with Seenu Reddy previously: https://topmedtalk.libsyn.com/the-eras-cardiac-society-conference-day-2-topmedtalk-0 https://topmedtalk.libsyn.com/eras-cardiac-2019-seenu-reddy And we mention a forthcoming “mini-doc” on the subject of Drinking Eating and Mobilising which will include part of our essential interview with Henrik Kehlet, that you can hear here: https://topmedtalk.libsyn.com/asa-henrik-kehlet-recovery-is-all-about-inflammation

This wide ranging conversation starts with a focus on the importance of Near Infra-Red Spectroscopy (NIRS) and echocardiograms, how do we move forward in patient safety while keeping in line with what works in practice? How do we go from thinking we do not need, or even consider, a piece of kit to being ready to postpone surgery without it? What does that journey look like? Here Desiree Chappell, Monty Mythen and Andy Cumpstey speak with their guest Sean Bennet, cardiac anesthetist and intensivist at University Hospital Southampton NHS Foundation Trust. TopMedTalk were at this year’s annual conference of The European Society of Anaesthesiology and Intensive Care (ESAIC); Euroanesthesia 2023. This piece was recorded there at the GE Healthcare stand. ESAIC is the leading European Organisation for Anaesthesia, Intensive Care, Pain and Perioperative Medicine. TopMedTalk is proud to continue to bring you coverage of their annual conference. For more information on the work ESIAC do check out their website here: https://www.esaic.org/event/euroanaesthesia-2023/

Here Desiree Chappell and Andy Cumpstey speak with Michelle Chew, Academic Chair and Professor in Anaesthesiology, Intensive Care and Acute Care at Linköping University Hospital, Sweden and Giovanna Luratibuse, consultant and anesthesiology Professor at the University Hospital Düsseldorf, Germany. For more on this topic - and the check out the guidelines - go to: https://journals.lww.com/ejanaesthesiology/pages/default.aspx Or straight to the guidelines here: https://journals.lww.com/ejanaesthesiology/Fulltext/9900/ESAIC_focused_guideline_for_the_use_of_cardiac.98.aspx?WT.mc_id=HPxADx20100319xMP This piece was recorded while TopMedTalk were at this year’s annual conference of The European Society of Anaesthesiology and Intensive Care (ESAIC); Euroanesthesia 2023. We had a presence there at the GE Healthcare stand. ESAIC is the leading European Organisation for Anaesthesia, Intensive Care, Pain and Perioperative Medicine. TopMedTalk is proud to continue to bring you coverage of their annual conference. For more information on the work ESIAC do check out their website here: https://www.esaic.org/event/euroanaesthesia-2023/

Desiree Chappell and Andy Cumpstey talk to Manfred Blobner, Professor, Anesthesiology and the Coordinator of the Residency Program at Technische Universität München. TopMedTalk were at this year’s annual conference of The European Society of Anaesthesiology and Intensive Care (ESAIC); Euroanesthesia 2023. This piece was recorded there at the GE Healthcare stand. ESAIC is the leading European Organisation for Anaesthesia, Intensive Care, Pain and Perioperative Medicine. TopMedTalk is proud to continue to bring you coverage of their annual conference. For more information on the work ESIAC do check out their website here: https://www.esaic.org/event/euroanaesthesia-2023/

TopMedTalk recorded this piece at the European Society of Anaesthesiology and Intensive Care (ESAIC) conference, Euroanaesthesia 2023 in Glasgow. It features Desiree Chappell, Monty Mythen and Andy Cumpstey in conversation with Vera von Dossow, Director of the Institute for Anesthesiology and Pain Therapy at the HDZ NRW, Bad Oeynhausen. With thanks to Edwards Lifesciences for their generous support in bringing free open access medical education to you.

Enhanced Recovery After Surgery (ERAS) is a foundational aspect of perioperative medicine. This piece covers ERAS® Cardiac, a non-profit organization with the mission to develop evidence-based expert consensus statements promoting best practice recovery practices: https://www.erascardiac.org/about/our-team We discuss The Perioperative Quality Initiative: https://www.thepoqi.org/ We also discuss the value proposition for perioperatvie care, the need for open access medical information and collaboration in cardiac surgery. We discuss this paper in detail: Adult Cardiac Surgery-Associated Acute Kidney Injury: Joint Consensus Report: https://www.jcvaonline.com/article/S1053-0770(23)00340-3/fulltext Presented by Desiree Chappell and Monty Mythen with their guest Vicki Morton, Director of Clinical and Quality Outcomes at Providence Anesthesiology Associates in Charlotte, NC.

This piece is presented by Desiree Chappell and Sol Aronson with their guest Jed Wolpaw, Anesthesiologist, intensivist, founder and host of http://accrac.com podcast, Program Director, Johns Hopkins Anesthesiology. TopMedTalk is very proud to be partnered with the American Society of Anesthesiologists® ANESTHESIOLOGY® 2022, bringing you our most comprehensive and extensive coverage of the largest gathering of anesthesiologists in the world! TopMedTalk is provided to you for free; if you want to help support our work and help give these conversations a wider audience please like and subscribe (if and where possible) before sharing it on your social media. We are on Twitter here: https://twitter.com/topmedtalk We are on LinkedIn here: https://www.linkedin.com/company/topmedtalk We are on Facebook here: https://www.facebook.com/TopMedTalk1/

The World Congress of Prehabilitation Medicine preceded this year’s Evidence Based Perioperative Medicine (EBPOM). TopMedTalk had an open table and this podcast contains two of the conversations we recorded in between presentations and live streaming. We mention two trials: https://bmjopen.bmj.com/content/13/1/e065992 And: https://clinicaltrials.gov/study/NCT05756283 We hear from, Heather Gill, a vascular surgeon at McGill University and Research Chair for the Canadian Society of vascular surgery, President elect about the wide applicability of prehabilitation balanced against the evidence and Professor Enoch Akowuah, Chair of cardiac surgery at Newcastle University and a consultant cardiac surgeon and at South Tees Hospitals NHS Foundation Trust in the UK.

TopMedTalk is very proud to be partnered with the American Society of Anesthesiologists® (ASA), providing comprehensive and extensive coverage of the largest gathering of anesthesiologists in the world. Here we reflect on the conference, plans for its future and the wider picture of the discipline. This piece is presented by Desiree Chappell, Sol Aronson and Monty Mythen with their guest Sheela Pai Cole, Clinical Professor, Anesthesiology, Perioperative and Pain Medicine at Stanford Health Center. -- TopMedTalk can be found on YouTube here: https://www.youtube.com/channel/UC-HYQmeIwcFCYO1hoQ8jShQ We are on Twitter here: https://twitter.com/topmedtalk We are on LinkedIn here: https://www.linkedin.com/company/topmedtalk We are on Facebook here: https://www.facebook.com/TopMedTalk1/

“It's kind of easy to say it; ‘drinking, eating, mobilizing’ and yet actually what does it mean? Drinking, how much? Eating, what? And mobilizing, in what way? And so we refined the definitions so that everyone was measuring the same thing…” The Perioperative Quality Improvement Programme (PQIP): https://www.rcoa.ac.uk/research/research-projects/perioperative-quality-improvement-programme-pqip Presented by Desiree Chappell and Monty Mythen with their guest Ramani Moonesinghe, OBE, Professor of Perioperative Medicine at University College London and Honorary Consultant in Anaesthesia and Perioperative Medicine at University College London Hospital.

Is sustainability now one of the key performance indicators by which we are judged? How has the medical industry responded to this and where are the pressures coming from for an environmentally conscious future? Desiree Chappell, Monty Mythen and Sol Aronson with their guest Liam Hynes, Operations Leader for Respiratory Interventions at Medtronic. This piece was recorded at the Evidence Based Perioperative Medicine (EBPOM) World Congress held in London in 2023. If you would like more information about the incredible work EBPOM do please go here: www.ebpom.org TopMedTalk is not possible without the support of our generous industry partners and supporters; we would like to thank Medtronic for their assistance in bringing you free open access medical education.

This piece is presented by Desiree Chappell and Sol Aronson with their guest Elizabeth Drum, Associate Professor of Clinical Anesthesiology and Critical Care Medicine at the Perelman School of Medicine, University of Pennsylvania, Philadelphia. Our conversation about Lifebox is here: https://topmedtalk.libsyn.com/asa-2019-lifebox For more information about the American Society of Anesthesiologist's global humanitarian outreach go here: https://www.asahq.org/charity Part one of TopMedTalk’s conversation with the global scholars is here: https://topmedtalk.libsyn.com/the-asa-global-scholars-program-part-1-anesthesiology-2022 And part two is here: https://topmedtalk.libsyn.com/the-asa-global-scholars-program-part-2-anesthesiology-2022 This piece was originally put out “as live” from Anesthesiology 2022 the American Society of Anesthesiologists annual conference. -- TopMedTalk is provided to you for free; if you want to help support our work and help give these conversations a wider audience please like and subscribe (if and where possible) before sharing it on your social media. TopMedTalk can be found on YouTube here: https://www.youtube.com/channel/UC-HYQmeIwcFCYO1hoQ8jShQ We are on Twitter here: https://twitter.com/topmedtalk We are on LinkedIn here: https://www.linkedin.com/company/topmedtalk We are on Facebook here: https://www.facebook.com/TopMedTalk1/

Here we look back upon The Anesthesia Patient Safety Foundation (APSF) at last year’s Anesthesiology conference. This piece is presented by Desiree Chappell and Monty Mythen with their guests JW Beard, Chief Medical Officer of GE Patient Care solutions, GE Healthcare, APSF Board of Directors and Jeffery Feldman, Attending Anesthesiologist, Children’s Hospital of Philadelphia (CHOP) and Professor of Clinical Anesthesiology at the Perelman School of Medicine, University of Pennsylvania, APSF Board of Directors. The educational resources mentioned in this piece are here: https://www.apsf.org/apsf-technology-education-initiative/ The APSF website is here: http://www.apsf.org We spoke previously to The Anesthesia Patient Safety Foundation in 2019 here: https://www.topmedtalk.com/asa-2019-anesthesia-patient-safety-foundation-mark-warner/ We also consulted them during our coverage of the COVID-19 crisis: https://www.topmedtalk.com/the-anesthesia-patient-safety-foundation-covid-19/ TopMedTalk; proud to be partnered with the American Society of Anesthesiologists® at ANESTHESIOLOGY® 2022. -- TopMedTalk is provided to you for free; if you want to help support our work and help give these conversations a wider audience please like and subscribe (if and where possible) before sharing it on your social media. TopMedTalk can be found on YouTube here: https://www.youtube.com/channel/UC-HYQmeIwcFCYO1hoQ8jShQ We are on Twitter here: https://twitter.com/topmedtalk We are on LinkedIn here: https://www.linkedin.com/company/topmedtalk We are on Facebook here: https://www.facebook.com/TopMedTalk1/

The big talking point at The World Congress of Evidence Based Perioperative Medicine (EBPOM) 2023 was the results of the ‘OPtimisation of Peri-operaTive CardIovascular Management to Improve Surgical outcomE II (OPTIMISE II)’ trial. The OPTIMISE II trial is an international, multi-centre, pragmatic, randomised controlled trial with an open study group allocation, to determine whether cardiac output-guided fluid therapy, with a low dose inotrope infusion is clinically effective when compared to usual care in patients undergoing major gastrointestinal surgery. This podcast captures the moment the world has been waiting for as this global trial (with over 30 participating centres in Australia, Canada, Germany, Jordan, Poland, Romania, Spain, Switzerland, US and the UK) which launched in January 2017, reports its results. Presented by Desiree Chappell, Monty Mythen and Mark Edwards, Consultant in Anaesthesia and Perioperative Medicine, University Hospital Southampton, Honorary Senior Clinical Lecturer, University of Southampton. We speak to Rupert Pearse here:https://topmedtalk.libsyn.com/topmedtalks-to-rupert-pearse-esaic-2023 This story is one of the first TopMedTalk ever covered! Our second podcast (back in 2017) covers it here: https://topmedtalk.libsyn.com/monty-boston-pod-two This podcast was recorded “as live” at EBPOM 2023 in London. Expect to find more excellent free content from that meeting soon on TopMedTalk. However, if you can’t wait, why not try going deeper by joining up or getting a ticket to one of our forthcoming conferences: www.ebpom.org The official website for the trial is here: https://optimiseii.org/

This week we are drawing attention to an excellent talk from our archive and warming up for the biggest moment in the perioperative calendar; Evidence Based Perioperative Medicine (EBPOM) and the World Congress of Prehabilitation Medicine 2023. Go now to www.ebpom.org to book your virtual tickets, if you can’t make it in person. In this podcast we look at some of the upcoming sessions and reflect on the contributions made previously to TopMedTalk by some of the panelists and speakers. We discuss this episode of TopMedTalk featuring Gerrit Slooter & Mike Grocott - https://topmedtalk.libsyn.com/the-international-prehabilitation-and-perioperative-exercise-testing-society-ipoetts-ebpom-world-conference We mention the fact that Franco Carli makes important contributions during to this panel discussion: Exercise and the cancer patient during the COVID-19 crisis: https://topmedtalk.libsyn.com/exercise-and-the-cancer-patient-during-the-covid-19-crisis-ebpom-2021 Feras Hatib features in the 2019 Prehabilitation World Congress here: Prehab Periop World Congress: Feras Hatib, Simon Davies https://topmedtalk.libsyn.com/prehab-periop-world-congress-feras-hatib-simon-davies And "Nutrition and surgery a dieticians perspective" with Chelsia Gillis is here: https://topmedtalk.libsyn.com/ebpom-2019-nutrition-and-surgery-a-dieticians-perspective-0 Meanwhile the talk in this week's podcast, from 2018, Sir Bruce Keogh features here in it's original form: https://topmedtalk.libsyn.com/the-topmedtalk-top-ten-sir-bruce-keogh-the-nhs-at-70  

What is the future of AI and autonomous systems in perioperative medicine? This piece revisits a conversation we had at 'Anesthesiology'; the Annual General Meeting of the American Society of Anesthesiologists (ASA). Presented by Desiree Chappell and Monty Mythen with their guest Alexandre Joosten, Anesthetist at Hospital Erasme. This conversation references our earlier chat with our guest which you can listen to here: https://topmedtalk.libsyn.com/topmedtalk-a-step-between-a-simple-monitor-and-a-fully-automated-system

How far can we go with patient monitoring, how do we push forward with patient safety? What sort of monitoring is appropriate and when? How should we continue through the night time period? Where are the 'gaps and opportunities' for new technology? This conversation, originally part of our coverage of 'Anesthesiology' the Annual General Meeting of the American Society of Anesthesiologists (ASA), features Sol Aronson with his guests Sadia Khan, Consultant Physician, Clinical Director and Service Director for Cardiology at Chelsea and Westminster Hospital and Frank Overdyk, Professor of Anaesthesiology, Charleston, South Carolina. Sadia has featured on TopMedTalk previously here: https://www.topmedtalk.com/topmedtalks-to-sadia-khan-ebpom-2022/ We spoke with Frank here on the subject of pain monitoring: https://www.topmedtalk.com/11813-2/

You may have heard of Telemedicine but have you heard of TeleICU? How does it work? What's it like to work in one? How do you avoid alarm fatigue? To what scale can this tecnhology be safely extended? Our guest Mike Scott, Professor of Anesthesiology at the University of Pennsylvania in conversation with Desiree Chappell, Monty Mythen and Sol Aronson. The paper mentioned towards the end of the piece is here: https://www.sciencedirect.com/science/article/abs/pii/S0952818022002914 This piece was originally released here: https://topmedtalk.libsyn.com/creating-high-reliability-using-tele-icu-anesthesiology-2022

TopMedTalk were at this year’s annual conference of The European Society of Anaesthesiology and Intensive Care (ESAIC); Euroanesthesia 2023. For more information on the work ESIAC do check out their website here https://euroanaesthesia.org/ This piece is presented by Monty Mythen with Ellen O’Sullivan, Consultant Anaesthesiologist at St James’s Hospital Dublin, Ross Hofmeyr, Associate Professor of Anaesthesiology at the University of Cape Town and Alistair McNarry, Consultant Anaesthetist Western General and St John's Hospitals Edinburgh.

The TopMedTalk team have a look at some of the products which were on display during Anesthesiology 2022. Specifically, RFID and infusion pumps. Sol Aronson speaks with his guest Robert Canfield, Director of Marketing, Fresenius Kabi and Desiree Chappell talks with her guest, Gwen Volpe, Senior Director Medication Technology and Analytics, Fresenius Kabi.

Our coverage of Euroanesthesia 2023 continues; The European Society of Anaesthesiology and Intensive Care (ESAIC) is the leading European Organisation for Anaesthesia, Intensive Care, Pain and Perioperative Medicine. TopMedTalk is proud to bring you 'as live' coverage of their annual conference. For more information on the work ESIAC do check out their website here https://euroanaesthesia.org/ Desiree Chappell, Monty Mythen and Andy Cumpstey, join Rupert Pearse, Professor of Intensive Care Medicine at Queen Mary, University of London. Last year's conversation with our guest gets mentioned in the piece, if you want to check it out go here: https://topmedtalk.libsyn.com/rupert-pearse-from-the-university-of-london-at-euroanesthesia-2022-topmedtalk We also highly praise the OPtimisation of Peri-operaTive CardIovascular Management to Improve Surgical outcomE II (OPTIMISE II) trial and its website: https://optimiseii.org/  

Our coverage of Euroanesthesia 2023 continues; The European Society of Anaesthesiology and Intensive Care (ESAIC) is the leading European Organisation for Anaesthesia, Intensive Care, Pain and Perioperative Medicine. TopMedTalk is proud to bring you 'as live' coverage of their annual conference. For more information on the work ESIAC do check out their website here https://euroanaesthesia.org/ This piece covers a conversation about hemodynamics and fluid management as Desiree Chappell, Monty Mythen and Andy Cumpstey speak with their guest Marlies Ostermann, Consultant in Critical Care and Nephrology at Guy's and St Thomas' NHS Foundation Trust.

Our coverage of Euroanesthesia 2023 continues; The European Society of Anaesthesiology and Intensive Care (ESAIC) is the leading European Organisation for Anaesthesia, Intensive Care, Pain and Perioperative Medicine. TopMedTalk is proud to bring you 'as live' coverage of their annual conference. For more information on the work ESIAC do check out their website here https://euroanaesthesia.org/ Here Desiree Chappell, Monty Mythen and Andy Cumpstey speak to Adrian Gelb, Professor (emeritus) in the Department of Anesthesia & Perioperative Care, University of California San Francisco (UCSF) and Immediate Past President of The World Federation of Societies of Anaesthesiologists (WFSA) and the current president; Wayne Morriss, Clinical Associate Professor, University of Otago, Christchurch and Christian Werner, Chair of Anesthesia at Johannes Gutenberg University in Mainz and WFSA Chair of the Scientific Affairs Committee. We covered The American Society of Anesthesiologists, Global Scholar programme here: https://topmedtalk.libsyn.com/the-asa-global-scholars-program-part-1-anesthesiology-2022 https://topmedtalk.libsyn.com/the-asa-global-scholars-program-part-2-anesthesiology-2022 Find out more about the WFSA here: https://wfsahq.org/

Our coverage of Euroanesthesia 2023 continues; The European Society of Anaesthesiology and Intensive Care (ESAIC) is the leading European Organisation for Anaesthesia, Intensive Care, Pain and Perioperative Medicine. TopMedTalk is proud to bring you 'as live' coverage of their annual conference. For more information on the work ESIAC do check out their website here https://euroanaesthesia.org/ This piece is a discussion about oxygen; can you have too much of a good thing? Join Desiree Chappell, Monty Mythen and Andy Cumpstey, NIHR Clinical Lecturer in Anaesthetics & Intensive Care Medicine, Southampton. We mention this paper here: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9438193/ And we discuss www.exovent.org

Our coverage of Euroanesthesia 2023 continues; The European Society of Anaesthesiology and Intensive Care (ESAIC) is the leading European Organisation for Anaesthesia, Intensive Care, Pain and Perioperative Medicine. TopMedTalk is proud to bring you 'as live' coverage of their annual conference. For more information on the work ESIAC do check out their website here https://euroanaesthesia.org/ This piece features Desiree Chappell, Monty Mythen and Andy Cumpstey in conversation with Jean-Louis Vincent, Professor of intensive care at University of Brussels.

Our coverage of Euroanesthesia 2023 continues; The European Society of Anaesthesiology and Intensive Care (ESAIC) is the leading European Organisation for Anaesthesia, Intensive Care, Pain and Perioperative Medicine. TopMedTalk is proud to bring you 'as live' coverage of their annual conference. For more information on the work ESIAC do check out their website here https://euroanaesthesia.org/ Monty Mythen and Desiree Chappell speak with Thomas Scheeren, Senior Director of Medical Affairs Critial Care and Vascular, Europe, Edwards Lifesciences and Bernd Saugel, Professor and Vice Chair of the Department of Anesthesiology, Center of Anesthesiology and Intensive Care Medicine at the University Medical Center Hamburg-Eppendorf, Germany about two important pieces of work: "Intraoperative hypotension when using hypotension prediction index software during major noncardiac surgery: a European multicentre prospective observational registry (EU HYPROTECT)" https://www.bjaopen.org/article/S2772-6096(23)00019-9/fulltext -- "Continuous finger-cuff versus intermittent oscillometric arterial pressure monitoring and hypotension during induction of anesthesia and non-cardiac surgery: The DETECT randomized trial" https://pubmed.ncbi.nlm.nih.gov/37265355/ -- Like this, want more? Try these: https://www.topmedtalk.com/euroanaes2019-thomas-scheeren/ https://topmedtalk.libsyn.com/bernd-saugel-at-euroanesthesia-2022-topmedtalk    

The European Society of Anaesthesiology and Intensive Care (ESAIC) is the leading European Organisation for Anaesthesia, Intensive Care, Pain and Perioperative Medicine. TopMedTalk is proud to bring you 'as live' coverage of their annual conference. For more information on the work ESIAC do check out their website here: www.esaic.org This piece features Desiree Chappell, Monty Mythen and Joyce Yeung, Associate Clinical Professor of Anesthesia and critical care, University of Warwick. Our guest kindly shares her Twitter address: @yeung_joyce The UK Perioperative Medicine Clinical Trials Network is here: https://pomctn.org.uk/ The Volatile vs Total intravenous Anaesthesia for major non-cardiac surgery: A pragmatic randomised (VITAL) trial is here: https://www.pomctn.org.uk/VITAL Platform trials for anaesthesia and perioperative medicine: a narrative review is here:  https://www.bjanaesthesia.org/article/S0007-0912(22)00601-8/fulltext    

Monty Mythen, Desiree Chappell and Andy Cumpstey talk you through the opening ceremony of Euroanaesthesia 2023. Should we be advocating "supported" rather than "shared" decision making? What does the future hold for anesthesiology? What is the role of trials in intensive care medicine? And, what instrument do you expect to be playing at the start of this piece from Glasgow, Scotland? The European Society of Anaesthesiology and Intensive Care (ESAIC) is the leading European Organisation for Anaesthesia, Intensive Care, Pain and Perioperative Medicine. TopMedTalk is proud to bring you 'as live' coverage of their annual conference. For more information on the work ESIAC do check out their website here: www.esaic.org

TopMedTalk is live from the European Society of Anaesthesiology and Intensive Care. We will be bringing you interviews from the conference as well as live streaming, check our Twitter for the live feed! Desiree Chappell and Monty Mythen introduce us to a new team member; Andy Cumpstey, NIHR Clinical Lecturer in Anaesthetics & Intensive Care Medicine University of Southampton.

Time to focus on “burnout”; this piece looks back at the coverage TopMedTalk did during the American Society of Anesthesiologists (ASA). We’re proud to be associated with the ASA, for more on them go here: www.asahq.org In this piece you will hear Desiree Chappell, Monty Mythen and Sol Aronson with their guests Amy Vinson, Pediatrician and Anesthesiologist at Boston Children's Hospital and Mark Pinosky, Regional Chief Medical Officer for NorthStar Anesthesia. The podcasts which form the bulk of this piece are here: https://topmedtalk.libsyn.com/provider-burnout-and-well-being-anesthesiology-2022 https://topmedtalk.libsyn.com/burnout-a-systemic-problem-in-need-of-systemic-organizational-policy-level-solutions-anesthesiology-2022 Further support on the subject of “burnout” can be found here: https://topmedtalk.libsyn.com/sunday-special-burn-out-0 https://topmedtalk.libsyn.com/topmedtalk-gezz-van-zwanenberg-matt-wiles-and-marcus-peck-0 https://topmedtalk.libsyn.com/topmedtalk-emotional-intelligence-and-occupational-stress-0 https://topmedtalk.libsyn.com/sca-burn-out-a-frank-discussion

What is the wider view when it comes to perioperative medicine and anesthesiology? How and why should we become leaders, what opportunities for change are there? Presented by Desiree Chappell, Monty Mythen and Sol Aronson, in conversation with; Lee Fleisher, Professor Emeritus of Anesthesiology and Critical Care, University of Pennsylvania. ORIGINAL UNEDITED CONVERSATION HERE: https://topmedtalk.libsyn.com/topmedtalks-to-lee-fleisher-anesthesiology-2022

This week we revisit one of the most popular moments from our coverage of Anesthesiology 2022; a conversation about the big picture theme of TopMedTalk, Perioperative Medicine. This piece begins with Desiree Chappell, Monty Mythen and Sol Aronson introducing their guests; BobbieJean Sweitzer, Systems Director of Perioperative Practices at Inova Health, Falls Church, Virginia and Angela Edwards, Vice Chair Professional Affairs, Atrium Health WFB Anesthesiology, Winston-Salem, North Carolina. The original unedited conversation is here: https://topmedtalk.libsyn.com/perioperative-medicine-anesthesiology-2022

This piece focuses upon trainee led research as Monty Mythen and Desiree Chappell speak with this year's trainee representative Cameron Dunn, Consultant Anaesthetist at Prince of Wales Hospital and Community Health Services, Sydney. This year TopMedTalk is proud to be providing exclusive coverage of the annual ANZCA conference, the professional body responsible for the specialties of anaesthesia and pain medicine in Australia and New Zealand. For more on ANZCA go here: https://www.anzca.edu.au/ And join in the conversation by checking out their socials here: instagram.com/the_anzca/ https://facebook.com/ANZCA1992 https://youtube.com/AnzcaEduAu

This podcast is part of the historic meeting which officially announed the merging of the Perioperative Exercise Testing and Training Society (POETTS) and International Prehabilitation Society (IPS) to promote the professional practice of prehabilitatation and exercise testing. Hear how and why the society is moving forward with an international focus and an unmatched passion for prehabilitation. IPOETTS is here: https://ipoetts.org/ This piece is chaired by Denny Levett, Professor in Perioperative Medicine and Critical Care at the University of Southampton and a Consultant in Perioperative Medicine at Southampton University Hospital NHS Foundation trust (UHS), Gerrit Slooter, Surgical Oncologist, Maxima Medical Centre, The Netherlands and Gerard Danjoux, consultant in Anaesthesia and Sleep Medicine at South Tees Hospitals NHS Trust, Mike Grocott, Professor of Anaesthesia and critical care at the University of Southampton, with questions and comments from the audience. -- Denny is a popular name here on TopMedTalk, if you liked this piece why not delve into our extensive free archive - with more presentations here: POETTS – Nutrition and patient living with and beyond cancer – the Macmillan Trust | EBPOM 2021 https://www.topmedtalk.com/poetts-nutrition-and-patient-living-with-and-beyond-cancer-the-macmillan-trust-ebpom-2021/ EBPOM 2020 London | Fit for surgery with Denny Levett https://www.topmedtalk.com/ebpom-2020-london-fit-for-surgery-with-denny-levett-2/

Welfare and advocacy, a wide topic which intersects a little with the subject of burnout. How do we put our patients first while still listening to our own needs? Monty Mythen speaks with Tracey Tay, Chief Medical Advisor, Calvary Health Care, NSW and Jo Sinclair, Interim Clinical Lead for Employee Wellbeing, Te Whatu Ora Health NZ. -- This year TopMedTalk is proud to be providing exclusive coverage of the annual ANZCA conference, the professional body responsible for the specialties of anaesthesia and pain medicine in Australia and New Zealand. For more on ANZCA go here: https://www.anzca.edu.au/ And join in the conversation by checking out their socials here: instagram.com/the_anzca/ https://facebook.com/ANZCA1992 https://youtube.com/AnzcaEduAu

This piece focuses upon disability and patient centered outcomes. Hear Monty Mythen and Desiree Chappell speaking with 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 Paul Myles, Director, Anaesthesiology and Perioperative Medicine, Alfred Hospital and Monash University. -- This year TopMedTalk is proud to be providing exclusive coverage of the annual ANZCA conference, the professional body responsible for the specialties of anaesthesia and pain medicine in Australia and New Zealand. For more on ANZCA go here: https://www.anzca.edu.au/ And join in the conversation by checking out their socials here: instagram.com/the_anzca/ https://facebook.com/ANZCA1992 https://youtube.com/AnzcaEduAu

Opiods and clinician versus patient expectations. This conversation covers all the key areas; how to reduce opioid use, where ketamine might fit into the picture, the importance of the haemodynamic response and how to lead an opioid reduced response. Here Monty Mythen speaks with Michael Vagg, Immediate past Dean of the Faculty of pain medicine for the Australian and New Zealand College of Anaesthetists (ANZCA), Chair of the Procedures and Payments Committee, Director of Professional Affairs and a Pain Medicine Specialist in Geelong and Malcolm Hogg, staff specialist, anaesthesia and pain management at Melbourne Health. -- This year TopMedTalk is proud to be providing exclusive coverage of the annual ANZCA conference, the professional body responsible for the specialties of anaesthesia and pain medicine in Australia and New Zealand. For more on ANZCA go here: https://www.anzca.edu.au/ And join in the conversation by checking out their socials here: instagram.com/the_anzca/ https://facebook.com/ANZCA1992 https://youtube.com/AnzcaEduAu

Dr Jess Davies is a staff anaesthetist at Austin Health who has a proven track record of being passionate about implementing environmentally sustainable practices into healthcare while still delivering a high standard of patient care. While a trainee she started a sustainability research network called TRA2SH that has over 370 members in Australia, NZ and UK. Find out more about them here: https://www.tra2sh.org/ She is an honorary clinical fellow in the University of Melbourne’s Department of Critical Care, an active member of their sustainability and planetary health network and is embarking on a PhD exploring how implementation science can improve the uptake of sustainable practices in perioperative settings. Here she speaks with our Editor in Chief, Monty Mythen about environmental sustainability. -- This year TopMedTalk is proud to be providing exclusive coverage of the annual Australian and New Zealand College of Anaesthetists (ANZCA) conference, the professional body responsible for the specialties of anaesthesia and pain medicine in Australia and New Zealand. For more on ANZCA go here: https://www.anzca.edu.au/ And join in the conversation by checking out their socials here: instagram.com/the_anzca/ https://facebook.com/ANZCA1992 https://youtube.com/AnzcaEduAu

What is a 'clinical trials network' and why is it important? This piece explores one of ANZCA’s Annual Scientific Meeting’s big talking points with two of the key opinion leaders in the field. Desiree Chappell and Monty Mythen speak with Stefan Dieleman, Cardiac Anaesthetist at Westmead Hospital, Clinical Associate Professor at the University of Sydney and Andrew Davidson, Senior Staff Anaesthetist at the Royal Children's Hospital, head of Anaesthesia Research at the Murdoch Childrens Research Institute and Professor in the Department of Paediatrics, University of Melbourne.

This piece is a conversation with two fascinating guests who are in attendance at the Australian and New Zealand College of Anaesthetists Annual Scientific Meeting (ANZCA). Desiree Chappell and Monty Mythen speak with Jill Van Acker, Specialist Anaesthetist, Canberra Hospitals, Chair Perioperative Medicine SIG, ACE, ANZCA, ASA, NZSA and Louise Speedy, Anesthetist and Intensive Care Specialist at Te Matau a Maui Hawkes Bay Hospital, New Zealand and Medical Officer for the New Zealand Army, Reserve Force Major with the Deployable Health Organisation. -- This year TopMedTalk is proud to be providing exclusive coverage of the annual Australian and New Zealand College of Anaesthetists (ANZCA) conference, the professional body responsible for the specialties of anaesthesia and pain medicine in Australia and New Zealand. For more on ANZCA go here: https://www.anzca.edu.au/ And join in the conversation by checking out their socials here: instagram.com/the_anzca/ https://facebook.com/ANZCA1992 https://youtube.com/AnzcaEduAu

Desiree and Monty break down the schedule for TopMedTalk over the year. Where we’ll be and what we’ll be doing. How to get involved and where to find us. Don’t forget, for more on Evidence Based Perioperative Medicine (EBPOM) go here: www.EBPOM.org This year TopMedTalk is proud to be providing exclusive coverage of the annual Australian and New Zealand College of Anaesthetists (ANZCA) conference, the professional body responsible for the specialties of anaesthesia and pain medicine in Australia and New Zealand. For more on ANZCA go here: https://www.anzca.edu.au/ And join in the conversation by checking out their socials here: instagram.com/the_anzca/ https://facebook.com/ANZCA1992 https://youtube.com/AnzcaEduAu

This piece focuses upon the “REMAP-CAP” trial; A Randomised, Embedded, Multi-factorial, Adaptive Platform Trial for Community-Acquired Pneumonia. It’s a wide ranging discussion which looks behind the headlines of this fascinating piece of research. Their website is here: https://www.remapcap.org/ In the podcast you will hear Monty Mythen speaking with Steve Webb, Professor of Critical Care Research at Monash University, Director of Research for St John of God Healthcare, and a ICU consultant at St John of God Subiaco and the Mount Hospital and Doug Campbell, Anaesthetic specialist at Auckland City Hospital.

The subject of this piece is; neurocognition, after surgery and major anesthesia. We reference previous episodes of TopMedTalk, linked to in the footnotes. Monty Mythen in conversation with Lis Evered, Associate Professor of Neuroscience and Anesthesiology Weill Cornell Medicine in New York and Robert Sanders, Nuffield Chair of Anaesthetics at the University of Sydney and Royal Prince Alfred Hospital and Executive Board member of the Institute of Academic Surgery, Royal Prince Alfred Hospital. -- Lis Evered’s previous piece: https://topmedtalk.libsyn.com/prato-2019-lis-evered -- This year TopMedTalk is proud to be providing exclusive coverage of the annual Australian and New Zealand College of Anaesthetists (ANZCA) conference, the professional body responsible for the specialties of anaesthesia and pain medicine in Australia and New Zealand. For more on ANZCA go here: https://www.anzca.edu.au/ And join in the conversation by checking out their socials here: instagram.com/the_anzca/ https://facebook.com/ANZCA1992 https://youtube.com/AnzcaEduAu

Diversity and gender balance is an important part of the bigger picture in medicine. This piece looks at the facts. Monty Mythen and Desiree Chappell have an important conversation with Kate Leslie, Honorary Professor, Monash University, Melbourne, Australia, Specialist Anaesthetist, The Royal Melbourne Hospital & North Western Mental Health and Non-Executive Director, Australian Medical Council and Claire Stewart, Anaesthetist, Westmead Hospital. This year TopMedTalk is proud to be providing exclusive coverage of the annual Australian and New Zealand College of Anaesthetists (ANZCA) conference, the professional body responsible for the specialties of anaesthesia and pain medicine in Australia and New Zealand. For more on ANZCA go here: https://www.anzca.edu.au/ And join in the conversation by checking out their socials here: instagram.com/the_anzca/ https://facebook.com/ANZCA1992 https://youtube.com/AnzcaEduAu

“This week sees the launch of our diploma in perioperative medicine” Hear Desiree Chappell and Monty Mythen speaking with Vanessa Beavis, Immediate Past President, Australian and New Zealand College of Anaesthetists (ANZCA) about how they are moving on and moving forward. Go now to their website and find out more: https://www.anzca.edu.au/ TopMedTalk is proud to be offering 'as live' coverage of ANZCA’s annual meeting. As mentioned, Vanessa, has impressed our listeners previously here: https://topmedtalk.libsyn.com/pocapalooza-sydney-education-education-education

The Australian and New Zealand College of Anaesthetists (ANZCA) is the professional body responsible for the specialties of anaesthesia and pain medicine in Australia and New Zealand; their annual general conference is this year being covered by TopMedTalk. Monty Mythen is there live with Desiree Chappell joining him remotely. For more on ANZCA go here: https://www.anzca.edu.au/ And check out their socials: instagram.com/the_anzca/ https://facebook.com/ANZCA1992 https://youtube.com/AnzcaEduAu

This essential TopMedTalk Highlight represents the culmination of a number of important threads we’ve been examining over the last few years around interoperative hypotension (IOH). Now though we’re hearing from practitioners who are looking at the consequences of new methods and technology to deal with this threat at scale. Could we see an end to the era of dangerous interoerative hypotension? Selected and edited for your convenience this was originally released as a long form conversation; part of our exclusive coverage of the annual International Anesthesia Research Society, (IARS) meeting organised with the Association of University Anesthesiologists (AUA) and The Society of Critical Care Anesthesiologists (SOCCA). Check out their website here: ​https://iars.org/ It features Monty Mythen, Desiree Chappell and Mike Grocott in conversation with Wael Saasouh, Regional Director of Research at NorthStar Anesthesia. If you have comments or questions about the research and would like to take it further email: contact@topmedtalk.com NOTES: FEDORA trial: https://www.bjanaesthesia.org/article/S0007-0912(17)54207-5/fulltext TOPMEDTALK PREVIOUSLY: https://topmedtalk.libsyn.com/journal-club-the-fedora-trial The RELIEF (Restrictive versus liberal fluid therapy in major abdominal surgery) trial: https://www.nejm.org/doi/full/10.1056/NEJMoa1801601 TOPMEDTALK PREVIOUSLY: https://topmedtalk.libsyn.com/the-relief-trial-results 

This piece is a reflection of the fact that The Society of Cardiovascular Anesthesiologists Annual General Meeting is coming up this weekend, we hope to hear from people who attend. What are the big debates this year? Email contact@topmedtalk.com TopMedTalk’s proud association with the SCA continues as we look back on our ‘as live’ coverage in the past and look forward to future updates in the future. The clips used in this piece have been taken from: https://topmedtalk.libsyn.com/emily-methangkool-at-the-sca-topmedtalk https://topmedtalk.libsyn.com/julius-balogh-at-the-sca-topmedtalk https://topmedtalk.libsyn.com/brad-cardonell-at-the-sca-topmedtalk https://topmedtalk.libsyn.com/monty-and-desiree-at-sca-topmedtalk https://topmedtalk.libsyn.com/andy-shaw-at-the-sca-topmedtalk

This piece is a question and answer session, it's divided into two parts, this is part two. Following on from our previous podcasts, https://topmedtalk.libsyn.com/a-patients-perioperative-perspective-ebpom-world-congress / https://topmedtalk.libsyn.com/essential-update-the-center-for-perioperative-care-ebpom-world-congress / https://topmedtalk.libsyn.com/whats-new-in-education-and-training-in-perioperative-care-ebpom-world-congress this discussion is an invaluable and at points frank examination of perioperative care. What does it look like when ‘the rubber meets the road’? Hosted by Dave Selwyn, Deputy Medical Director at Nottingham University Hospitals NHS Trust and Director of The Centre for Perioperative Care (CPOC) and Mike Grocott, Professor of Anaesthesia and critical care at the University of Southampton. We join them as questions from the online audience are answered by the panel, which includes; Patient Advocate - Lawrence Mudford, enjoyed a 38-year healthcare career working as a dentist and dental educator within both primary and secondary care, Steven Evans, Center for Perioperative Care (CPOC) Fellow and anaesthetic trainee (ST7), Sophie Randall, Director of the Patient Information Forum and Scarlett McNally, Deputy Director for CPOC and honoree, Clinical Professor at Brighton and Sussex medical school and consultant orthopedic surgeon in East Sussex.

Our coverage of annual International Anesthesia Research Society, (IARS) meeting organised with the Association of University Anesthesiologists (AUA) and The Society of Critical Care Anesthesiologists (SOCCA) continues. Here Mike Grocott and Desiree Chappell speak with Jiapeng Huang, Tenured Professor and Vice Chairman of the Department of Anesthesiology and Perioperative Medicine at the University of Louisville, ASA Board of Directors.

This conversation is one of the key reasons we wanted to attend the annual general meeting of the International Anesthesia Research Society, in association with the Society of Critical Care Anesthesiologists and the Association of University Anesthesiologists. Bringing together various strands which we have covered previously here on TopMedTalk around the subject of Interoperative Hypotension (IOH) this in depth, long form conversation, brings you up to date with the latest research. Hear Monty Mythen and Desiree Chappell discuss interoperative hypotension with their guests, Rick Dutton, Chief Quality Officer for US Anesthesia Partners (USAP) and Josh Lumley, Chief Quality Officer from NorthStar Anesthesia before welcoming Wael Saasouh, Regional Director of Research at NorthStar Anesthesia, to the discussion along with Anna Christensen, Director of health research strategy and analytics, Mathematica. -- We spoke previously with Rick Dutton at the ASA here:https://topmedtalk.libsyn.com/rick-dutton-chief-quality-officer-us-anesthesia-partners-topmedtalk-at-the-asa We spoke in more depth to Wael Saasouh here: https://topmedtalk.libsyn.com/topmedtalks-to-wael-saasouh-topmedtalk  

Following on from our previous podcasts, https://topmedtalk.libsyn.com/a-patients-perioperative-perspective-ebpom-world-congress / https://topmedtalk.libsyn.com/essential-update-the-center-for-perioperative-care-ebpom-world-congress / https://topmedtalk.libsyn.com/whats-new-in-education-and-training-in-perioperative-care-ebpom-world-congress this discussion is an invaluable and at points frank examination of perioperative care. What does it look like when ‘the rubber meets the road’? Hosted by Dave Selwyn, Deputy Medical Director at Nottingham University Hospitals NHS Trust and Director of The Centre for Perioperative Care (CPOC) and Mike Grocott, Professor of Anaesthesia and critical care at the University of Southampton. We join them as questions from the online audience are answered by the panel, which includes; Patient Advocate - Lawrence Mudford, enjoyed a 38-year healthcare career working as a dentist and dental educator within both primary and secondary care, Steven Evans, Center for Perioperative Care (CPOC) Fellow and anaesthetic trainee (ST7), Sophie Randall, Director of the Patient Information Forum and Scarlett McNally, Deputy Director for CPOC and honoree, Clinical Professor at Brighton and Sussex medical school and consultant orthopedic surgeon in East Sussex.

This piece released ‘as live’ from the annual International Anesthesia Research Society, (IARS) meeting organised with the Association of University Anesthesiologists (AUA) and The Society of Critical Care Anesthesiologists (SOCCA). Day 2 and the team reflect upon the conference so far. Including thoughts on the interaction between quantum physicas and anethesia. Check out the IARS website here: https://iars.org/ Desiree Chappell, Mike Grocott and Monty Mythen give us a sense of what's happening and what's coming up.

TopMedTalk’s exclusive coverage of #IARS2023 continues; the annual International Anesthesia Research Society, (IARS) meeting organised with the Association of University Anesthesiologists (AUA) and The Society of Critical Care Anesthesiologists (SOCCA). Expect to hear more reports from the conference as they happen as well as longer pieces over the next few months with key opinion leaders and thinkers. Check out their website here: ​https://iars.org/ This piece features Monty Mythen, Desiree Chappell and Mike Grocott in conversation with Wael Saasouh, Regional Director of Research at NorthStar Anesthesia.

This piece released ‘as live’ from the annual International Anesthesia Research Society, (IARS) meeting organised with the Association of University Anesthesiologists (AUA) and The Society of Critical Care Anesthesiologists (SOCCA). Expect to hear more reports from the conference as they happen as well as longer pieces over the next few months with key opinion leaders and thinkers. Check out their website here: https://iars.org/ Desiree Chappell and Mike Grocott begin proceedings.

Steven Evans, Center for Perioperative Care (CPOC) Fellow and anaesthetic trainee (ST7) provides a full update on what’s new in education and training. Originally broadcast to the attendees (both online and in person) of the Evidence Based Perioperative Medicine (EBPOM) World Congress. What are the new innovations, attitudes and standards which are emerging as perioperative practice is pushed forward? If you enjoy this talk, please ensure you are subscribed to TopMedTalk; also ensure you are part of our EBPOM mailing list and go now to the www.ebpom.org site to check out incredible low prices for some of our forthcoming events and conferences.

“The Center for Perioperative Care (CPOC) was set up as a cross organisational collaboration with the patients at the heart of it; focusing on improving care ‘from the moment of contemplation of surgery, through the perioperative period, to recovery’ and really hoping to change the emphasis from patients being ‘surgical patients’ to patients 'being in the perioperative pathway’.” This piece was originally presented as a talk at the Evidence Based Perioperative Medicine (EBPOM) World Congress; “What work has The Center for Perioperative Care (CPOC) been doing?”. It is a full update, on behalf of CPOC, from Jugdeep Dhesi, Consultant Geriatrician, Guys and St Thomas' NHS Trust, Clinical Lead for "Proactive care for Older People undergoing Surgery" (POPS) and a Deputy Director of CPOC. For more on POPS go here: https://www.topmedtalk.com/sunday-special-the-pops-clinic-at-guys-st-thomass-2/ This exclusive update is provided to you for free by TopMedTalk, the broadcasting arm of EBPOM. If you would like to see or attend the EBPOM World Congress - go now to www.ebpom.org

Laurence Mudford (see full bio below) provides the patient perspective and here begins a discussion about perioperative care; what is it, what do people think it is, what should we make it? Taken from the Centre for Perioperative Care’s (CPOC) outstanding contribution to the Evidence Based Perioperative Medicine’s (EBPOM) World Congress; this piece is the first in a series which originally streamed on the EBPOM.org platform. Ensure you check out their site now as we offer incredible prices on this year’s “World Congress”. See these podcasts live, before anyone else and interact with the panel via our easy to use interaction platforms and social media. The piece also features co-chairs Dave Selwyn, Deputy Medical Director at Nottingham University Hospitals NHS Trust and Director of The Centre for Perioperative Care (CPOC) and Mike Grocott, Professor of Anaesthesia and critical care at the University of Southampton. Lawrence Mudford has enjoyed a 38-year healthcare career working as a dentist and dental educator within both primary and secondary care. This has included serving on the Board of the Faculty of General Dental Practice (UK) and as a member of the General Dental Council. Following diagnosis and successful treatment for cancer in 2016, Lawrence has realigned his focus and combines his healthcare background with his passion to champion the “patient voice” In this capacity, he sits on the Board of the CPOC. More information about CPOC go here: https://cpoc.org.uk/

This is part three of a three part piece. Although it works as a stand alone podcast we suggest you find time to loop back on episodes one ( here: https://topmedtalk.libsyn.com/does-increased-volume-improve-cancer-outcomes-ebpom-world-congress ) and two ( here: https://topmedtalk.libsyn.com/does-increased-volume-improve-cancer-outcomes-part-2-ebpom-world-congress ) if you've not yet had time. The topic up for discussion is; “Does increased volume improve cancer outcomes?”. On the panel: Shaman Jhanj, Head of Anaesthesia and Intensive Care Research at the Royal Marsden Hospital, Blanche Symons, patient representative, an ex patient of University Collage London Hospital, Daniel Martin, Consultant in anaesthesia and intensive care medicine, working on the intensive care unit at Derriford hospital. The piece is co-chaired by Denny Levett, Professor in Perioperative Medicine and Critical Care at the University of Southampton and a Consultant in Perioperative Medicine at Southampton University Hospital NHS Foundation trust (UHS) with Tim Wigmore, consultant, anesthetist and intensivist at the Royal Marsden Hospital. It was taken from the www.ebpom.org World Congress. Check out their site now and learn how you can attend a discussion like this. Also, as mentioned in the piece, here are some links to other moments we have on TopMedTalk where Vicki Morton provides more characteristically honest, incisive and occasionally challenging input: https://www.topmedtalk.com/covid-19-usa-south-carolina-vicki-morton-joins-desiree-and-monty/ https://www.topmedtalk.com/enhanced-recovery-after-cardiac-surgery-eras-is-it-really-that-different-dingle-2022/ https://www.topmedtalk.com/cardiac-eras-covid-and-beyond-ebpom/ https://www.topmedtalk.com/novel-therapies-for-perioperative-care-ebpom-dingle/

This is part two of a three part piece. Part one ( here: https://topmedtalk.libsyn.com/does-increased-volume-improve-cancer-outcomes-ebpom-world-congress ) presents a short introduction to the subject of “volume and cancer outcomes”. It's presented by Shaman Jhanj, Head of Anaesthesia and Intensive Care Research at the Royal Marsden Hospital. In this part we are joined by the rest of the panel; Blanche Symons, patient representative, ex patient of University Collage London Hospital, Daniel Martin, Consultant in anaesthesia and intensive care medicine, Derriford Hospital. The discussion, which includes audience questions, is co-chaired by Denny Levett, Professor in Perioperative Medicine and Critical Care at the University of Southampton and a Consultant in Perioperative Medicine at Southampton University Hospital NHS Foundation trust (UHS) and Tim Wigmore, consultant, anesthetist and intensivist at the Royal Marsden Hospital. To attend an event like this go now to www.ebpom.org and ensure you subscribe to our newsletter.

This piece is a short introduction to the subject of “volume and cancer outcomes” which is presented by Shaman Jhanj, Head of Anaesthesia and Intensive Care Research at the Royal Marsden Hospital. The fascinating debate and panel discussion which followed will be released soon here on TopMedTalk but supporters of Evidence Based Perioperative Medicine (EBPOM) may recognise this piece as one of the big moments of the world congress. As mentioned in the piece, it was jointly chaired with The Onco Anesthesia Collaboration. If you’d like more information about EBPOM or to attend one of our conferences please direct yourself to www.ebpom.org

Part three continues our investigation into perioperative anemia, following on from our exclusive reaction and analysis to the Centre For Perioperative Care (CPOC) publication “Guideline for the Management of Anaemia in the Perioperative Pathway” from Scarlett McNally, Deputy Director for CPOC and honoree, Clinical Professor at Brighton and Sussex medical school and consultant orthopedic surgeon in East Sussex this piece covers the first part of the panel discussion which followed. PART 1 https://traffic.libsyn.com/topmedtalk/PERIOPERATIVE_ANEMIA.mp3 PART 2 https://traffic.libsyn.com/topmedtalk/ANEM_2.mp3  Taken from the EBPOM London session on the subject of perioperative anemia, chaired by Mike Grocott, Professor of Anaesthesia and critical care at the University of Southampton, and Rachel Barlow, National Lead, Enhanced Recovery, Prehabilitation and Optimisation, at Cardiff and Vale health board, Wales. The Center for Perioperative Care (CPOC) is ‘a cross-specialty collaboration dedicated to the promotion, advancement and development of perioperative care for the benefit of patients at all stages of their surgical journey’. The Prevent Study is here: https://preventdementia.co.uk/ At the time of this presentation the CPOC guidelines had just been published, now you can find them online here: https://www.cpoc.org.uk/sites/cpoc/files/documents/2022-09/1. CPOC_GuidelinefortheManagementofAnaemia_September2022.pdf This piece was made in collaboration with both Evidence Based Perioperative Medicine (EBPOM) http://www.ebpom.org and The Enhanced Recovery After Surgery Society (ERAS UK): https://www.erasuk.net/

The Center for Perioperative Care (CPOC) is ‘a cross-specialty collaboration dedicated to the promotion, advancement and development of perioperative care for the benefit of patients at all stages of their surgical journey’. Following on from our exclusive reaction and analysis to the CPOC publication “Guideline for the Management of Anaemia in the Perioperative Pathway” from Scarlett McNally, Deputy Director for CPOC and honoree, Clinical Professor at Brighton and Sussex medical school and consultant orthopedic surgeon in East Sussex ( https://directory.libsyn.com/episode/index/id/25808664 ) this piece covers the first part of the panel discussion which followed. Taken from the EBPOM London session on the subject of perioperative anemia, chaired by Mike Grocott, Professor of Anaesthesia and critical care at the University of Southampton, and Rachel Barlow, National Lead, Enhanced Recovery, Prehabilitation and Optimisation, at Cardiff and Vale health board, Wales. The Prevent Study is here: https://preventdementia.co.uk/ At the time of this presentation the CPOC guidelines had just been published, now you can find them online here: https://www.cpoc.org.uk/sites/cpoc/files/documents/2022-09/1. CPOC_GuidelinefortheManagementofAnaemia_September2022.pdf This piece was made in collaboration with both Evidence Based Perioperative Medicine (EBPOM) http://www.ebpom.org and The Enhanced Recovery After Surgery Society (ERAS UK): https://www.erasuk.net/

The Center for Perioperative Care (CPOC) is ‘a cross-specialty collaboration dedicated to the promotion, advancement and development of perioperative care for the benefit of patients at all stages of their surgical journey’. Here we have exclusive reaction and analysis to their publication “Guideline for the Management of Anaemia in the Perioperative Pathway” from Scarlett McNally, Deputy Director for CPOC and honoree, Clinical Professor at Brighton and Sussex medical school and consultant orthopedic surgeon in East Sussex. This is the first piece of an EBPOM London session on the subject of perioperative anemia which was chaired by Mike Grocott, Professor of Anaesthesia and critical care at the University of Southampton, and Rachel Barlow, National Lead, Enhanced Recovery, Prehabilitation and Optimisation, at Cardiff and Vale health board, Wales. At the time of this presentation the guidelines had just been published, now you can find them online here: https://www.cpoc.org.uk/sites/cpoc/files/documents/2022-09/1. CPOC_GuidelinefortheManagementofAnaemia_September2022.pdf This piece was made in collaboration with both Evidence Based Perioperative Medicine (EBPOM) www.ebpom.org and The Enhanced Recovery After Surgery Society (ERAS UK): https://www.erasuk.net/

A stand out moment from Dingle’s Evidence Based Perioperative Medicine (EBPOM) conference; the inaugural Tom Crean Plenary Lecture, presented by Mike Grocott, Professor of Anaesthesia and critical care at the University of Southampton. To find out more about EBPOM’s fantastic line up of future events go now to www.ebpom.org Mike Grocott is a popular contributor to TopMedTalk, if you enjoyed this why not check out some of his previous appearances: Prehabilitation with Mike Grocott - https://topmedtalk.libsyn.com/anes19-prehabilitation-with-mike-grocott Efficient Trial Design; ‘evidence’ in the era of ‘Big Data’ - https://topmedtalk.libsyn.com/efficient-trial-design-evidence-in-the-era-of-big-data-dingle-2022 Prehabilitation, the word of the year - https://topmedtalk.libsyn.com/asa-prehabilitation-the-word-of-the-year

The Royal Collage of Anesthetists (RCoA) are re-evaluating in the face of a global crisis; where do you stand in the forthcoming debate? This piece, chaired by Monty Mythen and Mike Grocott, originally closed EBPOM Dingle. It’s a much needed full and frank discussion regarding the realities of non-physician anaesthesia providers; could they be a realistic solution to the global staffing crisis we have heard about in recent years? It’s a perfect storm which combines ‘mass retirement’, COVID-19 measures and the related delay in elective surgery. When the RCoA grapple publicly with a debate like this there’s a responsibility for anaesthesia practitioners to consider it as well. As always TopMedTalk is interested to hear what you think, email us on contact@topedtalk.com - your comments might be shared with our audience in the future. The discussion is inspired by and uses a clip from “The future of the anaesthetic workforce in the UK - a personal view” which is available for free, in full, here: https://www.topmedtalk.com/the-future-of-the-anaesthetic-workforce-in-the-uk-a-personal-view-william-harrop-griffiths-ebpom-2022/ TopMedTalk has also made the Question and Answer session which followed that presentation available here: https://www.topmedtalk.com/the-future-of-the-anaesthetic-workforce-in-the-uk-part-2-qa-session-ebpom-2022/ Evidence Based Perioperative Medicine (EBPOM) conferences are also available in video form! Check out www.ebpom.org now to find out more and to discover how you can attend a conference either in person or virtually.

“I personally think this is a worse pandemic than the one we’ve just had and it’s impact - if we don’t do something about it - is going to be even more far reaching than COVID has been; this is about the global inactivity pandemic” This talk is a timely reminder of the importance of the value of exercise. It is presented by Denny Levett, Professor in Perioperative Medicine and Critical Care at the University of Southampton and a Consultant in Perioperative Medicine at Southampton University Hospital NHS Foundation trust (UHS). The Morpheus Plenary Lecture was originally part of Evidence Based Perioperative Medicine’s EBPOM London conference of 2022. To find out more about EBPOM go now to www.ebpom.org Denny is a popular name here on TopMedTalk, if you liked this piece why not delve into our extensive free archive - with more presentations here: POETTS – Nutrition and patient living with and beyond cancer – the Macmillan Trust | EBPOM 2021 https://www.topmedtalk.com/poetts-nutrition-and-patient-living-with-and-beyond-cancer-the-macmillan-trust-ebpom-2021/ EBPOM 2020 London | Fit for surgery with Denny Levett https://www.topmedtalk.com/ebpom-2020-london-fit-for-surgery-with-denny-levett-2/

Celebrating 5 years of TopMedTalk at 'Anesthesiology'; the Annual General Meeting of the American Society of Anesthesiologists (ASA). Please share this interview to you social media channels to help us reach a wider audience. TopMedTalk is presented by Desiree Chappell, Monty Mythen and Sol Aronson with their guest; Michael Champeau, President-Elect of The American Society of Anesthesiologists. It covers ‘the vision for the year ahead’ as the ASA's incoming president explains how the organisation intends to deal with the implementation of the ‘No Surprises Act’. We took a look into our archive recently and dug out interviews with ASA Presidents over the years, have a listen here: https://directory.libsyn.com/episode/index/id/24676698 TopMedTalk is very proud to be partnered with the American Society of Anesthesiologists® at ANESTHESIOLOGY® 2022. Now in our fifth year TopMedTalk is bringing you our most comprehensive and extensive coverage of the largest gathering of anesthesiologists in the world! TopMedTalk is provided to you for free; if you want to help support our work and help give these conversations a wider audience please like and subscribe (if and where possible) before sharing it on your social media. TopMedTalk can be found on YouTube here: https://www.youtube.com/channel/UC-HYQmeIwcFCYO1hoQ8jShQ We are on Twitter here: https://twitter.com/topmedtalk We are on LinkedIn here: https://www.linkedin.com/company/topmedtalk We are on Facebook here: https://www.facebook.com/TopMedTalk1/

This piece looks at how The National Institute for Health and Care Research (NIHR) is taking an active role in perioperative medicine and surgery; addressing unanswered questions and ensuring research is both inclusive and extensive in the UK health industry. How have the NIHR moved medicine forward and what lessons can be learned from the recent COVID-19 crisis? Presented by Lucy Chappell, Professor, Chief Scientific Adviser to the Department of Health and Social Care and Chief Executive of the National Institute for Health and Care Research (NIHR) with contributions and questions from the audience and panel including; Mike Grocott, Professor of Anaesthesia and Critical Care in Southampton and Director of the NIHR Biomedical Research Center in Southampton, Guy Ludbrook, Professor of Anaesthesia at the University of Adelaide and Royal Adelaide Hospital and Ramani Moonesinghe OBE, Professor of Perioperative Medicine at University College London and a Consultant in Anaesthetics and Critical Care Medicine at UCL Hospitals.

In 2022 we covered many live events and conferences both on the subject of anesthesia and perioperative medicine; we produced audio versions of some of the most interesting speakers in the field of perioperative medicine and provided you with exclusive interviews and behind the scenes access to some of the key opinion leaders and thinkers in medicine. That's not to mention occasional exclusive news releases, hard hitting debates and the friendly charm of your favorite presenters; Desiree, Monty, Sol, Mike and the rest of the team. Do ensure you’ve taken advantage of the current offers available now on the Evidence Based Perioperative Medicine (EBPOM) website: www.ebpom.org In this podcast: A preview of "The National Institute for Health and Care Research | EBPOM London" https://topmedtalk.libsyn.com/the-national-institute-for-health-and-care-research-ebpom-london - this link will be active upon release. We also look back at: "I know nothing..." Hugh Montgomery https://topmedtalk.libsyn.com/i-know-nothing-hugh-montgomery-ernest-henry-starling-plenary-lecture-ebpom-2022 The Great Fluid Debate | EBPOM 2022 https://topmedtalk.libsyn.com/the-great-fluid-debate-ebpom-2022 Novel Therapies for Perioperative Care. This from EBPOM Dingle 2022 https://www.topmedtalk.com/novel-therapies-for-perioperative-care-ebpom-dingle/ Efficient trial design, ‘evidence’ in the era of ‘Big Data’ | Dingle 2022 https://www.topmedtalk.com/efficient-trial-design-evidence-in-the-era-of-big-data-dingle-2022/ Enhanced Recovery After Cardiac Surgery (ERAS) - Is it really that different? | Dingle 2022 https://www.topmedtalk.com/enhanced-recovery-after-cardiac-surgery-eras-is-it-really-that-different-dingle-2022/ ASA Global Scholars - Part 1: https://www.topmedtalk.com/the-asa-global-scholars-program-part-1-anesthesiology-2022/ Part 2: https://www.topmedtalk.com/the-asa-global-scholars-program-part-2-anesthesiology-2022/

TopMedTalk's 2022 retrospective covers some of the big topics of the year in perioperative medicine: Perioperative diabetes management; Connected Health and the COVID era; ‘is day case total knee replacement taking ERAS too far?; are perioperative nutrition clinics essential? - and a deep dive into Intraoperative Hypotension. The links to the shows mentioned in this piece are, in order: "Key update on Intraoperative Hypotension | EBPOM Chicago": https://www.topmedtalk.com/key-update-on-interoperative-hypotension-ebpom-chicago/ "Nutrition clinics | EBPOM Chicago" https://www.topmedtalk.com/nutrition-clinics-ebpom-chicago/ “Nutrition clinics - panel discussion” - https://www.topmedtalk.com/nutrition-clinics-panel-discussion-ebpom-chicago-ireland/ "1st Transatlantic Leadership Forum - Connected Health - COVID Hyperdrive or Hype? | EBPOM Dingle" - https://www.topmedtalk.com/1st-transatlantic-leadership-forum-connected-health-covid-hyperdrive-or-hype-ebpom-dingle/ “2nd Transatlantic Leadership Forum - Is day case total knee replacement taking ERAS too far? | EBPOM Chicago” https://www.topmedtalk.com/2nd-transatlantic-leadership-forum-is-day-case-total-knee-replacement-taking-eras-too-far-ebpom-chicago/ ”Perioperative diabetes management, nuts and bolts | EBPOM Chicago” - https://www.topmedtalk.com/perioperative-diabetes-management-nuts-and-bolts-ebpom-chicago/ "Perioperative diabetes clinic; panel discussion | EBPOM Chicago" - https://www.topmedtalk.com/perioperative-diabetes-clinic-panel-discussion-ebpom-chicago/

This entertaining talk is a rewarding look at the heart in a linguistic and cultural context; what does the word and the heart itself actually mean to us? Originally part of the Evidence Based Perioperative Medicine (EBPOM) Dingle conference it is presented here to you for free. If you would like to learn more about EBPOM and the fantastic forthcoming conferences we have to come please go to www.ebpom.org Presented by Desmond Sheridan, Emeritus Professor of Cardiology, National Heart and Lung Institute, Imperial College London.

Originally entitled “The Future of Training” this talk evaluates four key concepts in anaesthesia training. It was originally presented as part of the hugely successful Evidence Based Perioperative Medicine (EBPOM) Dingle conference. If you would like to know more about when and where their next conference is please go now to the EBPOM website: www.ebpom.org Presented by George Shorten, Professor of Anaesthesia and Intensive Care Medicine and Foundation Director of the ASSERT Centre at University College Cork, Ireland

As patients live longer their needs are becoming more acute during surgery; this piece asks how we can adapt practice to meet the new challenges this brings. These talks take a long view across the perioperative continuum with a focus upon cognitive impairment and other vulnerable brain patients. Presented by Laura MacDarby, Consultant Anaesthetist in The Royal London Hospital, a referral centre for Major Trauma and Stroke in the Whitechapel area of London and Roisin Coary, SpR in Geriatric and General Internal Medicine, with a specialist interest in Peri-operative Medicine, currently based in Dublin, Ireland.

This vital conversation comes in the wake of the COVID-19 crisis; how different is enhanced recovery after surgery (ERAS) and does it really get the results we want? Recorded at the Dingle Evidence Based Perioperative Medicine (EBPOM) conference in 2022. If you’d like to attend an EBPOM conference check out www.ebpom.org now. Chaired by Monty Mythen with contributions from Aoife Lavelle, Consultant St James’s Hospital, Dublin, Aisling Kinsella, Consultant Cardiothoracic and Transplant Surgeon at Mater Misericordiae University Hospital and Vicki Morton, Director of Clinical and Quality Outcomes, Providence Anesthesiology Associates.

This week we have the Evidence Based Perioperative Medicine (EBPOM) Visiting Professor Plenary Lecture question and answer session for; "The future of the anaesthetic workforce in the UK - a personal view". The full talk - if you’ve not yet heard it - is here: https://www.topmedtalk.com/the-future-of-the-anaesthetic-workforce-in-the-uk-a-personal-view-william-harrop-griffiths-ebpom-2022/ Presented by William Harrop-Griffiths, Vice-President Royal Collage of Anesthetists (September 2020-22) and introduced by Mike Grocott, Professor of Anaesthesia and critical care at the University of Southampton.

“This is not a book about the current evidence, this is a book about how you keep making things better in perioperative care”. TopMedTalk speaks with the co-editors of the new book; “Perioperative Quality Improvement”. Following on from our extensive coverage of Anesthesiology 2022, this piece was originally intended to be part of that but - for reasons explained within - it was delayed. To buy it now go to: https://www.amazon.co.uk/Perioperative-Quality-Improvement-Carol-Peden/dp/0323833993 Presented by Desiree Chappell and Monty Mythen with their guests, Carol Peden, Adjunct Profesor in Anesthesiology at both the Keck School of Medicine of USC in Los Angeles, California and the Perelman School of Medicine at the University of Pennsylvania in Philadelphia, Pennsylvania, Michael Engelsbe is the Cyrenus G. Darling Sr., MD and Cyrenus G. Darling Jr., MD Professor of Surgery within the Section of Transplantation Surgery at Michigan Medicine, University of Michigan, Ann Arbor, MI, USA and Lee Fleisher, Professor Emeritus, Perelman School of Medicine, University of Pennsylvania.

This fundamental conversation is given a fresh perspective during one of the stand out moments of the recent Evidence Based Perioperative Medicine (EBPOM) Dingle conference. How do we define evidence in the era of big data? Can we further improve the speed at which we do trials and yet still gather reliable data? In the wake of COVID-19 what new innovations can be made to how we trial and test vital medical help? Chaired by Ramani Moonesinghe, OBE, Professor of Perioperative Medicine at University College London, Consultant in Anaesthetics and Critical Care Medicine at UCL Hospitals, this piece features; Mark Edwards, Consultant in Anaesthesia & Perioperative Medicine, University Hospital Southampton, Honorary Senior Clinical Lecturer, University of Southampton, Mike Grocott, Professor of Anaesthesia and Critical Care Medicine, University of Southampton and Matt Wilson, Anesthetist, UCL Hospitals and University College London and a PhD candidate.

This is the concluding Q&A session regarding the Perioperative Quality Initiative (POQI). Please listen to parts 1 and 2 here: Part 1: https://directory.libsyn.com/episode/index/id/24529878?_ga=2.112287174.319377695.1666031811-966310048.1569589661 Part 2: https://directory.libsyn.com/episode/index/id/24714003?_ga=2.112287174.319377695.1666031811-966310048.1569589661 And don't forget to use the resources and website here: www.poqi.org Hosted by Mike Grocott, Professor of Anaesthesia and critical care at the University of Southampton with a panel including; Monty Mythen, Professor of Anaesthesia and Critical Care, University College London, Andy Shaw, Department of Intensive Care and Resuscitation at The Cleveland Clinic, Cleveland, Ohio, Tong Joo (TJ) Gan, Professor and Chairman at Stoney Brook in New York, Tim Miller, Associate Professor of Anesthesiology from Duke University Medical Center, Desiree Chappell, Certified Registered Nurse Anesthetist (CRNA) and Vice President of Clinical Quality for NorthStar Anesthesia, 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 and Cheryl Crisafi, Cardiac Surgery Care Coordinator Nurse at Baystate Medical Center in Springfield, MA

What is the Perioperative Quality Initiative (POQI) and why is this episode always a popular download - each year - for TopMedTalk listeners? How can POQI help practitioners make informed choices? Where's the POQI website and the resources? It's here: http://thepoqi.org/ This is the second of a three part series which covers the entire POQI session from the Evidence Based Perioperative Medicine (EBPOM) conference 2022. Hosted by Mike Grocott, Professor of Anaesthesia and critical care at the University of Southampton; it continues with Monty Mythen, Professor of Anaesthesia and Critical Care, University College London, giving a presentation about "POQI II"; moving onto a "POQI III" presentation from Andy Shaw, Department of Intensive Care and Resuscitation at The Cleveland Clinic, Cleveland, Ohio. If you've not heard Part 1 please follow this link here: https://directory.libsyn.com/episode/index/id/24529878

What is the Perioperative Quality Initiative (POQI) and why is this episode always a popular download - each year - for TopMedTalk listeners? How can POQI help practitioners make informed choices? Where's the POQI website and the resources? It's here: http://thepoqi.org/ This is the first of a three part series which will cover the entire POQI session from the Evidence Based Perioperative Medicine (EBPOM) conference 2022. Hosted by Mike Grocott, Professor of Anaesthesia and critical care at the University of Southampton; it begins with a short introductory presentation from Tong Joo (TJ) Gan, Professor and Chairman at Stoney Brook in New York; moving onto Tim Miller, Associate Professor of Anesthesiology from Duke University Medical Centre, on the subject of "POQI I".

Celebrating 5 years of TopMedTalk at 'Anesthesiology'; the Annual General Meeting of the American Society of Anesthesiologists (ASA). This piece is presented by Desiree Chappell and Monty Mythen with their guest; Jeff Simmons, Medical Director for UAB’s Preoperative Assessment, Consultation, and Treatment Clinics and all Paranesthesia Care Units. Jeff has featured on TopMedTalk previously: Here: https://www.topmedtalk.com/anes19-jeff-simmons/ And here: https://www.topmedtalk.com/asa-2019-we-advocate-good-public-health-within-the-crucible-of-surgery/ The article mentioned in the piece is here: https://www.researchgate.net/publication/358651570_Preoperative_Risk_Stratification_Identifying_Modifiable_Risks_for_Optimization TopMedTalk is very proud to be partnered with the American Society of Anesthesiologists® at ANESTHESIOLOGY® 2022. Now in our fifth year TopMedTalk is bringing you our most comprehensive and extensive coverage of the largest gathering of anesthesiologists in the world! This audio is presented to you "as live" - if you'd like to see our coverage as it happens go now to: https://live.topmedtalk.com/ TopMedTalk is provided to you for free; if you want to help support our work and help give these conversations a wider audience please like and subscribe (if and where possible) before sharing it on your social media. TopMedTalk can be found on YouTube here: https://www.youtube.com/channel/UC-HYQmeIwcFCYO1hoQ8jShQ We are on Twitter here: https://twitter.com/topmedtalk We are on LinkedIn here: https://www.linkedin.com/company/topmedtalk We are on Facebook here: https://www.facebook.com/TopMedTalk1/

Celebrating 5 years of TopMedTalk at 'Anesthesiology'; the Annual General Meeting of the American Society of Anesthesiologists (ASA). This piece is presented by Desiree Chappell, Monty Mythen and Sol Aronson with their guest; BobbieJean Sweitzer, Systems Director of Perioperative Practices at Inova Health, Falls Church, Virginia and Angela Edwards, Vice Chair Professional Affairs, Atrium Health WFB Anesthesiology, Winston-Salem, North Carolina. Both of our guests have impressed TopMedTalk listeners in the past; here’s a couple of pieces featuring them: Angela Edwards: https://www.topmedtalk.com/asa-2018-san-francisco-improving-outcomes-for-the-perioperative-patient/ BobbieJean Sweitzer: https://www.topmedtalk.com/asa-frailty-and-the-perioperative-patient-enhancing-recovery/ TopMedTalk is very proud to be partnered with the American Society of Anesthesiologists® at ANESTHESIOLOGY® 2022. Now in our fifth year TopMedTalk is bringing you our most comprehensive and extensive coverage of the largest gathering of anesthesiologists in the world! This audio is presented to you "as live" - if you'd like to see our coverage as it happens go now to: https://live.topmedtalk.com/ TopMedTalk is provided to you for free; if you want to help support our work and help give these conversations a wider audience please like and subscribe (if and where possible) before sharing it on your social media. TopMedTalk can be found on YouTube here: https://www.youtube.com/channel/UC-HYQmeIwcFCYO1hoQ8jShQ We are on Twitter here: https://twitter.com/topmedtalk We are on LinkedIn here: https://www.linkedin.com/company/topmedtalk We are on Facebook here: https://www.facebook.com/TopMedTalk1/

Celebrating 5 years of TopMedTalk at 'Anesthesiology'; the Annual General Meeting of the American Society of Anesthesiologists (ASA). This piece is presented by Desiree Chappell, Monty Mythen and Sol Aronson with their guest; Randall M. Clark, M.D., FASA, outgoing President of the ASA 2022. The Anesthesia Quality Institute (AQI) is here: https://www.aqihq.org/ We took a look into our archive recently and dug out interviews with past ASA Presidents over the years, have a listen here: https://directory.libsyn.com/episode/index/id/24676698 TopMedTalk is very proud to be partnered with the American Society of Anesthesiologists® at ANESTHESIOLOGY® 2022. Now in our fifth year TopMedTalk is bringing you our most comprehensive and extensive coverage of the largest gathering of anesthesiologists in the world! This audio is presented to you "as live" - if you'd like to see our coverage as it happens go now to: https://live.topmedtalk.com/ TopMedTalk is provided to you for free; if you want to help support our work and help give these conversations a wider audience please like and subscribe (if and where possible) before sharing it on your social media. TopMedTalk can be found on YouTube here: https://www.youtube.com/channel/UC-HYQmeIwcFCYO1hoQ8jShQ We are on Twitter here: https://twitter.com/topmedtalk We are on LinkedIn here: https://www.linkedin.com/company/topmedtalk We are on Facebook here: https://www.facebook.com/TopMedTalk1/

Celebrating 5 years of TopMedTalk at 'Anesthesiology'; the Annual General Meeting of the American Society of Anesthesiologists. This piece is presented by Desiree Chappell with her guests; representatives of the ASA Global Scholars Program; supporting young leaders in the specialty from low- and middle-lower income countries. Part One of this piece is here: https://directory.libsyn.com/episode/index/id/24794133 This conversation was triggered by our meeting with Elizabeth Drum which you can also listen to here: https://www.topmedtalk.com/global-humanitarian-outreach-with-elizabeth-drum-anesthesiology-2022/ TopMedTalk is very proud to be partnered with the American Society of Anesthesiologists® at ANESTHESIOLOGY® 2022. Now in our fifth year TopMedTalk is bringing you our most comprehensive and extensive coverage of the largest gathering of anesthesiologists in the world! This audio is presented to you "as live" - if you'd like to see our coverage as it happens go now to: https://live.topmedtalk.com/ TopMedTalk is provided to you for free; if you want to help support our work and help give these conversations a wider audience please like and subscribe (if and where possible) before sharing it on your social media. TopMedTalk can be found on YouTube here: https://www.youtube.com/channel/UC-HYQmeIwcFCYO1hoQ8jShQ We are on Twitter here: https://twitter.com/topmedtalk We are on LinkedIn here: https://www.linkedin.com/company/topmedtalk We are on Facebook here: https://www.facebook.com/TopMedTalk1/

Celebrating 5 years of TopMedTalk at 'Anesthesiology'; the Annual General Meeting of the American Society of Anesthesiologists. This piece is presented by Desiree Chappell with her guests, representatives of the ASA Global Scholars Program; supporting young leaders in the specialty from low- and middle-lower income countries. This conversation was triggered by our meeting with Elizabeth Drum which you can also listen to here: https://www.topmedtalk.com/global-humanitarian-outreach-with-elizabeth-drum-anesthesiology-2022/ TopMedTalk is very proud to be partnered with the American Society of Anesthesiologists® at ANESTHESIOLOGY® 2022. Now in our fifth year TopMedTalk is bringing you our most comprehensive and extensive coverage of the largest gathering of anesthesiologists in the world! This audio is presented to you "as live" - if you'd like to see our coverage as it happens go now to: https://live.topmedtalk.com/ TopMedTalk is provided to you for free; if you want to help support our work and help give these conversations a wider audience please like and subscribe (if and where possible) before sharing it on your social media. TopMedTalk can be found on YouTube here: https://www.youtube.com/channel/UC-HYQmeIwcFCYO1hoQ8jShQ We are on Twitter here: https://twitter.com/topmedtalk We are on LinkedIn here: https://www.linkedin.com/company/topmedtalk We are on Facebook here: https://www.facebook.com/TopMedTalk1/

Celebrating 5 years of TopMedTalk at 'Anesthesiology'; the Annual General Meeting of the American Society of Anesthesiologists. This piece is presented by Desiree Chappell and Monty Mythen with their guest Mike Scott, Professor of Anesthesiology at the University of Pennsylvania. TopMedTalk is very proud to be partnered with the American Society of Anesthesiologists® at ANESTHESIOLOGY® 2022. Now in our fifth year TopMedTalk is bringing you our most comprehensive and extensive coverage of the largest gathering of anesthesiologists in the world! This audio is presented to you "as live" - if you'd like to see our coverage as it happens go now to: https://live.topmedtalk.com/ TopMedTalk is provided to you for free; if you want to help support our work and help give these conversations a wider audience please like and subscribe (if and where possible) before sharing it on your social media. TopMedTalk can be found on YouTube here: https://www.youtube.com/channel/UC-HYQmeIwcFCYO1hoQ8jShQ We are on Twitter here: https://twitter.com/topmedtalk We are on LinkedIn here: https://www.linkedin.com/company/topmedtalk We are on Facebook here: https://www.facebook.com/TopMedTalk1/

Celebrating 5 years of TopMedTalk at 'Anesthesiology'; the Annual General Meeting of the American Society of Anesthesiologists. This piece is presented by Desiree Chappell and Sol Aronson with her guest Amy Vinson, Pediatrician and Anesthesiologist at Boston Children's Hospital. TopMedTalk is very proud to be partnered with the American Society of Anesthesiologists® at ANESTHESIOLOGY® 2022. Now in our fifth year TopMedTalk is bringing you our most comprehensive and extensive coverage of the largest gathering of anesthesiologists in the world! This audio is presented to you "as live" - if you'd like to see our coverage as it happens go now to: https://live.topmedtalk.com/ TopMedTalk is provided to you for free; if you want to help support our work and help give these conversations a wider audience please like and subscribe (if and where possible) before sharing it on your social media. TopMedTalk can be found on YouTube here: https://www.youtube.com/channel/UC-HYQmeIwcFCYO1hoQ8jShQ We are on Twitter here: https://twitter.com/topmedtalk We are on LinkedIn here: https://www.linkedin.com/company/topmedtalk We are on Facebook here: https://www.facebook.com/TopMedTalk1/

Celebrating 5 years of TopMedTalk at 'Anesthesiology'; the Annual General Meeting of the American Society of Anesthesiologists. This piece is presented by Desiree Chappell, Sol Aronson and Monty Mythen with their guest Sheela Pai Cole, Clinical Professor, Anesthesiology, Perioperative and Pain Medicine at Stanford Health Center. TopMedTalk is very proud to be partnered with the American Society of Anesthesiologists® at ANESTHESIOLOGY® 2022. Now in our fifth year TopMedTalk is bringing you our most comprehensive and extensive coverage of the largest gathering of anesthesiologists in the world! This audio is presented to you "as live" - if you'd like to see our coverage as it happens go now to: https://live.topmedtalk.com/ TopMedTalk is provided to you for free; if you want to help support our work and help give these conversations a wider audience please like and subscribe (if and where possible) before sharing it on your social media. TopMedTalk can be found on YouTube here: https://www.youtube.com/channel/UC-HYQmeIwcFCYO1hoQ8jShQ We are on Twitter here: https://twitter.com/topmedtalk We are on LinkedIn here: https://www.linkedin.com/company/topmedtalk We are on Facebook here: https://www.facebook.com/TopMedTalk1/

Celebrating 5 years of TopMedTalk at 'Anesthesiology'; the Annual General Meeting of the American Society of Anesthesiologists. This piece is presented by Desiree Chappell and Monty Mythen with their guest Bernd Saugel, Professor and Vice Chair of the Department of Anesthesiology, Center of Anesthesiology and Intensive Care Medicine at the University Medical Center Hamburg-Eppendorf, Germany. Bernd has previously appeared on TopMedTalk here: https://www.topmedtalk.com/bernd-saugel-at-euroanesthesia-2022-topmedtalk/ TopMedTalk is very proud to be partnered with the American Society of Anesthesiologists® at ANESTHESIOLOGY® 2022. Now in our fifth year TopMedTalk is bringing you our most comprehensive and extensive coverage of the largest gathering of anesthesiologists in the world! This audio is presented to you "as live" - if you'd like to see our coverage as it happens go now to: https://live.topmedtalk.com/ TopMedTalk is provided to you for free; if you want to help support our work and help give these conversations a wider audience please like and subscribe (if and where possible) before sharing it on your social media. TopMedTalk can be found on YouTube here: https://www.youtube.com/channel/UC-HYQmeIwcFCYO1hoQ8jShQ We are on Twitter here: https://twitter.com/topmedtalk We are on LinkedIn here: https://www.linkedin.com/company/topmedtalk We are on Facebook here: https://www.facebook.com/TopMedTalk1/

Celebrating 5 years of TopMedTalk at 'Anesthesiology'; the Annual General Meeting of the American Society of Anesthesiologists (ASA). This piece is presented by Desiree Chappell and Sol Aronson with their guest Evan Kharasch, Professor and Vice Chair for Innovation in the Department of Anesthesiology at Duke University, Director of Academic Entrepreneurship in Duke University School of Medicine and editor-in-chief of 'Anesthesiology' the official medical journal of ASA. Find out more about the journal here: https://pubs.asahq.org/anesthesiology TopMedTalk is very proud to be partnered with the American Society of Anesthesiologists® at ANESTHESIOLOGY® 2022. Now in our fifth year TopMedTalk is bringing you our most comprehensive and extensive coverage of the largest gathering of anesthesiologists in the world! This audio is presented to you "as live" - if you'd like to see our coverage as it happens go now to: https://live.topmedtalk.com/ TopMedTalk is provided to you for free; if you want to help support our work and help give these conversations a wider audience please like and subscribe (if and where possible) before sharing it on your social media. TopMedTalk can be found on YouTube here: https://www.youtube.com/channel/UC-HYQmeIwcFCYO1hoQ8jShQ We are on Twitter here: https://twitter.com/topmedtalk We are on LinkedIn here: https://www.linkedin.com/company/topmedtalk We are on Facebook here: https://www.facebook.com/TopMedTalk1/

Celebrating 5 years of TopMedTalk at 'Anesthesiology'; the Annual General Meeting of the American Society of Anesthesiologists. This piece is presented by Sol Aronson and with his guests Sadia Khan, Consultant Physician, Clinical Director and Service Director for Cardiology at Chelsea and Westminster Hospital and Frank Overdyk, Professor of Anaesthesiology, Charleston, South Carolina. Sadia has featured on TopMedTalk previously here: https://www.topmedtalk.com/topmedtalks-to-sadia-khan-ebpom-2022/ We spoke with Frank here on the subject of pain monitoring: https://www.topmedtalk.com/11813-2/ TopMedTalk is very proud to be partnered with the American Society of Anesthesiologists® at ANESTHESIOLOGY® 2022. Now in our fifth year TopMedTalk is bringing you our most comprehensive and extensive coverage of the largest gathering of anesthesiologists in the world! This audio is presented to you "as live" - if you'd like to see our coverage as it happens go now to: https://live.topmedtalk.com/ TopMedTalk is provided to you for free; if you want to help support our work and help give these conversations a wider audience please like and subscribe (if and where possible) before sharing it on your social media. TopMedTalk can be found on YouTube here: https://www.youtube.com/channel/UC-HYQmeIwcFCYO1hoQ8jShQ We are on Twitter here: https://twitter.com/topmedtalk We are on LinkedIn here: https://www.linkedin.com/company/topmedtalk We are on Facebook here: https://www.facebook.com/TopMedTalk1/

Celebrating 5 years of TopMedTalk at 'Anesthesiology'; the Annual General Meeting of the American Society of Anesthesiologists. This piece is presented by Sol Aronson with his guest Robert Canfield, Director of Marketing, Fresenius Kabi. TopMedTalk is very proud to be partnered with the American Society of Anesthesiologists® at ANESTHESIOLOGY® 2022. Now in our fifth year TopMedTalk is bringing you our most comprehensive and extensive coverage of the largest gathering of anesthesiologists in the world! This audio is presented to you "as live" - if you'd like to see our coverage as it happens go now to: https://live.topmedtalk.com/ TopMedTalk is provided to you for free; if you want to help support our work and help give these conversations a wider audience please like and subscribe (if and where possible) before sharing it on your social media. TopMedTalk can be found on YouTube here: https://www.youtube.com/channel/UC-HYQmeIwcFCYO1hoQ8jShQ We are on Twitter here: https://twitter.com/topmedtalk We are on LinkedIn here: https://www.linkedin.com/company/topmedtalk We are on Facebook here: https://www.facebook.com/TopMedTalk1/

Celebrating 5 years of TopMedTalk at 'Anesthesiology'; the Annual General Meeting of the American Society of Anesthesiologists (ASA). This piece is presented by Desiree Chappell, Monty Mythen and Sol Aronson with their guest Mark Pinosky, Regional Chief Medical Officer for NorthStar Anesthesia. We consider 'burn out' to be a very important subject and have covered it extensively elsewhere, if you need to hear more on this subject try you can go here: https://www.topmedtalk.com/sca-burn-out-a-frank-discussion/ And here: https://www.topmedtalk.com/aana-emotional-intelligence-and-occupational-stress-2/ TopMedTalk is very proud to be partnered with the American Society of Anesthesiologists® at ANESTHESIOLOGY® 2022. Now in our fifth year TopMedTalk is bringing you our most comprehensive and extensive coverage of the largest gathering of anesthesiologists in the world! This audio is presented to you "as live" - if you'd like to see our coverage as it happens go now to: https://live.topmedtalk.com/ TopMedTalk is provided to you for free; if you want to help support our work and help give these conversations a wider audience please like and subscribe (if and where possible) before sharing it on your social media. We are on Twitter here: https://twitter.com/topmedtalk We are on LinkedIn here: https://www.linkedin.com/company/topmedtalk We are on Facebook here: https://www.facebook.com/TopMedTalk1/

Celebrating 5 years of TopMedTalk at 'Anesthesiology'; the Annual General Meeting of the American Society of Anesthesiologists (ASA). Here we focus upon The Anesthesia Patient Safety Foundation (APSF). This piece is presented by Desiree Chappell and Monty Mythen with their guests JW Beard, Chief Medical Officer of GE Patient Care solutions, GE Healthcare, APSF Board of Directors and Jeffery Feldman, Attending Anesthesiologist, Children’s Hospital of Philadelphia (CHOP) and Professor of Clinical Anesthesiology at the Perelman School of Medicine, University of Pennsylvania, APSF Board of Directors. The educational resources mentioned in this piece are here: https://www.apsf.org/apsf-technology-education-initiative/ The APSF website is here: www.apsf.org We spoke previously to The Anesthesia Patient Safety Foundation in 2019 here: https://www.topmedtalk.com/asa-2019-anesthesia-patient-safety-foundation-mark-warner/ We also consulted them during our coverage of the COVID-19 crisis: https://www.topmedtalk.com/the-anesthesia-patient-safety-foundation-covid-19/ TopMedTalk is very proud to be partnered with the American Society of Anesthesiologists® at ANESTHESIOLOGY® 2022. Now in our fifth year TopMedTalk is bringing you our most comprehensive and extensive coverage of the largest gathering of anesthesiologists in the world! This audio is presented to you "as live" - if you'd like to see our coverage as it happens go now to: https://live.topmedtalk.com/ TopMedTalk is provided to you for free; if you want to help support our work and help give these conversations a wider audience please like and subscribe (if and where possible) before sharing it on your social media. TopMedTalk can be found on YouTube here: https://www.youtube.com/channel/UC-HYQmeIwcFCYO1hoQ8jShQ We are on Twitter here: https://twitter.com/topmedtalk We are on LinkedIn here: https://www.linkedin.com/company/topmedtalk We are on Facebook here: https://www.facebook.com/TopMedTalk1/

Celebrating 5 years of TopMedTalk at 'Anesthesiology'; the Annual General Meeting of the American Society of Anesthesiologists (ASA). This piece is presented by Desiree Chappell and Sol Aronson with their guest Jed Wolpaw, Anesthesiologist, intensivist, founder and host of http://accrac.com podcast, Program Director, Johns Hopkins Anesthesiology. TopMedTalk is very proud to be partnered with the American Society of Anesthesiologists® at ANESTHESIOLOGY® 2022. Now in our fifth year TopMedTalk is bringing you our most comprehensive and extensive coverage of the largest gathering of anesthesiologists in the world! This audio is presented to you "as live" - if you'd like to see our coverage as it happens go now to: https://live.topmedtalk.com/ TopMedTalk is provided to you for free; if you want to help support our work and help give these conversations a wider audience please like and subscribe (if and where possible) before sharing it on your social media. We are on Twitter here: https://twitter.com/topmedtalk We are on LinkedIn here: https://www.linkedin.com/company/topmedtalk We are on Facebook here: https://www.facebook.com/TopMedTalk1/

Celebrating 5 years of TopMedTalk at 'Anesthesiology'; the Annual General Meeting of the American Society of Anesthesiologists. This piece is presented by Desiree Chappell, Monty Mythen and Sol Aronson and features their guest Lee Fleisher, Professor Emeritus of Anesthesiology and Critical Care, University of Pennsylvania. Lee is a firm TopMedTalk favorite, find out why by listening to some of his previous appearances: Lee Fleisher at The ASA: https://www.topmedtalk.com/talks-to-lee-fleisher-topmedtalk-at-the-asa/ Postoperative Critical Care - How Do We Help? https://www.topmedtalk.com/postoperative-critical-care-how-do-we-help-ebpom-2020-2/ And this particularly popular piece here: https://www.topmedtalk.com/ebpom-usa-part-3-a-perioperative-practicum-with-dr-lee-a-fleisher/ TopMedTalk is very proud to be partnered with the American Society of Anesthesiologists® at ANESTHESIOLOGY® 2022. Now in our fifth year TopMedTalk is bringing you our most comprehensive and extensive coverage of the largest gathering of anesthesiologists in the world! This audio is presented to you "as live" - if you'd like to see our coverage as it happens go now to: https://live.topmedtalk.com/ TopMedTalk is provided to you for free; if you want to help support our work and help give these conversations a wider audience please like and subscribe (if and where possible) before sharing it on your social media. TopMedTalk can be found on YouTube here: https://www.youtube.com/channel/UC-HYQmeIwcFCYO1hoQ8jShQ We are on Twitter here: https://twitter.com/topmedtalk We are on LinkedIn here: https://www.linkedin.com/company/topmedtalk We are on Facebook here: https://www.facebook.com/TopMedTalk1/

This week's podcast is the Evidence Based Perioperative Medicine (EBPOM) Visiting Professor Plenary Lecture; "The future of the anaesthetic workforce in the UK - a personal view". The question and answer session mentioned in this piece will be available on TopMedTalk in the near future. Presented by William Harrop-Griffiths, Vice-President Royal Collage of Anesthetists (September 2020-22) and introduced by Mike Grocott, Professor of Anaesthesia and critical care at the University of Southampton.

Celebrating 5 years of TopMedTalk at 'Anesthesiology'; the Annual General Meeting of the American Society of Anesthesiologists (ASA). This piece is presented by Desiree Chappell with her guest, Gwen Volpe, Senior Director Medication Technology and Analytics, Fresenius Kabi. TopMedTalk is very proud to be partnered with the American Society of Anesthesiologists® at ANESTHESIOLOGY® 2022. Now in our fifth year TopMedTalk is bringing you our most comprehensive and extensive coverage of the largest gathering of anesthesiologists in the world! This audio is presented to you "as live" - if you'd like to see our coverage as it happens go now to: https://live.topmedtalk.com/ TopMedTalk is provided to you for free; if you want to help support our work and help give these conversations a wider audience please like and subscribe (if and where possible) before sharing it on your social media. We are on Twitter here: https://twitter.com/topmedtalk We are on LinkedIn here: https://www.linkedin.com/company/topmedtalk We are on Facebook here: https://www.facebook.com/TopMedTalk1/

Celebrating 5 years of TopMedTalk at 'Anesthesiology'; the Annual General Meeting of the American Society of Anesthesiologists (ASA). This piece is presented by Desiree Chappell and Monty Mythen with their guests JW Beard, Chief Medical Officer of GE Patient Care solutions, GE Healthcare, Eric Ruedinger, General Manager for Anesthesia and Respiratory Care, Patient Care Solutions, GE Healthcare and Guy Dear, Pediatric Anesthesiologist at Duke University Hospital. TopMedTalk is very proud to be partnered with the American Society of Anesthesiologists® at ANESTHESIOLOGY® 2022. Now in our fifth year TopMedTalk is bringing you our most comprehensive and extensive coverage of the largest gathering of anesthesiologists in the world! This audio is presented to you "as live" - if you'd like to see our coverage as it happens go now to: https://live.topmedtalk.com/ TopMedTalk is provided to you for free; if you want to help support our work and help give these conversations a wider audience please like and subscribe (if and where possible) before sharing it on your social media. TopMedTalk can be found on YouTube here: https://www.youtube.com/channel/UC-HYQmeIwcFCYO1hoQ8jShQ We are on Twitter here: https://twitter.com/topmedtalk We are on LinkedIn here: https://www.linkedin.com/company/topmedtalk We are on Facebook here: https://www.facebook.com/TopMedTalk1/ Et Control in the USA is approved for patients 18 years of age and older

"The system is not going to work by itself but just under the control of the clinicians; so it's always ... human and machine together." -- Celebrating 5 years of TopMedTalk at 'Anesthesiology'; the Annual General Meeting of the American Society of Anesthesiologists (ASA). This piece is presented by Desiree Chappell and Monty Mythen with their guest Alexandre Joosten, Anesthetist at Hospital Erasme. Our guest featured previously on TopMedTalk here: https://www.topmedtalk.com/euroanaes2019-alexandre-joosten/ TopMedTalk is very proud to be partnered with the American Society of Anesthesiologists® at ANESTHESIOLOGY® 2022. Now in our fifth year TopMedTalk is bringing you our most comprehensive and extensive coverage of the largest gathering of anesthesiologists in the world! This audio is presented to you "as live" - if you'd like to see our coverage as it happens go now to: https://live.topmedtalk.com/ TopMedTalk is provided to you for free; if you want to help support our work and help give these conversations a wider audience please like and subscribe (if and where possible) before sharing it on your social media. TopMedTalk can be found on YouTube here: https://www.youtube.com/channel/UC-HYQmeIwcFCYO1hoQ8jShQ We are on Twitter here: https://twitter.com/topmedtalk We are on LinkedIn here: https://www.linkedin.com/company/topmedtalk We are on Facebook here: https://www.facebook.com/TopMedTalk1/

Celebrating 5 years of TopMedTalk at 'Anesthesiology'; the Annual General Meeting of the American Society of Anesthesiologists (ASA). This piece is presented by Desiree Chappell, Sol Aronson and Monty Mythen and Sol Aronson with their guest Kamal Maheshwari, Director, Center for Perioperative Intelligence, Cleveland Clinic. As mentioned Kamal has featured on TopMedTalk previously here: https://www.topmedtalk.com/kamal-maheshwari-director-center-for-perioperative-intelligence-topmedtalk/ TopMedTalk is very proud to be partnered with the American Society of Anesthesiologists® at ANESTHESIOLOGY® 2022. Now in our fifth year TopMedTalk is bringing you our most comprehensive and extensive coverage of the largest gathering of anesthesiologists in the world! This audio is presented to you "as live" - if you'd like to see our coverage as it happens go now to: https://live.topmedtalk.com/ TopMedTalk is provided to you for free; if you want to help support our work and help give these conversations a wider audience please like and subscribe (if and where possible) before sharing it on your social media. TopMedTalk can be found on YouTube here: https://www.youtube.com/channel/UC-HYQmeIwcFCYO1hoQ8jShQ We are on Twitter here: https://twitter.com/topmedtalk We are on LinkedIn here: https://www.linkedin.com/company/topmedtalk We are on Facebook here: https://www.facebook.com/TopMedTalk1/

Celebrating 5 years of TopMedTalk at 'Anesthesiology'; the Annual General Meeting of the American Society of Anesthesiologists (ASA). This piece is presented by Desiree Chappell and Monty Mythen with their guests Rick Dutton, Chief Quality Officer at United States Anesthesia Partners Baltimore, Maryland Area, Josh Lumbley, Chief Quality Officer of NorthStar Anesthesia and Wael Saasouh, Regional Director for Research at NorthStar Anesthesia. Rick Dutton is a popular contributor to TopMedTalk; you can hear more from him in our extensive podcast archive here: https://www.topmedtalk.com/rick-dutton-chief-quality-officer-us-anesthesia-partners-topmedtalk-at-the-asa/ And here: https://www.topmedtalk.com/topmedtalks-to-rick-dutton-2/ And here: https://www.topmedtalk.com/desirees-roundtable-rick-dutton-qa-session-2/ TopMedTalk is very proud to be partnered with the American Society of Anesthesiologists® at ANESTHESIOLOGY® 2022. Now in our fifth year TopMedTalk is bringing you our most comprehensive and extensive coverage of the largest gathering of anesthesiologists in the world! This audio is presented to you "as live" - if you'd like to see our coverage as it happens go now to: https://live.topmedtalk.com/ TopMedTalk is provided to you for free; if you want to help support our work and help give these conversations a wider audience please like and subscribe (if and where possible) before sharing it on your social media. TopMedTalk can be found on YouTube here: https://www.youtube.com/channel/UC-HYQmeIwcFCYO1hoQ8jShQ We are on Twitter here: https://twitter.com/topmedtalk We are on LinkedIn here: https://www.linkedin.com/company/topmedtalk We are on Facebook here: https://www.facebook.com/TopMedTalk1/

Celebrating 5 years of TopMedTalk at 'Anesthesiology'; the Annual General Meeting of the Amercan Society of Anesthesiologists. This piece is presented by Desiree Chappell, Monty Mythen and Sol Aronson with their guest Davinder Ramsingh, Vice President of Clinical Research and Development at Butterfly Network and Professor of Anesthesiology at Loma Linda Medical Center. For more information go to: https://www.butterflynetwork.com/ A popular contributor to TopMedTalk you can hear more from Davinder in our extensive podcast archive here: https://www.topmedtalk.com/live-from-boston-asa-2017-enhanced-recovery-and-protocolised-care-in-cardiac-surgery/ Here: https://www.topmedtalk.com/asa-2018-san-francisco-point-of-care-ultrasound-pocus/ And here: https://www.topmedtalk.com/sca-davinder-ramisingh/ TopMedTalk is very proud to be partnered with the American Society of Anesthesiologists® at ANESTHESIOLOGY® 2022. Now in our fifth year TopMedTalk is bringing you our most comprehensive and extensive coverage of the largest gathering of anesthesiologists in the world! This audio is presented to you "as live" - if you'd like to see our coverage as it happens go now to: https://live.topmedtalk.com/ TopMedTalk is provided to you for free; if you want to help support our work and help give these conversations a wider audience please like and subscribe (if and where possible) before sharing it on your social media. TopMedTalk can be found on YouTube here: https://www.youtube.com/channel/UC-HYQmeIwcFCYO1hoQ8jShQ We are on Twitter here: https://twitter.com/topmedtalk We are on LinkedIn here: https://www.linkedin.com/company/topmedtalk We are on Facebook here: https://www.facebook.com/TopMedTalk1/

Celebrating 5 years of TopMedTalk at 'Anesthesiology'; the Annual General Meeting of the American Society of Anesthesiologists. This piece is presented by Desiree Chappell and Sol Aronson with their guest Elizabeth Drum, Associate Professor of Clinical Anesthesiology and Critical Care Medicine at the Perelman School of Medicine, University of Pennsylvania, Philadelphia. For more information about the American Society of Anesthesiologist's global humanitarian outreach go here: https://www.asahq.org/charity TopMedTalk is very proud to be partnered with the American Society of Anesthesiologists® at ANESTHESIOLOGY® 2022. Now in our fifth year TopMedTalk is bringing you our most comprehensive and extensive coverage of the largest gathering of anesthesiologists in the world! This audio is presented to you "as live" - if you'd like to see our coverage as it happens go now to: https://live.topmedtalk.com/ TopMedTalk is provided to you for free; if you want to help support our work and help give these conversations a wider audience please like and subscribe (if and where possible) before sharing it on your social media. TopMedTalk can be found on YouTube here: https://www.youtube.com/channel/UC-HYQmeIwcFCYO1hoQ8jShQ We are on Twitter here: https://twitter.com/topmedtalk We are on LinkedIn here: https://www.linkedin.com/company/topmedtalk We are on Facebook here: https://www.facebook.com/TopMedTalk1/

Celebrating 5 years of TopMedTalk at 'Anesthesiology'; the Annual General Meeting of the American Society of Anesthesiologists. This piece is presented by Desiree Chappell and Sol Aronson with their guests Michael Matthews, Senior Vice President of Acute Care for Heron Therapeutics and Randy Robbins, Managing Partner at Valliant Anesthesia Associates. For more information check out these links: Zynrelef: https://zynrelef.com/ Heron Therapeutics: https://www.herontx.com/ TopMedTalk is very proud to be partnered with the American Society of Anesthesiologists® at ANESTHESIOLOGY® 2022. Now in our fifth year TopMedTalk is bringing you our most comprehensive and extensive coverage of the largest gathering of anesthesiologists in the world! This audio is presented to you "as live" - if you'd like to see our coverage as it happens go now to: https://live.topmedtalk.com/ TopMedTalk is provided to you for free; if you want to help support our work and help give these conversations a wider audience please like and subscribe (if and where possible) before sharing it on your social media. TopMedTalk can be found on YouTube here: https://www.youtube.com/channel/UC-HYQmeIwcFCYO1hoQ8jShQ We are on Twitter here: https://twitter.com/topmedtalk We are on LinkedIn here: https://www.linkedin.com/company/topmedtalk We are on Facebook here: https://www.facebook.com/TopMedTalk1/  

Celebrating 5 years of TopMedTalk at 'Anesthesiology'; the Annual General Meeting of the American Society of Anesthesiologists. This piece is an introduction to our coverage with your hosts this year; Desiree Chappell, Monty Mythen and Sol Aronson. TopMedTalk is very proud to be partnered with the American Society of Anesthesiologists® at ANESTHESIOLOGY® 2022. Now in our fifth year TopMedTalk is bringing you our most comprehensive and extensive coverage of the largest gathering of anesthesiologists in the world! This audio is presented to you "as live" - if you'd like to see our coverage as it happens go now to: https://live.topmedtalk.com/ TopMedTalk is provided to you for free; if you want to help support our work and help give these conversations a wider audience please like and subscribe (if and where possible) before sharing it on your social media. TopMedTalk can be found on YouTube here: https://www.youtube.com/channel/UC-HYQmeIwcFCYO1hoQ8jShQ We are on Twitter here: https://twitter.com/topmedtalk We are on LinkedIn here: https://www.linkedin.com/company/topmedtalk We are on Facebook here: https://www.facebook.com/TopMedTalk1/

Celebrating 5 years of TopMedTalk at 'Anesthesiology'; the Annual General Meeting of the American Society of Anesthesiologists.  This piece is presented by your hosts Desiree Chappell and Sol Aronson and features a run down of what you can expect if you go now to checkout our live stream and what to expect here on the TopMedTalk podcast channel. TopMedTalk is very proud to be partnered with the American Society of Anesthesiologists® at ANESTHESIOLOGY® 2022. Now in our fifth year TopMedTalk is bringing you our most comprehensive and extensive coverage of the largest gathering of anesthesiologists in the world! This audio is presented to you "as live" - if you'd like to see our coverage as it happens go now to: https://live.topmedtalk.com/ TopMedTalk is provided to you for free; if you want to help support our work and help give these conversations a wider audience please like and subscribe (if and where possible) before sharing it on your social media.

If you missed part one of this series it can be found in full here: https://topmedtalk.libsyn.com/anesthesiology-a-retrospective-topmedtalk-at-the-asa TopMedTalk’s proud association with the American Society of Anesthesiologists (ASA) continues to be celebrated in this specially made podcast where we reflect on some of the big conversations we’ve enjoyed at their annual conference, Anesthesiology. For more on Anesthesiology 2022, please go to www.asahq.org These clips come from some of the most popular podcasts we’ve done about the conference. For the fuller conversations and podcasts please go here: Post operative nausea and vomiting | TopMedTalk at the ASA https://www.topmedtalk.com/post-operative-nausea-and-vomiting-topmedtalk-at-the-asa/ The ASA's Immediate Past President | TopMedTalk at the ASA https://www.topmedtalk.com/the-asas-immediate-past-president-topmedtalk-at-the-asa/ ASA 2019 | Perioperative Quality Initiative P.O.Q.I. news https://www.topmedtalk.com/asa-2019-perioperative-quality-initiative-p-o-q-i-news/ ASA 2019 | Depth of anaesthesia: https://www.topmedtalk.com/asa-2019-depth-of-anaesthesia/ Ashish Khanna on intraoperative hypotension and beyond | TopMedTalk at the ASA: https://www.topmedtalk.com/ashish-khanna-on-intraoperative-hypotension-and-beyond-topmedtalk-at-the-asa/ -- Go now to https://live.topmedtalk.com/ to find out more about your chance to experience TopMedTalk at The ASA.

What is the value proposition when approaching industry partnerships; is there such a thing as information overload; where on the perioperative continuum should the focus be? With thanks to our generous sponsor, Edwards Lifesciences. Presented by Desiree Chappell and Sol Aronson with their guests, Patrick Farrer, Director, Professional Education at Edwards Lifesciences, Doug Marshall, Senior Director, Outcomes Managing Group, Eastern Half of the USA, Sotiris Rompas, Global Health Economics and Reimbursement, Edwards Lifesciences

TopMedTalk’s long and proud association with the American Society of Anesthesiologists (ASA) means we’ve had the chance to interview many of the Presidents of the organization over the years. Here we present some selected highlights from some of those conversations featuring; Linda Mason, MD, FASA, (2019 President of the American Society of Anesthesiologists), Mary Dale Peterson, M.D., MHA, FACHE, FASA, (2020 President of he ASA) Beverly K. Philip, MD, FACA, FASA (2021 President of the ASA) and Randall M. Clark, M.D., FASA (current President of the ASA 2022). – Go now to https://live.ebpom.org to find out more about your chance to experience TopMedTalk at The ASA. Other conversations with past ASA Presidents are available here: Mark Warner (2011): https://directory.libsyn.com/episode/index/id/11741321?_ga=2.5532915.1520077474.1664448308-966310048.1569589661 Jim Grant (2018): https://directory.libsyn.com/episode/index/id/18347285?_ga=2.85944409.1520077474.1664448308-966310048.1569589661 Alexander Hannenberg: https://directory.libsyn.com/episode/index/id/11717234?_ga=2.85944409.1520077474.1664448308-966310048.1569589661 -- For the fuller conversations and podcasts please go here: Linda Mason is here: https://directory.libsyn.com/episode/index/id/10007243?_ga=2.34504801.1520077474.1664448308-966310048.1569589661 Mary Dale Peterson is here: https://directory.libsyn.com/episode/index/id/20798921?_ga=2.96963039.1520077474.1664448308-966310048.1569589661 Beverly K Philip and Randall M Clark are here: https://directory.libsyn.com/episode/index/id/20798759

"Good surgeons are good communicators" How do we define a best case scenario for post operative value? What are the post operative realities and behaviors which interact with cost pressures, reimbursement, payer dynamics and go on to influence the site of service choices that confront us today? Presented by Desiree Chappell and Sol Aronson with their guests, Sam Ajizian, Chief Medical Officer of the Patient Monitoring Operating Unit in Medtronic, Alan Kirk, Surgeon in Chief for The Duke University Health System, Melissa Cohen, Vice President for Medicare at Aurrera Health Group.

This wide ranging discussion from Evidence Based Perioperative Medicine (EBPOM) USA asks how we should best try to manage the intraoperative period, where is the evidence telling us to focus? Do we get the impression that Enhanced Recovery After Surgery (ERAS) delivers the value proposition? Are reduced complications always a good thing, even from a business perspective? What are the economic barriers to adopting enhanced recovery? Is Enhanced Recovery more spoken about than actually practiced? Presented by Monty Mythen and Desiree Chappell with their guests, Mark Koch, President and CEO of Somnia Anesthesia, Josh Lumbley, Chief Quality Officer of NorthStar Anesthesia, Sotiris Rompas, Global Health Economics and Reimbursement, Edwards Lifesciences - with additional questions from the audience.

"A very different philosophy of going about the business of anesthesia..." Where are CRNA's placed in the current market. What are going to be the pitfalls and the plus points as we move on from a challenging time? With thanks to NorthStar Anesthesia for their help in helping TopMedTalk to cover the American American Association of Nurse Anesthesiology's annual conference 2022. Presented by Desiree Chappell with her co-host Randall Moore, CRNA, Chief Anesthetist Officer at NorthStar Anesthesia and Adam Spiegel, CEO, NorthStar Anesthesia.

TopMedTalk's coverage of the American Association of Nurse Anesthesiology's 2022 conference continues with another installment of "Women in Anesthesia". If you enjoy this piece why not listen to some of our earlier episodes in the popular series; they are found here: https://www.topmedtalk.com/?s=women+in+anaesthesia Presented by Desiree Chappell, Co Editor in Chief, VP of Clinical Quality, with Jennifer Squibbs, Vice President of CRNA Services, NorthStar Anesthesia, Chris Hendren, Vice President of CRNA Services NorthStar Anesthesia, Jennifer Harpe-Bates, CRNA and Director of Quality, Louisville, KY, NorthStar Anesthesia.

"And the good news is that we may or may not have an answer to this fluid debate that's been running now for 25 years..." The Great Fluid Debate is a popular fixture at Evidence Based Perioperative Medicine (EBPOM) and this year that was once again the case. Are we genuinely starting to see evidence based practice emerging and finally knocking "eminence based" notions off the shelf? Presented by Monty Mythen and starting with a short presentation from Professor John A Myburgh, Intensive Care Medicine, University of New South Wales; Director of the Division of Critical Care and Trauma at the George Institute for Global Health and Senior Intensive Care Physician at the St George Hospital, Sydney. He holds honorary Professorial appointments at the University of Sydney and Monash University School of Public Health and Preventive Medicine. This piece is then complimented by a debate and discussion featuring Desiree Chappell, Certified Registered Nurse Anesthetist (CRNA) and Vice President of Clinical Quality for NorthStar Anesthesia and Andy Shaw, Chairman, Department of Intensive Care and Resuscitation at The Cleveland Clinic, Cleveland, Ohio. With further questions from the audience.

"It's not just about us [Anesthesia]. It's about all the stakeholders that are invested" How can the American Association of Nurse Anesthesiology (AANA) help to maximize the value of Certified Registered Nurse Anesthetists? This vital conversation tackles that question head on. What are the big opportunities for the profession and how do we make the most of them? TopMedTalk brings you access to exclusive coverage of the AANA 2022 meeting. For more on the AANA go here: https://www.aana.com/ Presented by TopMedTalk's lead presenter Desiree Chappell with her guest Joseph A. Rodriguez, DNAP, CRNA, AANA Board of Directors and Managing Partner at Arizona Anesthesia Solutions. This podcast is brought to you with thanks for the support of NorthStar Anesthesia.

"Certified Registered Nurse Anesthetists (CRNA's) handle meeting with you ahead of time; alleviating your fears of surgery; getting an extensive health history so that we can really tailor your anesthetic to your needs. We work as a member of a team with surgeons and with nurses - in the operating room. And then afterwards; we want to make sure that you're comfortable and make sure that you're in a good spot to go home." What is the role of the CRNA? Where might it expand to and what principles lie at the core of the job? This exclusive conversation with the new President of the American Association of Nurse Anesthetists takes on the challenges and embraces the opportunities. Presented by Desiree Chappell with her guests, Angela R. Mund, DNP, CRNA, Chair, Dept of Clinical Sciences, Charleston, South Carolina, and The President of the AANA alongside, Dru Riddle, PhD,DNP, CRNA, FAANA President-Elect, AANA, CRNA, Northstar Anesthesia and Associate Professor, Texas Christian University TCU. This podcast is brought to you with thanks for the support of NorthStar Anesthesia.

EBPOM USA gets off to an incredible start; the value proposition which drives the push towards perioperative medicine on both sides of the Atlantic. How far do we go when explaining to both practitioners and patients the importance of perioperative medicine, prehabilitation and preoperative assessment? Can a focus upon the value we add motivate people to follow the evidence and provide true enhanced recovery after surgery (ERAS)? Presented by Desiree Chappell and Sol Aronson with their guests BobbieJean Sweitzer, Editor of Preoperative Assessment and Management (currently 3rd edition) and the Systems Director of Perioperative Practices at Inova Health, Falls Church, Virginia and Chris Steel, Chief Medical Officer at White River Health System, medical director for the Perioperative Surgical Home Learning Collaborative 2020 and Chief Medical Consultant for Community Business Resources.

What is the value proposition when it comes to data, when does data become information and how do we mitigate between useful monitoring and an irrelevant miasma? This timely conversation takes place at a key moment in medicine as the limits on what we can know pull back thanks to increasing technological innovation. This piece presented to you with thanks to our sponsor Medtronic. It is with such partnerships that we are able to bring you TopMedTalk entirely for free each week. Co-Chaired by Monty Mythen and Sol Aronson with their guests, led by Sam Ajizian, Chief Medical Officer of the Patient Monitoring Operating Unit in Medtronic and Karen Philips, Chief Medical Officer for the respiratory interventions business at Medtronic.

Where is Enhanced Recovery After Surgery (ERAS) for cardiac, now we find ourselves towards the start of the "post-COVID19" era? Where is the data taking us? How do we turn our principles into everyday practice? This piece originally contained the "Cardiac enhanced recovery - essential update | EBPOM Chicago" presentation from our panelist Mike Grant. Listeners are advised to follow this link if they've not yet heard that essential talk: https://topmedtalk.libsyn.com/cardiac-enhanced-recovery-essential-update-ebpom-chicago Presented and Chaired by Vicki Morton, Director of Clinical and Quality Outcomes, Providence Anesthesiology Associates, with panelists; Mike Grant, Medical Co-Director, Cardiovascular Surgical ICU, The Johns Hopkins University School of Medicine, Amanda Rea, Lead of Advanced Practice For Cardiac Surgery, University of Maryland, Rakesh Arora, Medical Director, Cardiac Surgery and Intensive Care Cardiac Sciences, St Boniface General Hospital and Marjan Jahangiri, Professor of Cardiac Surgery, St George's University Hospital.

"We need to stop accepting the tenants we've all been given throughout our careers and accept that maybe we've been misinformed and maybe we've misinformed ourselves and have a bit of humility and start again" The Ernest Henry Starling Plenary Lecture; a stand out moment from EBPOM 2022, London.  Our speaker calls for medicine to significantly reevaluate itself and focus upon the caring aspect of 'intensive care'. Presented by Hugh Montgomery OBE; Hugh obtained a first class degree in cardiorespiratory physiology and neuropharmacology, before graduating from the Middlesex Hospital Medical School in 1987. He has since accredited in general medicine, cardiology and intensive care medicine, and is UCL Professor of Intensive Care. He directs the UCL Institute for Human Health and Performance, and was science lead for Caudwell Xtreme Everest in 2007. He has published over 180 scientific articles, and has a specific interest in hypoxiac adaptation. Hugh has previously presented a piece here on TopMedTalk on the subject of Nasogastric Feeding: https://www.topmedtalk.com/intensive-care-society-nasogastric-feeding/

This piece focuses upon continuous ward monitoring. It provides real world experience as our guest explains how technology is moving forward. How do we avoid information overload? Do staff shortages mean this technology is rapidly going from "optional" to "essential"? How does more monitoring mean more value and better patient care? This piece presented to you with Portrait Mobile and kindly sponsored by GE Healthcare. Presented by Desiree Chappell and Monty Mythen with Sadia Khan, Consultant Cardiologist at West Middlesex University Hospital; with questions from the audience, both online and in attendance.

Due to the importance of this topic the TopMedTalk team would appreciate it if you could help to share and boost this podcast amongst your social media networks. Pulse Oximetry has been in the news recently, the COVID crisis has revealed discrepancies in its efficacy with patients who have darker skin tones. This conversation cuts to the realities of the situation; are pulse oximeters "racist" or is this a potentially dangerous click bait fallacy? Presented by Desiree Chappell and Monty Mythen with their guest Sam Ajizian, Chief Medical Officer of the Patient Monitoring Operating Unit in Medtronic

Laryngosopy latest; what can we see? This piece is a full and frank update regarding where we're at from a charismatic - self described - "laryngoscopy geek". Videolaryngoscopy versus direct laryngoscopy for adults undergoing tracheal intubation - discussed in this piece under the name "The Cochrane Review" - is here: https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD011136.pub3/full Our guest kindly shares his Twitter handle: https://twitter.com/altgm Presented by Desiree Chappell and Monty Mythen with their guest Alistair McNarry Consultant Anaesthetist Western General and St John’s Hospitals Edinburgh and UK National Airway Lead (Joint position between Royal College of Anaesthetists and Difficult Airway Society).

TopMedTalk presented here as live during Evidence Based Perioperative Medicine (EBPOM)'s 2022 annual London conference. Two presentations (the full video of which will be available on EBPOM.org) and then a panel discussion on the subjects of Enhanced Recovery After Surgery (ERAS) Cardiac and hypotension. If you enjoyed this conversation there is a vast archive of discussion on the topic of Acute Kidney Injury on TopMedTalk here: https://www.topmedtalk.com/?s=AKI Presented by Desiree Chappell and Monty Mythen with their guests Nick Fletcher, Professor and Chair, Institute of Critical Care, Anaesthesia and Pain at the Cleveland Clinic London and Gabor Zilahi, Consultant at St George’s University Hospital (SGH) Cardiothoracic Intensive Care Unit (CTICU) and General Intensive Care Unit (GICU). With gratitude to our sponsor Edwards Lifesciences.

This vital discussion brings to the fore the realities of cognitive prehabilitation, what is possible, how do we do it right and why does it work? Linking back to a presentation which we've heard earlier on TopMedTalk - https://topmedtalk.libsyn.com/cognitive-prehabilitation-ebpom-chicago?_ga=2.222682203.1756392790.1657624918-966310048.1569589661 - the panel add context and experience to the picture. If you'd like to attend an Evidence Based Perioperative Medicine (EBPOM) conference please follow this link to their site here: www.ebpom.org Chaired by Feyce M. Peralta, obstetrical anesthesiologist, Program Director for the Obstetric Anesthesiology Fellowship and Director of Faculty Development for the Department of Anesthesiology at Northwestern University Feinberg School of Medicine with guest speaker, Michelle Humeidan, Associate Professor, Neuroanesthesiology, Associate Faculty, Institute for Behavioural Medicine Research, Medical Director, Enhanced Surgical Recovery and panelists; Charles Hogue, Professor and Chair of Anesthesiology at Northwestern University in Chicago, Sol Aronson, Professor Emeritus, Duke University, Durham, North Carolina and additional contributions from Mike Grocott, Professor of Anaesthesia and critical care at the University of Southampton, Desiree Chappell VP Clinical Quality for NorthStar Anesthesia and Monty Mythen, Smiths Medical Professor of Anaesthesia and Critical Care.

"I think the vast majority of our colleagues still think of anesthesia as a task that has to be completed; rather than a system, or anesthesia being part of a holistic picture or whole system. I think that is something that we need to think when we think of the future" Ravi Mahajan, Former President of The Royal College of Anaesthetists, UK. This talk 'Reflections on Anaesthesia and Perioperative medicine; looking back / looking forward' was the Rod Armstrong Plenary Lecture of (Evidence Based Perioperative Medicine) EBPOM Ireland 2021. It is presented to you here, in full, free of charge. If you are interested in attending forthcoming events organised by EBPOM please visit www.EBPOM.org Chaired by George Shorten, Professor of Anaesthesia and Intensive Care Medicine at University College Cork and Mike Grocott, Professor of Anaesthesia and Critical Care Medicine at The University of Southampton.

"EEG is more than a number" This piece is an early taste of the forthcoming highlights of Evidence Based Perioperative Medicine (EBPOM)'s TopMedTalk presentation. Subtitled: "pEEG Monitoring in the OR and ICU: From The Table to The Bedside" it was kindly suported by Medtronic Presented by Desiree Chappell and Monty Mythen with their guest Alex Oliver, Consultant Anaesthetist at The Royal Marsden NHS Foundation Trust.

"It's been such an amazing.. electric atmosphere" This bonus piece gives you a taste of the 2022 Evidence Based Perioperative Medicine (EBPOM) meeting in London this year. Look out for some of the talks from EBPOM - provided exclusively for TopMedTalk for free, with thanks to our generous sponsorships and partners. How has Perioperative Medicine been trust to the forefront of medicine in the wake of the COVID catastrophe? Are we right to take a leadership role as the healthcare industry attempts to recover from the crisis and establish a new normal? Where are the challenges in our field? Also - prehabilitation has been a hot topic for us on TopMedTalk for a few years now, what are some of the big developments there? Presented by Nick Margerrison, TopMedTalk's senior producer with his guest Adam Beebeejaun, Fellow of Perioperative Medicine at University College London.

Recorded at EBPOM and presented here 'as live' this piece is an exclusive extra conversation held in between sessions on the subject of fluid balance; is the perennial debate of our conference over, or is there still more to be said? Listeners are advised further reading is here: Which goal for fluid therapy during colorectal surgery is followed by the best outcome: near-maximal stroke volume or zero fluid balance?  https://pubmed.ncbi.nlm.nih.gov/22710266/ Effects of intravenous fluid restriction on postoperative complications: comparison of two perioperative fluid regimens: a randomized assessor-blinded multicenter trial  https://pubmed.ncbi.nlm.nih.gov/14578723/ Goal-directed fluid therapy in emergency abdominal surgery: a randomised multicentre trial  https://pubmed.ncbi.nlm.nih.gov/34389168/ Presented by Monty Mythen and Desiree Chappell with their guest Birgitte Brandstrup, Consultant Surgeon, Head of the Endoscopic Unit at The Surgical Gastroenterological Department at Glostrup University Hospital.

A staffing crisis globally in healthcare is pushing forward the need for sedation in non anaesthetic areas. What does this mean for medical practitioners? What are the safest ways to work within this crisis? This is not a conversation about shortcuts and poor practices, it's about delivering a higher and better standard of care within a perioperative environment. Listen in to find out more. Recorded - as live - at EBPOM 2022; go now to www.ebpom.org for more details about Evidence Based Perioperative Medicine (EBPOM). Presented by Desiree Chappell and Monty Mythen with their guest Amit Prakash, Consultant in Anaesthesia & Perioperative medicine, Clinical lead Neuroanaesthesia at Cambridge University Hospital, Addenbrookes NHS trust, UK. This EBPOM extra for TopMedTalk listeners was graciously supported by Medtronic. Thanks to our sponsors we are able to bring you TopMedTalk entirely for free.

Hear the complete live session with questions from the online audience at one of the stand out presentations of Evidence Based Perioperative Medicine (EBPOM)'s Dingle Conference. Don't forget if you want full access to our video presentations on demand and are interested in attending the next EBPOM conference ensure you check out www.ebpom.org Here are the two articles referenced in this piece: Current status of perioperative hypnotics, role of benzodiazepines, and the case for remimazolam: a narrative review https://doi.org/10.1016/j.bja.2021.03.028 Intraoperative hypotension and the risk of postoperative adverse outcomes: a systematic review https://doi.org/10.1016/j.bja.2018.04.036 Presented by Desiree Chappell VP Clinical Quality for NorthStar Anesthesia and Vicki Morton, Director of Clinical and Quality Outcomes at Providence Anesthesiology Associates, P.A. with their guests; Rob Sneyd, Emeritus Professor, University of Plymouth, Jeff Gadsden, Associate Professor of Anesthesiology, Duke University, USA, Dru Riddle Associate Professor of Professional Practice and Director of Clinical Education, Fort Worth Texas.

"Most non clinicians.. think the most risky time when you're having surgery is when you're having surgery. That is categorically false; the most risky time is after surgery!" This piece came shortly after GE Healthcare's Portrait Mobile product launch, live from the European Society of Anaesthesiology and Intensive Care (ESAIC). Presented by Desiree Chappell and Sol Aronson with their guests Neal Sandy, General Manager, Monitoring Solutions at GE Healthcare and Karla Asikainen, Senior Global Product Manager, Mobile Digital Health at GE Healthcare. -- Get all the headlines and information about the hot topics and major events of this conference exclusively from TopMedTalk, thanks to our partners in GE Healthcare. Go now to www.twitter.com/topmedtalk Go now to https://www.youtube.com/channel/UC-HYQmeIwcFCYO1hoQ8jShQ Go now to https://www.facebook.com/TopMedTalk1 Go now to https://www.linkedin.com/company/topmedtalk/ Find out more about The ESAIC here: https://www.esaic.org/ Find out more about GE Healthcare here: https://www.gehealthcare.com/

"We listen a lot to our customers and their patients" This piece came shortly after GE Healthcare's Portrait Mobile product launch, live from the European Society of Anaesthesiology and Intensive Care (ESAIC). Presented by Desiree Chappell and Sol Aronson with their guests Tom Westrick, President & Chief Executive Officer of Life Care Solutions at GE Healthcare and Brandon Henak, Global Marketing Director, Monitoring Solutions at GE Healthcare. -- Get all the headlines and information about the hot topics and major events of this conference exclusively from TopMedTalk, thanks to our partners in GE Healthcare. Go now to www.twitter.com/topmedtalk Go now to https://www.youtube.com/channel/UC-HYQmeIwcFCYO1hoQ8jShQ Go now to https://www.facebook.com/TopMedTalk1 Go now to https://www.linkedin.com/company/topmedtalk/ Find out more about The ESAIC here: https://www.esaic.org/ Find out more about GE Healthcare here: https://www.gehealthcare.com/

Personalized versus protocolised perioperative pain prediction and management; what are the considerations for a modern practitioner. Where does the data take us? What are the ethics for a responsible value based care approach that seeks to reduce or perhaps even eliminate opioid use? What insights can we glean from a truly transatlantic conversation on these topics? How do we both manage and set expectations for the patient? This discussion - in its original form - also featured a presentation which you can find here: https://topmedtalk.libsyn.com/website/category/perioperative-pain-control-a-spine-surgeons-perspective-we-have-to-do-better-ebpom-chicago A full panel discussion chaired by Desiree Chappell, Vice President of Clinical Quality at NorthStar Anesthesia, TopMedTalk lead presenter, Monty Mythen, Smiths Medical Professor of Anaesthesia and Critical Care, TopMedTalk Editor in Chief and Sol Aronson, Emeritus Professor at Duke University, TopMedTalk USA presenter with their guests Geeta Nagpal, Associate Professor of Anesthesiology and Medical Education at Feinberg School of Medicine, David Edwards, Chief Division of Pain Medicine Vanderbilt University Medical Center and Nicholas Levy, Consultant in Anaesthesia and Acute Pain Medicine in Suffolk.

This piece is an essential contribution to the debate regarding patient centered value based care. Are you able to say you are putting your orthopaedic patients' needs and priorities at the forefront of your practice? Some of the questions from the online audience include: Is Enhanced Recovery After Surgery (ERAS) in orthopaedics a step too far?  How do patients who have significant arthropathys engage with a prehab program that makes them fitter? Those that successfully complete the program, are they not the ones who probably don't need joint replacement today and rehab might actually look at elongating that reoperative window? This piece is presented in proud association with the South of Ireland Association of Anaesthetists (SIAA). The Centre for Perioperative Care (CPOC) is here: https://cpoc.org.uk/ "Effect of Individualized vs Standard Blood Pressure Management Strategies on Postoperative Organ Dysfunction Among High-Risk Patients Undergoing Major Surgery" is here: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5710560/ "Intraoperative hypotension and the risk of postoperative adverse outcomes: a systematic review" is here: https://pubmed.ncbi.nlm.nih.gov/30236233/ "Intraoperative Hypotension Is Associated With Adverse Clinical Outcomes After Noncardiac Surgery" is here: https://pubmed.ncbi.nlm.nih.gov/33177322/ Presented by Brian O'Donnell, Consultant Anaesthesiologist, Cork University Hospital and Frank Loughnane, Consultant Anaesthesiologist, Cork University Hospital with their guests, Emer Aherne, Consultant Geriatrician specialising in Trauma & Orthopaedic Care at Cork University Hospital, Co-lead Irish Hip Fracture Database and John Whittle, Associate Professor, Perioperative Medicine UCL.

"Decide to be part of the solution" This inspirational talk focuses upon how and why we need to focus on and improve attitudes toward pain control.  Working as a team, being proactive and engaging with our wider culture are emphasized along with the need for education, standardisation and the ability to learn from other specialties. Presented by Jeffrey L. Gum, MD, Adult and Pediatric Spine Surgeon, Norton Leatherman Spine Center, Associate Professor University of Louisville Department of Orthopedics.

This wide ranging conversation starts with a focus upon blood pressure and moves through some of the bigger trails on what an appropriate target is for a perioperative practitioner. What is the most sensible way to manage blood pressure and where are the data driving us to? Further conversation evolves around the post-op period and transition of care. Presented by Desiree Chappell, Monty Mythen and Sol Aronson with their guest Bernd Saugel, Professor and Vice Chair of the Department of Anesthesiology, Center of Anesthesiology and Intensive Care Medicine at the University Medical Center Hamburg-Eppendorf, Germany. -- Get all the headlines and information about the hot topics and major events of this conference exclusively from TopMedTalk, thanks to our partners in GE Healthcare. Go now to www.twitter.com/topmedtalk Go now to https://www.youtube.com/channel/UC-HYQmeIwcFCYO1hoQ8jShQ Go now to https://www.facebook.com/TopMedTalk1 Go now to https://www.linkedin.com/company/topmedtalk/ Find out more about The ESAIC here: https://www.esaic.org/ Find out more about GE Healthcare here: https://www.gehealthcare.com/

This piece goes over some cognitive risk factors for post op delirium alongside a look at cognitive prehabilitation and a review of the results from an aerobics trial. What are the next steps for future research? This piece was followed by a panel discussion which will be released soon here on TopMedTalk. For more information about Evidence Based Perioperative Medicine (EBPOM) go here www.ebpom.org Presented by Michelle Humeidan, Associate Professor, Neuroanesthesiology, Associate Faculty, Institute for Behavioural Medicine Research, Medical Director, Enhanced Surgical Recovery.

This piece is highlighted because of its significance. Please check out the rest of TopMedTalk's coverage of the conference on our website - www.topmedtalk.com Regular listeners will appreciate the importance of the PeriOperative ISchemic Evaluation-3 Trial (POISE-3). Here we highlight a conversation containing late breaking news on the subject. The New England Journal of Medicine is here: https://www.nejm.org/doi/full/10.1056/NEJMoa2201171 Presented by Desiree Chappell and Monty Mythen with their guests Frederic Michard, MD of MiCo Consulting and Daniel Sessler, Michael Cudahy Professor and Chair at Cleveland Clinic, Director of The Outcomes Research Consortium.

A welcome return to TopMedTalk for two big names both of whom made a huge impact with their previous appearances, links to which are here: Dan Sessler is here: https://topmedtalk.libsyn.com/topmedtalks-to-dan-sessler-0 Frederic Michard is here: https://topmedtalk.libsyn.com/topmedtalk-wireless-wearables-on-the-ward-the-new-www-revolution Presented by Desiree Chappell and Monty Mythen with their guests Frederic Michard, MD of MiCo Consulting and Daniel Sessler, Michael Cudahy Professor and Chair at Cleveland Clinic, Director of The Outcomes Research Consortium.

"There's been a really noticeable shift, especially in the UK, towards big pragmatic research answering the big simple questions..." This wide ranging conversation with a TopMedTalk favorite at the European Society of Anaesthesiology and Intensive Care (ESAIC) provides a fresh perspective on how the world is going to recover from the COVID catastrophe, how it forced us to improve our standards and priorities and how it effects trials and research in the field of perioperative medicine? If you enjoyed our guest's take today why not go here for more? http://www.topmedtalk.com/anaesthesia-2019-rupert-pearse/ Presented by Desiree Chappell and Sol Aronson with their guest Rupert Pearse, Professor of Intensive Care Medicine at Queen Mary, University of London.

"Hypotension is always a problem..." This piece is provided 'as live' from the European Society of Anaesthesiology and Intensive Care (ESAIC). Presented by Desiree Chappell, Monty Mythen and Sol Aronson with their guest Thomas Scheeren, Professor of Anesthesiology, Department of Anesthesiology, University Medical Center Groningen, Groningen, the Netherlands. Our guest has featured on TopMedTalk before, worth checking it out here: http://www.topmedtalk.com/euroanaes2019-thomas-scheeren/ -- Get all the headlines and information about the hot topics and major events of this conference exclusively from TopMedTalk, thanks to our partners in GE Healthcare. Go now to www.twitter.com/topmedtalk Go now to https://www.youtube.com/channel/UC-HYQmeIwcFCYO1hoQ8jShQ Go now to https://www.facebook.com/TopMedTalk1 Go now to https://www.linkedin.com/company/topmedtalk/ Find out more about The ESAIC here: https://www.esaic.org/ Find out more about GE Healthcare here: https://www.gehealthcare.com/

"Moving from being reactive to being proactive" The Portrait Mobile product launch, live from the ESAIC. Presented by Monty Mythen, Smiths Medical Professor UCL and TopMedTalk's Editor in Chief, with his guest Frederic Clement, Chief Marketing Officer at GE Healthcare. -- Get all the headlines and information about the hot topics and major events of this conference exclusively from TopMedTalk, thanks to our partners in GE Healthcare. Go now to www.twitter.com/topmedtalk Go now to https://www.youtube.com/channel/UC-HYQmeIwcFCYO1hoQ8jShQ Go now to https://www.facebook.com/TopMedTalk1 Go now to https://www.linkedin.com/company/topmedtalk/ Find out more about The ESAIC here: https://www.esaic.org/ Find out more about GE Healthcare here: https://www.gehealthcare.com/

The TopMedTalk team are live at the European Society of Anaesthesiology and Intensive Care (ESAIC). Join Desiree Chappell and Monty Mythen with the team, TopMedTalk's Henry Howe and Jenny Gomez, both of whom are junior doctors. Get all the headlines and information about the hot topics and major events of this conference exclusively from TopMedTalk, thanks to our partners in GE Healthcare. Go now to www.twitter.com/topmedtalk Go now to https://www.youtube.com/channel/UC-HYQmeIwcFCYO1hoQ8jShQ Go now to https://www.facebook.com/TopMedTalk1 Go now to https://www.linkedin.com/company/topmedtalk/ Find out more about The ESAIC here: https://www.esaic.org/ Find out more about GE Healthcare here: https://www.gehealthcare.com/

"We just thought you guys would just tell us facts about how smoking is bad for us but you're actually giving us tools and helping us practice them and implement them and it is by far nothing I have ever experienced" Smoking cessation clinics, as an essential part of a truly perioperative practice, is discussed in detail here. How do you reach the level of patient satisfaction outlined in the above quote in an efficient way which also reflects the principles of value based care, enhanced recovery after surgery and effective long term outcomes? Like this, want more? This piece directly relates to a presentation we recently enjoyed here on TopMedtalk, follow this link to hear it: https://directory.libsyn.com/episode/index/id/21964205 Presented by Sol Aronson, Emeritus Professor, Duke University with assistance from Monty Mythen, Smiths Medical Professor of Anaesthesia and Critical Care, University College London and featuring panelists; Jillian Dirkes, Program Manager, Duke Smoking Cessation Program and Andrea Pratt, Tobacco Treatment Specialist, Duke Smoking Cessation Program, Toby Richards, Professor of Surgery, UWA and Sher-Lu Pai, Clinical Director, Preoperative Evaluation (POE) clinic, Mayo Clinic College of Medicine.

This piece looks at how and why you should be either setting up or running a smoking cessation clinic as part of a perioperative practice. How do you find patients for whom treatment is appropriate? How do you assess progress? How should staff be trained? What are the key indicators that treatment will be successful? This presentation was complimented with a panel discussion which will follow soon here on TopMedTalk. Please ensure you are subscribed to us on your podcatcher. Also, check out Evidence Based Perioperative Medicine (EBPOM) now for details of our next event near you: www.ebpom.org Presented by Jillian Dirkes, Program Manager, Duke Smoking Cessation Program and Andrea Pratt, Tobacco Treatment Specialist, Duke Smoking Cessation Program.

"We're able to really optimize the nutrition for that specific surgery ... we're able to individualise our care plans as dieticians for these patients" This discussion follows on from a previous piece which you can find here: https://topmedtalk.libsyn.com/website/category/nutrition-clinics-ebpom-chicago Discussion picks up, following on from the above presentation with questions from the live audience who were attending one of Evidence Based Perioperative Medicine's (EBPOM) cutting edge conferences in either Chicago or Ireland. To find out more about EBPOM's next exciting conference please go now to www.ebpom.org Chaired by John Whittle, Associate Professor, Perioperative Medicine, University College London, and Vicki Morton, Director of Clinical and Quality Outcomes, Providence Anesthesiology Associates, with their guests, Oonagh Griffin, Senior Dietician - pancreatic cancer care, St Vincent's University Hospital, Leah Cox, Specialist Dietician - cancer rehabilitation, nutrition and dietetic department Kings College, London, Rebecca Ilic, Clinical Nutrition Manager, Northwestern Memorial Hospital.

This piece is an 'as live' interview from the Society of Cardiovascular Anesthesiologists and part of TopMedTalk's exclusive coverage of the event. Presented by Desiree Chappell and Monty Mythen with their guest Emily Methangkool, Vice Chair of Quality and Patient Safety at the UCLA Department of Anesthesiology and Perioperative Medicine.

This piece is an 'as live' interview from the Society of Cardiovascular Anesthesiologists and part of TopMedTalk's exclusive coverage of the event. Presented by Monty Mythen and Desiree Chappell and Andy Shaw, Department of Intensive Care and Resuscitation at The Cleveland Clinic, Cleveland, Ohio, Fellow of the Royal College of Physicians and Surgeons of Canada, a Fellow of the Royal College of Anaesthetists (UK), a Fellow of the American College of Critical Care Medicine and a Fellow of the Faculty of Intensive Care Medicine (UK).

Welcome to the Society of Cardiovascular Anesthesiology (SCA) annual conference. This piece is a quick look at what you can expect from us as we cover one of the world's most important medical gatherings. Presented by Desiree Chappell and Monty Mythen.

This piece is an 'as live' interview from the Society of Cardiovascular Anesthesiologists and part of TopMedTalk's exclusive coverage of the event. Presented by Desiree Chappell and Monty Mythen with their guest Brad Cardonell, Assistant Professor of Clinical Anesthesiology at the University of Missouri School of Medicine, Director of cardiovascular anesthesiology, University Hospital in Columbia.

This piece is an 'as live' interview from the Society of Cardiovascular Anesthesiologists and part of TopMedTalk's exclusive coverage of the event. Presented by Desiree Chappell and Monty Mythen with their guest, Julias Balogh, Anesthesiologist, Director of CVICU, Division Chief of Anesthesia Critical Care, Executive Director for the Donor ICU and Medical Director for the Cardiovascular ICU, at the University of Arkansas for Medical Science. Our guest kindly shared their email: JBalogh@uams.edu

This piece is an essential guide to running your own perioperative pre-operative diabetes clinic as well as how to manage this condition before, during and after and operation.  With questions from the online audience and reference to the TopMedTalk presentation - linked to here: https://directory.libsyn.com/episode/index/id/21961259 - this podcast will get you and your colleagues thinking about how to add value and patient centered care to those who come through your institution with this condition. Introduced by Sol Aronson, Emeritus Professor, Duke University, Chaired by Owen O Sullivan, consultant anaesthestist, with Kathryn Evans Kreider, Associate Clinical Professor, Duke University School of Nursing, Nurse Practitioner, Division of Endocrinology, Metabolism and Nutrition; Duke University Medical Centre with questions and contributions from Niamh McAuliffe, Consultant Anaesthetist, Cork University Hospital, Tracy Setji, Medical Director, Endocrine Consultation Service, Duke University Hospital, Padraig O'Scannaill, National Coordinator for The Moped Study (Ireland), Feyce Peralta, Associate Professor, Northwester University, Feinberg School of Medicine.

"This is an excellent opportunity to improve your care pathways, to help improve patient outcomes and really to optimise care throughout the continuum of the perioperative period." This piece emphasises the importance of perioperative glucose management and describes evidence-based approaches for perioperative management throughout. What about pre-admission? During hospitalisation? What are the best practices for discharge? This piece is complimented by "Perioperative Diabetes Clinic - How to set up and run" - which is soon to be released on TopMedTalk. Ensure you are subscribed to catch all of our exclusive free content. For listeners who can't wait, it is worth checking out Evidence Based Perioperative Medicine (EBPOM) directly here: www.ebpom.org Presented by Kathryn Evans Kreider, DNP, FNP-BC, BC-ADM, FAANP, Associate Clinical Professor, Duke University School of Nursing, Nurse Practitioner, Division of Endocrinology, Metabolism and Nutrition; Duke University Medical Centre.

"Now we've declared it possible, is it the right thing to do?" This timely discussion considers the wisdom of day case total knee replacement: What do the data say? Can we do this without the use of opioids? What is reasonable to consider as part of an enhanced recovery after surgery program? How do patients make an informed decision when this kind of surgery is in their possible future? The first TopMedTalk piece mentioned in the discussion is here: TopMedTalk | Henrik Kehlet and Nick Scott: https://www.topmedtalk.com/topmedtalk-henrik-kehlet-and-nick-scott-2/ And the second is here: https://www.topmedtalk.com/cryoneurolysis-and-pain-management-topmedtalk-2/ Chaired by Sol Aronson, Emeritus Professor, Duke University & Desiree Chappell, VP Clinical Quality Northstar Anaesthesia with David Howard, Honorary Consultant, Ear Nose and Throat / Head and Neck Surgeon, Imperial and UCLH NHS Trust Hospitals, Brian O'Donnell, consultant anaesthesiologist, Cork University Hospital, Vinod Dasa, VP for Academic Affairs, Dept of Orthopedics, LSU.

"How do we share enhanced recovery with the world? There's been a lot of work in this area..." This crucial update covers enhanced recovery in cardiac; all the latest on investigation, implementation science, integration and dissemination. Recorded at the Evidence Based Perioperative Medicine (EBPOM) Chicago Conference. For more information on EBPOM check out www.ebpom.org Presented by Michael C Grant, Associate Professor, Department of Anesthesiology/Critical Care Medicine, Johns Hopkins University School of Medicine.

How do you go about setting up and then running a perioperative nutrition clinic? How do you convince patients and providers that this will increase value and efficacy? Is nutrition really an essential part of enhanced recovery after surgery? This piece is complimented by a panel discussion soon to be released here on TopMedTalk. However, if you can't wait to hear more you will want to check out the Evidence Based Perioperative Medicine (EBPOM) site here: www.ebpom.org Presented by Elizabeth Villalta, MS, RD, LDN, Licensed Registered Dietitian.

"It certainly has ignited some sort of telemedicine and remote monitoring revolution; I think we'll look back in 10 years and say, well, that's really when things ramped up and changed" This piece is an engaging look at "connected health"; how are new technologies bringing world class experts straight to patients both safely, effectively and at a scale which was previously unimaginable? What are the drawbacks from both the perspective of patient and practitioner? Has the acceleration of these processes - caused by COVID19 restrictions - been a good thing or is it causing some people to be left behind? Presented by Desiree Chappell, VP Clinical Quality for NorthStar Anaesthesia and Monty Mythen, Smiths Medical Professor of Anaesthesia and Critical Care, with John Whittle, consultant anesthetist, critical care physician and perioperative medicine physician and Honorary Associate Professor of perioperative medicine at University College London, Imogen Fecher-Jones, lead nurse for perioperative medicine and pre assessment services at University of Southampton Hospital, Betty Jo Rocchio, CRNA and Senior Vice President and Chief Nursing Officer, Mercy Health in the US, Sam Ajizian, CMO for patient monitoring, Vice President of Global clinical research and medical science for patient monitoring respiratory interventions at Medtronic and, as patient advocate, Neil Johnson, Chief Executive of the Croi, Heart and Stroke Centre, The National Institute for Prevention and Cardiovascular Health and The Global Heart Hub, Ireland.

In part two the conversation moves to more detail about Transnasal Humidified Rapid-Insufflation Ventilatory Exchange (THRIVE). There are also wider questions about "the future of anaesthesia". Ensure you are now subscribed to TopMedTalk so you never miss out. Chaired by Mike Grocott Professor of Anaesthesia and critical care at the University of Southampton and Rodney Meeke, recently retired Anaesthesiologist and Intensivist, Cork University Hospital with contributions from David Howard, Professor of Head and Neck Oncology at Imperial College London in 2008 and remains Honorary Consultant ENT/Head and Neck Surgeon at Imperial and UCLH NHS Trust Hospitals, Korle-Bu Hospital, Accra, and KCMC Hospital, Tanzania, Jim Roberts, Consultant anaesthetist & medical innovator at University College London Hospital & Anil Patel, Professor, consultant anaesthetist at The Royal National ENT & Eastman Dental Hospitals, University College London Hospital and DAS professor of anaesthesia & airway management.

TopMedTalk's essential series on acute kidney injury continues, supported by the "Know AKI campaign" – a bioMérieux global campaign to raise awareness about AKI. For part one of the series follow this link: https://topmedtalk.libsyn.com/part-1-know-aki-and-say-no-to-acute-kidney-injury-for-patients-perioperative-renal-injury In this podcast you will discover how The Perioperative Quality Initiative (POQI) focuses upon renal injury. How do we identify patients early? How do we treat the condition? What should out approach to biomarkers be? What are we looking for when it comes to urine output? Make sure you check out POQI's website here: https://www.thepoqi.org/ While you're online why not book tickets for the next EBPOM conference: www.ebpom.org Presented by Andy Shaw, Chairman, Department of Intensive Care and resuscitation at The Cleveland Clinic, Fellow of the Royal College of Anaesthetists (UK), the American College of Critical Care Medicine and the Faculty of Intensive Care Medicine (UK), Mike Grocott, Professor of Anaesthesia and critical care at the University of Southampton, John Prowle, Senior clinical lecturer, intensivist nephrologist, Royal London Hospital in East London, Marlies Ostermann, Consultant in critical care and nephrology, Guy's and St Thomas's NHS Foundation Trust and Sandy Kane-Gill, Professor, Pharmacy and Theraputics, Univeristy of Pittsburgh School of Pharmacy.

"New '21st Century iron lung' ventilator designed by British experts could revolutionise Covid treatment by taking patients out of intensive care wards" Daily Mail UK, 19th Jan 2021 This is part one of a two part piece. This piece looks at the development of a new negative-pressure ventilatory support device: Exovent. Their website is here: https://exovent.org/ We also cover questions from the EBPOM Dingle audience; what is 'the next big thing' in ventilation? How do we optimise what we currently do? Should we expect to see more negative pressure devices and techniques? How do we get around the perennial problem of ventilator induced lung injury? In part two the conversation moves to more detail about Transnasal Humidified Rapid-Insufflation Ventilatory Exchange (THRIVE). Ensure you are subscribe to TopMedTalk so you can't miss it. Chaired by Mike Grocott Professor of Anaesthesia and critical care at the University of Southampton and Rodney Meeke, recently retired Anaesthesiologist and Intensivist, Cork University Hospital with contributions from David Howard, Professor of Head and Neck Oncology at Imperial College London in 2008 and remains Honorary Consultant ENT/Head and Neck Surgeon at Imperial and UCLH NHS Trust Hospitals, Korle-Bu Hospital, Accra, and KCMC Hospital, Tanzania, Jim Roberts, Consultant anaesthetist & medical innovator at University College London Hospital & Anil Patel, Professor, consultant anaesthetist at The Royal National ENT & Eastman Dental Hospitals, University College London Hospital and DAS professor of anaesthesia & airway management.

This podcast is in addition to a series supported by the "Know AKI campaign", a bioMérieux global campaign to raise awareness about AKI. Go here for part one: https://www.topmedtalk.com/part-1-know-aki-and-say-no-to-acute-kidney-injury-for-patients-perioperative-renal-injury/ It includes contributions from Dan Engelman, Medical Director of the Heart, Vascular and Critical Care Units at Baystate Medical Center, Associate Professor of Surgery at The University of Massachusetts-Baystate, and an Associate Professor-Adjunct at Tufts University School of Medicine and Sandra Kane-Gill, Professor of Pharmacy and Therapeutics at the University of Pittsburgh School of Pharmacy, secondary appointments in the School of Medicine in the Clinical Translational Science Institute, Department of Critical Care Medicine and the Department of Biomedical Informatics, she also serves as Professor for the Center for Critical Care Nephrology and Center for Medical Machine Learning. If you would like to hear the full presentation from Sandra Kane-Gill go here: https://directory.libsyn.com/episode/index/id/21482261 And the clips of Dan Engelman come from here: https://www.topmedtalk.com/daniel-engelman-qa-ebpom-chicago-2/

How should we best monitor and treat acute kidney injury (AKI)? Where is the information leading our best practitioners to? How can monitoring incidences of AKI help to reduce it? This podcast is Part 5 in a series supported by the "Know AKI campaign", a bioMérieux global campaign to raise awareness about AKI. For part one go here: https://topmedtalk.libsyn.com/part-1-know-aki-and-say-no-to-acute-kidney-injury-for-patients-perioperative-renal-injury For part two go here: https://topmedtalk.libsyn.com/part-2-know-aki-and-say-no-to-acute-kidney-injury-for-patients-perioperative-aki-recomendations-and-research-priorities-from-adqi-24poqi-7 Part three is here: https://topmedtalk.libsyn.com/part-3-know-aki-and-say-no-to-acute-kidney-injury-for-patients-health-systems-perspectives-in-aki And part four is here: https://topmedtalk.libsyn.com/part-4-know-aki-and-say-no-to-acute-kidney-injury-for-patients-andy-shaw-on-acute-kidney-injury-aki-biomarkers You can watch a video of the lecture in the on demand section of the EBPOM Education Hub (www.live.ebpom.org). For more on AKI go here: https://www.topmedtalk.com/?s=acute+kidney+injury "Postoperative acute kidney injury in adult non-cardiac surgery: joint consensus report of the Acute Disease Quality Initiative and PeriOperative Quality Initiative" is here: https://www.nature.com/articles/s41581-021-00418-2 Presented by Monty Mythen with Desiree Chappell and their guests Mike Grocott, Professor of Anaesthesia and critical care at the University of Southampton and Vicki Morton, Director of Clinical and Quality Outcomes at Providence Anesthesiology Associates, P.A.

How did your intensive care unit manage during COVID19? What are the common experiences of practitioners from the developed world who bravely faced a pandemic like no other? This is part two of a two part piece. The previous installment is here: https://topmedtalk.libsyn.com/intensive-care-during-covid19-p1-topmedtalk The TV show mentioned in this piece is available here: https://www.channel4.com/programmes/help Editor's note; parts of this conversation which suffered from technical issues have been removed from this podcast. Chaired by Ramani Moonesinghe, OBE, Professor of Perioperative Medicine at UCL and a consultant anesthetist at UCL hospitals, Director of the Health Services Research Center of the Royal College of Anaesthetists and national Clinical Director for critical and perioperative care at NHS England with remote assistance from Catherine Motherway, consultant in Anaesthesia and Intensive Care in University Hospital Limerick and contributions from panelists; David Walker, Professor in Anaesthesia and Critical Care Medicine, University College London Hospitals, Honorary Senior Lecturer UCL, Jim Down, Intensivist and Consultant Anaesthetist, University College London Hospital. Colman O'Loughlin, consultant Anaesthesia, Critical Care Medicine, Extracorporeal Life Support at the Mater Hospital, Dublin, Enda O'Connor, physician intensivist and current ICU Lead and Education Lead in St James’s Hospital.

This podcast is part 4 in a series which is supported by the "Know AKI campaign", a bioMérieux global campaign to raise awareness about AKI. For part one go here: https://topmedtalk.libsyn.com/part-1-know-aki-and-say-no-to-acute-kidney-injury-for-patients-perioperative-renal-injury For part two go here: https://topmedtalk.libsyn.com/part-2-know-aki-and-say-no-to-acute-kidney-injury-for-patients-perioperative-aki-recomendations-and-research-priorities-from-adqi-24poqi-7 And for part three follow this link here: https://topmedtalk.libsyn.com/part-3-know-aki-and-say-no-to-acute-kidney-injury-for-patients-health-systems-perspectives-in-aki Acute kidney injury (AKI) is an important topic for anyone practicing value based care, here we learn how research is developing and where the debate is at as regards biomarkers; what do the data tell us, where can improvements be made and why is it so important? This piece was originally available to attendees of EBPOM 2021 where it was this year's Siobhan Mythen Visiting Plenary lecture. You can watch a video of this lecture in the on demand section of of the EBPOM Education Hub (www.ebpom.live.org). Presented by Andy Shaw, Department of Intensive Care and Resuscitation at The Cleveland Clinic, Cleveland, Ohio, Fellow of the Royal College of Physicians and Surgeons of Canada, a Fellow of the Royal College of Anaesthetists (UK), a Fellow of the American College of Critical Care Medicine and a Fellow of the Faculty of Intensive Care Medicine (UK).

How did your intensive care unit manage during COVID19? What are the common experiences of practitioners from the developed world who bravely faced a pandemic like no other? This is part one of a two part piece. The TV show mentioned in this piece is available here: https://www.channel4.com/programmes/help Editor's note; parts of this conversation which suffered from technical issues have been removed from this podcast. Chaired by Ramani Moonesinghe, OBE, Professor of Perioperative Medicine at UCL and a consultant anesthetist at UCL hospitals, Director of the Health Services Research Center of the Royal College of Anaesthetists and national Clinical Director for critical and perioperative care at NHS England, with remote assistance from Catherine Motherway, consultant in Anaesthesia and Intensive Care in University Hospital Limerick and contributions from panelists; David Walker, Professor in Anaesthesia and Critical Care Medicine, University College London Hospitals, Honorary Senior Lecturer UCL, Jim Down, Intensivist and Consultant Anaesthetist, University College London Hospital. Colman O'Loughlin, consultant Anaesthesia, Critical Care Medicine, Extracorporeal Life Support at the Mater Hospital, Dublin, Enda O'Connor, physician intensivist and current ICU Lead and Education Lead in St James’s Hospital.

"Kidney disease ... is clearly a public health concern" Health systems perspectives in acute kidney injury, this podcast is part 3 in a series which is supported by the "Know AKI campaign", a bioMérieux global campaign to raise awareness about AKI. For part one go here: https://topmedtalk.libsyn.com/part-1-know-aki-and-say-no-to-acute-kidney-injury-for-patients-perioperative-renal-injury For part two go here: https://topmedtalk.libsyn.com/part-2-know-aki-and-say-no-to-acute-kidney-injury-for-patients-perioperative-aki-recomendations-and-research-priorities-from-adqi-24poqi-7 This piece is one of the highlights of both EBPOM London and EBPOM Dingle/Chicago where it provoked much discussion amongst the delegates. What does the data and evidence tell us about acute kidney injury (AKI) and how to respond to it? How do we detect and diagnose it as soon as possible? What else can be done? You can watch a video of the lecture in the on demand section of of the EBPOM Education Hub (www.ebpom.live.org). This piece was recorded in advance of the the annual general meeting of the American Society of Anesthesiologists (ASA). TopMedTalk will be live streaming from the event, checkout www.ebpom.live.org for more details. Presented by Sandra Kane-Gill, PharmD, MSc, FCCM, FCCP, is Professor of Pharmacy and Therapeutics at the University of Pittsburgh School of Pharmacy.

This piece is the first of a four part series, supported in part through an unrestricted educational grant from Acacia Pharma, Inc, tackling the subject of post operative nausea and vomiting. How do practitioners who have an emphasis upon value based care incorporate dealing with one of the less pleasant realities of surgery for a patient? For the fuller conversations quoted in this piece please checkout the following: New treatments for Post Operative Nausea and Vomiting | TopMedTalk https://www.topmedtalk.com/new-treatments-for-post-operative-nausea-and-vomiting-topmedtalk/ Why do we need a new rescue antiemetic | Novel Rescue PONV therapy https://editors-top-picks.libsyn.com/why-do-we-need-a-new-rescue-antiemetic-novel-rescue-ponv-therapy Quality measures in Anesthesia | Novel Rescue PONV Therapy https://editors-top-picks.libsyn.com/quality-measures-in-anesthesia-novel-rescue-ponv-therapy Stop your patients feeling sick | Novel Rescue PONV Therapy https://editors-top-picks.libsyn.com/stop-your-patients-feeling-sick-novel-rescue-ponv-therapy

For part one of this series go here: https://topmedtalk.libsyn.com/part-1-know-aki-and-say-no-to-acute-kidney-injury-for-patients-perioperative-renal-injury This piece is a series of recommendations from the Acute Disease Quality Initiative (ADQI-24) and the Perioperative Quality Initiative (POQI-7). The article mentioned in this piece is here: https://www.nature.com/articles/s41581-021-00418-2 Originally part of the Evidence Based Perioperative Medicine (EBPOM) World Congress this presentation is also available in video format via www.ebpom.org Presented by John Prowle, Senior Clinical Lecturer in Intensive Care Medicine within the Critical Care and Perioperative Medicine Research Group at Barts and the London School of Medicine and Dentistry, Queen Mary University of London and is an Honorary Consultant Physician in Intensive Care Medicine and Nephrology at the Royal London Hospital, Barts Health NHS Trust, London, UK.

"We have to decide; if it's safe, how do we do it, and how do we do it right?" This piece provides a much needed overview of anesthesia in the USA, clinical innovation, best practice and enhanced recovery. How do we deliver on the value proposition safely and efficiently? What is the responsibility of practitioners to patients when measuring the impact of new products, medications and equipment? How do we mitigate cost, need and quality? Supported in part through an unrestricted educational grant from Acacia Pharma, Inc. To hear more from our guest go here: https://www.topmedtalk.com/topmedtalks-to-rick-dutton/ Presented by Desiree Chappell and Monty Mythen with Rick Dutton, Chief Quality Officer for US Anesthesia Partners (USAP), Texas.

This deep dive into intraoperative hypotension provides an essential update on this area. Does the cause of hypotension reveal more about the specifics of the condition and therefore treatments? How can we understand what it is that we are doing well when it comes to prevention? Presented by Desiree Chappell and Monty Mythen with their guests Thomas Scheeran, Professor of Anaesthesiology, University Medical Centre, Groningen, Netherlands and Ashish Khan, Associate Professor, Department of Anesthsiology, Wake Forest School of Medicine.

This piece has been supported by the "Know AKI campaign" – a bioMérieux global campaign to raise awareness about acute kidney injury. It features a wide selection of clips on the subject of acute kidney injury, restrictive versus liberal fluid therapy and the trials we've seen in recent years which have revitalized debate and learning. The clips used come from the following podcasts: Michelle Chew's clip comes from here: EUROANAES2019 | Michelle Chew http://www.topmedtalk.com/euroanaes2019-michelle-chew/ Andy Shaw's clip comes from here: SCA | Improving your practice http://www.topmedtalk.com/sca-improving-your-practice/ John Kellum is here: Perioperative Nephrology Fluids and the Kidney http://www.topmedtalk.com/periop-coach-4-06-perioperative-nephrology-fluids-and-the-kidney/ Renal Injury Biomarkers http://www.topmedtalk.com/renal-injury-biomarkers/ Urine Output http://www.topmedtalk.com/urine-output/ Vincent D’Intini's contribution originally appeared here: Periop SIG18 | Goal directed therapy to prevent acute kidney injury http://www.topmedtalk.com/periop-sig18-goal-directed-therapy-to-prevent-acute-kidney-injury/ Paul Myles's contributions feature also in this pertinent piece alongside Rupert Pearse: EBPOM London 2018 – any answers | Part 3 The Big Trials http://www.topmedtalk.com/ebpom-london-2018-any-answers-part-3-the-big-trials/ Tim Miller is worth listening to in more detail here: Live from Boston ASA 2017 – Intraoperative Goal Directed Fluid Therapy http://www.topmedtalk.com/live-from-boston-asa-2017-intraoperative-goal-directed-fluid-therapy/ Dan Sessler is here: Live from Boston ASA 2017 – The Elephant In The Room – intraoperative hypotension http://www.topmedtalk.com/live-from-boston-asa-2017-the-elephant-in-the-room-intraoperative-hypotension/ David Kauffman and Greg Martin feature here: Fluid Matters 3/6 | Fluid Responsiveness and venous capacitance http://www.topmedtalk.com/fluid-matters-3-6-fluid-responsiveness-and-venous-capacitance/ Dan Engelman features here: Daniel Engelman Q&A | EBPOM Chicago http://www.topmedtalk.com/daniel-engelman-qa-ebpom-chicago-2/ EBPOM Highlight | Enhanced Recovery After Cardiac Surgery http://www.topmedtalk.com/ebpom-highlight-enhanced-recovery-after-cardiac-surgery/ For more from (Trainees in Perioperative Medicine) TRIPOM and Mike Grant go here: TRIPOM 1.02 | EBPOM USA 2019 http://www.topmedtalk.com/tripom-1-02-ebpom-usa-2019/ TopMedTalk is proud to act as the broadcasting arm of Evidence Based Perioperative Medicine (EBPOM) for more information please go now to www.ebpom.org

"Our top priority must be safety" A real stand out piece from this year's incredible Evidence Based Perioperative Medicine (EBPOM) Dingle/Chicago conference. This piece dives into the realities of sedation from the point of view of a patient focused practitioner. For more conversations along these lines make sure you listen to our coverage of the annual general meeting of the American Society of Anesthesiologists (ASA) on October the 9th. TopMedTalk will be live streaming from the event, checkout www.ebpom.live.org for more details. Presented by Monty Mythen and Desiree Chappell with their guest Rob Sneyd, Emeritus Professor at University of Plymouth, Faculty of Medicine and Dentistry.

"There are so many, many studies on prophylaxis, but very few on treatment" Post operative nausea and vomiting, secondary nausea, how can we put the danger of these unfortunate moments behind us in a modern practice? This piece focuses upon nausea and treatment in particular as part of an Enhanced Recovery practice. Fourth Consensus Guidelines for the Management of Postoperative Nausea and Vomiting: https://journals.lww.com/anesthesia-analgesia/fulltext/2020/08000/fourth_consensus_guidelines_for_the_management_of.16.aspx Supported in part through an unrestricted educational grant from Acacia Pharma, Inc. Presented by Desiree Chappell and Monty Mythen with their guest Tricia Meyers, PharmD, adjunct Professor, Texas A&M, College of Medicine.

What are the known challenges for patients and practitioners who face anemia preoperatively? How do you set up and run an anemia clinic? Is there any need for this to be considered an essential part of the perioperative process? This piece follows on from a presentation regarding how to set up and run an anemia clinic, follow this link here to hear that presentation: https://topmedtalk.libsyn.com/how-to-set-up-and-run-a-perioperative-anemia-clinic-ebpom-chicago For more on this topic listen to our popular podcast "Iron Man vs Anemia" which also features Toby Richards: https://www.topmedtalk.com/topmedtalk-iron-man-vs-anemia-2/ Chaired by Feyce M. Peralta, obstetrical anesthesiologist, Program Director for the Obstetric Anesthesiology Fellowship and Director of Faculty Development for the Department of Anesthesiology at Northwestern University Feinberg School of Medicine with guest speaker, Professor Bobbi Jean Sweitzer, The Associate Chair for Clinical Perioperative Practice, Northwestern University in Chicago, Illinois and panel members Toby Richards, Professor, Anaesthesia Teaching & Research Faculty of Medicine, Nursing and Health Sciences Central Clinical School, Monash University, Obianuju Okocha medical director of the preoperative clinic at Northwestern Memorial Hospital, Chicago & Frank Loughnane, Consultant Anaesthesiologist Cork University Hospital, Clinical lead for orthopaedic elective and trauma anaesthesia, Joint Clinical lead for pre-operative assessment, Clinical lecturer University College Cork.

This piece continues the discussion regarding blood pressure regulation, moving from the brain to the kidney, heart and lungs via a number of distinguished experts in the field. How do we safely cut through the opinions on these areas and focus instead on relevant data? How do these organs interact in terms of auto regulation? How closely do our clinical tools allow us to infer accurately what a particular patient's needs are? This piece is part two of two, the first part is advised listening and can be found here: https://topmedtalk.libsyn.com/pathophysiology-of-blood-pressure-auto-regulation-p1-topmedtalk Presented by Dan Martin, with Monty Mythen, Sol Aronson and panelists Damian Bailey, Professor of Physiology at the University of South Wales, Maryam Khosravi, clinical nephrology, University College London, Andrew Shaw, Chairman, Department of Anesthesiology and Pain Medicine at The University of Alberta, Edmonton, Alberta and Zone Clinical Department Head for Anesthesia, Alberta Health Services Edmonton Zone and Fellow of the Royal College of Anaesthetists (UK), the American College of Critical Care Medicine and the Faculty of Intensive Care Medicine (UK), Erik Swenson, Director of Pulmonary Diagnostics Service at VA Puget Sound Health Care System, Seattle, WA, Kim Dora, Professor of Microvascular Pharmacology, Oxford University, Chris Garland, Professor of Vascular Pharmacology, Oxford University.

The focus of this conversation is auto regulation in the brain, it leads into a longer conversation - part 2 - where the subject is discussed more broadly. What tools do we now have and how are they changing the way we see and understand this area? Are there hard and fast rules when it comes to blood pressure or is there still significant debate? Although this works as a stand alone listen it is in reference to the talk "Redefining Hypotension based on Real-time Cerebral Autoregulation Monitoring | EBPOM Chicago" - https://www.topmedtalk.com/redefining-hypotension-based-on-real-time-cerebral-autoregulation-monitoring-ebpom-chicago/ Presented by Monty Mythen with Dan Martin, OBE, Professor of Perioperative and Intensive Care Medicine, University of Plymouth and the Royal Free Hospital, London and Sol Aronson, tenured Professor, Duke University, Durham, North Carolina with their guest Charles Hogue, Professor and Chair of Anesthesiology at Northwestern University in Chicago.

"Choosing Wisely is an initiative of the American Board of Internal Medicine started about 10 years ago to advertise important aspects of medicine ... their number one recommendation was to not proceed with elective surgery in patients with properly diagnosed and correctable anemia, until the anemia has been appropriately treated." Taken from the hugely popular EBPOM Chicago meeting this piece explains how and why you need an anemia clinic as part of your perioperative practice. For more of this check out our piece here, which also features Bobbie Jean Sweitzer: "Promote your anemia clinics in the pandemic era?" https://www.topmedtalk.com/covid-19-promote-your-anemia-clinics-in-the-pandemic-era/ Presented by Professor Bobbi Jean Sweitzer, The Associate Chair for Clinical Perioperative Practice, Northwestern University in Chicago, Illinois.

Near infrared spectroscopy (NIRS) ... 'a variation of pulse oximetry; it transmits red and infrared light into tissue' measures information from arterial venous and capillary blood simultaneously to deduce tissue saturation; an aggregate estimate of arteriovenous capillary blood and whatever tissue you're shining the light into. 'So typically, we're using it in on the brain at least in the cardiac and vascular space, but people also in other areas like the surgical ICU, can use it to measure muscle oxygenation as well'. Learn how this technique could enhance your practice, what its potential for advancement is and where its limits lie. This piece is likely to be of critical interest to most cardiac surgeons and those who work alongside them. This piece was generously supported and brought to you by Medtronic. Presented by Desiree Chappell and Monty Mythen with their guests Robert Thiele, Cardiac Anesthesiologist and Intensivist at the University of Virginia, Carol Ann Rosenberg Associate Director of Perfusion and ECMO, Kenan Yount, Cardiac Surgeon and Director of the Valve center and Director of the Aortic Center at the University of Virginia.

Originally recorded during Evidence Based Perioperative Medicine (EBPOM)'s London conference this piece focuses upon pulmonary complications in the perioperative period. What do the data say, what are the key trials? 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 with Mark Hamilton, Consultant and Honorary Senior Lecturer in Anaesthesia & Critical Care Medicine at St. George’s Hospital and Medical School, clinical lead for the Perioperative Assessment & Planning Unit at St. George’s Hospital, clinical director for critical care at St. George’s Hospital, alongside, Linda Denehy, Head of the Melbourne School of Health Sciences and Professor of Physiotherapy at The University of Melbourne, Australia, Rinaoldo Bellomo, Professor of Intensive Care Medicine, University of Melbourne, Honorary Professor, Faculty of Medicine, Monash University, Honorary Professorial Fellow, Faculty of Medicine, The University of Sydney, Honorary Professorial Fellow, The George Institute, Honorary Fellow, Florey Institute of Physiology, Honorary Professor, Faculty of Medicine, Nanjing University, Visiting Professor, Università Vita-Salute San Raffaele, he was awarded an Officer of the Order of Australia for distinguished service and Rupert Pearse, Professor of Intensive Care Medicine at Queen Mary, University of London.

One of the standout moments of Evidence Based Perioperative Medicine (EBPOM) 2021 this piece is a bonus podcast for the holiday season which looks in detail at oxygen from a perioperative medicine perspective, amongst other things this talk throws up some troubling and challenging observations about pulse oximetry. The piece is introduced by Mike Grocott, Professor of Anaesthesia and critical care at the University of Southampton. Presented by David Story, Professor and Foundation Chair of Anaesthesia at the University of Melbourne; Head of the University Department of Critical Care and a member of Council of the Australian and New Zealand College of Anesthetists (ANZCA) and the Chair of the ANZCA Safety and Quality Committee. Like this, want more? Check out www.ebpom.org now, great prices on conferences are available including access to high quality video presentations on demand.

"We have seen a very significant transition (in respiratory care) through COVID" What have we learned about how to treat lung and breathing issues over the last few years? Away from alarming headlines and looking instead at data - is there a consensus on how COVID-19 should be treated? How has ventilation improved and developed? This podcast focuses on respiratory intervention and was originally broadcast as part of the hugely successful EBPOM Dingle/Chicago 2021 conference. For more details on EBPOM and for access to a huge library of resources, that goes beyond even TopMedTalk's extensive archive, go now to www.ebpom.org Presented by Desiree Chappell and Monty Mythen with their guest Karen A. Phillips, Chief Medical Officer, Respiratory Interventions, Consultant Anesthesiologist and Intensivist.

Amisulpride is an antiemetic medication used at lower doses intravenously to prevent and treat postoperative nausea and vomiting; what does it look like in practice? Can it work as a 'rescue therapy'? What does the data tell us? Could a treatment for post-operative nausea and vomiting be a way to really enhance value based care and enhanced recovery? Supported in part through an unrestricted educational grant from Acacia Pharma, Inc. Presented by Desiree Chappell and Monty Mythen with their guest Dru Riddle, Associate Professor of Professional Practice in the School of Nurse Anesthesia at Texas Christian University, Associate Professor of Medical Education, TCU School of Medicine, and Director of the Center for Translational Research: A JBI Center of Excellence and Cochrane US TCU Center.

"Precision anesthesia [...] where we can give patients the anesthetic and the doses that they require on a patient specific basis" This piece looks at nociception, the neural processes of encoding and processing "noxious" stimuli. By monitoring this anesthetic practitioners can deploy a level of precision not previously possible. Regular listeners may wish to refer back to previous podcasts on this subject: EBPOM LIVE from London | Pain monitoring - with Frank Overdyk, Professor of Anaesthesiology, Charleston, South Carolina: https://www.topmedtalk.com/11813-2/ TopMedTalks to … | Dan Longrois on nociception: https://www.topmedtalk.com/topmedtalks-to-dan-longrois-on-nociception/ Presented by Desiree Chappell and Monty Mythen with their guest Anil Hormis, Professor, Consultant in anesthesia and Critical Care Medicine, Rotherham NHS Foundation Trust.

The Hypotension Prediction Index is rapidly gaining a well deserved place in the hands of modern perioperative practitioners. Here we look at the history of this tool, why it is needed so badly and how it has developed. Many of the conversations referenced in this piece are worthy of further attention. The clips used are taken from the following TopMedTalk programmes: Live from Boston ASA 2017 – The Elephant In The Room – intraoperative hypotension: https://www.topmedtalk.com/live-from-boston-asa-2017-the-elephant-in-the-room-intraoperative-hypotension/ Intraoperative Hypotension: https://www.topmedtalk.com/intraoperative-hypotension/ ASA 2019 | Perioperative Quality Initiative P.O.Q.I. news https://www.topmedtalk.com/asa-2019-perioperative-quality-initiative-p-o-q-i-news/ ASA 2019 | Hypotension Index: Data drives change https://www.topmedtalk.com/the-hypotension-prediction-index-hpi/ The Roundtable | The Hypotension Prediction Index (HPI) https://www.topmedtalk.com/the-roundtable-the-hypotension-probability-index-hpi/ EBPOM 2018 | Hypotension probability in practice https://www.topmedtalk.com/ebpom-2018-hypotension-probability-in-practice/ Prehab Periop World Congress: Feras Hatib, Simon Davies https://www.topmedtalk.com/prehab-periop-world-congress-feras-hatib-simon-davies/ The Hypotension Prediction Index (HPI) https://www.topmedtalk.com/the-hypotension-prediction-index-hpi/ The picture features TopMedTalk in conversation with Thomas Scheeren, Chair Cardiovascular Dynamics Section at European Society of Intensive Care Medicine (ESICM). TopMedTalk is proud to act as the broadcasting arm of Evidence Based Perioperative Medicine (EBPOM) - our world famous conferences continue to grow in size and scope as the COVID recovery gets underway -, find out more here: www.ebpom.org

With a global focus this piece moves into obstetric anesthesia, perioperative medicine and anemia management. Covering iron deficiency, hemoglobin, post-partum management and how to improve outcomes for all. For more on this go now to www.ebpom.org where you will find the pre-recorded video contributions made by our speakers in anticipation of this discussion. Presented by Sam Bampoe, Tripom Co-Founder, Consultant in Anaesthesia and Perioperative Medicine at University College London NHS Foundation Trust and 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 with their guests; Anita Sugavaganam, Consultant Anaesthetist and Lead for adult general anaesthesia and patient blood management at University Hospitals Sussex, Honorary Senior Clinical lecturer at the University of Sussex, Pervez Sultan, Associate Professor of Obstetric Anesthesiology, Stanford University School of Medicine, California, Honorary Faculty position as Associate Professor at University College London and Charlotte Holm, Obstetrics and Gynecology, resident at the Department of Obstetrics and Gynecology, Hvidovre Hospital, Denmark.

"I think it really comes down to teamwork" How rapidly should you perform a tracheostomy? When do you "start the conversation" about the procedure? What about when it comes to patients with COVID19? Where does a data driven approach take us to? This essential piece is provided to TopMedTalk listeners as a sneak preview of EBPOM Dingle and Chicago; recorded in advance of the meeting and shared with you as a preview of this year's Evidence Based Perioperative Medicine's global conference offering. We would like to thank Medtronic, for their generous support which enabled us to bring this piece to you for free. Presented by Desiree Chappell and Monty Mythen with their guest Babak Sarani, Professor of surgery and emergency medicine and Director for the Center for Trauma and Critical Care at George Washington.

Welcome to TopMedTalk's exclusive - as live - coverage of The American Society of Anesthesiologists (ASA) annual general meeting; join Desiree Chappell, TopMedTalk's lead presenter, Monty Mythen TopMedTalk's Editor in Chief and Sol Aronson, tenured Professor, Duke University speak with their guest, Mary Dale Peterson, M.D., MHA, FACHE, FASA, ASA Immediate Past President.

Welcome to TopMedTalk's exclusive - as live - coverage of The American Society of Anesthesiologists (ASA) annual general meeting; join Desiree Chappell, TopMedTalk's lead presenter, Monty Mythen TopMedTalk's Editor in Chief and Sol Aronson, tenured Professor, Duke University speak with their guest, TJ Gan, MD, MHS, FRCA, MBA, Professor and Chairman of the Deptartment of anesthesiology at Stony Brook Medicine in Stony Brook, New York. For more on this topic check out our exclusive min-series here: https://editors-top-picks.libsyn.com/the-value-of-tackling-post-operative-nausea-and-vomiting-topmedtalk

Welcome to TopMedTalk's exclusive - as live - coverage of The American Society of Anesthesiologists (ASA) annual general meeting; join Desiree Chappell, TopMedTalk's lead presenter, Monty Mythen TopMedTalk's Editor in Chief and Sol Aronson, tenured Professor, Duke University speak with their guest, Alex Lewis, Founder of The Alex Lewis Trust. More here: https://www.alex-lewis.co.uk/innovation-technology/koalaa/

Welcome to TopMedTalk's exclusive - as live - coverage of The American Society of Anesthesiologists (ASA) annual general meeting; join Desiree Chappell, TopMedTalk's lead presenter, Monty Mythen TopMedTalk's Editor in Chief and Sol Aronson, tenured Professor, Duke University speak with their guest, Richard Dutton, M.D., M.B.A., Chief Quality Officer US Anesthesia Partners.

Welcome to TopMedTalk's exclusive - as live - coverage of The American Society of Anesthesiologists (ASA) annual general meeting; join Desiree Chappell, TopMedTalk's lead presenter and Sol Aronson, tenured Professor, Duke University speak with their guests; Beverly Philip, M.D., FACA, FASA, President of The American Society of Anesthesiologists and Randall Clark, M.D., FASA, President-Elect of the American Society of Anesthesiologists.

Welcome to TopMedTalk's exclusive - as live - coverage of The American Society of Anesthesiologists (ASA) annual general meeting; join Desiree Chappell, TopMedTalk's lead presenter, Monty Mythen TopMedTalk's Editor in Chief and Sol Aronson, tenured Professor, Duke University speak with their guest, Stephanie Byerly, M.D. Chair of the ASA Committee on Women Anesthesiologists, Professor of Anesthesiology and Pain Management, UT Southwestern, Dallas, Cheif, Obstetrical Anesthesiology, Clements University Hospital, Dallas.

Welcome to TopMedTalk's exclusive - as live - coverage of The American Society of Anesthesiologists (ASA) annual general meeting; join Desiree Chappell, TopMedTalk's lead presenter, Sol Aronson, tenured Professor, Duke University speak with their guest, Evan Kharasch, Chair of the ASA Committee on excellence in research, Professor and Vice Chair for Innovation in the Department of Anesthesiology at Duke University, and Director of Academic Entrepreneurship in Duke University School of Medicine.

Welcome to TopMedTalk's exclusive - as live - coverage of The American Society of Anesthesiologists (ASA) annual general meeting; join Desiree Chappell, TopMedTalk's lead presenter, Sol Aronson, tenured Professor, Duke University speak with their guest, Lee Fleisher, Emeritus Professor of Anesthesiology and Critical Care, University of Pennsylvania.

Welcome to TopMedTalk's exclusive - as live - coverage of The American Society of Anesthesiologists (ASA) annual general meeting; join Desiree Chappell, TopMedTalk's lead presenter, Monty Mythen TopMedTalk's Editor in Chief and Sol Aronson, tenured Professor, Duke University speak with their guest, Adam Striker, MD FASA. Chair, ASA Committee on Communications, Associate Professor, Anesthesiology, University of Cincinnati and University of Kentucky.

Welcome to TopMedTalk's exclusive - as live - coverage of The American Society of Anesthesiologists (ASA) annual general meeting; join Desiree Chappell, TopMedTalk's lead presenter, Monty Mythen TopMedTalk's Editor in Chief and Sol Aronson, tenured Professor, Duke University speak with their guest Chris Steel, MD, In Patient CMO, White River Health System, Batesville Arkansas. More here: https://www.asahq.org/psh

Welcome to TopMedTalk's exclusive - as live - coverage of The American Society of Anesthesiologists (ASA) annual general meeting; join Desiree Chappell, TopMedTalk's lead presenter, Monty Mythen TopMedTalk's Editor in Chief and Sol Aronson, tenured Professor, Duke University speak with their guest Bonnie Milas, Cardiac anesthesiologist, University of Pennsylvania. More info here: https://www.asahq.org/advocating-for-you/reviveme

Welcome to TopMedTalk's exclusive - as live - coverage of The American Society of Anesthesiologists (ASA) annual general meeting; join Desiree Chappell, TopMedTalk's lead presenter, Monty Mythen TopMedTalk's Editor in Chief and Sol Aronson, tenured Professor, Duke University speak with their guest Ashish Khanna, Associate Professor, Section Head for Research, Department of Anesthesiology, Section on Critical Care Medicine, Wake Forest School of Medicine.

Cancer and anesthetic drugs, informed by the basic science the pre-clinical work and observational studies suggest the way that we provide anesthesia could have an impact on cancer outcomes. This piece explores the evidence, with reference to trials both resolved and ongoing. Presented by Monty Mythen with Tom Wall, consultant anesthesiology in the Mater Hospital he also has an academic affiliation with University College Dublin, Joyce Yeung, associate clinical professor of anesthesia and critical care, University of Warwick and Director of the UK perioperative medicine clinical trials network, Bernhard Riedel, Professor, Director of the Department of Anesthesia, Perioperative and Pain Medicine at the Peter MacCallum Cancer Centre, with an honorary academic appointment at the University of Melbourne and Vijaya Gottumukkala, Professor of Anesthesia and Deputy Chair at MD Anderson.

Welcome to TopMedTalk's exclusive - as live - coverage of The American Society of Anesthesiologists (ASA) annual general meeting; join Desiree Chappell, TopMedTalk's lead presenter, Monty Mythen TopMedTalk's Editor in Chief as they talk to their guests, Jonathan Gal, Associate Professor, System Medical Director- Facility Revenue Integrity & Optimization; System Medical Director- Offsite ASC Anesthesia; Associate Professor of Anesthesiology, Director Governmental & Reimbursement Affairs, Mount Sinai Hospital.

Welcome to TopMedTalk's exclusive - as live - coverage of The American Society of Anesthesiologists (ASA) annual general meeting; join Desiree Chappell, TopMedTalk's lead presenter, Monty Mythen TopMedTalk's Editor in Chief as they talk to their guests, Tricia Meyer, PharmD, adjunct Professor, Texas A&M, College of Medicine and Dru Riddle, Associate Professor of Professional Practice in the School of Nurse Anesthesia at Texas Christian University, Associate Professor of Medical Education, TCU School of Medicine, and Director of the Center for Translational Research: A JBI Center of Excellence and Cochrane US TCU Center.

Welcome to TopMedTalk's exclusive - as live - coverage of The American Society of Anesthesiologists (ASA) annual general meeting; join Desiree Chappell, TopMedTalk's lead presenter, Monty Mythen TopMedTalk's Editor in Chief, as they talk to their guest Amy Wilkinson, Director of Clinical Marketing Butterfly Network.

Welcome to TopMedTalk's exclusive - as live - coverage of The American Society of Anesthesiologists (ASA) annual general meeting; join Desiree Chappell, TopMedTalk's lead presenter, Monty Mythen TopMedTalk's Editor in Chief and Sol Aronson, tenured Professor Duke University, as they talk to their guest Kamal Maheshwari, Director, Center for Perioperative Intelligence, Cleveland Clinic.

  TopMedTalk's exclusive - as live - coverage of The American Society of Anesthesiologists (ASA) annual general meeting; join Desiree Chappell, TopMedTalk's lead presenter, Monty Mythen TopMedTalk's Editor in Chief and Sol Aronson, tenured Professor Duke University, as they talk with their guest Kraig S. de Lanzac, Assistant Secretary of the ASA. For more on the ASA go here: https://www.asahq.org/  

  Welcome to TopMedTalk's exclusive - as live - coverage of The American Society of Anesthesiologists (ASA) annual general meeting; join Desiree Chappell, TopMedTalk's lead presenter, Monty Mythen TopMedTalk's Editor in Chief and Sol Aronson, tenured Professor Duke University, as they talk about the hot topics, major issues and where the data is leading us. For more on the ASA go here: https://www.asahq.org/  

This piece focuses upon multimodal prehabilitation through the lived experience of clinicians from the different healthcare systems of Europe, the United States and the UK; both prior to and during the pandemic. We hear about the implementation of rehabilitation programs and research studies, which have managed to adapt, in the COVID era. 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 with her guests Franco Carli, Professor of Anesthesia at McGill University and Associate Professor in the School of Dietetics and Human Nutrition at McGill University, Staff anesthesiologist at the McGill University Health Centre, Gerard Danjoux, consultant in Anaesthesia and Sleep Medicine at South Tees Hospitals NHS Trust, Professor Sandy Jack, PhD, Consultant Clinician Scientist in The Anaesthesia and Critical Care Research Unit at University Hospital Southampton NHS Foundation Trust, Honorary Senior Lecturer at the University of Liverpool, University of Southampton and University College London, Dan Engelman, President of the Enhanced Recovery after Cardiac surgery society, Baystate Health in Massachusetts, Medical Director, Heart, Vascular & Critical Care Services, Baystate Medical Center and Associate Professor of Surgery University of Massachusetts Medical School-Baystate. Like this, want more? Try this piece now: https://www.topmedtalk.com/models-of-prehabilitation-ebpom-2020-2/ And remember, Evidence Based Perioperative Medicine (EBPOM) offers high quality video presentations as well as a chance to attend our next live conference here: www.ebpom.org

The Perioperative Exercise Testing and Training Society (POETTS) presents "Nutrition and patient living with and beyond cancer" in partnership with the Macmillan Trust. A real stand out moment from this year's Evidence Based Perioperative Medicine (EBPOM) London. This discussion is essential listening for anyone interested in pre-optimisation, muscle mass, nutrition, malnourishment - how to spot it and what to do about it, surgery and the importance of protein. 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, Gerrit Slooter, Surgical Oncologist, Maxima Medical Centre, The Netherlands, Steven Olde Damink, Consultant HBP Surgeon, University of Maastricht, Dileep Lobo, Professor of Gastrointestinal Surgery, Faculty of Medicine & Health Sciences, University of Nottingham and Consultant Hepatopancreaticobiliary Surgeon at Queen's Medical Centre, Chelsia Gillis, Registered Dietician, McGill University, Ca.

This piece looks at diabetes from a perioperative perspective, as a patient goes toward surgery how realistic and how important is it for us to treat and manage their condition? What can be done? How can our patients help? How has the evidence moved on these issues? Also, for more on diabetes check out this Journal Club; https://www.topmedtalk.com/journal-club-1-12-various-articles-from-bmj-open-journal-of-bone-joint-surgery-american-volume-diabetes-care-annals-of-surgery/ or this Perioperative Coach; https://www.topmedtalk.com/periop-coach-3-04-perioperative-fluid-management-to-enhance-recovery-after-surgery/ And, for more on The Centre For Perioperative Care (CPOC) go here: https://www.topmedtalk.com/anaesthesia-2019-uk-centre-for-perioperative-care/ Presented by Mike Grocott, Professor of Anaesthesia and critical care at the University of Southampton, and Dave Selwyn, Deputy Medical Director at Nottingham University Hospitals NHS Trust and Director of The Centre for Perioperative Care (CPOC), Dennie Levett, Professor in Perioperative Medicine and Critical Care at Southampton University Hospital NHS Foundation trust and Honorary Associate Professor at the University of Southampton, Emma Page, Transformation Lead East Suffolk and North Essex NHS Foundation Trust, Goher Ayman, Diabetes UK, patient representative from the guideline group, Scarlett McNally, Deputy Director of The Centre for Perioperative Care (CPOC) consultant Orthopaedic Surgeon, Eastbourne DGH, UK, Gerry Rayman, Consultant physician, Ipswich Hospitals NHS Foundation Trust.

Introduced by Monty Mythen, TopMedTalk's Editor in Chief and Padma Gulur, Professor of Anesthesiology and Population Health and Executive Vice Chair for Performance and Operations Director, Pain Management Strategy and Opioid Surveillance at Duke University Health Systems. Presented by Ramani Moonesinghe, OBE, Professor of Perioperative Medicine at UCL and a consultant anesthetist at UCL hospitals, Director of the Health Services Research Center of the Royal College of Anaesthetists and national Clinical Director for critical and perioperative care at NHS England. Our speaker provided clinical leadership for the UK's national critical care response to COVID-19 and is now supporting the recovery of elective care as we emerge from the pandemic; her talk today focuses upon experiences and learnings from the past 18 months. Could it be that perioperative medicine is now the discipline which will help us build a road to recovery? For more information about The Morpheus Consortium, the branding of three universities, Duke University, University College London and University of Southampton, with one shared goal – to be the leaders in perioperative medicine and enhanced recovery after surgery, ultimately improving the patients’ journey from the moment their surgery is contemplated to full recovery, go here: http://morpheusconsortium.org/ For more talks like this take time to discover Evidence Based Perioperative Medicine; www.ebpom.org

"Once you work with it, you really do learn to trust it. And it's very accurate." This piece gives us an insight into practice from a cardiac perspective. What are "the TIGER protocols"? How is the HPI monitor being used? How has it impacted upon cardiac surgery? Presented by Desiree Chappell and Monty Mythen with their guest Brad Cardonell, Assistant Professor of clinical anesthesiology at the University of Missouri School of Medicine, Director of cardiovascular anesthesiology, University Hospital in Columbia. This piece was made available with generous support from Edwards Lifesciences.

Featuring a wide range of questions from the attending audience at EBPOM 2021 this piece gets into frailty: How do we assess it? How does it affect shared decision making? How can we raise awareness around it? How do we articulate what it means to patients and their loved ones? What does post operative frailty mean? Introduced by Mike Grocott, Professor of Anaesthesia and Critical Care at the University of Southampton, Chaired by Jugdeep Dhesi, Clinical Lead for "Proactive care for Older People undergoing Surgery" (POPS) and Consultant Geriatrician, Guys and St Thomas' NHS Trust, with their guests Jude Partridge, consultant geriatrician POPS, honorary senior lecturer, King's College London, Chairs the British Geriatrics Society POPS SIG, Lawrence Mudford, 38-years as a dentist and dental educator within both primary and secondary care, including serving on the Board of the Faculty of General Dental Practice (UK) and a member of the General Dental Council, Board member of the Centre for Perioperative Care, Jessie Lupino Colquhoun, General Practitioner, Trainee, Lewisham UK, Elizabeth Huddlestone, Consultant Anesthetist, Wirral University Teaching Hospital. If you enjoyed this piece make sure you check out www.ebpom.org for great ways you can attend our next conference.

An exclusive chance to hear from the editors in chief of the major journals in our field discussing the big issues of 2021; 'The Journal of Perioperative Medicine', 'Anesthesiology', 'The British Journal of Anaesthesia', 'Anesthesia & Analgesia' and 'Anaesthesia'. This piece was initially presented at Evidence Based Perioperative Medicine (EBPOM)'s 2021 online conference as part of the POCAPALOOZA. Make sure you check out www.ebpom.org now for more details on our other conferences this year. Presented by Mike Grocott, Professor of Anaesthesia and critical care at the University of Southampton and co-editor in Chief of the Journal of Perioperative Medicine with his guests, Evan Kharasch, Professor and Vice Chair for Innovation in the Department of Anesthesiology at Duke University, and Director of Academic Entrepreneurship in Duke University School of Medicine, Editor in Chief of 'Anesthesiology', Hugh Hemmings, Senior Associate Dean for Research, Professor and Chair of Anesthesiology at Weill Cornell Medicine and the Editor in Chief of the 'British Journal of Anaesthesia', Jean-Francois Pittet, Professor, University of Alabama, Department of Anesthesiology, Editor in Chief of 'Anesthesia & Analgesia', Andy Klein, Cardiothoracic Anaesthetist at Royal Papworth Hospital in Cambridge and Editor in Chief of 'Anaesthesia' and Lee Fleisher, Emeritus Professor of Anesthesiology and Critical Care, University of Pennsylvania, co-editor in Chief of the Journal of Perioperative Medicine.

"Implementation science is really focused on bridging the evidence to practice gap" One of the highlights of the 2021 Evidence Based Perioperative Medicine (EBPOM) conference. This talk is provided to you in the hope you can help us to spread its content as far and wide as possible. It is introduced by Mike Grocott, Professor of Anaesthesia and critical care at the University of Southampton. Presented by Meghan Fall-Lane, Assistant Professor of Anesthesiology and Critical Care at the Perelman School of Medicine; Co-Director of the Penn Center for Perioperative Outcomes Research and Transformation; and Senior Fellow at the Leonard Davis Institute of Health Economics, University of Pennsylvania. Also - make sure you check out www.EBPOM.org for more information about the next conference in the perioperative medicine calendar.

This essential discussion covers total intravenous anaesthesia (TIVA) versus inhalation anesthesia, the pros, the cons, and the benefits of the process such as monitoring. Included in this extended podcast are the two presentations (2:40mins in and 20:55mins in) and the question and answer session which followed (starts at 33:05mins in). The Safe Brain Initiative is here: http://safebraininitiative.com/ Chaired by Desiree Chappell with her guests, Peter Kikegaard, Senior consultant and Medical Staff specialist at the Department of Anaesthesia and Intensive Care, Nykoebing Falster Hospital, University of Southern Denmark (SDU) and Anoushka Afonso, Assistant Professor of Anesthesia and critical care at Memorial Sloan Kettering Cancer Center, New York.

Ways to simplify the entire surgical encounter. This piece looks at the process of accepting patients into the surgical journey. Care coordination with a focus on the patient and the workflow associated with them; taking a fully integrated approach to the process from inception to preparation to completion and aftermath. More information about cloud-based Provation® SurgicalValet™ Perioperative Care Coordination can be found here: Provation® SurgicalValet™ Platform: Simplifying the Entire Surgical Encounter Presented by Desiree Chappell and Monty Mythen with their guests, Kari Beth Christie, Physician Anesthesiologist, NorthStar Anesthesia at Norton Healthcare in Louisville, KY and Tiffany Beatty, formerly the Director of Customer Success and now the Clinical Specialist Engineer at Provation.

Care home residents in South East London are to be the first in line to access remote examination technology. Residents across 46 care homes in South East London are first in line to access innovative diagnostic technology from Arc Health ( www.archealth.io ), enabling doctors to remotely perform a clinical examination during a video call. Where next for this sort of technology? Is a face to face meeting still the 'gold standard' of medical diagnosis? Presented by Nick Margerrison with his guest Caroline Pilot, Honorary Professor of Algorithmic Medicine at DeMontfort University and Head of Clinical Product at Arc Health.

Perioperative enhancement teams have been a theme on TopMedTalk for years. This program, part two of two, goes into more detail around what could be the crucial next steps for your institution as it distinguishes itself from the pack with excellent value based care instead of excessive volume driven disasters. In this program we cover the importance of prehabilitation, the need for respect in a multidisciplinary team, cardiopulmonary exercise testing (CPET), a centre for geriatric surgery and palliative care and perioperative smoking cessation clinics. Further listening: Olle Ljungqvist, Prof. of Surgery, MD, PhD, Surgeon, Örebro University Hospital & Karolinska Institute, Sweden and Franco Carli, Prof. MD, PhD, Anesthesiologist, McGill University, Canada can be found in their original form here: https://www.topmedtalk.com/the-second-annual-prehabilitation-world-congress-part-1/ Desiree Chappell and Monty Mythen with their guest Amir Jaffer, Chief Medical Officer, New York Presbyterian/ Queens feature here: https://www.topmedtalk.com/perioperative-medicine-summit-2019-1-02-amir-jaffer/ John Whittle, assistant Professor at Duke University Medical Centre provides some essential listening on the subject of CPET here: https://www.topmedtalk.com/topmedtalk-cpet-cardio-pulmonary-exercise-testing/ Angela Bader, Vice Chair of Perioperative Medicine at Brigham and Women's Hospital can be heard in full here: https://www.topmedtalk.com/perioperative-medicine-summit-2019-1-03-angela-bader/ James Davis, MD, Duke Smoking Cessation Program, presents and excellent talk here: https://www.topmedtalk.com/part-1-of-3-smoking-kills-more-than-all-addictive-substances-combined-plus-car-accidents/

This podcast is a look at some of the work done by practitioners who intend to take perioperative medicine to the next level; the "perioperative enhancement teams". The program broadly follows a patient's surgical journey, we start with the UK's PREPWELL project, as explained by Gerard Danjoux, consultant in Anaesthesia and Sleep Medicine at South Tees Hospitals NHS Trust. For more information on that go to https://prepwell.co.uk/ - also, if you'd like to hear the original conversation you can find that here: https://www.topmedtalk.com/rcoa-03-adverse-outcomes-and-patient-optimisation/ Further discussion on the subject of psychological optimisation comes from, Chloe Grimmett, behavioural scientist and lead for Wesfit prehabilitation. If you'd like more details on the project go here: http://wesfit.org.uk/ - to hear the original presentation in full follow this link: https://www.topmedtalk.com/ebpom-2019-psychology-and-behavioural-change/ The fascinating debate which follows features Shawna Butler of the Singularity University in Exponential Medicine and Jennifer Brandon of the Hoag Orthopedic Institute in Irvine, California. That can be heard in full here: https://www.topmedtalk.com/using-new-technology-with-elderly-patients/ The essential contribution from Angela Coulter, a UK based health policy analyst and researcher, on the crucial area of "shared decision making" can be enjoyed in full here: https://www.topmedtalk.com/ebpom-2018-shared-decision-making-in-perioperative-care/ More wisdom from Steve Flanagan, Chair of Physical Medicine and Rehabilitation at NYU Langone can be found here: https://www.topmedtalk.com/rehabilitation-exercise-is-real-medicine/

Post EBPOM Monty and Desiree explain how TopMedTalk is building on the incredible success of the last few years. After producing a podcast every day for 3+ years we are now going to produce a new podcast each week with more focus on specific topics with bespoke documentary style pieces which will help us to present complicated content in a more digestible form. We will also continue to present the core principles of Enhance Recovery After Surgery alongside cutting edge talks we think need a wider audience. It will continue to be essential listening each week for perioperative practitioners, students and people interested in how and why their forthcoming operations will work as well as what to do as a patient to prepare. We look forward to continuing the journey with you, our audience, who have helped turn TopMedTalk into the success it is today. Presented by Desiree Chappell, Monty Mythen and Nick Margerrison. --ARCHIVE LINKS Bruce Keogh's excellent talk: https://topmedtalk.libsyn.com/ebpom-highlight-the-nhs-over-70 Can Medicine be cured? https://topmedtalk.libsyn.com/dingle-highlight-can-medicine-be-cured Paul Wischmeyer is here: https://topmedtalk.libsyn.com/topmedtalks-to-dr-paul-wischmeyer-0

This piece is a listener generated question and answer session from EBPOM 2020. Although it works as a stand alone piece it relates directly to this talk here: https://www.topmedtalk.com/ebpom-2020-london-prediction-of-opioid-induced-respiratory-depression-on-the-general-care-floor-does-surveillance-monitoring-help/ Some of the questions considered include: How much do you think partial / inadequate neuromuscular blockade reversal, contributes to post pulmonary complications, perhaps in combination with opioids? Why as a group would we prefer to save money by avoiding sugammadex to reverse rocuronium to ensure complete reversal? Lack of reversal more than an issue? If you did a pre op sleep study on these patients, would you not find similar frequencies of desaturation? Is it just monitoring sleep? Should all wards have the capability for continuous monitoring? Presented by Monty Mythen and Desiree Chappell with their guests, Ashish Khanna, Associate Professor, Section Head for Research, Department of Anesthesiology, Section on Critical Care Medicine,Wake Forest School of Medicine, Frank Overdyk, Professor of Anaesthesiology, Charleston, South Carolina, Leif Saager, Executive Vice Chair of the Department of anesthesiology in Germany at the University of Nottingham. There's more from Frank Overdyk here: https://www.topmedtalk.com/11813-2/

"The delivery of good medical care is to do as much nothing as possible." - Samuel Shem. The POCAPALOOZA (POC, perioperative care; apalooza - a celebration of) wraps up in true style with a look at Australia and their current situation. Lauded for their handling of COVID19 but not yet 'through the woods' the conversation looks at how doing the right thing can be innovative and why a good rapport with your patient is invaluable. 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.

Presenting 2021's POCApalooza West; the annual tradition continues in the wake of last year's hugely successful international gathering of perioperative practitioners; hear how the rest of the world is handling the COVID-19 crisis, how the connectivity between patients and practitioners is improving and how one of TopMedTalk's favourite contributors is now taking perioperative medicine to the heart of healthcare in the USA. Featuring Desiree Chappell, Monty Mythen and their guests, Lee Fleisher, Emeritus Professor of Anesthesiology and Critical Care, University of Pennsylvania, Sol Aronson, Professor Emeritus, Duke University, Durham, North Carolina and Carol Peden, adjunct Professor at USC and Pennsylvania and current Chair of The American Society of Anesthesiology's Brain Health Initiative.

Presenting 2021's POCApalooza East. The now annual tradition continues in the wake of last year's hugely successful international gathering of perioperative practitioners; hear how the rest of the world is handling the COVID-19 crisis, how the vaccines are getting on and why perioperative medicine is primed to help in the near and necessary journey to be taken out of this current situation. Featuring Desiree Chappell, Monty Mythen and their guests, Bruce Biccard, consultant anaesthetist at the University of Kwazulu-Natal, Director, Perioperative Research Unit, Department of Anaesthetics, Nelson R Mandela School of Medicine, Paul Myles, Director, Anaesthesiology and Perioperative Medicine, Alfred Hospital and Monash University and Mike Irwin, Professor, Head and Chief of Service, Anaesthesiology Hong Kong University, Gleneagles Hospital.

"Perioperative medicine ... I always think of a Venn diagram where there's truly an intersection between surgery anesthesia and medicine, and perhaps even a subset of medicine called geriatrics, that really create this convergence of what we're now creating as a novel science ... Perioperative medicine, I would say is a new clinical science that really incorporates all that" This piece is a fascinating debate, it follows on from Part 1 of the same name; the panel discuss ways forward for perioperative medicine and the new opportunities being presented by a recent focus on both population health and the wider needs of a national healthcare system. Presented by Desiree Chappell and Sol Aronson with panelists; Angela Bader, Harvard Medical School and Vice Chair of Perioperative Medicine at Mass General Brigham, BobbieJean Sweitzer, Professor of Anesthesiology and Director of Perioperative Medicine at Northwestern University in Chicago, Illinois, Rob Shakar, Medical Director of a 32-physician group in Wilmington, NC he oversees the Perioperative Surgical Home Project for New Hanover Regional Medical Center, Thomas Vetter, Director of Perioperative Care and Director of Comprehensive Pain Management and Professor of Surgery and Perioperative Care and Professor of Population Health, at the Dell Medical School at The University of Texas, Austin.

"Data is key and having champions is key" This piece provides a truly transatlantic in-depth perspective on an area of opportunity highlighted by our needs in the wake of COVID 19; now more than ever true enhanced recovery after surgery (ERAS) is essential. Optimising value, reducing the need for return visits, decreased length of stay, there is almost no aspect of perioperative medicine and enhanced recovery that is not going to be crucial for our institutions in the near and present future. A data driven approach makes it clear, there is no other way forward. Also in this podcast a fascinating dive into one of our favorite topics, goal directed fluid management. How have the terms "restricted" and "liberal" evolved over the years? What should we make of the new evidence that ha come in over the last few years? Hear how these challenges are being met in this exclusive conversation, generously supported by Deltex Medical. Presented by Desiree Chappell and Monty Mythen with their guest Michael Scott, M.B., Ch.B. Professor of Anesthesiology at the University of Pennsylvania

"Connected care is a combination of the right tech, to monitor the patient, that's human factor friendly and easy to use" This piece is an in-depth look at how remote patient monitoring is evolving to suit a need that's growing as patients require more from their healthcare. The COVID-19 crisis has pushed these issues to the forefront, how can your institution modernize and evolve in this direction? Presented by Desiree Chappell with Monty Mythen and their guest Sam Ajizian CMO Patient monitoring at Medtronic.

"We've been doing cryoneurolysis for total knees now for three years... people gravitate to practices that that practice this technology" This piece focuses upon two 'early adopter' orthopedic surgeons changing up the way we treat joint pain for surgical patients. We mention Iovera, a provider at the forefront of this technology: https://www.iovera.com/ The Doc Social website is here: www.doc.social/ The Evidence Based Perioperative Medicine (EBPOM) website is here: www.ebpom.org This piece also features important news for TopMedTalk fans as, towards the end, we explain how your favorite perioperative podcast is asking listeners for feedback and thoughts. Email contact@topmedtalk.com Presented by Desiree Chappell and Monty Mythen with their guests Vinod Dasa, Vice Chairman of Academic Affairs, Irv Cahen Chair of Orthopaedic Surgery and Research, Co-Director LSU Musculoskeletal Research Consortium and Josh Urban, board-certified orthopedic surgeon, OrthoNebraska, Omaha, Nebraska.

This piece is a worthwhile deep dive into this perioperative medicine and how we go forward with it. Hear the panel speak about what it is they want for the future and what it is they are doing now. With questions submitted from the online audience the panel get into the detail. Essential listening for any student of perioperative medicine. It includes a mention for the Welsh Perioperative Medicine Society, their website is here: https://www.welshpoms.com/ This is part two of a two part piece of the same name. Presented by David Walker, Professor in Anaesthesia and Critical Care Medicine, University College London Hospitals, Honorary Senior Lecturer UCL, Kim Caulfield, Perioperative Medicine Fellow, University College London Hospitals NHS Foundation Trust, Mike Grocott Professor of Anaesthesia and critical care at the University of Southampton, Aislinn Sherwin, a Fellow in Perioperative Medicine and Onco-Anaesthesia at the Peter MacCallum Cancer Centre, Melbourne, Roisin Coary, final year SpR in Geriatric and General Internal Medicine, with a specialist interest in Peri-operative Medicine, Dublin Ireland and Isra Hassan, a post-CCT Perioperative Medicine Fellow at the University College of London Hospital she co-founded the Welsh Perioperative Medicine Society in 2018 which now has over 100 members, and to date has delivered two national conferences, Andrea Haren, perioperative medicine fellow at UCLH she worked with Guys and St Thomas' working with the POPS Clinic she is currently a locum consultant anaesthetist at St. Vincent's Hospital in Dublin and Pádraig Ó Scanaill, Locum Consultant Anaesthetist at the Mater Misericordiae University Hospital, Dublin.

This is a story that starts with some of the challenges faced in our world outside the operating theatre and it's about how we might address some of these problems systematically. Healthcare organizations have to deliver high quality, competitive and sustainable results and costs. Good quality perioperative surgery is absolutely critical to maintain the health and well being of our population going forwards; this talk is a step in that direction. Presented by Guy Ludbrook Professor of Anaesthesia at the University of Adelaide and Royal Adelaide Hospital.

This piece is a worthwhile deep dive into this perioperative medicine and how we go forward with it. Hear the panel speak about what it is they want for the future and what it is they are doing now. With questions submitted from the online audience the panel get into the detail. Essential listening for any student of perioperative medicine. When should we pre-assess patients? Should all anaesthetists be doing pre-operative sessions? What is it about the role of the anaesthestist that makes it uniquely suited to the discipline of perioperative medicine? This is part one of a two part piece of the same name. Presented by David Walker, Professor in Anaesthesia and Critical Care Medicine, University College London Hospitals, Honorary Senior Lecturer UCL, Kim Caulfield, Perioperative Medicine Fellow, University College London Hospitals NHS Foundation Trust, Mike Grocott Professor of Anaesthesia and critical care at the University of Southampton, Aislinn Sherwin, a Fellow in Perioperative Medicine and Onco-Anaesthesia at the Peter MacCallum Cancer Centre, Melbourne, Roisin Coary, final year SpR in Geriatric and General Internal Medicine, with a specialist interest in Peri-operative Medicine, Dublin Ireland and Isra Hassan, a post-CCT Perioperative Medicine Fellow at the University College of London Hospital she co-founded the Welsh Perioperative Medicine Society in 2018 which now has over 100 members, and to date has delivered two national conferences, Andrea Haren, perioperative medicine fellow at UCLH she worked with Guys and St Thomas' working with the POPS Clinic she is currently a locum consultant anaesthetist at St. Vincent's Hospital in Dublin and Pádraig Ó Scanaill, Locum Consultant Anaesthetist at the Mater Misericordiae University Hospital, Dublin.

  "More than 300 million patients have surgery annually worldwide and an increasing proportion of them are elderly and at risk of perioperative adverse events. There's very few proven primary or secondary prevention measures, and the resources for monitoring and trading complications are inadequate. So - more action is required". This piece looks at the evidence as regards perioperative outcomes for the elderly, depth of anesthesia and mortality. Also, what's the latest on depth of anesthesia and delirium? Presented by Kate Leslie, Honorary Professor, Monash University, Melbourne, VIC, Australia, Specialist Anaesthetist, The Royal Melbourne Hospital & North Western Mental Health and Non-Executive Director, Australian Medical Council.  

"The song remains the same" The story picks up toward the end of the 1970's; "interesting stuff was going on ... Professor William Shoemaker, a surgeon and intensive care doctor one of the founding members of the American critical care society ... fiddling around with pulmonary artery catheters in his high risk surgical patients in South Los Angeles, and identified that those patients that were surviving tended to have higher cardiac indexes higher option deliveries than the non survivors". This piece was Dingle 2020's Inaugural Siobhan Mythen Visiting Lecturer. For more content from that meeting check TopMedTalk's archive or go to www.ebpom.org for video presentations. Presented by Jonathan Wilson, retired Consultant Anaesthetist, York Hospital, York.

"Accelerated surgery for hip fracture is safe and feasable, with troponin elevation before randomization, there was a mortality advantage with accelerated surgery. The logistics and resources required for accelerated surgery need to be balanced with the demonstrated benefits and patient's desires for accelerated surgery" This exciting piece from EBPOM 2020 provides a data download that further illucidates the perennial debate surrounding hip fractures and their management and treatment. What is the correct perioperative approach to this nasty injury? For more on the Hip Attack Trial go here: https://clinicaltrials.gov/ct2/show/NCT02027896 Presented by P.J. Devereaux, cardiologist, clinical epidemiologist, and perioperative care physician, Professor in the Departments of Health Research Methods, Evidence, and Impact (HEI) and Medicine, Director of the Division of Perioperative Care, McMaster University, Associate Deputy Director of the Population Health Research Institute, President of the Society of Perioperative Research and Care.

This piece is divided into two parts, the first being discussion between the panelists and the second, part 2, being questions from the online audience: What is your opinion about spinals and hip fractures for patients on clopidogrel? Do you use any near patient tests to confirm residual anticoagulation? Where are the best guidelines to be found? We suggest you listen to this piece alongside part 1. Presented by Sol Aronson, tenured Professor at Duke University, with his guests; Angela Bader, Harvard Medical School and Vice Chair of Perioperative Medicine at Mass General Brigham, BobbieJean Sweitzer, Professor of Anesthesiology and Director of Perioperative Medicine at Northwestern University in Chicago, Illinois and Jeanna Blitz, Associate Professor of Anesthesiology, Director of the Preoperative Anesthesia and Surgery Screening Clinic, Director of Perioperative Medicine Fellowship at Duke University School of Medicine, Durham, North Carolina.

The conversation begins with "a day in the life" with respect to managing the anti coagulation questions that come up commonly. The contributors swap stories from their time in practice. The conversation moves to protocols, guidelines and also, when where and how to begin bridging. This piece is divided into two parts, the first being discussion between the panelists and the second, part 2, being questions from the online audience. Presented by Sol Aronson, tenured Professor at Duke University, with his guests; Angela Bader, Harvard Medical School and Vice Chair of Perioperative Medicine at Mass General Brigham, BobbieJean Sweitzer, Professor of Anesthesiology and Director of Perioperative Medicine at Northwestern University in Chicago, Illinois and Jeanna Blitz, Associate Professor of Anesthesiology, Director of the Preoperative Anesthesia and Surgery Screening Clinic, Director of Perioperative Medicine Fellowship at Duke University School of Medicine, Durham, North Carolina.

How can enhanced recovery after surgery (ERAS) be applied to cardiac and what exciting opportunities are there for those who have made this their mission? This detail driven address contains more information on The Society for Enhanced Recovery After Cardiac Surgery (ERAS® Cardiac), more information can be found on their website: https://www.erascardiac.org/ Since this address was given at Evidence Based Perioperative Medicine (EBPOM) Chicago's 2020 meeting TopMedTalk has been proud to bring you coverage of ERAS® Cardiac's online meeting. For more on that start here: https://www.topmedtalk.com/the-eras-cardiac-society-conference-topmedtalk/ Presented by Daniel Engleman, 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.

"Look at it from where is the patient, and what's best for the patient; I think that the other answers follow and yes, it is higher quality, yes, there can be some opportunities for cost savings; even if it 'breaks even' if the patients are happier, isn't that worth moving into the concept and proving that it does make a difference?" The value proposition is an essential element of advocating perioperative care; we know it provides safer, better quality outcomes but how do we translate that into a language that both patients, fee payers and providers can all understand? This piece follows on from "The size and scope of the problem with Jim Grant & Mike Englesbe | EBPOM 2021" Las Vegas, if you'd like to hear that go here: https://topmedtalk.libsyn.com/the-size-and-scope-of-the-problem-with-jim-grant-mike-englesbe-ebpom-2021-las-vegas Presented by Desiree Chappell, introducing her panellists Linda Groah, CEO, Executive Director of the Association of periOperative Registered Nurses (AORN) and Amy Stout, Operating Partner at Cranemere and Interim President Clinical Services at NorthStar; alongside contributions from additional contributors from the previous session, Jim Grant, Senior Vice President and Chief Medical Officer at Blue Cross Blue Shield of Michigan and Mike Englesbe Darling Sr. & Cyrenus G. Darling Jr. Professor of Surgery, Michigan.

"When I heard Sol Aronson, speak about perioperative medicine as 'population health', for me, it was like a eureka moment because our platform within Michigan is really an unmatched place to kind of realize that vision." This piece asks the question; "why do we need perioperative medicine"? The answer is illustrated with a real success story where practitioners realise the value proposition it unlocks for their patients every day. Hear how it is achieved and why it is so important. Presented by Desiree Chappell with her guests Jim Grant, Senior Vice President and Chief Medical Officer at Blue Cross Blue Shield of Michigan and Mike Englesbe, Darling Sr. & Cyrenus G. Darling Jr. Professor of Surgery, Michigan. If you enjoyed this piece you'll love TopMedTalk's exclusive and ground breaking series POET: Perioperative Enhancement Team "Perioperative medicine is population health": https://topmedtalk.libsyn.com/poet-601-perioperative-medicine-is-population-health

This piece is part one of a two part piece. It's a short didactic presentation on the tough realities the U.S. healthcare system faces as the fee for payment system creaks against concerns about rising costs and the need for population health management. Can we move forward with "the science of value" which true perioperative medicine offers us? It's a talk which is designed to spark debate and that follows in part two of this piece. Presented by Sol Aronson, tenured Professor, Duke University, Durham, North Carolina.

"So in all these ERAS programs, you need a physician champion, a nurse champion, a coordinator; then we brought our pharmacist in - I will not start rounds without a pharmacist. I refuse. I won't start because the pharmacist is integral ... it's just you need that multidisciplinary team" This piece is a question and answer session prompted by the address our guest gave during EBPOM Chicago. Both the online audience and the team challenge our speaker to explain more. If you missed the address TopMedTalk has it for you here: https://topmedtalk.libsyn.com/daniel-engelman-updates-in-cardiac-ebpom-chicago Presented by Desiree Chappell and Monty Mythen with Daniel Engelman, Cardiac Surgeon, Medical Director of the Heart, Vascular and Critical Care Units at Baystate Medical Center, Associate Professor of Surgery at The University of Massachusetts - Baystate, Associate Professor-Adjunct at Tufts University School of Medicine. He president and co-founder of the ERAS® Cardiac Society.

This piece is a question and answer session with questions from the online audience. What do we think is the clinical care difference that having an elevated level of monitoring and more people around of all all sorts? Why is it good for our patients? As regards admissions to your campus care area; what criteria do you use? Do we need rapid critical care expansion in countries with very few beds? Could the enhanced care wards, in their approach, be compared with the post anaesthetic care unit? Would you cancel or postpone a cancer patient's operation, if not enhanced care or post operative critical care bed available? If you feel it is essential, if you feel the operation essential? Presented by Mike Grocott, Professor of Anaesthesia and Critical Care at the University of Southampton and Lee Fleisher, Emeritus Professor of Anesthesiology and Critical Care, University of Pennsylvania with Ramani Moonsinghe, Professor of Perioperative Medicine at University College London (UCL), Hon Consultant in Anaesthesia, UCLH, Mike Swart, Consultant in Anaesthesia and Critical Care Medicine at Torbay Hospital and advisor to the UK Department of Health for the Enhanced Recovery Programme and Anna Batchellor, trained in anaesthesia and Intensive Care Medicine (ICM) she works in Newcastle upon Tyne; past President of the Intensive Care Society, past Dean of the Faculty of ICM, past member of Council of the Royal College of Anaesthetists. She tried to retire in June 2016 and managed to spend a year working part time before being hijacked by the Getting It Right First Time (GIRFT) programme.

This roundtable discussion tackles questions from the online audience and is the third part of a longer discussion. It follows on from "The value proposition in perioperative medicine | EBPOM 2021 Las Vegas", if you'd like to hear that go here: https://topmedtalk.libsyn.com/the-value-proposition-in-perioperative-medicine-ebpom-2021-las-vegas How do we as practitioners deliver value? How does 'population health' fit into the picture? How long before and after surgery are we invested in managing? What's the key point to start a perioperative medicine program in a low income country with no incentives at all; how do you approach the hospital financial department? Presented by Desiree Chappell, introducing her panelists Linda Groah, CEO, Executive Director of the Association of periOperative Registered Nurses (AORN) and Amy Stout, Operating Partner at Cranemere and Interim President of Clinical Services at NorthStar; alongside contributions from additional contributors from the previous session, Jim Grant, Senior Vice President and Chief Medical Officer at Blue Cross Blue Shield of Michigan and Mike Englesbe, Darling Sr. & Cyrenus G. Darling Jr. Professor of Surgery, Michigan.

This piece is the second part of a conversation about leadership in medicine, during times of change. It follows on from the first part where our speaker outlines his thoughts in a short talk. Now questions from the audience are considered and the conversation develops. What have we learned after the recent huge changes we've seen in our profession? Presented by Desiree Chappell and Monty Mythen with Jeff Vender, Emeritus, Harris Family Foundation Chairman of the Department of Anesthesiology at NorthShore University Health System, Evanston, Illinois and Clinical Professor at the University Of Chicago Pritzker School Of Medicine in Chicago, Illinois.

"I believe most people can be leaders or better leaders. You can create or participate in change and a better future. You can make a difference in your own lives, the lives of others and the life of your organization. If you believe you can." This piece contains a powerful, inspirational and prescient talk about leadership. Part 1 contains some conversation and the talk, to be followed by questions from the audience in Part 2. Where do leaders come from, what makes them stand out and how do they learn the skills necessary to take what they do to the next level? Presented by Desiree Chappell and Monty Mythen with Jeff Vender, Emeritus, Harris Family Foundation Chairman of the Department of Anesthesiology at NorthShore University Health System, Evanston, Illinois and Clinical Professor at the University Of Chicago Pritzker School Of Medicine in Chicago, Illinois.

This question and answer session was a highlight of EBPOM London 2020, it works as a standalone piece or as a companion piece to this talk here: https://topmedtalk.libsyn.com/ebpom-2020-london-am-i-safe The discussion follows themes outlined in the presentation as our online audience asked a series of questions. Some of the questions included in the discussion are "How should leaders deal with anxiety both in themselves and their team? What is the evidence on perceived command gradient in residents and the fear of looking inadequate in front of peers and superiors? Bad for patients, versus bad for me? The people at the top end, the older people within an organization, are often the most resistant to culture change, yet they have the most influence over culture, any advice? What defines the people who are ready for change?" Conversational in tone this piece was first heard on the "TopMedTalk stage" at Evidence Based Perioperative Medicine (EBPOM) for more details go now to www.ebpom.org Presented by Monty Mythen and Desiree Chappell with Lee Fleisher, Emeritus Professor of Anesthesiology and Critical Care, University of Pennsylvania.

This piece focuses on iDelirium; The International Federation of Delirium Societies on world delirium day. As well as considering this difficult condition the conversation asks what the latest research shows us and how things could improve both for patients and practitioners. For more detail check out their website here: http://www.idelirium.org/ Presented by Desiree Chappell and Monty Mythen with their guests Heidi L. Lindroth, Senior Associate Consultant Nurse Scientist, Nursing Research Division Critical Care Nurse, Gideon Caplan, Director, Geriatric Medicine, Prince of Wales Hospital, Alasdair Macclullich, Professor of Geriatric Medicine, Honorary Consultant in Geriatric Medicine, Edinburgh, Delirium Research Group, Rakesh C. Arora, Co-Founder of IDelirium, Professor and Head of Cardiac Surgery and Cardiac Critical Care at Max Rady College of Medicine - University of Manitoba, Canada.

"The goal of ERAS® Cardiac is when you leave one of our meetings, you're going to be chock full of tips and tricks that you can take back and implement, if not the next day, then in the next week or next month." TopMedTalk's coverage of The Society for Enhanced Recovery After Cardiac Surgery (ERAS® Cardiac) conference continues with a conversation that covers the nuggets and insights that a conference such as this delivers. This exclusive chat is only possible thanks to the support of the society who's excellent website is here: https://erasvirtual2021.com/ "I think that also your [TopMedTalk] platform is going to be key. We need to have more of these podcasts. We need short little vignettes, eight to 15 minutes that people can listen to in the car on the way home where they learn and thought leaders having interactive discussions and get ideas. And that's the future really of education" Presented by Desiree Chappell with her guests, Seenu Reddy, Cardiothoracic Surgeon at HCA‘s TriStar Cardiovascular Surgery in Nashville, National Physician Director for HCA Healthcare's CV Service line and Daniel Engelman, Cardiac Surgeon, Medical Director of the Heart, Vascular and Critical Care Units at Baystate Medical Center, Associate Professor of Surgery at The University of Massachusetts - Baystate, Associate Professor-Adjunct at Tufts University School of Medicine and President of the ERAS Cardiac international Society.

"You didn't have to think about it, the compliance continued, because it was so standardized. We had a well oiled machine that just kept on working through COVID". The Society for Enhanced Recovery After Cardiac Surgery (ERAS® Cardiac)'s conference has gotten off to a great start; this exclusive chat gets into some of the stand out moments so far; nutrition, data collection, the essentials of ERAS and the importance of standardization. For more information on the conference check out https://www.erascardiac.org/ We mention Dan Engelman in this piece, he features in this popular conversation from the TopMedTalk archives here: https://www.topmedtalk.com/sunday-special-preoperative-optimization-framing-up-the-value-proposition/ Paul Wischmeyer gets mentioned on this piece as a "fan favourite", he features frequently. If you've not yet heard him start with this podcast - one of our most popular so far - here: https://www.topmedtalk.com/topmedtalks-to-dr-paul-wischmeyer/ Presented by Desiree Chappell with her guests Gina McConnell, ERAS Coordinator for all WakeMed health systems and Cheryl Crisafi, Cardiac Surgery Care Coordinator Nurse at Baystate Medical Center in Springfield, MA.

"You have to take the viewpoint that if the Nurses and the Physical Therapists and the Pharmacists are resisting the idea that you're putting forward, then there's probably something wrong with it, it doesn't work for them, for some reason, and you got to find out what that is..." This long form conversation is a highlight for TopMedTalk's coverage of The Society for Enhanced Recovery After Cardiac Surgery (ERAS® Cardiac) conference. The conversation covers a wide range of interesting areas, including; the nature of leadership in medicine, the global nature of many of the questions we face, how the internet is changing what we do, what the phrase "better never stops" means, how to take and use feedback and why the patient has to be at the heart of what we do, the importance of "the growth mindset". Also, discover how one of our guests has learned from his experience becoming a Lieutenant Colonel, US Army Reserves; what can a military mindset tell us about the task we face as advocates of perioperative medicine? We wrap with a conversation about blood transfusion reduction. This exclusive chat is only possible thanks to the support of the society, their excellent website is here: https://erasvirtual2021.com/ Presented by Desiree Chappell with her guests Kevin Lobdell, Professor and the Director of Regional Cardiovascular and Thoracic Quality, Education, and Research for Carolinas HealthCare System, Charlotte, NC, USA, as well as the Clinical Professor at the University of North Carolina-Chapel Hill, Chapel Hill, NC, USA and Rawn Salenger, Chief of Cardiac Surgery at University of Maryland St. Joseph Medical Center, Assistant Professor of Surgery at the University of Maryland School of Medicine.

"Our real 'next barrier' in the continuum of care is, it's okay to have pain, right? It's expected to have pain. [...] but it is better for you recovery wise, complication wise; to be able to get up, move around, know what's going on, not be confused, right? A little bit of that education goes a really long way." The opioid crisis, spine surgery, working as a team, pioneering efforts being done at the world leading Norton Leatherman Spine Center, enhanced recovery after surgery (ERAS) and some of the fascinating research our guest is conducting; all this and more as our "TopMedTalks to..." series makes a welcome return. Presented by Desiree Chappell with Jeffrey Gum, Assistant Clinical Professor (Gratis), Department of Orthopaedic Surgery, University of Louisville, Pediatric and Adult spine surgeon at the Leatherman Spine Center in Louisville, KY.

This piece is a continued deep dive into the subject, of 'fitness, function, or frailty' and, perhaps, "fixing". It's essential listening for anyone interested in the latest thinking on this crucial topic and was a highlight of the London conference. How can we integrate frailty and cognitive scores in risk assessment tools to facilitate inclusion in shared decision making? How can we improve a surgical colleague's ability to identify frailty? Most patients will have an operation sometime in their life; should surgical school be renamed and moved to being a "well being" clinic and offered to all patients? What screening tools would you recommend if only minimal time or money is available? Is pre-op screening actually 'public health' and should it really be being done for everyone? What are the differences and where is the overlap between fitness functional capacity, frailty, and sarcopenia? In mild cognitive impairment, should we tell patient that it will work and postop and not be expected to fully recover? What strategies have you found most helpful in engaging surgeons with identifying their frail patients? How are we tackling the workforce shortage among geriatricians? What has your experience been in advising achieving physical fitness in patients who present to surgery with persistent pain which is a limitation? This is part two of a two part piece. Each of the contributors comments upon talks which they gave at EBPOM 2020, all of which are now available as part of the TopMedTalk podcast. To ensure you are among the first to hear information of this kind please investigate www.ebpom.org for more details about how you can attend our online conferences. -- Presented by Scarlett McNally, Deputy Director of The Centre for Perioperative Care (CPOC) consultant Orthopaedic Surgeon, Eastbourne DGH, UK and Monty Mythen, Smiths Medical Professor of Anaesthesia and Critical Care at University College London with questions from the online audience for their guests; 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, Daniel Conway, Consultant in Anaesthesia and Critical Care, Group Lead for Perioperative Medicine, Manchester Royal Infirmary, UK and Chair of the Manchester Perioperative Medicine Society, Jude Partridge, consultant geriatrician POPS, honorary senior lecturer, King's College London, Chairs the British Geriatrics Society POPS SIG, Vicki Morton, Director of Clinical and Quality Outcomes at Providence Anesthesiology Associates, P.A.

Fitness, function and, or, frailty are important determinants of the quality of the life that we live. In the context of major surgery it's very important we recognize and work with individual patients improving and optimizing them and their ability to handle an operation. This piece is an essential deep dive into the subject, essential listening for anyone interested in the latest thinking on this crucial topic. What are the limitations on your resources when considering a plan of preoperative evaluation? This is part one of a two part piece. Each of the contributors comments upon talks which they gave at EBPOM 2020, all of which are now available as part of the TopMedTalk podcast. To ensure you are among the first to hear information of this kind please investigate www.ebpom.org for more details about how you can attend our online conferences. -- Presented by Scarlett McNally, Deputy Director of The Centre for Perioperative Care (CPOC) consultant Orthopaedic Surgeon, Eastbourne DGH, UK and Monty Mythen, Smiths Medical Professor of Anaesthesia and Critical Care at University College London with questions from the online audience for their guests; 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, Daniel Conway, Consultant in Anaesthesia and Critical Care, Group Lead for Perioperative Medicine, Manchester Royal Infirmary, UK and Chair of the Manchester Perioperative Medicine Society, Jude Partridge, consultant geriatrician POPS, honorary senior lecturer, King's College London, Chairs the British Geriatrics Society POPS SIG, Vicki Morton, Director of Clinical and Quality Outcomes at Providence Anesthesiology Associates, P.A.

With questions from the online audience, this piece looks at the "not too much and not too litte" sweet spot regarding fuel, fluid and oxygen; where is it and how do we get there, according to our distinguished panel? This podcast works well as a companion piece to the following talks which have already been released here on TopMedTalk: Helen McKenna, "Fuel, can you have too much?" https://www.topmedtalk.com/ebpom-2020-london-fuel-can-you-have-too-much/ Tim Miller "Optimising fluid and hemodynamic management during major surgery" https://www.topmedtalk.com/ebpom-london-2020-optimizing-fluid-and-hemodynamic-management-during-major-surgery/ Dan Martin "Perioperative Oxygenation" https://www.topmedtalk.com/ebpom-london-2020-perioperative-oxygenation/ Presented by Mike Grocott and Dennie Levett with their panelists; Tim Miller, Associate Professor of Anesthesiology from Duke University Medical Centre, Helen McKenna, is in the final year of her PhD at University College London, investigating bioenergetic and redox function in critically ill patients and Dan Martin, OBE anaesthetist and intensivist at the Royal Free Hospital and Reader at University College London (UCL).

"I just feel there is some intrinsic value to, you know, a human presence" This piece tells the story of an anesthesiologist who, once vaccinated, decided to go the extra mile and work out a way to spend some quality time with his COVID-19 patients. Hear how he went through the appropriate procedures to arrange for them to be able to have as much human interaction as was safely possible. "With vaccination with full PPE, N-95, you know, face shield, gloves, gown, all the rest of it, you are very low risk" Read more here: https://www.statnews.com/2021/01/27/vaccinated-health-care-workers-immunity-spend-time-visiting-covid-19-patients/ Presented by TopMedTalk's Nick Margerrison with his guest Dr. Ben Moor, Anesthesiologist at Beth Israel Deaconess Hospital in Plymouth, Boston.

Part 2 of this conversation continues the momentum of Part 1 with a conversation about electronic medical records (EMR), how important data is to the process, the need for those who collect it to understand it and then, more broadly, the importance of putting the patient at the heart of what you do. Presented by Desiree Chappell with Vicki Morton, Director of Clinical and Quality Outcomes at Providence Anesthesiology Associates, P.A, Cheryl Crisafi, Cardiac Surgery Care Coordinator Nurse at Baystate Medical Center in Springfield, MA and Gina McConnell, ERAS Coordinator for all WakeMed health systems.

This piece is a two part conversation about the essence of what many of TopMedTalk's listeners do; Enhanced Recovery. A fascinating conversation between a number of experts in the field the conversation presented here was part of the hugely popular EBPOM Chicago 2020 meeting. For more on Evidence Based Perioperative Medicine (EBPOM) go to www.ebpom.org This first part of the conversation covers what the main elements of an Enhanced Recovery After Surgery program entail, what literature our contributors favor and what service lines include enhanced recovery at their practice. Presented by Desiree Chappell with Vicki Morton, Director of Clinical and Quality Outcomes at Providence Anesthesiology Associates, P.A, Cheryl Crisafi, Cardiac Surgery Care Coordinator Nurse at Baystate Medical Center in Springfield, MA and Gina McConnell, ERAS Coordinator for all WakeMed health systems.

How important is it to screen patients and measure their fitness prior to surgery? What is exercise training in the preoperative period? There is a very clear relationship between physical fitness and mortality. Importantly, when we think of prehabilitation, or exercise training, it's good to remember that you get the greatest benefit in the most unfit patients, in terms of mortality reductions. The "pandemic ... of physical inactivity worldwide" is believed to cause more than 5 million deaths annually. The advantage of fitness in terms of predicting perioperative outcomes is it is an important modifiable risk factor before major surgery; we can modify health behaviors and exercise and we can sometimes optimize comorbidities before surgery. Exercise is real medicine! Originally part of the hugely successful EBPOM Live from London 2020 conference this piece is nicely complimented by the panel discussion which TopMedTalk has also released free of charge here: https://www.topmedtalk.com/ebpom-london-2020-prehabilitation-update/ 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.

"Accelerated surgery is not a panacea" This piece, presented in two parts, is a discussion about enabling enhanced recovery. Originally part of EBPOM London this is an 'as live' discussion with four of the main presenters from the conference. Get more detail on nutrition, hip fractures, psychological optimisation and discover both where the difficulties are and what opportunities they provide. For more of this sort of content go now to www.ebpom.org to find out more about how you can be part of Evidence Based Perioperative Medicine. Presented by Professor Denny Levett and Jugdeep Dhesi with their guests P.J. Devereaux, cardiologist, clinical epidemiologist, and perioperative care physician, Professor in the Departments of Health Research Methods, Evidence, and Impact (HEI) and Medicine, Director of the Division of Perioperative Care, McMaster University, Associate Deputy Director of the Population Health Research Institute, President of the Society of Perioperative Research and Care, 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, Dr Paul Wischmeyer, Professor of Anaesthesiology and Surgery at Duke Anesthesiology.

"Accelerated surgery is not a panacea" This piece, presented in two parts, is a discussion about enabling enhanced recovery. Originally part of EBPOM London this is an 'as live' discussion with four of the main presenters from the conference. Get more detail on nutrition, hip fractures, psychological optimisation and discover both where the difficulties are and what opportunities they provide. For more of this sort of content go now to www.ebpom.org to find out more about how you can be part of Evidence Based Perioperative Medicine. Presented by Professor Denny Levett and Jugdeep Dhesi with their guests P.J. Devereaux, cardiologist, clinical epidemiologist, and perioperative care physician, Professor in the Departments of Health Research Methods, Evidence, and Impact (HEI) and Medicine, Director of the Division of Perioperative Care, McMaster University, Associate Deputy Director of the Population Health Research Institute, President of the Society of Perioperative Research and Care, 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, Dr Paul Wischmeyer, Professor of Anaesthesiology and Surgery at Duke Anesthesiology.

This piece is an informative conversation about the models of prehabilitation from a number of different angles. Questions come in from an online audience as our panelists tackle the topic from their respective areas. What are the risks and how are they mitigated? Where does your funding come from and why? How safe is iron for cancer patients? The link to Safe Fit self referal is here: https://www.macmillan.org.uk/cancer-information-and-support/get-help/physical-help/safefit%20#refer_yourself_to_this_service 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 and Gerard Danjoux, consultant in Anaesthesia and Sleep Medicine at South Tees Hospitals NHS Foundation Trust with their guests John Moore, Clinical Director for Intensive Care at Manchester Royal Infirmary and Medical Lead for Enhanced Recovery After Surgery, Professor Sandy Jack, PhD, Consultant Clinician Scientist in The Anaesthesia and Critical Care Research Unit at University Hospital Southampton NHS Foundation Trust, Honorary Senior Lecturer at the University of Liverpool, University of Southampton and University College London and Rachel Barlow, National Lead, Enhanced Recovery, Prehabilitation and Optimisation, at Cardiff and Vale health board, Wales.

"In the United States approximately 112,000 patients annually are at risk for adverse events associated with discharge from the operating room with residual neuromuscular blockade" This talk highlights the latest thinking on both monitoring and management of neuromuscular blockade. Where does the data lead us to? How big a problem do they suggest poor efficiency in this area is? What are the realities behind postoperative pulmonary complications? How can we reduce the risk of residual block? Presented by Glenn Murphy, Jeffery S. Vender Chair of Anesthesiology Research and Education and Director of Cardiac Anesthesia and Clinical Research at NorthShore University HealthSystem, a hospital affiliated with the University of Chicago Pritzker School of Medicine.

"As a cardiac surgeon, I feel like I'm hearing more and more about ERAS than ever before" "The CSCS Beat - more than just matters of the heart" is a fantastic new podcast from The Canadian Society of Cardiac Surgeons (CSCS); this piece sees TopMedTalk teaming up with them to tackle their first episode on the subject of Enhanced Recovery After Surgery and perioperative medicine. What is ERAS? How is it being implemented? Why is it so successful? If you'd like to hear more of "The CSCS Beat" their iTunes profile is here: https://podcasts.apple.com/ca/podcast/the-cscs-beat-more-than-just-matters-of-the-heart/id1559309108?l=fr Presented by Ansar Hassan with his guests Desiree Chappell, lead presenter for TopMedTalk, Certified Registered Nurse Anesthetist (CRNA) and Vice President of Clinical Quality for NorthStar Anesthesia and Monty Mythen, TopMedTalk's Editor in Chief, Professor of Anesthesia and Critical Care at the University College London, co-president of the International Board of Perioperative Medicine and Rakesh C. Arora, Chief of Cardiac Surgery and a Critical Care specialist at St. Boniface hospital, Winnipeg, Manitoba, co-founder of the Canadian Cardiovascular Critical Care Society, President of the Canadian Society of Cardiac Surgeons and Dan Engelman, Medical Director of the Heart, Vascular and Critical Care Units at Baystate Medical Center, Associate Professor of Surgery at The University of Massachusetts-Baystate Medical School

This piece deals with the prediction of opioid induced respiratory depression for our inpatients on hospital wards, could a change in monitoring practices help? The postoperative period seems to be critical, the thirty day period immediately after anesthesia being a key area. 7.7% of postoperative deaths are in this period, according to The Lancet here; https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(18)33139-8/fulltext What is happening in the post operative period? How do we find out more? Are hospital general care wards the safe haven we expect them to be? What should we monitor and how do we avoid "alarm fatigue"? More on the "PRediction of Opioid-induced Respiratory Depression In Patients Monitored by capnoGraphY (PRODIGY)" trial here: https://clinicaltrials.gov/ct2/show/NCT02811302 The official STOP BANG score website is here: http://www.stopbang.ca/osa/screening.php This piece was sponsored by Medtronic. This is part 1 of a two part piece. Presented by Monty Mythen with Desiree Chappell and Ashish Khanna, Associate Professor, Section Head for Research, Department of Anesthesiology, Section on Critical Care Medicine,Wake Forest School of Medicine. If you loved this piece you'll also enjoy this piece here: Desiree’s Roundtable | Can you bite your upper lip? Assessing patients to reduce post-op respiratory complications http://www.topmedtalk.com/desirees-roundtable-can-you-bite-your-upper-lip-assessing-patients-to-reduce-post-op-respiratory-complications-2/

"Maybe it's time to evolve our practice" Many believe ultrasound is an essential bedside tool which should be as common as the archetypal Doctor's stethoscope, with training made mandatory for all acute medicine specialists. This piece is structured as a debate where this point of view is advocated and debated. Presented by Mark Edwards, Consultant in Anaesthesia and Perioperative Medicine at The University Hospital Southampton NHS Foundation Trust with Catherine Nix, Consultant Anaesthetist Intensivist at University Hospital Limerick, with panelists; Janette Brohan, Consultant in Anaesthesia and Intensive Care Medicine in Cork University Hospital, David Walker, Professor in Anaesthesia and Critical Care Medicine, University College London Hospitals, Honorary Senior Lecturer UCL, Kevin Murphy, Professor of Endocrinology & Metabolism at University College London, Ashley Miller, Intensivist at Shrewsbury and Telford Hospitals and Monty Mythen, Smiths Medical Professor of Anaesthesia and Critical Care, University College London.

This piece starts with the challenges faced by non-consultant hospital doctors (NCHD's) in this pandemic environment and the challenges of teaching novice anesthesiologists during COVID19. What insights can be gained from this high stress high demand environment where correct and comprehensive training is essential? The conversation is then thrown out to a panel and questions are considered; what is the future of training, what have we learned and what must we prioritize in the near and long term future? Chaired by Janette Brohan, Consultant in Anaesthesia Intensive Care Medicine in Cork University Hospital with an initial short presentation from Niamh McAuliffe Anesthesiologist in Cork University Hospital and featuring the following panellists; Viki Mitchell, consultant anaesthetist and divisional clinical director at University College London Hospitals, Brian O'Brien, Consultant in Anaesthesia and Intensive Care Medicine, at Cork University Hospital, where he is Chairman of Department, Ray O'Conner Consultant in Anaesthesia at Cork University Hospital and Monty Mythen, Smiths Medical Professor of Anaesthesia and Critical Care, University College London.

"There is some great literature out there that has been shared ... great data, especially in cardiac surgery, which is where we are using it and I would like to expand it out to other service lines as well..." Methadone has had something of a resurgence recently, thanks in part to the work of some of our contributors in this piece. Could it be that this "opioid sparing opioid" could be a way to actually help fight the crisis we can see in US hospitals and beyond? This piece gets into the detail, how and where and why is it used? Presented by Sol Aronson with questions from the online audience for his panelists; Glenn Murphy, Jeffery S. Vender Chair of Anesthesiology Research and Education and Director of Cardiac Anesthesia and Clinical Research at NorthShore University HealthSystem, a hospital affiliated with the University of Chicago Pritzker School of Medicine, Evan Kharasch, Professor and Vice Chair for Innovation in the Department of Anesthesiology at Duke University, and Director of Academic Entrepreneurship in Duke University School of Medicine and Vicki Morton Director of Clinical and Quality Outcomes at Providence Anesthesiology Associates, P.A. We suggest listening to this piece alongside this excellent talk: https://www.topmedtalk.com/ebpom-chicago-methadone-use-in-perioperative-medicine/ This piece was originally part of EBPOM Chicago and is presented for the first time here exclusively to TopMedTalk listeners. For more details on Evidence Based Perioperative Medicine go now to www.ebpom.org

This piece, part 2 of 2, is a series of questions related to part 1; "Monitoring and management of neuromuscular blockade | EBPOM Chicago". This piece gets into the detail regarding one of the stand out moments of EBPOM Chicago 2020; questions from the online audience facilitate the discussion. Given the fact that our methods of monitoring residual neuromuscular blockade are often inadequate do you transport and do you recommend routine transport to patients from the operating room to the post-anesthesia care unit? Sugammadex is a unique drug that does exactly what we want it to do; why are alternatives still used and available? Some wearables have accelerometer hardware, are you aware of, or do you know if anyone is studying, firm software solutions, marshaling this ubiquitous hardware? Don't forget, for more details on Evidence Based Perioperative Medicine EBPOM conferences go now to www.ebpom.org Presented by Sol Aronson, tenured Professor at Duke University, Glenn Murphy, Jeffery S. Vender Chair of Anesthesiology Research and Education and Director of Cardiac Anesthesia and Clinical Research at NorthShore University HealthSystem, a hospital affiliated with the University of Chicago Pritzker School of Medicine.

This piece is an informative conversation about "the Perioperative Care Team"; who is essential to the team and how do we make sure everyone feels included? What elements do you need to make up such a team, how do you keep people energized and excited about it over the long term? How do we ensure, in this context, that a fee for service system interlocks with the needs of both the institution and its patients? Furthermore, how does such a team increase our commitment to value based care and good quality long term outcomes? Also, an exciting commitment is made toward a journal club, stick with TopMedTalk for more details. Presented by Vicki Morton with panelists Dennie Levett, Professor in Perioperative Medicine and Critical Care at Southampton University Hospital NHS Foundation trust and Honorary Associate Professor at the University of Southampton, Kay Mitchell, Senior Research Manager for Critical Care Research, NIHR Biomedical Research Center, University Hospital, Southampton, UK and Gina McConnell, ERAS Coordinator for all WakeMed health systems.

"If you want to take population based data, and define hypotension, you'll be right for the majority of our average patients, but not for all patients and it appears that the amount of time we spend below the lower limit of autoregulation has meaning for patient outcomes" Starting from the origins of blood pressure monitoring, via the father of neurosurgery endocrinology, Harvey Cushing, through to the current debate as to what exactly constitutes hypotension this piece is an important part of a longstanding discussion here on TopMedTalk. How and why does hypotension occur and what is the correct evidence based strategy now the data are mounting as regards potential patient harm and unsatisfactory outcomes? Presented by Charles Hogue, Professor and Chair of Anesthesiology at Northwestern University in Chicago.

"It was successful early on within the National Health Service.. [because] you could eliminate the cost of some unhelpful, unnecessary tests... referrals to other "-ologists"... in our system that works, because more work is just more work. It's not more money." Is the business case for prehabilitation a "slam dunk", as some enthusiasts claim? If so how do you measure value versus volume, is value always a subjective term and can the balance between the two be addressed? How does the NHS's "internal market" compare to the US's fee for service environment? Furthermore, where are the sensible limits of prehabilitation, how far do we take it before we move forward to an operation? This piece has been available to EBPOM London attendees since it was first recorded in the earlier part of the year. For exclusive access to other similar pieces now and in the future please visit www.ebpom.org Presented by Monty Mythen and Kay Mitchell, Senior Research Manager for critical care research, NIHR Biomedical Research Centre, University Hospital Southampton, UK, with their guests, David Selwyn, Deputy Medical Director at Nottingham University Hospitals NHS Trust and Director of The Centre for Perioperative Care (CPOC), Sol Aronson, tenured Professor, Duke University and Jeff Vender, Emeritus, Harris Family Foundation Chairman of the Department of Anesthesiology at NorthShore University Health System, Evanston, Illinois and Clinical Professor at the University Of Chicago Pritzker School Of Medicine in Chicago, Illinois  

What do we mean by "nutritionally fit" and why does it matter? How do we identify those most at risk in terms of screening and assessment and what's the difference between these two processes? How can we use screening and assessment to triage patients into care? Also, in the time of COVID19, are there ways we can perform some tasks related to these processes remotely? Presented by Steve Wooton, Senior Lecturer in Human Nutrition within Medicine at the University of Southampton.

"Studies suggest that even three fourths of patients may be anemic when they present for surgery and many of these patients are previously undiagnosed" This common problem is known to cause issues both within the perioperative period and beyond. How can we manage this condition and where does the latest data lead us? Following a presentation there is a panel discussion featuring questions from the EBPOM Chicago audience. Check out www.ebpom.org to find out how you can attend our online conferences. Make sure you also check out the article mentioned in this piece here: https://pubs.asahq.org/anesthesiology/article/133/1/109/109133/An-Effective-and-Efficient-Testing-Protocol-for If you enjoyed this piece we suggest you go here next: TopMedTalk | Iron Man vs Anemia https://www.topmedtalk.com/topmedtalk-iron-man-vs-anemia/ Presented by Monty Mythen with Bobbie Jean Sweitzer, Professor of Anesthesiology and Associate Chair for Perioperative Clinical Practice at Northwestern University and Jeanna Blitz, Associate Professor of Anesthesiology, Director of the Preoperative Anesthesia and Surgery Screening Clinic, Director of Perioperative Medicine Fellowship at Duke University School of Medicine, Durham, North Carolina.

This piece gets deep into a much needed discussion regarding frailty, delirium, post-operative cognitive dysfunction and brain health. Noted as one of the highlights of the year in our recent holiday specials and previously only available to attendees to the incredibly successful EBPOM Chicago 2020; go to www.ebpom.org now for more details on forthcoming events and special offers now. This piece is part two of two. This piece gets a mention "End of life decision planning in the perioperative setting: the elephant in the room?" https://academic.oup.com/bja/article/115/5/648/230412?login=true The Global Council on Brain Health is here on the American Association of Retired People's website: https://www.aarp.org/health/brain-health/global-council-on-brain-health/ This is part one of a two part piece, part two features questions from the online conference audience. Presented by Monty Mythen with Angela Bader, Professor of Anesthesia at Harvard Medical School and Vice Chair for Perioperative Medicine in the Department of Anesthesiology, Perioperative and Pain Medicine at Brigham and Women’s Hospital, founding Director of the Weiner Center for Preoperative Evaluation, Sarah Lenz Lock, Senior Vice President for Policy and Brain Health in the American Association of Retired People's (AARP) Policy, Research and International Affairs (PRI), Executive Director of the Global Council on Brain Health, Jeanna Blitz associate professor of Anesthesiology at Duke University School of Medicine, Director of the Preoperative Anesthesia Surgical Screening (PASS) Clinic. There's also a surprise appearance from the EBPOM Chicago 2020 host, Sol Aronson, tenured Professor at Duke University.

This piece gets deep into a much needed discussion regarding frailty, delirium, post-operative cognitive dysfunction and brain health. Noted as one of the highlights of the year in our recent holiday specials and previously only available to attendees to the incredibly successful EBPOM Chicago 2020; go to www.ebpom.org now for more details on forthcoming events and special offers. This piece gets a mention "End of life decision planning in the perioperative setting: the elephant in the room?" https://academic.oup.com/bja/article/115/5/648/230412?login=true The Global Council on Brain Health is here on the American Association of Retired People's website: https://www.aarp.org/health/brain-health/global-council-on-brain-health/ This is part one of a two part piece, part two features questions from the online conference audience. Presented by Monty Mythen with Angela Bader, Professor of Anesthesia at Harvard Medical School and Vice Chair for Perioperative Medicine in the Department of Anesthesiology, Perioperative and Pain Medicine at Brigham and Women’s Hospital, founding Director of the Weiner Center for Preoperative Evaluation, Sarah Lenz Lock, Senior Vice President for Policy and Brain Health in the American Association of Retired People's (AARP) Policy, Research and International Affairs (PRI), Executive Director of the Global Council on Brain Health, Jeanna Blitz associate professor of Anesthesiology at Duke University School of Medicine, Director of the Preoperative Anesthesia Surgical Screening (PASS) Clinic. There's also a surprise appearance from the EBPOM Chicago 2020 host, Sol Aronson, tenured Professor at Duke University.

"Cognitive testing has been in the news ... there are recommendations for keeping pets mentally sound by implementing nutritional modifications, regular exercise and mental stimulation, we should certainly think about providing the same support to our geriatric patients." What does the latest research say about this vital issue? How is frailty defined? What's the clinical impact of preoperative cognitive dysfunction? Presented by Angela Bader, MD, MPH Professor of Anesthesia at Harvard Medical School and Vice Chair for Perioperative Medicine in the Department of Anesthesiology, Perioperative and Pain Medicine at Brigham and Women’s Hospital. She is also the founding director of the Weiner Center for Preoperative Evaluation. For more on this subject check out this piece here: https://www.topmedtalk.com/poet-3-04-is-paternalism-always-bad/

This talk examines the rationale for using methadone in our surgical patient population, reviews clinical trials that assess the effect of intraoperative methadone on post operative outcomes and discusses some unanswered questions related to the administration of this long acting opioid in the perioperative period. Presented by Glenn Murphy, Jeffery S. Vender Chair of Anesthesiology Research and Education and Director of Cardiac Anesthesia and Clinical Research at NorthShore University HealthSystem, a hospital affiliated with the University of Chicago Pritzker School of Medicine. For more on the "opioid sparing opioid" go here: https://www.topmedtalk.com/ebpom-2019-methadone-the-overlooked-opiate-2/

"The main challenge around the variability in the perioperative period is nomenclature, definitions and standardized endpoints. Well designed and well conducted randomized control trials determine effectiveness to an unbiased comparison of outcomes, events, or endpoints between intervention groups". If data is destiny it is to this that we must look if we want to understand what the future may hold for prehabilitation. This piece takes a pragmatic approach toward the task of ensuring information and datasets are widely applicable, as free from bias as possible and ultimately standardised by consistent definitions and terminology alongside a methodology which produces clear outcomes. Find out more about the Comet Initiative here: https://www.comet-initiative.org/ Find more about the 'Standardised Endpoints in Perioperative Medicine-Core Outcome Measures in Perioperative and Anaesthetic Care (StEP-COMPAC) Group' here: https://www.comet-initiative.org/Studies/Details/1317 Presented by Malcolm West NIHR funded Clinical Lecturer in Surgery and Honorary colorectal surgical specialist registrar at the University of Southampton.

"In this session, we're going to talk about the importance of fitness, frailty, function and perioperative medicine." Fitness, frailty and function are overlapping concepts. In the UK, about quarter of patients will be over the age of 65 by 2034. As patients age they may develop comorbidities. These factors combine to present a unique opportunity for the perioperative physician; fitness increases the chances of a positive outcome, time to ensure every patient is "fit for surgery". The Making Every Contact Count (MECC) campaign is here: https://www.makingeverycontactcount.co.uk/ 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.

"Perhaps assessing functional performance is something that we've overlooked in medicine" This piece is about the role of functional assessment and status in perioperative medicine. The Duke Activity Status Index (DASI) can be found here: https://www.mdcalc.com/duke-activity-status-index-dasi The Mini Cog assessment is here: http://mini-cog.com/wp-content/uploads/2015/12/Mini-Cog-Form-010816.pdf The video resources mentioned in the piece are here: https://www.youtube.com/channel/UCvOamR8Sb4RXENr56fvRehA/featured Presented by Daniel Conway, Consultant in Anaesthesia and Critical Care, Group Lead for Perioperative Medicine, Manchester Royal Infirmary, UK and Chair of the Manchester Perioperative Medicine Society.

"I hope to impress upon you that this is a topic that we can and must do better at ... no malnourished patient should ever have elective surgery without having a nutrition assessment done" This piece is presented in two parts; this is part 2. Using perioperative nutrition to optimize our patients outcomes; data shows us that nutrition therapy or nutrition optimization is literally life saving. Anyone who uses evidence as their guide know it has to be part of their practice. Enhanced Recovery After surgery, sometimes called "fast track surgery" is about ensuring we apply the best information we have to the process. This talk focuses on how and why this ties into a sensible attitude towards nutrition and nutritional assessment. This talk pulls no punches and yet is powerfully optimistic in its message. We implore TopMedTalk listeners to share it with colleagues. The entertaining audio clips used in this piece are available, with video and in full here: https://www.youtube.com/watch?v=zHEincgSm1k&t=190s Our speaker kindly shares his email address for further correspondence and questions: paul.wischmeyer@duke.edu Presented by Paul Wischmeyer, Professor of Anaesthesiology and Surgery at Duke Anesthesiology.

"I hope to impress upon you that this is a topic that we can and must do better at ... no malnourished patient should ever have elective surgery without having a nutrition assessment done" This piece is presented in two parts; this is part 1. Using perioperative nutrition to optimize our patients outcomes; data shows us that nutrition therapy or nutrition optimization is literally life saving. Anyone who uses evidence as their guide know it has to be part of their practice. Enhanced Recovery After surgery, sometimes called "fast track surgery" is about ensuring we apply the best information we have to the process. This talk focuses on how and why this ties into a sensible attitude towards nutrition and nutritional assessment. This talk pulls no punches and yet is powerfully optimistic in its message. We implore TopMedTalk listeners to share it with colleagues. The entertaining audio clips used in this piece are available, with video and in full here: https://www.youtube.com/watch?v=zHEincgSm1k&t=190s Our speaker kindly shares his email address for further correspondence and questions: paul.wischmeyer@duke.edu Presented by Paul Wischmeyer, Professor of Anaesthesiology and Surgery at Duke Anesthesiology.

It's widely understood that high value care during, before and immediately after surgery is optimal whereas poor quality care in the perioperative period produces long term difficulties which are compounded by the acute stresses produced during and immediately after a procedure. This talk covers three main areas; surgical care for patients in Greater Manchester, "ERAS+"; prehabilitation for cancer, for the population of Greater Manchester; how Manchester has supported patients during the time of COVID19. This piece is mentioned in the introduction and serves as a useful compliment to the talk, "Implementing a system-wide cancer prehabilitation programme: The journey of Greater Manchester's ‘Prehab4cancer’": https://www.ejso.com/article/S0748-7983(20)30438-8/fulltext Find out more about the work in Greater Manchester here: https://gmcancer.org.uk/our-areas-of-work/prehab4cancer-2/ Also the Perioperative Quality Improvement Programme is here: https://pqip.org.uk/content/home Presented by Dr. John Moore, Clinical Director for Intensive Care at Manchester Royal Infirmary and Medical Lead for Enhanced Recovery After Surgery.

This piece looks at some of the advantages to having a perioperative interdisciplinary team reducing complications, understanding and discussing risk, facilitating better shared decision making and increased patient satisfaction, even among those who - as part of this process - decide not to go ahead with an operation. It also incorporates evidence regarding what we know about COVID-19; "The risks ... of the COVID-19 virus is that if people contract it during or after their surgery, they have a much worse result with perhaps 51% pulmonary complications or 24% mortality". The World Health Organisation report mentioned in this piece, "Smoking greatly increases risk of complications after surgery", is here: https://www.who.int/news/item/20-01-2020-smoking-greatly-increases-risk-of-complications-after-surgery The Montgomery ruling is covered on a previous TopMedTalk in more detail in "Sunday Special | Being on the right side of the law" here: https://www.topmedtalk.com/sunday-special-being-on-the-right-side-of-the-law-2/ The Centre for Perioperative Care website is an excellent resource, here is the section specifically for your patients: https://www.cpoc.org.uk/patients The Royal College of Surgeons is here: https://www.rcseng.ac.uk/ Our presenter has a website dedicated to her work here: http://www.scarlettmcnally.co.uk/ And she maintains a twitter feed - focused on medical issues - here: https://twitter.com/scarlettmcnally Presented by Scarlett McNally, Deputy Director of The Centre for Perioperative Care (CPOC) consultant Orthopaedic Surgeon, Eastbourne DGH, UK.

This piece is essential listening for any medical practitioner. The pathophysiology of COVID 19 is now being understood, although there are still a number of outstanding questions. This piece attempts to answer those questions; where does it come from, what do we know about it now, what would we like to know about it in the future? Why is the disease more pronounced in men, how come obesity seems to be a factor, what's the mechanism which leaves children less at risk than adults and senior citizens? This piece is a standout part of Evidence Based Perioperative Medicine's (EBPOM) Dingle 2020 conference. For more of the latest up to date information go now to www.ebpom.org Presented by Hugh Montgomery, Professor of Cardiovascular Genetics and Critical Care University College London.

"More than 300 million patients have surgery annually worldwide and an increasing proportion of them are elderly and at risk of perioperative adverse events. There's very few proven primary or secondary prevention measures, and the resources for monitoring and trading complications are inadequate. So - more action is required". This piece looks at the evidence as regards perioperative outcomes for the elderly, depth of anesthesia and mortality. Also, what's the latest on depth of anesthesia and delirium? Presented by Kate Leslie, Honorary Professor, Monash University, Melbourne, VIC, Australia, Specialist Anaesthetist, The Royal Melbourne Hospital & North Western Mental Health and Non-Executive Director, Australian Medical Council.

This panel discussion covers essential ground for any institution that is trying to make real and lasting change. What do we need to know? What do our patients need to know? Who is responsible for questions of safety? How important are checklists? What about "patient advocates"? Presented by Sol Aronson with Mike Ramsey, Chair of the department of Anesthesia and pain management at the Baylor University Medical Center in Dallas and Board Chair of the Patient Safety Movement Foundation, Lee Fleisher, CMO and director for the Center for Clinical Standards and Quality for the centers of Medicare and Medicaid, Sarah Lenz Lock, Senior Vice President for Policy Research and International Affairs for the AARP, Lili Brillstein, Director of Specialty Care Value Based Models for Horizon Blue Cross Blue Shield of New Jersey and Monty Mythen, Smiths Medical Professor of Anaesthesia and Critical Care at University College London.

  How have we adapted in our views on the use of video laryngoscopy during the Covid-19 pandemic? Who is best suited to intubate? Are we seeing "a poorly managed first wave"? How are practitioners changing their approach in light of the possibility of infections? What lessons are being learned by practitioners in the midst of the COVID crisis? This piece was generously supported by Medtronic.com Presented by Desiree Chappell with Monty Mythen and her guests, Patrick Schoettker, Professor of Anesthesia and Emergency Medicine at Lausanne University Hospital, Sol Aronson, tenured Professor, Duke University, Henry Howe, Junior Doctor, NHS England and TopMedTalk team member.  

This piece is a worthwhile deep dive into this perioperative medicine and how we go forward with it. Hear the panel speak about what it is they want for the future and what it is they are doing now. With questions submitted from the online audience the panel get into the detail. Essential listening for any student of perioperative medicine. It includes a mention for the Welsh Perioperative Medicine Society, their website is here: https://www.welshpoms.com/ This is part two of a two part piece of the same name. Presented by David Walker, Professor in Anaesthesia and Critical Care Medicine, University College London Hospitals, Honorary Senior Lecturer UCL, Kim Caulfield, Perioperative Medicine Fellow, University College London Hospitals NHS Foundation Trust, Mike Grocott Professor of Anaesthesia and critical care at the University of Southampton, Aislinn Sherwin, a Fellow in Perioperative Medicine and Onco-Anaesthesia at the Peter MacCallum Cancer Centre, Melbourne, Roisin Coary, final year SpR in Geriatric and General Internal Medicine, with a specialist interest in Peri-operative Medicine, Dublin Ireland and Isra Hassan, a post-CCT Perioperative Medicine Fellow at the University College of London Hospital she co-founded the Welsh Perioperative Medicine Society in 2018 which now has over 100 members, and to date has delivered two national conferences, Andrea Haren, perioperative medicine fellow at UCLH she worked with Guys and St Thomas' working with the POPS Clinic she is currently a locum consultant anaesthetist at St. Vincent's Hospital in Dublin and Pádraig Ó Scanaill, Locum Consultant Anaesthetist at the Mater Misericordiae University Hospital, Dublin.

"We've been doing cryoneurolysis for total knees now for three years... people gravitate to practices that that practice this technology" This piece focuses upon two 'early adopter' orthopedic surgeons changing up the way we treat joint pain for surgical patients. We mention Iovera, a provider at the forefront of this technology: https://www.iovera.com/ The Doc Social website is here: www.doc.social/ The Evidence Based Perioperative Medicine (EBPOM) website is here: www.ebpom.org This piece also features important news for TopMedTalk fans as, towards the end, we explain how your favorite perioperative podcast is asking listeners for feedback and thoughts. Email contact@topmedtalk.com Presented by Desiree Chappell and Monty Mythen with their guests Vinod Dasa, Vice Chairman of Academic Affairs, Irv Cahen Chair of Orthopaedic Surgery and Research, Co-Director LSU Musculoskeletal Research Consortium and Josh Urban, board-certified orthopedic surgeon, OrthoNebraska, Omaha, Nebraska.

This piece is a worthwhile deep dive into this perioperative medicine and how we go forward with it. Hear the panel speak about what it is they want for the future and what it is they are doing now. With questions submitted from the online audience the panel get into the detail. Essential listening for any student of perioperative medicine. When should we pre-assess patients? Should all anaesthetists be doing pre-operative sessions? What is it about the role of the anaesthestist that makes it uniquely suited to the discipline of perioperative medicine? This is part one of a two part piece of the same name. Presented by David Walker, Professor in Anaesthesia and Critical Care Medicine, University College London Hospitals, Honorary Senior Lecturer UCL, Kim Caulfield, Perioperative Medicine Fellow, University College London Hospitals NHS Foundation Trust, Mike Grocott Professor of Anaesthesia and critical care at the University of Southampton, Aislinn Sherwin, a Fellow in Perioperative Medicine and Onco-Anaesthesia at the Peter MacCallum Cancer Centre, Melbourne, Roisin Coary, final year SpR in Geriatric and General Internal Medicine, with a specialist interest in Peri-operative Medicine, Dublin Ireland and Isra Hassan, a post-CCT Perioperative Medicine Fellow at the University College of London Hospital she co-founded the Welsh Perioperative Medicine Society in 2018 which now has over 100 members, and to date has delivered two national conferences, Andrea Haren, perioperative medicine fellow at UCLH she worked with Guys and St Thomas' working with the POPS Clinic she is currently a locum consultant anaesthetist at St. Vincent's Hospital in Dublin and Pádraig Ó Scanaill, Locum Consultant Anaesthetist at the Mater Misericordiae University Hospital, Dublin.

  In this piece you can hear the co-editors of the Journal of Perioperative Medicine describing this year's "Editor's Picks"; the best manuscripts, literature and lessons learned in the last year in the space of perioperative medicine. "Functional performance and 30-day postoperative mortality after emergency laparotomy—a retrospective, multi-center, observational cohort study of 1084 patients" is here: https://perioperativemedicinejournal.biomedcentral.com/articles/10.1186/s13741-020-00143-7 There is more information about the Eastern Cooperative Oncology Group (ECOG) here: https://ecog-acrin.org/resources/ecog-performance-status "A randomised trial of non-invasive cardiac output monitoring to guide haemodynamic optimisation in high risk patients undergoing urgent surgical repair of proximal femoral fractures (ClearNOF trial NCT02382185)" is here: https://perioperativemedicinejournal.biomedcentral.com/articles/10.1186/s13741-019-0119-x "The effect of virtual reality technology on preoperative anxiety in children: a Solomon four-group randomized clinical trial" is here: https://perioperativemedicinejournal.biomedcentral.com/articles/10.1186/s13741-019-0116-0 Presented by Mike Grocott, Professor of Anaesthesia and Critical Care at the University of Southampton and a Consultant in Critical Care Medicine at University Hospital Southampton NHS Foundation Trust with his guests Clifford Ko, Professor of Surgery at UCLA, Director of the Division of Research and Optimal Patient Care at the American College of Surgeons and Lee Fleisher, Professor of Anesthesiology and Critical Care, University of Pennsylvania. Originally part of the hugely successful EBPOM 2020 Chicago this piece is introduced by Sol Aronson, tenured Professor at Duke University.  

This piece is part one of a two part piece. It's a short didactic presentation on the tough realities the U.S. healthcare system faces as the fee for payment system creaks against concerns about rising costs and the need for population health management. Can we move forward with "the science of value" which true perioperative medicine offers us? It's a talk which is designed to spark debate and that follows in part two of this piece. Presented by Sol Aronson, tenured Professor, Duke University, Durham, North Carolina.

"Data is key and having champions is key" This piece provides a truly transatlantic in-depth perspective on an area of opportunity highlighted by our needs in the wake of COVID 19; now more than ever true enhanced recovery after surgery (ERAS) is essential. Optimising value, reducing the need for return visits, decreased length of stay, there is almost no aspect of perioperative medicine and enhanced recovery that is not going to be crucial for our institutions in the near and present future. A data driven approach makes it clear, there is no other way forward. Also in this podcast a fascinating dive into one of our favorite topics, goal directed fluid management. How have the terms "restricted" and "liberal" evolved over the years? What should we make of the new evidence that ha come in over the last few years? Hear how these challenges are being met in this exclusive conversation, generously supported by Deltex Medical. Presented by Desiree Chappell and Monty Mythen with their guest Michael Scott, M.B., Ch.B. Professor of Anesthesiology at the University of Pennsylvania

"If I were to develop a simple uncomplicated urinary tract infection, I may well be able to continue to go to work as I was being treated for that illness but if an older frail patient develops a similar uncomplicated urinary tract infection, that can be a very significant illness, that patient may well be unable to walk or transfer as they could" Frailty in the perioperative period - what is it, what is it not and how do we work with and manage it before, during and after an operation so as to increase the value of care to our patients? The opening article refered to in this piece is here: https://journals.sagepub.com/doi/full/10.1177/1756287220916614 The British Geriatrics Society "Fit for Frailty" document is here: https://www.bgs.org.uk/resources/resource-series/fit-for-frailty More information on Perioperative medicine for older people undergoing surgery (POPS), an award winning geriatrician led service and the first of its kind in the UK, go here: https://www.guysandstthomas.nhs.uk/our-services/ageing-and-health/specialties/pops/overview.aspx Presented by Jude Partridge, consultant geriatrician POPS, honorary senior lecturer, King's College London, Chairs the British Geriatrics Society POPS SIG.

"It's useful to reflect on what SNAP-2 EPICCS might offer us in the brave new world that we find ourselves in with Coronavirus" The 2nd Sprint National Anaesthesia Project: Epidemiology of Critical Care after Surgery (SNAP-2 - EPICCS) study launched in March 2017 around the UK. More than 2,200 investigators at more than 250 sites across the UK were signed up to take part. The observational study collected data on all patients undergoing inpatient surgery during a one-week period (21 March to 27 March) in UK NHS hospitals. What is the scale of the problem; when it comes to cancellation of inpatient surgery surgery, with a specific lens on critical care capacity? What about the value of higher levels of post operative care for high risk surgical patients? What are the essential ingredients for higher intensity post operative care? Also, learn about some of the organically developed solutions that have come around to capacity issues for high risk surgical patients in the NHS and overseas. As well as this hear how we might select patients to be admitted to higher levels of care; the methods that we might use for risk stratification of inpatient surgical patients and what we think the potential benefits of post operative high levels of care could be. Do we have any data to support the notion that critical care confers benefits on post surgical patients? The website is here: https://www.niaa-hsrc.org.uk/SNAP-2-EpiCCS More on SNAP-2 is here: https://www.topmedtalk.com/what-is-snap-2/ Presented by Ramani Moonesinghe, OBE, Professor of Perioperative Medicine at University College London (UCL), Hon Consultant in Anaesthesia, UCLH.

Patient safety, as a priority, is assumed to be at the heart of medical practice. Yet still, preventable harm and death occurs in our profession, how do we change this and how do we make the changes we implement last? Can safety and avoidable harm be somehow hardwired into the culture of what we do in a way similar to that of the airline industry? This popular and refreshing talk is presented here after it was a big hit at the Chicago 2020 conference organised by Evidence Based Perioperative Medicine (EBPOM). For more check out www.ebpom.org Presented by Mike Ramsey, Chair of the Board of Directors of the Patient Safety Movement Foundation (PSMF), Chair of the Department of Anesthesiology at Baylor University Medical Center in Dallas, Texas.

This roundtable discussion tackles questions from the online audience and is the third part of a longer discussion. It follows on from "The value proposition in perioperative medicine | EBPOM 2021 Las Vegas", if you'd like to hear that go here: https://topmedtalk.libsyn.com/the-value-proposition-in-perioperative-medicine-ebpom-2021-las-vegas How do we as practitioners deliver value? How does 'population health' fit into the picture? How long before and after surgery are we invested in managing? What's the key point to start a perioperative medicine program in a low income country with no incentives at all; how do you approach the hospital financial department? Presented by Desiree Chappell, introducing her panelists Linda Groah, CEO, Executive Director of the Association of periOperative Registered Nurses (AORN) and Amy Stout, Operating Partner at Cranemere and Interim President of Clinical Services at NorthStar; alongside contributions from additional contributors from the previous session, Jim Grant, Senior Vice President and Chief Medical Officer at Blue Cross Blue Shield of Michigan and Mike Englesbe, Darling Sr. & Cyrenus G. Darling Jr. Professor of Surgery, Michigan.

"Look at it from where is the patient, and what's best for the patient; I think that the other answers follow and yes, it is higher quality, yes, there can be some opportunities for cost savings; even if it 'breaks even' if the patients are happier, isn't that worth moving into the concept and proving that it does make a difference?" The value proposition is an essential element of advocating perioperative care; we know it provides safer, better quality outcomes but how do we translate that into a language that both patients, fee payers and providers can all understand? This piece follows on from "The size and scope of the problem with Jim Grant & Mike Englesbe | EBPOM 2021" Las Vegas, if you'd like to hear that go here: https://topmedtalk.libsyn.com/the-size-and-scope-of-the-problem-with-jim-grant-mike-englesbe-ebpom-2021-las-vegas Presented by Desiree Chappell, introducing her panellists Linda Groah, CEO, Executive Director of the Association of periOperative Registered Nurses (AORN) and Amy Stout, Operating Partner at Cranemere and Interim President Clinical Services at NorthStar; alongside contributions from additional contributors from the previous session, Jim Grant, Senior Vice President and Chief Medical Officer at Blue Cross Blue Shield of Michigan and Mike Englesbe Darling Sr. & Cyrenus G. Darling Jr. Professor of Surgery, Michigan.

"When I heard Sol Aronson, speak about perioperative medicine as 'population health', for me, it was like a eureka moment because our platform within Michigan is really an unmatched place to kind of realize that vision." This piece asks the question; "why do we need perioperative medicine"? The answer is illustrated with a real success story where practitioners realise the value proposition it unlocks for their patients every day. Hear how it is achieved and why it is so important. Presented by Desiree Chappell with her guests Jim Grant, Senior Vice President and Chief Medical Officer at Blue Cross Blue Shield of Michigan and Mike Englesbe, Darling Sr. & Cyrenus G. Darling Jr. Professor of Surgery, Michigan. If you enjoyed this piece you'll love TopMedTalk's exclusive and ground breaking series POET: Perioperative Enhancement Team "Perioperative medicine is population health": https://topmedtalk.libsyn.com/poet-601-perioperative-medicine-is-population-health

This question and answer session was a highlight of EBPOM London 2020, it works as a standalone piece or as a companion piece to this talk here: https://topmedtalk.libsyn.com/ebpom-2020-london-am-i-safe The discussion follows themes outlined in the presentation as our online audience asked a series of questions. Some of the questions included in the discussion are "How should leaders deal with anxiety both in themselves and their team? What is the evidence on perceived command gradient in residents and the fear of looking inadequate in front of peers and superiors? Bad for patients, versus bad for me? The people at the top end, the older people within an organization, are often the most resistant to culture change, yet they have the most influence over culture, any advice? What defines the people who are ready for change?" Conversational in tone this piece was first heard on the "TopMedTalk stage" at Evidence Based Perioperative Medicine (EBPOM) for more details go now to www.ebpom.org Presented by Monty Mythen and Desiree Chappell with Lee Fleisher, Emeritus Professor of Anesthesiology and Critical Care, University of Pennsylvania.

"So in all these ERAS programs, you need a physician champion, a nurse champion, a coordinator; then we brought our pharmacist in - I will not start rounds without a pharmacist. I refuse. I won't start because the pharmacist is integral ... it's just you need that multidisciplinary team" This piece is a question and answer session prompted by the address our guest gave during EBPOM Chicago. Both the online audience and the team challenge our speaker to explain more. If you missed the address TopMedTalk has it for you here: https://topmedtalk.libsyn.com/daniel-engelman-updates-in-cardiac-ebpom-chicago Presented by Desiree Chappell and Monty Mythen with Daniel Engelman, Cardiac Surgeon, Medical Director of the Heart, Vascular and Critical Care Units at Baystate Medical Center, Associate Professor of Surgery at The University of Massachusetts - Baystate, Associate Professor-Adjunct at Tufts University School of Medicine. He president and co-founder of the ERAS® Cardiac Society.

This piece is a question and answer session with questions from the online audience. What do we think is the clinical care difference that having an elevated level of monitoring and more people around of all all sorts? Why is it good for our patients? As regards admissions to your campus care area; what criteria do you use? Do we need rapid critical care expansion in countries with very few beds? Could the enhanced care wards, in their approach, be compared with the post anaesthetic care unit? Would you cancel or postpone a cancer patient's operation, if not enhanced care or post operative critical care bed available? If you feel it is essential, if you feel the operation essential? Presented by Mike Grocott, Professor of Anaesthesia and Critical Care at the University of Southampton and Lee Fleisher, Emeritus Professor of Anesthesiology and Critical Care, University of Pennsylvania with Ramani Moonsinghe, Professor of Perioperative Medicine at University College London (UCL), Hon Consultant in Anaesthesia, UCLH, Mike Swart, Consultant in Anaesthesia and Critical Care Medicine at Torbay Hospital and advisor to the UK Department of Health for the Enhanced Recovery Programme and Anna Batchellor, trained in anaesthesia and Intensive Care Medicine (ICM) she works in Newcastle upon Tyne; past President of the Intensive Care Society, past Dean of the Faculty of ICM, past member of Council of the Royal College of Anaesthetists. She tried to retire in June 2016 and managed to spend a year working part time before being hijacked by the Getting It Right First Time (GIRFT) programme.

This piece considers the need to understand the patient having surgery and the complexity with which they present so we can match our skills to them. Developing these skills requires new approaches; to education and training at undergraduate and postgraduate level; to challenge the old ways of delivering perioperative care. This requires new ways of working, the breaking down of silos, a rethink of the financial support that is required and that we share good practice rather than 'reinventing the wheel'. It also means ensuring that we continue to gain evidence from the real world of clinical medicine, whether that's through original research or through employing quality improvement and implementation science. More on Proactive care for Older People undergoing Surgery (POPS) here: https://www.guysandstthomas.nhs.uk/our-services/ageing-and-health/specialties/pops/overview.aspx If you enjoy this piece you'll love our series here: "POPS Part 1| TopMed talk at Guy’s and St Thomas’s Hospital in Central London" - https://www.topmedtalk.com/pops-part-1-topmed-talk-at-guys-and-st-thomass-hospital-in-central-london/ Presented by Jugdeep Dhesi, Clinical Lead for "Proactive care for Older People undergoing Surgery" (POPS) and Consultant Geriatrician, Guys and St Thomas' NHS Trust.

This piece is the second part of a conversation about leadership in medicine, during times of change. It follows on from the first part where our speaker outlines his thoughts in a short talk. Now questions from the audience are considered and the conversation develops. What have we learned after the recent huge changes we've seen in our profession? Presented by Desiree Chappell and Monty Mythen with Jeff Vender, Emeritus, Harris Family Foundation Chairman of the Department of Anesthesiology at NorthShore University Health System, Evanston, Illinois and Clinical Professor at the University Of Chicago Pritzker School Of Medicine in Chicago, Illinois.

"I believe most people can be leaders or better leaders. You can create or participate in change and a better future. You can make a difference in your own lives, the lives of others and the life of your organization. If you believe you can." This piece contains a powerful, inspirational and prescient talk about leadership. Part 1 contains some conversation and the talk, to be followed by questions from the audience in Part 2. Where do leaders come from, what makes them stand out and how do they learn the skills necessary to take what they do to the next level? Presented by Desiree Chappell and Monty Mythen with Jeff Vender, Emeritus, Harris Family Foundation Chairman of the Department of Anesthesiology at NorthShore University Health System, Evanston, Illinois and Clinical Professor at the University Of Chicago Pritzker School Of Medicine in Chicago, Illinois.

This piece presents an invaluable wealth of first hand experience in setting up various business cases in relation to perioperative medicine in the UK. At University College London (UCL) cardiopulmonary exercise testing (CPET) was set up as a research tool "but then clinicians came, became interested in the results of the tests and started to ask for tests to be done on their patients for clinical evaluation". An external contractor model, using a charitable organisation, enabled them to charge the NHS for these tests; as the service expanded they were able to expand to other clinical sites connected with UCL, published early data on outcomes and obtained grant funding to look at a robust evaluation model. Hear how this model was refined and the idea has evolved during its growth within the UK's National Health Service (NHS). Also, consider what other models could apply this thought process; learn how new perioperative care pathways offer interesting opportunities in these areas. This piece is further enhanced by the discussion we released recently on the same topic: https://www.topmedtalk.com/ebpom-london-2020-the-business-case-for-prehabilitation/ Presented by Kay Mitchell, Senior Research Manager for Critical Care Research, NIHR Biomedical Research Center, University Hospital, Southampton, UK.

"Just having more staff doesn't always equate to better care, especially when the staff do not have the skills required." Perioperative medicine has the opportunity to lead the way in advanced practice; the extended role of the practitioner within the perioperative pathway can be done with nurses, allied health professionals or physician associates. As we evolve these roles, we must be mindful and recognise not all services will be the same. How can you tailor your service to your specific needs? How do you construct a business case which provides a better quality of value based care within your institution? Could this help by giving the practitioner role focus and allowing you to measure their effectiveness? For more information about Guy's and St Thomas's practice we suggest you look at their website, an excellent information resource, here: https://www.guysandstthomas.nhs.uk/our-services/ageing-and-health/specialties/pops/overview.aspx Presented by Jason Cross, Advanced Nurse Practitioner, Department of Aging and Health, Guy's and St Thomas's, London.

"46% pretty much means every other patient who was getting IV opioids was having some sort of a respiratory depression event" After a quick round up of COVID news in the contributor's respective areas this piece gets involved in a much needed discussion about the “PRediction of Opioid-induced Respiratory Depression In Patients Monitored by capnoGraphY (PRODIGY)” trial. PRODIGY trial is here: https://clinicaltrials.gov/ct2/show/NCT02811302 Presented by Desiree Chappell and Monty Mythen with Mike Grocott, and their guests Ashish Khanna, Associate Professor, Section Head for Research, Department of Anesthesiology, Section on Critical Care Medicine, Wake Forest School of Medicine and Roop Kaw, Associate Professor of Medicine at Cleveland Clinic, Founder Member of The Society of Anesthesia and Sleep Medicine. As mentioned TopMedTalk have been eagerly following the development of this research, you might also enjoy this piece we did here: https://www.topmedtalk.com/ebpom-2020-london-prediction-of-opioid-induced-respiratory-depression-on-the-general-care-floor-does-surveillance-monitoring-help/ More discussion regarding risk factors for opioid-induced respiratory depression in surgical patients here: https://www.topmedtalk.com/topmedtalks-to-paul-grant-2/

Armed with a background in biomedical engineering, doubled with an EMBA in Finance, our guest has spent the past 20 years within the medical device industry. In 2010 he was instrumental in setting up MDoloris Medical Systems, with the mission to provide technologies that allow clinicians a reliable, continuous and non-invasive evaluation of autonomic nervous system (ANS) activity. Based on 23 years of academic research, performed by a French research lab, the technology allows anaesthetists and intensivists to effectively tailor analgesia; more so for patients who are unable to communicate. The technology is available for adults, paediatrics, neonates as well as animals (specifically horses, cats and dogs), in both standalone and more recently modular format. Presented by Desiree Chappell and Monty Mythen with their guest Fabian Pagniez, CEO and founder of MDoloris Medical Systems. For more details on EBPOM please visit www.ebpom.org Also, if you enjoyed this piece we cover nociception in more detail here: https://www.topmedtalk.com/topmedtalks-to-dan-longrois-on-nociception/

This piece looks at the most recent guidance regarding prehabilitation for cancer, developed and published in 2009 by Macmillan Cancer Care. Extremely well received across the UK, and internationally, here we look at the details and some context in terms of UK national policy. From an NHS England point of view the desire is to ensure that all patients and participants have personalized care embedded into everyday NHS services. Work around streamlining multidisciplinary team meetings for cancer include the opportunity to discuss the needs of people with cancer and the importance of preparing people in advance and during treatment. Furthermore you will hear elements of the principles of rehabilitation, as well as the importance of earlier and faster diagnosis, the importance of perioperative medicine and prehabilitation before surgery. Further reading here "Principles and guidance for prehabilitation": https://www.macmillan.org.uk/about-us/health-professionals/resources/practical-tools-for-professionals/prehabilitation.html Originally part of the hugely successful EBPOM Live from London 2020 conference this piece is nicely complimented by the panel discussion which TopMedTalk has also released free of charge here: https://www.topmedtalk.com/ebpom-london-2020-prehabilitation-update/ Presented by June Davis, Director of Allied Health Solutions, Allied Health Professions Advisor (part time) for Macmillan Cancer Support and a professional advisor to the Care Quality Commission.

"Oxygen is the commonest drug that we give to our patients today during surgery and the general anaesthetic" but what do we really know and understand about it from a perioperative perspective? This talk illustrates why, even with some of the evidence and background physiology that we have at our fingertips today, the following questions are still perplexing: How much is too little oxygen? How much is too much oxygen? And how much is just the right amount of oxygen? Presented by Daniel Martin, OBE, Professor of Perioperative and Intensive Care Medicine, University of Plymouth and the Royal Free Hospital, London.

This piece is a listener generated question and answer session from EBPOM 2020. Although it works as a stand alone piece it relates directly to this talk here: https://www.topmedtalk.com/ebpom-2020-london-prediction-of-opioid-induced-respiratory-depression-on-the-general-care-floor-does-surveillance-monitoring-help/ Some of the questions considered include: How much do you think partial / inadequate neuromuscular blockade reversal, contributes to post pulmonary complications, perhaps in combination with opioids? Why as a group would we prefer to save money by avoiding sugammadex to reverse rocuronium to ensure complete reversal? Lack of reversal more than an issue? If you did a pre op sleep study on these patients, would you not find similar frequencies of desaturation? Is it just monitoring sleep? Should all wards have the capability for continuous monitoring? Presented by Monty Mythen and Desiree Chappell with their guests, Ashish Khanna, Associate Professor, Section Head for Research, Department of Anesthesiology, Section on Critical Care Medicine,Wake Forest School of Medicine, Frank Overdyk, Professor of Anaesthesiology, Charleston, South Carolina, Leif Saager, Executive Vice Chair of the Department of anesthesiology in Germany at the University of Nottingham. There's more from Frank Overdyk here: https://www.topmedtalk.com/11813-2/

With questions from the online audience, this piece looks at the "not too much and not too litte" sweet spot regarding fuel, fluid and oxygen; where is it and how do we get there, according to our distinguished panel? This podcast works well as a companion piece to the following talks which have already been released here on TopMedTalk: Helen McKenna, "Fuel, can you have too much?" https://www.topmedtalk.com/ebpom-2020-london-fuel-can-you-have-too-much/ Tim Miller "Optimising fluid and hemodynamic management during major surgery" https://www.topmedtalk.com/ebpom-london-2020-optimizing-fluid-and-hemodynamic-management-during-major-surgery/ Dan Martin "Perioperative Oxygenation" https://www.topmedtalk.com/ebpom-london-2020-perioperative-oxygenation/ Presented by Mike Grocott and Dennie Levett with their panelists; Tim Miller, Associate Professor of Anesthesiology from Duke University Medical Centre, Helen McKenna, is in the final year of her PhD at University College London, investigating bioenergetic and redox function in critically ill patients and Dan Martin, OBE anaesthetist and intensivist at the Royal Free Hospital and Reader at University College London (UCL).

This piece is a continued deep dive into the subject, of 'fitness, function, or frailty' and, perhaps, "fixing". It's essential listening for anyone interested in the latest thinking on this crucial topic and was a highlight of the London conference. How can we integrate frailty and cognitive scores in risk assessment tools to facilitate inclusion in shared decision making? How can we improve a surgical colleague's ability to identify frailty? Most patients will have an operation sometime in their life; should surgical school be renamed and moved to being a "well being" clinic and offered to all patients? What screening tools would you recommend if only minimal time or money is available? Is pre-op screening actually 'public health' and should it really be being done for everyone? What are the differences and where is the overlap between fitness functional capacity, frailty, and sarcopenia? In mild cognitive impairment, should we tell patient that it will work and postop and not be expected to fully recover? What strategies have you found most helpful in engaging surgeons with identifying their frail patients? How are we tackling the workforce shortage among geriatricians? What has your experience been in advising achieving physical fitness in patients who present to surgery with persistent pain which is a limitation? This is part two of a two part piece. Each of the contributors comments upon talks which they gave at EBPOM 2020, all of which are now available as part of the TopMedTalk podcast. To ensure you are among the first to hear information of this kind please investigate www.ebpom.org for more details about how you can attend our online conferences. -- Presented by Scarlett McNally, Deputy Director of The Centre for Perioperative Care (CPOC) consultant Orthopaedic Surgeon, Eastbourne DGH, UK and Monty Mythen, Smiths Medical Professor of Anaesthesia and Critical Care at University College London with questions from the online audience for their guests; 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, Daniel Conway, Consultant in Anaesthesia and Critical Care, Group Lead for Perioperative Medicine, Manchester Royal Infirmary, UK and Chair of the Manchester Perioperative Medicine Society, Jude Partridge, consultant geriatrician POPS, honorary senior lecturer, King's College London, Chairs the British Geriatrics Society POPS SIG, Vicki Morton, Director of Clinical and Quality Outcomes at Providence Anesthesiology Associates, P.A.

Fitness, function and, or, frailty are important determinants of the quality of the life that we live. In the context of major surgery it's very important we recognize and work with individual patients improving and optimizing them and their ability to handle an operation. This piece is an essential deep dive into the subject, essential listening for anyone interested in the latest thinking on this crucial topic. What are the limitations on your resources when considering a plan of preoperative evaluation? This is part one of a two part piece. Each of the contributors comments upon talks which they gave at EBPOM 2020, all of which are now available as part of the TopMedTalk podcast. To ensure you are among the first to hear information of this kind please investigate www.ebpom.org for more details about how you can attend our online conferences. -- Presented by Scarlett McNally, Deputy Director of The Centre for Perioperative Care (CPOC) consultant Orthopaedic Surgeon, Eastbourne DGH, UK and Monty Mythen, Smiths Medical Professor of Anaesthesia and Critical Care at University College London with questions from the online audience for their guests; 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, Daniel Conway, Consultant in Anaesthesia and Critical Care, Group Lead for Perioperative Medicine, Manchester Royal Infirmary, UK and Chair of the Manchester Perioperative Medicine Society, Jude Partridge, consultant geriatrician POPS, honorary senior lecturer, King's College London, Chairs the British Geriatrics Society POPS SIG, Vicki Morton, Director of Clinical and Quality Outcomes at Providence Anesthesiology Associates, P.A.

"We have to create the culture of learning; the culture of having a safe space, the culture of wanting to do better and learning those conditions in which we do do better" This powerful talk looks directly at how a clear approach to patient safety really can improve the standard of care where you work. What is the culture of quality and safety that you're trying to embed, can you actually do better? Learn why it's important to focus on psychological safety; "if people start being scared, everyone gets scared then it expands". Learn how an evidence based approach can allow us to tackle these issues rather than shy away from them; "what factors are maintaining safety? How do we get to good outcomes? What are the things working well? How do we understand human variation?". Presented by Lee Fleisher, Emeritus Professor of Anesthesiology and Critical Care, University of Pennsylvania.

This piece covers the PREP-WELL project which is a community based prehabilitation program in South Tees, in the North of England: "We established the following guiding principles; we wanted to provide patient centered care under one roof with facilitated self management; we wanted to work as a cross sector collaborative, by that I mean primary care, secondary care and public health; all working together to try and improve on the fragmented service provision and sign work that we often see in our health care services; we wanted to provide a community based facility for patients; and I'll come to the reasons for this". See the PREP-WELL team here: https://www.southtees.nhs.uk/services/prepwell-project/meet-the-prepwell-team/ The links mentioned in the talk are here: Home exercises: https://www.southtees.nhs.uk/services/prepwell-project/home-exercises/ Nutrition: https://www.southtees.nhs.uk/services/prepwell-project/nutrition/ Pdf download: https://bmjopenquality.bmj.com/content/bmjqir/9/1/e000898.full.pdf We've been following the groundbreaking success of the PREP-WELL project for some time now here on TopMedTalk, why not check out this piece here, the first part in our most recent "P.O.E.T - Perioperative Enhancement Teams" series; https://www.topmedtalk.com/poet-2-01-the-uks-prepwell-initiative/ This piece was originally part of EBPOM 2020 - Live from London, our groundbreaking virtual conference; find out more about Evidence Based Perioperative Medicine (EBPOM) here: www.ebpom.org Presented by Gerard Danjoux, consultant in Anaesthesia and Sleep Medicine at South Tees Hospitals NHS Foundation Trust.

"We have to remember that patients have a team" How do we involve patients in the increasingly complex conversations we have in the perioperative space? This piece is a detailed case study which shows how shared decision making works in the perioperative setting. We know this improves patient experience yet in the last 10 or so years, consistently only 50 to 60% of patients say they were involved in decision making. How can shifting towards a value based care model help? What is "moral injury" and how do we avoid it? Can a data driven analysis actually show shared decision making reduces costs? Perioperative medicine for older people undergoing surgery (POPS) is an award winning geriatrician led service and the first of its kind in the UK - find out more here: https://www.guysandstthomas.nhs.uk/our-services/ageing-and-health/specialties/pops/overview.aspx The Centre for Perioperative Care is here: https://cpoc.org.uk/ Presented by Ramai Santhirapala, Consultant Anaesthetist and Perioperative Medicine Lead at Guy’s and St Thomas’ NHS Foundation Trust, fellow of the Royal College of Anaesthetists, Faculty of Intensive Care Medicine and Higher Education Academy, Honorary Associate Professor at University College London, Clinical Lead for the UK arm of an international programme in shared decision making, “Choosing Wisely”, which is led by the Academy of Medical Royal Colleges, Shared Decision Making Lead at the Centre for Perioperative Care and sits on the Choosing Wisely International Roundtable.

This talk aims to answer four major questions: How much fluid should you give perioperatively? Does hypotension matter? Should you use advanced hemodynamic monitoring, and do colloids have any advances over crystalloids? Using high quality studies and a data based approach in all four categories, a lot of which has come from conversations that have had happened at Evidence Based Perioperative Medicine (EBPOM) meetings, this talk draws some interesting conclusions. The American Society of Enhanced Recovery (ASER) is here: https://www.aserhq.org/web/ The Perioperative Quality Initiative (POQI) is here: https://thepoqi.org/ Presented by Tim Miller, Associate Professor of Anesthesiology from Duke University Medical Centre.

"As Anaesthetists the ultimate goal of almost all of our interventions and monitoring is to support cell energy production to provide mitochondria with the oxygen and the fuel they need to produce enough adenosine triphosphate (ATP) to power cell function and integrity". How human cells produce energy, how this changes in response to stress and how this may influence survival; this piece focuses what we know about how our bodies get the fuel they need to survive surgery and thrive as a result, providing a positive long term outcome. This is not a piece about nutrition, it's a provocative session exploring concepts designed to provide food for thought. Presented by Helen McKenna, is in the final year of her PhD at University College London, investigating bioenergetic and redox function in critically ill patients.

This is a story that starts with some of the challenges faced in our world outside the operating theatre and it's about how we might address some of these problems systematically. Healthcare organizations have to deliver high quality, competitive and sustainable results and costs. Good quality perioperative surgery is absolutely critical to maintain the health and well being of our population going forwards; this talk is a step in that direction. Presented by Guy Ludbrook Professor of Anaesthesia at the University of Adelaide and Royal Adelaide Hospital.

"I cannot sleep. It's like, I wake up at 1am and my mind's going crazy ... if you had someone come to you and say; 'I'm really struggling right now, I'm having a lot of anxiety, with work with family, with kids with whatever'; what are some of the top things that you want to share with them?" How can a regular yoga practice bring you into a deeper union with what you do and help improve your performance? Why is it that people in the caring profession sometimes leave self care at the bottom of their priority list? What resources can professional bodies offer you? With special thanks to the American Association of Nurse Anesthetists (AANA) for their help with this piece, their excellent website is here: www.aana.com/covidwellness The help number mentioned is: 1-800 654 5167 The Breathing App is here: https://eddiestern.com/the-breathing-app/ The book "Why we sleep" is here: https://www.amazon.co.uk/Why-We-Sleep-Science-Dreams/dp/0141983760 "Insight Timer" is here: https://insighttimer.com/ Presented by Desiree Chappell with her guests Bridget Petrillo, CRNA at The Mayo Clinic in Phoenix Arizona, volunteer member for the AANA Peer Assistance Advisors Committee, State Peer Advisor for the Arizona Association of Nurse Anesthetists (AZANA), member of the Wellness Committee for AZANA and Jessica Switzman, CRNA, MSN, Johns Hopkins, also served on the AANA Wellness Committee and AANA Peer Advisors Committee, State Peer Advisor for MANA and has been teaching Yoga since 2007.

"I think you're now famous in the CRNA community for being one of the first people in Fargo to receive the the COVID vaccine" This piece sees us catching up with Certified Registered Nurse Anesthetists (CRNA's) who have just been vaccinated for COVID-19. Their story reminds us that even now some practitioners are facing their first real wave of the pandemic in their area: "We had a kind of trickle in, so to say, of COVID patients, and then this in this fall, the middle of November was really when it hit us pretty hard". Presented by Desiree Chappell with Jordan Rohrich CRNA, Anesthesiology, Fargo, North Dakota and Jordi Idso MS, CRNA, Sanford Health in Fargo.

"Perioperative medicine ... I always think of a Venn diagram where there's truly an intersection between surgery anesthesia and medicine, and perhaps even a subset of medicine called geriatrics, that really create this convergence of what we're now creating as a novel science ... Perioperative medicine, I would say is a new clinical science that really incorporates all that" This piece is a fascinating debate, it follows on from Part 1 of the same name; the panel discuss ways forward for perioperative medicine and the new opportunities being presented by a recent focus on both population health and the wider needs of a national healthcare system. Presented by Desiree Chappell and Sol Aronson with panelists; Angela Bader, Harvard Medical School and Vice Chair of Perioperative Medicine at Mass General Brigham, BobbieJean Sweitzer, Professor of Anesthesiology and Director of Perioperative Medicine at Northwestern University in Chicago, Illinois, Rob Shakar, Medical Director of a 32-physician group in Wilmington, NC he oversees the Perioperative Surgical Home Project for New Hanover Regional Medical Center, Thomas Vetter, Director of Perioperative Care and Director of Comprehensive Pain Management and Professor of Surgery and Perioperative Care and Professor of Population Health, at the Dell Medical School at The University of Texas, Austin.

This piece is essential listening for any medical practitioner. The pathophysiology of COVID 19 is now being understood, although there are still a number of outstanding questions. This piece attempts to answer those questions; where does it come from, what do we know about it now, what would we like to know about it in the future? Why is the disease more pronounced in men, how come obesity seems to be a factor, what's the mechanism which leaves children less at risk than adults and senior citizens? This piece is a standout part of Evidence Based Perioperative Medicine's (EBPOM) Dingle 2020 conference. For more of the latest up to date information go now to www.ebpom.org Presented by Hugh Montgomery, Professor of Cardiovascular Genetics and Critical Care University College London.

This piece is divided into two parts, the first being discussion between the panelists and the second, part 2, being questions from the online audience: What is your opinion about spinals and hip fractures for patients on clopidogrel? Do you use any near patient tests to confirm residual anticoagulation? Where are the best guidelines to be found? We suggest you listen to this piece alongside part 1. Presented by Sol Aronson, tenured Professor at Duke University, with his guests; Angela Bader, Harvard Medical School and Vice Chair of Perioperative Medicine at Mass General Brigham, BobbieJean Sweitzer, Professor of Anesthesiology and Director of Perioperative Medicine at Northwestern University in Chicago, Illinois and Jeanna Blitz, Associate Professor of Anesthesiology, Director of the Preoperative Anesthesia and Surgery Screening Clinic, Director of Perioperative Medicine Fellowship at Duke University School of Medicine, Durham, North Carolina.

The conversation begins with "a day in the life" with respect to managing the anti coagulation questions that come up commonly. The contributors swap stories from their time in practice. The conversation moves to protocols, guidelines and also, when where and how to begin bridging. This piece is divided into two parts, the first being discussion between the panelists and the second, part 2, being questions from the online audience. Presented by Sol Aronson, tenured Professor at Duke University, with his guests; Angela Bader, Harvard Medical School and Vice Chair of Perioperative Medicine at Mass General Brigham, BobbieJean Sweitzer, Professor of Anesthesiology and Director of Perioperative Medicine at Northwestern University in Chicago, Illinois and Jeanna Blitz, Associate Professor of Anesthesiology, Director of the Preoperative Anesthesia and Surgery Screening Clinic, Director of Perioperative Medicine Fellowship at Duke University School of Medicine, Durham, North Carolina.

How can enhanced recovery after surgery (ERAS) be applied to cardiac and what exciting opportunities are there for those who have made this their mission? This detail driven address contains more information on The Society for Enhanced Recovery After Cardiac Surgery (ERAS® Cardiac), more information can be found on their website: https://www.erascardiac.org/ Since this address was given at Evidence Based Perioperative Medicine (EBPOM) Chicago's 2020 meeting TopMedTalk has been proud to bring you coverage of ERAS® Cardiac's online meeting. For more on that start here: https://www.topmedtalk.com/the-eras-cardiac-society-conference-topmedtalk/ Presented by Daniel Engleman, 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 looks at some of the latest research from a perioperative perspective regarding an essential question, when and how is surgery possible after a COVID-19 infection? How do we balance that ideal with the other pressures coming to bare on patients, practitioners and public health as a whole? The paper "Timing of surgery following SARS‐CoV‐2 infection: an international prospective cohort study" is here: https://doi.org/10.1111/anae.15458 Presented by Desiree Chappell with Monty Mythen, Smiths Medical Professor of Anaesthesia and Critical Care at University College London, Sol Aronson, tenured Professor at Duke University and Mike Grocott, Professor of Anaesthesia and critical care at the University of Southampton. This piece is the first of in a series of two, supported by Deltex Medical, for more information on their work please go here: www.deltexmedical.com

This piece focuses on iDelirium; The International Federation of Delirium Societies on world delirium day. As well as considering this difficult condition the conversation asks what the latest research shows us and how things could improve both for patients and practitioners. For more detail check out their website here: http://www.idelirium.org/ Presented by Desiree Chappell and Monty Mythen with their guests Heidi L. Lindroth, Senior Associate Consultant Nurse Scientist, Nursing Research Division Critical Care Nurse, Gideon Caplan, Director, Geriatric Medicine, Prince of Wales Hospital, Alasdair Macclullich, Professor of Geriatric Medicine, Honorary Consultant in Geriatric Medicine, Edinburgh, Delirium Research Group, Rakesh C. Arora, Co-Founder of IDelirium, Professor and Head of Cardiac Surgery and Cardiac Critical Care at Max Rady College of Medicine - University of Manitoba, Canada.

"You have to take the viewpoint that if the Nurses and the Physical Therapists and the Pharmacists are resisting the idea that you're putting forward, then there's probably something wrong with it, it doesn't work for them, for some reason, and you got to find out what that is..." This long form conversation is a highlight for TopMedTalk's coverage of The Society for Enhanced Recovery After Cardiac Surgery (ERAS® Cardiac) conference. The conversation covers a wide range of interesting areas, including; the nature of leadership in medicine, the global nature of many of the questions we face, how the internet is changing what we do, what the phrase "better never stops" means, how to take and use feedback and why the patient has to be at the heart of what we do, the importance of "the growth mindset". Also, discover how one of our guests has learned from his experience becoming a Lieutenant Colonel, US Army Reserves; what can a military mindset tell us about the task we face as advocates of perioperative medicine? We wrap with a conversation about blood transfusion reduction. This exclusive chat is only possible thanks to the support of the society, their excellent website is here: https://erasvirtual2021.com/ Presented by Desiree Chappell with her guests Kevin Lobdell, Professor and the Director of Regional Cardiovascular and Thoracic Quality, Education, and Research for Carolinas HealthCare System, Charlotte, NC, USA, as well as the Clinical Professor at the University of North Carolina-Chapel Hill, Chapel Hill, NC, USA and Rawn Salenger, Chief of Cardiac Surgery at University of Maryland St. Joseph Medical Center, Assistant Professor of Surgery at the University of Maryland School of Medicine.

"Critical Care has a moment in time, a moment where we can make some big changes, a moment of opportunity" This uncompromising and informative talk from the technical lead for critical care in the Getting It Right First Time (GIRFT) project takes us through how services can improve and work alongside perioperative care to improve standards and outcomes for patients. Sharing best practice between trusts GIRFT identifies changes that help improve and change an institution’s procedures and cost savings, this is a vital talk and one of the highlights of the hugely successful EBPOM London 2020 virtual conference. For more details on up coming events from Evidence Based Perioperative Medicine EBPOM at www.ebpom.org The GIRFT website is here – https://gettingitrightfirsttime.co.uk/ Further listening regarding GIRFT can be found here: https://www.topmedtalk.com/rcoa-13-the-girft-getting-it-right-first-time-project/ Presented by Anna Batchelor, MB ChB, FRCA, FFICM, Consultant Anaesthetist - Intensive Care Medicine, Newcastle upon Tyne. She is the technical lead for critical care in the 'Getting It Right First Time' (GIRFT) programme.

From a UK perspective this piece covers variation in access to critical care, behaviors and decisions regarding its use. With reference to how, over the last 20 years, efforts have been made in Torbay to improve access to critical care we look at what can be done and what works. Finally there's a summary of where we are on this issue today. Getting it right first time (GIRFT) is here: https://www.gettingitrightfirsttime.co.uk/ Presented by Mike Swart, Consultant in Anaesthesia and Critical Care Medicine at Torbay Hospital and advisor to the UK Department of Health for the Enhanced Recovery Programme.

This piece provides an update on the Perioperative Exercise, Testing and Training Society (POETTS); "established back in 2017, in the context, in the United Kingdom, of cardiopulmonary exercise testing becoming much more common in the preoperative period". Now, more than half of acute hospital trusts in the United Kingdom have a cardiopulmonary exercise testing service to evaluate their patient's functional capacity prior to surgery. Furthermore exercise interventions to optimise a patient's fitness before surgery have seen a sudden and growing interest. With just over 400 members POETTS exists to help standardize education and training in the field, develop consensus clinical guidelines, look after patients around the time of surgery and help club together acute hospital trusts across the UK, so that they can do collaborative research. Their website is here: https://www.poetts.co.uk/ Presented by Denny Levett, Professor of Perioperative Medicine at the University of Southampton and President of the Perioperative Exercise, Testing and Training Society (POETTS).

This piece gives you the evidence base required to deliver an even higher standard of perioperative medicine where you work. Hear about the "Fit 4 surgery" studies; the "fit 4 surgery consortium", the ongoing e-studies, key findings, recent studies and the set up in Southampton. Physical fitness is greatly affected by chemotherapy; poor outcomes are significantly linked to physical fitness; learn how preoperative cardio-pulmonary exercise testing and training can monitor and track this potentially dangerous spiral. Hear how multiple studies are now providing a clear evidence base for this exciting area of perioperative care. Could more such targeted interventions, alongside shared decision making, provide a real difference to outcomes for your patients and a higher standard of value based care in your institution? For more on this go here: http://wesfit.org.uk/ Read more about the great work being done by MacMillan Cancer Trust here: https://www.macmillan.org.uk/ The video version of this presentation, along with slides, was presented to the many thousands of people who attended the hugely successful Evidence Based Perioperative Medicine (EBPOM) virtual conference, "Live from London". For more details on this and future conferences please visit www.ebpom.org Presented by Professor Sandy Jack, PhD, Consultant Clinician Scientist in The Anaesthesia and Critical Care Research Unit at University Hospital Southampton NHS Foundation Trust, Honorary Senior Lecturer at the University of Liverpool, University of Southampton and University College London.

"The goal of ERAS® Cardiac is when you leave one of our meetings, you're going to be chock full of tips and tricks that you can take back and implement, if not the next day, then in the next week or next month." TopMedTalk's coverage of The Society for Enhanced Recovery After Cardiac Surgery (ERAS® Cardiac) conference continues with a conversation that covers the nuggets and insights that a conference such as this delivers. This exclusive chat is only possible thanks to the support of the society who's excellent website is here: https://erasvirtual2021.com/ "I think that also your [TopMedTalk] platform is going to be key. We need to have more of these podcasts. We need short little vignettes, eight to 15 minutes that people can listen to in the car on the way home where they learn and thought leaders having interactive discussions and get ideas. And that's the future really of education" Presented by Desiree Chappell with her guests, Seenu Reddy, Cardiothoracic Surgeon at HCA‘s TriStar Cardiovascular Surgery in Nashville, National Physician Director for HCA Healthcare's CV Service line and Daniel Engelman, Cardiac Surgeon, Medical Director of the Heart, Vascular and Critical Care Units at Baystate Medical Center, Associate Professor of Surgery at The University of Massachusetts - Baystate, Associate Professor-Adjunct at Tufts University School of Medicine and President of the ERAS Cardiac international Society.

"You didn't have to think about it, the compliance continued, because it was so standardized. We had a well oiled machine that just kept on working through COVID". The Society for Enhanced Recovery After Cardiac Surgery (ERAS® Cardiac)'s conference has gotten off to a great start; this exclusive chat gets into some of the stand out moments so far; nutrition, data collection, the essentials of ERAS and the importance of standardization. For more information on the conference check out https://www.erascardiac.org/ We mention Dan Engelman in this piece, he features in this popular conversation from the TopMedTalk archives here: https://www.topmedtalk.com/sunday-special-preoperative-optimization-framing-up-the-value-proposition/ Paul Wischmeyer gets mentioned on this piece as a "fan favourite", he features frequently. If you've not yet heard him start with this podcast - one of our most popular so far - here: https://www.topmedtalk.com/topmedtalks-to-dr-paul-wischmeyer/ Presented by Desiree Chappell with her guests Gina McConnell, ERAS Coordinator for all WakeMed health systems and Cheryl Crisafi, Cardiac Surgery Care Coordinator Nurse at Baystate Medical Center in Springfield, MA.

"In the elective surgical domain 20% of people who are scheduled to have surgery are not ready for surgery" The road towards economic reality is paved with data; this talk, confidently assertive in tone, provides you with a number of useful facts and reassurances which can be transformed into reasons why you and your patients can enjoy the benefits of prehabilitation; a better value of care and a higher standard of good quality outcomes. This piece works well in tandem with this debate here: https://www.topmedtalk.com/ebpom-london-2020-the-business-case-for-prehabilitation/ Presented by Sol Aronson, tenured Professor, Duke University, Durham, North Carolina.

"There is some great literature out there that has been shared ... great data, especially in cardiac surgery, which is where we are using it and I would like to expand it out to other service lines as well..." Methadone has had something of a resurgence recently, thanks in part to the work of some of our contributors in this piece. Could it be that this "opioid sparing opioid" could be a way to actually help fight the crisis we can see in US hospitals and beyond? This piece gets into the detail, how and where and why is it used? Presented by Sol Aronson with questions from the online audience for his panelists; Glenn Murphy, Jeffery S. Vender Chair of Anesthesiology Research and Education and Director of Cardiac Anesthesia and Clinical Research at NorthShore University HealthSystem, a hospital affiliated with the University of Chicago Pritzker School of Medicine, Evan Kharasch, Professor and Vice Chair for Innovation in the Department of Anesthesiology at Duke University, and Director of Academic Entrepreneurship in Duke University School of Medicine and Vicki Morton Director of Clinical and Quality Outcomes at Providence Anesthesiology Associates, P.A. We suggest listening to this piece alongside this excellent talk: https://www.topmedtalk.com/ebpom-chicago-methadone-use-in-perioperative-medicine/ For more details on Evidence Based Perioperative Medicine go now to www.ebpom.org

This piece, part 2 of 2, is a series of questions related to part 1; "Monitoring and management of neuromuscular blockade | EBPOM Chicago". This piece gets into the detail regarding one of the stand out moments of EBPOM Chicago 2020; questions from the online audience facilitate the discussion. Given the fact that our methods of monitoring residual neuromuscular blockade are often inadequate do you transport and do you recommend routine transport to patients from the operating room to the post-anesthesia care unit? Sugammadex is a unique drug that does exactly what we want it to do; why are alternatives still used and available? Some wearables have accelerometer hardware, are you aware of, or do you know if anyone is studying, firm software solutions, marshaling this ubiquitous hardware? Don't forget, for more details on Evidence Based Perioperative Medicine EBPOM conferences go now to www.ebpom.org Presented by Sol Aronson, tenured Professor at Duke University, Glenn Murphy, Jeffery S. Vender Chair of Anesthesiology Research and Education and Director of Cardiac Anesthesia and Clinical Research at NorthShore University HealthSystem, a hospital affiliated with the University of Chicago Pritzker School of Medicine.

This piece is an informative conversation about "the Perioperative Care Team"; who is essential to the team and how do we make sure everyone feels included? What elements do you need to make up such a team, how do you keep people energized and excited about it over the long term? How do we ensure, in this context, that a fee for service system interlocks with the needs of both the institution and its patients? Furthermore, how does such a team increase our commitment to value based care and good quality long term outcomes? Also, an exciting commitment is made toward a journal club, stick with TopMedTalk for more details. Presented by Vicki Morton with panelists Dennie Levett, Professor in Perioperative Medicine and Critical Care at Southampton University Hospital NHS Foundation trust and Honorary Associate Professor at the University of Southampton, Kay Mitchell, Senior Research Manager for Critical Care Research, NIHR Biomedical Research Center, University Hospital, Southampton, UK and Gina McConnell, ERAS Coordinator for all WakeMed health systems.

Part 2 of this conversation continues the momentum of Part 1 with a conversation about electronic medical records (EMR), how important data is to the process, the need for those who collect it to understand it and then, more broadly, the importance of putting the patient at the heart of what you do. Presented by Desiree Chappell with Vicki Morton, Director of Clinical and Quality Outcomes at Providence Anesthesiology Associates, P.A, Cheryl Crisafi, Cardiac Surgery Care Coordinator Nurse at Baystate Medical Center in Springfield, MA and Gina McConnell, ERAS Coordinator for all WakeMed health systems.

This piece is a two part conversation about the essence of what many of TopMedTalk's listeners do; Enhanced Recovery. A fascinating conversation between a number of experts in the field the conversation presented here was part of the hugely popular EBPOM Chicago 2020 meeting. For more on Evidence Based Perioperative Medicine (EBPOM) go to www.ebpom.org This first part of the conversation covers what the main elements of an Enhanced Recovery After Surgery program entail, what literature our contributors favor and what service lines include enhanced recovery at their practice. Presented by Desiree Chappell with Vicki Morton, Director of Clinical and Quality Outcomes at Providence Anesthesiology Associates, P.A, Cheryl Crisafi, Cardiac Surgery Care Coordinator Nurse at Baystate Medical Center in Springfield, MA and Gina McConnell, ERAS Coordinator for all WakeMed health systems.

What are the aims of The International Prehabilitation Society? Its vision is about "bringing together international multidisciplinary expertise, across healthcare and beyond, creating a platform of shared learning, research and education for the benefit of patients". This piece updates you on the current board members, the roles of committee members, conferences that the society has previously supported alongside those being planned for the future. Also there's an update on some exciting new sponsorship news and a brief overview of future plans. The society's website is here: https://prehabsociety.com/ Presented by Gerard Danjoux, consultant in Anaesthesia and Sleep Medicine at South Tees Hospitals NHS Trust.

"The people of Wales are particularly unfit", there is a high incidence of smoking, physical inactivity, and alcohol intake. Grim news from one angle but on the other hand it's a huge opportunity to make a massive difference in the prehabilitation stage of the perioperative process. Hear how cancer outcomes are being dramatically improved as a clear pathway of optimisation is rolled out. Presented by Rachael Barlow, National Lead, Enhanced Recovery, Prehabilitation and Optimisation, at Cardiff and Vale health board, Wales.

This piece focuses on the great work done by The Anesthesia Patient Safety Foundation. We turn to their specific focus on COVID 19 and then look at the wider benefits of a network dedicated to patient safety in our field. Their section on COVID 19 is here: https://www.apsf.org/news-updates/perioperative-considerations-for-the-2019-novel-coronavirus-covid-19/ Furthermore there is a remarkably prescient article by Mike Grocott and Monty Mythen on there in which we discuss, Perioperative Fluid Management: Cheers to the Dream of Moderation: https://www.apsf.org/article/perioperative-fluid-management-cheers-to-the-dream-of-moderation/ Presented by Desiree Chappell and Monty Mythen with their guest Steven Greenberg, MD, FCCP, FCCM, Editor-in-Chief, Anesthesia Patient Safety Foundation (APSF) Newsletter, Vice Chairperson, Education, Department of Anesthesiology, Director of Critical Care Services, Evanston Hospital NorthShore University HealthSystem, Clinical Professor, Department of Anesthesiology Critical Care, University of Chicago, Pritzker School of Medicine.

"Accelerated surgery is not a panacea" This piece, presented in two parts, is a discussion about enabling enhanced recovery. Originally part of EBPOM London this is an 'as live' discussion with four of the main presenters from the conference. Get more detail on nutrition, hip fractures, psychological optimisation and discover both where the difficulties are and what opportunities they provide. For more of this sort of content go now to www.ebpom.org to find out more about how you can be part of Evidence Based Perioperative Medicine. Presented by Professor Denny Levett and Jugdeep Dhesi with their guests P.J. Devereaux, cardiologist, clinical epidemiologist, and perioperative care physician, Professor in the Departments of Health Research Methods, Evidence, and Impact (HEI) and Medicine, Director of the Division of Perioperative Care, McMaster University, Associate Deputy Director of the Population Health Research Institute, President of the Society of Perioperative Research and Care, 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, Dr Paul Wischmeyer, Professor of Anaesthesiology and Surgery at Duke Anesthesiology.

"Accelerated surgery is not a panacea" This piece, presented in two parts, is a discussion about enabling enhanced recovery. Originally part of EBPOM London this is an 'as live' discussion with four of the main presenters from the conference. Get more detail on nutrition, hip fractures, psychological optimisation and discover both where the difficulties are and what opportunities they provide. For more of this sort of content go now to www.ebpom.org to find out more about how you can be part of Evidence Based Perioperative Medicine. Presented by Professor Denny Levett and Jugdeep Dhesi with their guests P.J. Devereaux, cardiologist, clinical epidemiologist, and perioperative care physician, Professor in the Departments of Health Research Methods, Evidence, and Impact (HEI) and Medicine, Director of the Division of Perioperative Care, McMaster University, Associate Deputy Director of the Population Health Research Institute, President of the Society of Perioperative Research and Care, 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, Dr Paul Wischmeyer, Professor of Anaesthesiology and Surgery at Duke Anesthesiology.

This piece is an informative conversation about the models of prehabilitation from a number of different angles. Questions come in from an online audience as our panelists tackle the topic from their respective areas. What are the risks and how are they mitigated? Where does your funding come from and why? How safe is iron for cancer patients? The link to Safe Fit self referal is here: https://www.macmillan.org.uk/cancer-information-and-support/get-help/physical-help/safefit%20#refer_yourself_to_this_service 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 and Gerard Danjoux, consultant in Anaesthesia and Sleep Medicine at South Tees Hospitals NHS Foundation Trust with their guests John Moore, Clinical Director for Intensive Care at Manchester Royal Infirmary and Medical Lead for Enhanced Recovery After Surgery, Professor Sandy Jack, PhD, Consultant Clinician Scientist in The Anaesthesia and Critical Care Research Unit at University Hospital Southampton NHS Foundation Trust, Honorary Senior Lecturer at the University of Liverpool, University of Southampton and University College London and Rachel Barlow, National Lead, Enhanced Recovery, Prehabilitation and Optimisation, at Cardiff and Vale health board, Wales.

"I hope to impress upon you that this is a topic that we can and must do better at ... no malnourished patient should ever have elective surgery without having a nutrition assessment done" This piece is presented in two parts; this is part 2. Using perioperative nutrition to optimize our patients outcomes; data shows us that nutrition therapy or nutrition optimization is literally life saving. Anyone who uses evidence as their guide know it has to be part of their practice. Enhanced Recovery After surgery, sometimes called "fast track surgery" is about ensuring we apply the best information we have to the process. This talk focuses on how and why this ties into a sensible attitude towards nutrition and nutritional assessment. This talk pulls no punches and yet is powerfully optimistic in its message. We implore TopMedTalk listeners to share it with colleagues. The entertaining audio clips used in this piece are available, with video and in full here: https://www.youtube.com/watch?v=zHEincgSm1k&t=190s Our speaker kindly shares his email address for further correspondence and questions: paul.wischmeyer@duke.edu Presented by Paul Wischmeyer, Professor of Anaesthesiology and Surgery at Duke Anesthesiology.

"I hope to impress upon you that this is a topic that we can and must do better at ... no malnourished patient should ever have elective surgery without having a nutrition assessment done" This piece is presented in two parts; this is part 1. Using perioperative nutrition to optimize our patients outcomes; data shows us that nutrition therapy or nutrition optimization is literally life saving. Anyone who uses evidence as their guide know it has to be part of their practice. Enhanced Recovery After surgery, sometimes called "fast track surgery" is about ensuring we apply the best information we have to the process. This talk focuses on how and why this ties into a sensible attitude towards nutrition and nutritional assessment. This talk pulls no punches and yet is powerfully optimistic in its message. We implore TopMedTalk listeners to share it with colleagues. The entertaining audio clips used in this piece are available, with video and in full here: https://www.youtube.com/watch?v=zHEincgSm1k&t=190s Our speaker kindly shares his email address for further correspondence and questions: paul.wischmeyer@duke.edu Presented by Paul Wischmeyer, Professor of Anaesthesiology and Surgery at Duke Anesthesiology.

"In the United States approximately 112,000 patients annually are at risk for adverse events associated with discharge from the operating room with residual neuromuscular blockade" This talk highlights the latest thinking on both monitoring and management of neuromuscular blockade. Where does the data lead us to? How big a problem do they suggest poor efficiency in this area is? What are the realities behind postoperative pulmonary complications? How can we reduce the risk of residual block? Presented by Glenn Murphy, Jeffery S. Vender Chair of Anesthesiology Research and Education and Director of Cardiac Anesthesia and Clinical Research at NorthShore University HealthSystem, a hospital affiliated with the University of Chicago Pritzker School of Medicine.

"If you want to take population based data, and define hypotension, you'll be right for the majority of our average patients, but not for all patients and it appears that the amount of time we spend below the lower limit of autoregulation has meaning for patient outcomes" Starting from the origins of blood pressure monitoring, via the father of neurosurgery endocrinology, Harvey Cushing, through to the current debate as to what exactly constitutes hypotension this piece is an important part of a longstanding discussion here on TopMedTalk. How and why does hypotension occur and what is the correct evidence based strategy now the data are mounting as regards potential patient harm and unsatisfactory outcomes? Presented by Charles Hogue, Professor and Chair of Anesthesiology at Northwestern University in Chicago.

"Perhaps assessing functional performance is something that we've overlooked in medicine" This piece is about the role of functional assessment and status in perioperative medicine. The Duke Activity Status Index (DASI) can be found here: https://www.mdcalc.com/duke-activity-status-index-dasi The Mini Cog assessment is here: http://mini-cog.com/wp-content/uploads/2015/12/Mini-Cog-Form-010816.pdf The video resources mentioned in the piece are here: https://www.youtube.com/channel/UCvOamR8Sb4RXENr56fvRehA/featured Presented by Daniel Conway, Consultant in Anaesthesia and Critical Care, Group Lead for Perioperative Medicine, Manchester Royal Infirmary, UK and Chair of the Manchester Perioperative Medicine Society.

This piece digs deep into the realities of coping with COVID 19 patients who have had their care escalated to the Intensive Care Unit (ICU); "we don't seem to be looking at our typical sepsis patients who get multiple organ failure in the classical way" and "you're surprised at how young some of the patients are...". Our guest provides us further insight; a 'household name' in the haemodynamic monitoring space; he is treating patients in a medium sized hospital (500 beds) with mostly COVID patients in Spain. How are things going there, how does it compare to Italy? How are the patients being dealt with, what can we learn about the basics here, airway, breathing, ventilation (ABC)? There is also a gripping discussion regarding dynamic arterial elastance. If you'd like to know more about that do check out our discussion here: https://www.topmedtalk.com/periop-coach-2-09-haemodynamic-monitoring/ The webinar mentioned in this piece can be found here: https://www.esicm.org/education/webinars/ Presented by Desiree Chappell and Monty Mythen with their guest Dr. Manuel Ignacio Monge García who works in an ICU in the South of Spain.

This piece gives us a look at some of the latest thinking on Post Operative Nausea and Vomiting (PONV). It includes a discussion about Amisulpride and discusses new, yet to be published, consensus guidelines for PONV. The original guidelines are here: https://www.ncbi.nlm.nih.gov/pubmed/24356162 Also, you may like to check out the details of this paper here: Amisulpride: A New Dopamine Antagonist for Treatment of Postoperative Nausea and Vomiting https://www.ncbi.nlm.nih.gov/pubmed/31094771 Presented by Desiree Chappell and Monty Mythen with their guest Tong Joo (TJ) Gan, Professor and Chairman at Stoney Brook in New York. --- Like this, want more? Check out TJ Gan's masterful presentation "EBPOM USA Part 5| Practical realities; How and why multimodal Analgesia matters" here: https://www.topmedtalk.com/ebpom-usa-part-5-a-perioperative-practicum-with-tj-gan/

"Some practical tips you can take away and implement in your hospital..." In the UK there is a legal imperative to minimalise and individualise risk now but it's widely understood to be helpful if you want to provide better value and patient outcomes. How can risks be identified and minimised? How can these risks then help to provide better quality shared decision making? How can plan a perioperative pathway tailored to these needs? Presented by Ramani Moonsinghe, Professor of Perioperative Medicine at University College London (UCL). IMPORTANT NOTE: We discuss "The Montgomery Case" in more detail here; this piece is very relevant to you and your patients, legally speaking, if you work in the UK: https://www.topmedtalk.com/sunday-special-being-on-the-right-side-of-the-law-2

"I did a study back in 2002 where I was able to count a grand total of forty patients above the age of eighty in our (Intensive Care Unit) ICU and our (High Dependency Unit) HDU, nowadays I'd count close enough to a hundred and sixty" How do we refine our diagnostic tools? How can teaching in this area help to save lives? Should you consider a 'geriatric intensive care unit'? Is this an area where true perioperative practice and surgery is a guarantee we can immediately see improvement in an institution? Presented by Dr Brian Marsh, Anaesthesia, Critical Care Medicine, Extracorporeal Life Support, The Mater Hospital, Dublin.

This piece gets deep into a much needed discussion regarding frailty, delirium, post-operative cognitive dysfunction and brain health. Noted as one of the highlights of the year in our recent holiday specials and previously only available to attendees to the incredibly successful EBPOM Chicago 2020; go to www.ebpom.org now for more details on forthcoming events and special offers now. This piece is part two of two. This piece gets a mention "End of life decision planning in the perioperative setting: the elephant in the room?" https://academic.oup.com/bja/article/115/5/648/230412?login=true The Global Council on Brain Health is here on the American Association of Retired People's website: https://www.aarp.org/health/brain-health/global-council-on-brain-health/ This is part one of a two part piece, part two features questions from the online conference audience. Presented by Monty Mythen with Angela Bader, Professor of Anesthesia at Harvard Medical School and Vice Chair for Perioperative Medicine in the Department of Anesthesiology, Perioperative and Pain Medicine at Brigham and Women’s Hospital, founding Director of the Weiner Center for Preoperative Evaluation, Sarah Lenz Lock, Senior Vice President for Policy and Brain Health in the American Association of Retired People's (AARP) Policy, Research and International Affairs (PRI), Executive Director of the Global Council on Brain Health, Jeanna Blitz associate professor of Anesthesiology at Duke University School of Medicine, Director of the Preoperative Anesthesia Surgical Screening (PASS) Clinic. There's also a surprise appearance from the EBPOM Chicago 2020 host, Sol Aronson, tenured Professor at Duke University.

This piece gets deep into a much needed discussion regarding frailty, delirium, post-operative cognitive dysfunction and brain health. Noted as one of the highlights of the year in our recent holiday specials and previously only available to attendees to the incredibly successful EBPOM Chicago 2020; go to www.ebpom.org now for more details on forthcoming events and special offers. This piece gets a mention "End of life decision planning in the perioperative setting: the elephant in the room?" https://academic.oup.com/bja/article/115/5/648/230412?login=true The Global Council on Brain Health is here on the American Association of Retired People's website: https://www.aarp.org/health/brain-health/global-council-on-brain-health/ This is part one of a two part piece, part two features questions from the online conference audience. Presented by Monty Mythen with Angela Bader, Professor of Anesthesia at Harvard Medical School and Vice Chair for Perioperative Medicine in the Department of Anesthesiology, Perioperative and Pain Medicine at Brigham and Women’s Hospital, founding Director of the Weiner Center for Preoperative Evaluation, Sarah Lenz Lock, Senior Vice President for Policy and Brain Health in the American Association of Retired People's (AARP) Policy, Research and International Affairs (PRI), Executive Director of the Global Council on Brain Health, Jeanna Blitz associate professor of Anesthesiology at Duke University School of Medicine, Director of the Preoperative Anesthesia Surgical Screening (PASS) Clinic. There's also a surprise appearance from the EBPOM Chicago 2020 host, Sol Aronson, tenured Professor at Duke University.

"It might just be 'boring old blood pressure ... (but) ... every fourth operation there is evidence of a modifiable risk factor". The Perioperative Quality Initiative (POQI) is our starting point for this conversation, seven concensus conferences focusing on various topics of interest to the perioperative practitioner. Check out their extensive open source resources here: www.poqi.org Hypotension and Mean Arterial Pressure (MAP) are discussed in detail; how are patients now being managed? How can a 'hazard index' help? "25% of our patients experience hypotension!"; regular TopMedTalk listeners know this has been frequently highlighted as an issue for patient mortality. Also, 26 minutes in, hear about the recent POQI and Acute Dialysis Quality Initiative (ADQI) meeting of 2019. "There is no such thing as a bit of a creatinine bump that is 'normal'". Presented by Desiree Chappell, Monty Mythen and a surprise appearance from Sol Aronson, with their guest Andrew Shaw, Chairman, Department of Anesthesiology and Pain Medicine at The University of Alberta, Edmonton, Alberta and Zone Clinical Department Head for Anesthesia, Alberta Health Services Edmonton Zone. He is also a Fellow of the Royal College of Anaesthetists (UK), the American College of Critical Care Medicine and the Faculty of Intensive Care Medicine (UK). Like this, want more? Find out more about POQI here: "Desiree's Roundtable | What is the Perioperative Medicine Summit?" https://www.topmedtalk.com/desirees-roundtable-what-is-the-perioperative-medicine-summit/ For more regarding the papers published by POQI, referenced in this piece, go here: "Sunday Special | Blood Pressure" https://www.topmedtalk.com/sunday-special-blood-pressure/ We speak with Dan Sessler here: https://www.topmedtalk.com/topmedtalks-to-dan-sessler-2 Also, if you enjoyed Andrew Shaw's take on these issues go listen to this fascinating conversation: "Desiree's Roundtable | Fluids in the 2020's" https://www.topmedtalk.com/desirees-roundtable-fluids-in-the-2020s/ Finally, Professor Sol Aronson, tenured, Duke University, who features on this podcast, delivered a talk you're bound to love here: "Perioperative Medicine is population health" https://www.topmedtalk.com/poet-6-01-perioperative-medicine-is-population-health/

"We're so invested in outcomes and data that it really gives us an objective view on how to approach things" This wide ranging conversation looks at how a data driven approach to change can produce better results in terms of patient outcomes. How do you highlight those opportunities with tact and clarity? How do we start to reward and recognise the best care that the evidence supports? We also hear more about Evidence Based Perioperative Medicine (EBPOM) in 2021; for more on the opportunities mentioned in this piece please go to www.ebpom.org Also, if you're aligned with the great nation of Wales or you love perioperative medicine, you'll be delighted to hear about the Welsh Perioperative Medicine Society: Their Twitter is here: https://twitter.com/pomswelsh Their Facebook page is here: https://www.facebook.com/PomsWelsh/ And their excellent website is here: https://www.welshpoms.com/ Presented by Desiree Chappell and Monty Mythen with Marc Koch, President and CEO of Somnia Anesthesia and Shelley Sharma, Acute Pain service line Director for Somni Anesthesia.

Warning; this piece may make for uncomfortable listening. It is a fascinating look at the recent history of medicine and how our profession may in fact be sick. Contained within the story is a message of hope; evidence may contain the cure. In our recent history we seem to have enjoyed something of a "Golden Age" of medicine which, by raising quality of life so dramatically, has transformed our understanding of concepts such as "public health" and even "standard of living". However, running alongside that is an industry and society that is primarily interested in business and profit above evidence and health. Has the industry which built up around our profession during the 'Golden Age' now become a parasite which weakens its host to the point of near exhaustion? After a concise critique of the current culture of research this talk asks why we are wasting time on research that is not reliable, not useful and does not impact care. Could it be that market forces have strangely made us less efficient? Evidence based medicine is the way forward but can we overcome the inherent bias behind the fact that often big business funds the evidence gathering and its publication? Some assumed the period of rapid development, which included discovering the DNA helix, successful organ transplant and vaccinations, would soon inevitably be followed by equally epoch transforming breakthroughs, others are less optimistic. Are genomics and big data more often 'science' than medicine? Is "digital health" "simply one part of what has now been called surveillance capitalism"? This challenging but ultimately hopeful and inspirational talk was given at the EBPOM Dingle conference 2019, please share it to as wide an audience of your peers as you can to help make this important and healing conversation happen. Presented by Seamus O'Mahony, Consultant Gastroenterologist at Cork University Hospital, associate editor for medical humanities of the Journal of the Royal College of Physicians of Edinburgh and is a regular contributor to the Dublin Review of Books.

"We wanted to know if goal directed therpy using a (Hypotension Prediction Index) HPI monitor can prevent hypotension". This piece looks in detail at the HPI monitor in practice- what is the benefit of this piece of technology in relation to hypotensive episodes? Furthermore how else is it to be tested and when will these tests be carried out? Presented by Desiree Chappell and Monty Mythen with their guest Marit Habicher, Specialist, Department of Anesthesia and Critical Care at UKGM Giessen.

"We have to remember that patients have a team" How do we involve patients in the increasingly complex conversations we have in the perioperative space? This piece is a detailed case study which shows how shared decision making works in the perioperative setting. We know this improves patient experience yet in the last 10 or so years, consistently only 50 to 60% of patients say they were involved in decision making. How can shifting towards a value based care model help? What is "moral injury" and how do we avoid it? Can a data driven analysis actually show shared decision making reduces costs? Perioperative medicine for older people undergoing surgery (POPS) is an award winning geriatrician led service and the first of its kind in the UK - find out more here: https://www.guysandstthomas.nhs.uk/our-services/ageing-and-health/specialties/pops/overview.aspx The Centre for Perioperative Care is here: https://cpoc.org.uk/ Presented by Ramai Santhirapala, Consultant Anaesthetist and Perioperative Medicine Lead at Guy’s and St Thomas’ NHS Foundation Trust, fellow of the Royal College of Anaesthetists, Faculty of Intensive Care Medicine and Higher Education Academy, Honorary Associate Professor at University College London, Clinical Lead for the UK arm of an international programme in shared decision making, “Choosing Wisely”, which is led by the Academy of Medical Royal Colleges, Shared Decision Making Lead at the Centre for Perioperative Care and sits on the Choosing Wisely International Roundtable.

"In this session, we're going to talk about the importance of fitness, frailty, function and perioperative medicine." Fitness, frailty and function are overlapping concepts. In the UK, about quarter of patients will be over the age of 65 by 2034. As patients age they may develop comorbidities. These factors combine to present a unique opportunity for the perioperative physician; fitness increases the chances of a positive outcome, time to ensure every patient is "fit for surgery". The Making Every Contact Count (MECC) campaign is here: https://www.makingeverycontactcount.co.uk/ 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.

"If I were to develop a simple uncomplicated urinary tract infection, I may well be able to continue to go to work as I was being treated for that illness but if an older frail patient develops a similar uncomplicated urinary tract infection, that can be a very significant illness, that patient may well be unable to walk or transfer as they could" Frailty in the perioperative period - what is it, what is it not and how do we work with and manage it before, during and after an operation so as to increase the value of care to our patients? The opening article refered to in this piece is here: https://journals.sagepub.com/doi/full/10.1177/1756287220916614 The British Geriatrics Society "Fit for Frailty" document is here: https://www.bgs.org.uk/resources/resource-series/fit-for-frailty More information on Perioperative medicine for older people undergoing surgery (POPS), an award winning geriatrician led service and the first of its kind in the UK, go here: https://www.guysandstthomas.nhs.uk/our-services/ageing-and-health/specialties/pops/overview.aspx Presented by Jude Partridge, consultant geriatrician POPS, honorary senior lecturer, King's College London, Chairs the British Geriatrics Society POPS SIG.

TopMedTalk in Collaboration with MacMillan Cancer Support in the UK developed this podcast series to support patients during their cancer journey amidst the COVID 19 crisis. We know food gives us energy "but it also provides so much more". This podcast looks at the raw materials you'll need, when facing a cancer diagnosis, to get a better outcome; the vitamins, minerals and proteins, as well as the energy sources you're best using. What is a balanced diet when you have cancer? "We're talking about eating well to stay well [...] we're not really looking for people to lose weight"; it's often important for people to try to maintain their weight during a cancer diagnosis, should you track your weight throughout your cancer journey? Recorded at the height of the COVID 19 crisis this podcast also reflects upon how this information is applied in the context of a global pandemic. What foods can we store which also contain the vital building blocks of our body's natural defenses? Presented by Nick Margerrison with his guest Clare Shaw, consultant Dietician at The Royal Marsden NHS Foundation Trust. For more information, in the UK, phone: 0808 808 00 00 email: CancerPrehabilitation@macmillan.org.uk Twitter: @macmillancancersupport

TopMedTalk in Collaboration with MacMillan Cancer Support in the UK developed this podcast series to support patients during their cancer journey amidst the COVID 19 crisis. It's vital you remain active after a cancer diagnosis, why is this? Hear the fascinating story behind the discovery that activity not only reduces your overall levels of fatigue but also improves your chances of recuperation. "You have to pace yourself [...] listen to your body"; but any physical activity will help fight feelings of tiredness. In short, if you get active you feel good. Also in this podcast, with direct reference to medical trials and studies, our guests give you the mechanism behind incredibly helpful changes caused by moderate exercise in cancer patients, evidence which has led medics to conclude that "exercise is real medicine". "When we're talking about being active during cancer it's at any stage of the cancer journey: from prehabilitation through recovery". Prehabilitation is the process by which people prepare their bodies for a major obstacle such as an operation or chemotherapy. It's like rehabilitation but it takes place before the event. Just as when you start your recovery after treatment you would expect to get your body back to full health, here you try to achieve the best possible physical health before you start. The key point is that the medicine of exercise can be useful from diagnosis right through to full recovery and beyond. Again, with direct reference to the evidence, find out how incredible research into prehabilitation is changing the way we think about cancer and recovery. Recorded specifically at the height of the COVID 19 crisis hear how this research is being applied in the context of a global pandemic. Group forms of exercise are not an option while social distancing restrictions are in place, can exercising with other people bring us special benefits? If so, can those benefits be matched if we use the internet to continue the social side of going to a gym or a class? Presented by Nick Margerrison with the Professor of Clinical Exercise Science, Anna Campbell, MBE, of Edinburgh Napier University and the director of CAN Rehab and the Professor of Prehabilitation Medicine, Sandy Jack, a consultant clinician scientist from The University of Southampton and University of Southampton NHS Foundation Trust . For more information, in the UK, phone: 0808 808 00 00 email: CancerPrehabilitation@macmillan.org.uk Twitter: @macmillancancersupport

TopMedTalk in Collaboration with MacMillan Cancer Support in the UK developed this podcast series to support patients during their cancer journey amidst the COVID 19 crisis. "It's very normal to sit with some difficult thoughts and feelings" after a cancer diagnosis. Broadly there are two types of mindsets; anxiety, which can be helpful, an element of wanting to 'do something' and, on the other hand, low mood, a feeling of not wanting to do anything, this can be unhelpful if not addressed at a certain level. We should expect both of these mindsets the question is 'how does the latest scientific research show can we control them'? Your body and mind are not separate, one effects the other, this is why it is so important we look at mental health as part of an overall approach. "You can do quite a lot of things [...] that put you into a better mood"; exercise, meditation, even simple breathing exercises. Spending time communicating with friends and family is another suggestion. Recorded at the height of the COVID 19 crisis this podcast also reflects upon how this is applied in the context of a global pandemic; how important is it that people engage with online facilities and opportunities to maintain relationships? "In an odd way the relationships seem to intensify". It's not about ignoring negative feelings though, anxiety and low mood are very common for people with a cancer diagnosis. Hear how it is important to allow yourself to reflect, part of understanding your mental health is about regaining control, we are allowed to let ourselves feel difficult thoughts as part of the process of monitoring and working with them. This podcast also contains a reminder about the importance of goal setting in allowing people to regain control over their lives. Small, realistic and specific, short term goals are useful at this particular stage of life; "start with the thing you are most confident you are able to change [...] make a day and a time that you'll stick to". Presented by Nick Margerrison with his guests Judit Varkonyi-Sepp psychologist, psychology lead for the Wesfit prehabilitation programme and Chloe Grimmett, behavioural scientist and lead for Wesfit prehabilitation. For more information, in the UK, phone: 0808 808 00 00 email: CancerPrehabilitation@macmillan.org.uk Twitter: @macmillancancersupport

"Accelerated surgery for hip fracture is safe and feasable, with troponin elevation before randomization, there was a mortality advantage with accelerated surgery. The logistics and resources required for accelerated surgery need to be balanced with the demonstrated benefits and patient's desires for accelerated surgery" This exciting piece from EBPOM 2020 provides a data download that further illucidates the perennial debate surrounding hip fractures and their management and treatment. What is the correct perioperative approach to this nasty injury? For more on the Hip Attack Trial go here: https://clinicaltrials.gov/ct2/show/NCT02027896 Presented by P.J. Devereaux, cardiologist, clinical epidemiologist, and perioperative care physician, Professor in the Departments of Health Research Methods, Evidence, and Impact (HEI) and Medicine, Director of the Division of Perioperative Care, McMaster University, Associate Deputy Director of the Population Health Research Institute, President of the Society of Perioperative Research and Care.

This is an Edwards Lifesciences Sponsored Lecture which was originally streamed live on TopMedTalk from the hugely successful EBPOM USA 2019 in Dallas. In this piece we hear about the ongoing need for institutions and healthcare professionals to recognise the damaging consequences of intraoperative hypotension. Evidence has been mounting here on TopMedTalk over the last couple of years; there's no doubt hypotension is an area of concern for many of our experts and contributors. Listen to more on this here via our large selection of podcasts on the topic: https://www.topmedtalk.com/?s=hypotension For those who are already across the data the next question is, how do we detect it and prevent it, ideally before it even occurs? Here the HPI monitor comes into play, a cutting edge piece of technology which uses artificial intelligence to analyse the data and make predictions which could save your patient from a problematic outcome. Presented by Dr Simon Davies, Consultant Anaesthetist, York Teaching Hospitals, NHS Foundation Trust.

"Babies are still being born" Still! Revisiting this conversation from early in the pandemic, we discuss obstetrics during COVID. This piece looks at the area of obstetrics in the midst of an unprecedented global crisis regarding the COVID 19 outbreak. How can the delicate balance between reducing infections and social distancing be interwoven with the needs of modern childbirth. Should we be concerned that some patients may shun hospital assisted births for fear of contagion? How has the data from China, much of which focused upon cesarean section births, been useful to us in the West? Why do the data have that angle? Are there benefits to the new ways in which we have found to communicate during this global crisis which can be moved into a new life with COVID present but in a more manageable form? Presented by Desiree Chappell and Monty Mythen with Sam Bampoe, University College London Hospital, Consultant Anesthetist, Director, Trainees with an Interest in Perioperative Medicine (TRIPOM), Nuala Lucas, Consultant Anesthetist at Northwick Park Hospital, Executive Committee Member for the Obstetric Anesthetists’ association and Pat O'Brien, Consultant Obstetrician at University College London Hospital, Vice President of Royal College of Obstetricians and Gynecologists. Thank you to our sponsor Edwards Lifesciences. Edwards clinical education (ECE): https://www.edwards.com/clinicaleducation https://www.edwards.com/clinicaleducation

What are the latest developments in quality improvement programs that help operative teams around the world take what they do to the next level? When does the surgical journey begin? How has a focus upon patients prior to surgery improved outcomes? What are "the five phases of care"? How has data collection and management helped us to continually improve a patient's surgical journey? This piece is a talk which was given during the 8th Australian and New Zealand Symposium of Perioperative Medicine Special Interest Group: “Updates in Perioperative Medicine 360” which took place between November 7th-9th 2019 Presented by Clifford Ko, Professor of Surgery at UCLA, Director of the Division of Research and Optimal Patient Care at the American College of Surgeons.

This piece, originally streamed live on www.topmedtalk.com features a conversation about the implementation of enhanced recovery protocols and the results practitioners report. The discussion starts with the observation that just implementing the ERAS intraoperative protocols drove outstanding outcomes in practice. The wider discussion focuses on the importance of putting into practice a bigger plan. Presented by Desiree Chappell with her guests Raul Castillo, Anesthesia Medical Director at the University of Missouri Hospital, Jennifer Clark, Staff Nurse Anesthetist at the University of Missouri Hospital Department of Anesthesiology, and Kay Smith, pain nurse coordinator University of Missouri Hospital.  

"I'm also a United States Air Force Officer and reservist and on April 4th was activated and given approximately 48hrs to deploy on a C-5 Galaxy Military Aircraft to the epicenter, New York City and I've been here for approximately, it's been almost a month now" This piece follows on from a previous exclusive conversation regarding the US military deployment to New York; here we get more detail and spend time thinking about how Enhanced Recovery must be an essential part of any "new normal". The fascinating Carol Peden piece is here: https://www.topmedtalk.com/covid-19-disruptive-innovation/ And Bobbie Jean Sweitzer is here: https://www.topmedtalk.com/covid-19-promote-your-anemia-clinics-in-the-pandemic-era/ The previous conversation we mention is here: https://www.topmedtalk.com/covid-19-rapid-deployment-of-us-national-reserves-ease-stress-in-new-york Presented by Desiree Chappell with Captain Joel Sherwood United States Air Force Reserves and Medical Science Liaison, National Director, Government Affairs, Pacira Pharmaceuticals.

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.

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, Asmeet 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 Edwards Lifesciences for the generous support of our series "COVID 19 From the Frontlines"

"Obstetric anaesthesia" - originally streamed live from The Institute of Engineering and Technology (IET) in London during EBPOM 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: https://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 Carolyn Johnston, consultant Anaesthetist in St Georges hospital in London and Improvement lead for the National Emergency Laparotomy Network (NELA.org.uk).

"46% pretty much means every other patient who was getting IV opioids was having some sort of a respiratory depression event" After a quick round up of COVID news in the contributor's respective areas this piece gets involved in a much needed discussion about the “PRediction of Opioid-induced Respiratory Depression In Patients Monitored by capnoGraphY (PRODIGY)” trial. PRODIGY trial is here: https://clinicaltrials.gov/ct2/show/NCT02811302 Presented by Desiree Chappell and Monty Mythen with Mike Grocott, and their guests Ashish Khanna, Associate Professor, Section Head for Research, Department of Anesthesiology, Section on Critical Care Medicine, Wake Forest School of Medicine and Roop Kaw, Associate Professor of Medicine at Cleveland Clinic, Founder Member of The Society of Anesthesia and Sleep Medicine. As mentioned TopMedTalk have been eagerly following the development of this research, you might also enjoy this piece we did here: https://www.topmedtalk.com/ebpom-2020-london-prediction-of-opioid-induced-respiratory-depression-on-the-general-care-floor-does-surveillance-monitoring-help/ More discussion regarding risk factors for opioid-induced respiratory depression in surgical patients here: https://www.topmedtalk.com/topmedtalks-to-paul-grant-2/

Armed with a background in biomedical engineering, doubled with an EMBA in Finance, our guest has spent the past 20 years within the medical device industry. In 2010 he was instrumental in setting up MDoloris Medical Systems, with the mission to provide technologies that allow clinicians a reliable, continuous and non-invasive evaluation of autonomic nervous system (ANS) activity. Based on 23 years of academic research, performed by a French research lab, the technology allows anaesthetists and intensivists to effectively tailor analgesia; more so for patients who are unable to communicate. The technology is available for adults, paediatrics, neonates as well as animals (specifically horses, cats and dogs), in both standalone and more recently modular format. Presented by Desiree Chappell and Monty Mythen with their guest Fabian Pagniez, CEO and founder of MDoloris Medical Systems. For more details on EBPOM Las Vegas please visit www.ebpom.org Also, if you enjoyed this piece we cover nociception in more detail here: https://www.topmedtalk.com/topmedtalks-to-dan-longrois-on-nociception/

This piece highlights four papers published in the May 2019 edition of the (British Journal of Anaesthesia) BJA. Find them on www.poqi.org Furthermore, there's an interesting piece about the Perioperative Quality Initiative (POQI) here: https://www.topmedtalk.com/anesthesia-and-analgesia-go-big-on-poqi/ Presented by Desiree Chappell with Monty Mythen and Sol Aronson, tenured professor at Duke University and Executive Vice Chairman in the Department of Anesthesiology.  

"The peak keeps getting pushed..." What's the difference between a strategy of rationing as compared with one where the aim is concordence? As the crisis rumbles on, how do we decide who should have surgery, as well as the pressing question of how and where? The principles of perioperative medicine kick in here, pre-optimisation and enhanced recovery are uniquely suited within the profession to assist in the worldwide battle against this pandemic. What about the need for end of life conversations? How does the process of informed decision making apply here, how also does it apply to providers? How can we protect our essential human resources? Finally, the conversation wraps with an important nod from the healthcare profession to the overwhelming goodwill being expressed around the world to people in medicine who are risking their lives to defeat this virus. Presented by Desiree Chappell and Monty Mythen with their guest Professor of Anesthesia, Angela Bader, Harvard Medical School and Vice Chair of Perioperative Medicine at Mass General Brigham. If you loved Angela Bader's incisive take why not listen to this popular interview we previously featured here on TopMedTalk: https://www.topmedtalk.com/topmedtalks-to-angela-bader/ We also mention TopMedTalk favorite Carol Peden, why not check out her appearance here: https://www.topmedtalk.com/covid-19-disruptive-innovation/ And Bobbie Jean Sweitzer is here: https://www.topmedtalk.com/covid-19-promote-your-anemia-clinics-in-the-pandemic-era/ Thank you to our sponsor’s Edward’s Life Sciences. Edwards clinical education (ECE): https://www.edwards.com/clinicaleducation

This piece gives you clear practical suggestions which you might want to include in your practice and institution. How do we improve the physiological reserve of patients? Is there a way to do enhanced recovery with an extra edge? Specifically, how do we reduce pulmonary complications? What is 'surgery school'? How does 'icough' fit into this? How can practitioners and admin staff help to reduce anxiety as surgery comes closer? Visit the I COUGH UK website here: https://mft.nhs.uk/mri/services/i-cough-uk/ Make sure you check out the surgery school on the ERAS+ website here: https://www.erasplus.co.uk/How/SurgerySchool Presented by Dr Daniel Conway, consultant in anaesthesia and critial care at University Hospitals Manchester.

The opioid crisis "a unique American problem". This piece uncovers the origin of some of the misinformation about opioids, the consequences of calling pain a "fifth vital sign" and the absurd practice of waking patients up in the middle of the night to ask them if they are in any pain. As these factors combined fatalities started to spiral into the crisis we see today. Recent statistics make for grim reading, in 2017 it was estimated over 47,000 Americans died from an opioid overdose. However action is now being taken; learn how The American Association of Nurse Anesthetists (AANA) has pushed forward with a sensible, responsible, pain management strategy which tackles the crisis head on. Opioids are a last resort, many cases do not need them at all and a 30 day prescription to a highly addictive substance is something practitioners should never take lightly. Furthermore ensure patients are well informed, not 'opioid naive' and ideally do not have a family history of opioid dependence. If you enjoyed this piece we have more on the topic here: https://www.topmedtalk.com/periop-coach-3-06-is-pain-the-fifth-vital-sign/ Also, if you've not yet heard Paul Wishmeyer's powerful take on this topic we highly reccomend you go here: https://www.topmedtalk.com/treating-patients-properly-ebpom-usa/ The Center For Disease Control's guidelines, mentioned in this piece, are here: https://www.cdc.gov/drugoverdose/prescribing/guideline.html The PDF our guest mentions "The PAIN MANAGEMENT BEST PRACTICES INTER-AGENCY TASK FORCE REPORT" is here: https://www.hhs.gov/sites/default/files/pain-mgmt-best-practices-draft-final-report-05062019.pdf This piece was part of our coverage of The AANA 2019 Annual Congress in Chicago, Illinois. Check out the AANA here: https://www.aana.com/ Presented by Monty Mythen and Desiree Chappell with their guest, Bruce Schoneboom, PhD, CRNA, FAAN, Associate Dean for Practice, Innovation and Leadership at Johns Hopkins School of Nursing.

"Patients undergo surgery for important reasons, we need to improve surgical outcomes to the point where anyone can have surgery - and I believe that is do-able; we need to implement what we know, we need to avoid missed opportunities and we need to conduct more research. We should learn from the history of anesthesiology and how intraoperative care so dramatically improved outcomes" This powerful data based talk sets a bold standard for the year, a highlight from the momentous (Evidence Based Perioperative Medicine) EBPOM 2020 - Live From London, it featured as this year's Ernest Henry Starling Plenary Lecture, entitled: "Perioperative Care: A new paradigm for the next decade". Introduced by Mike Grocott and presented by P.J. Devereaux, MD, PhD, FRCP(C), McMaster University, cardiologist, clinical epidemiologist, and perioperative care physician. Director of the Division of Perioperative Care at McMaster University he is the Associate Deputy Director of the Population Health Research Institute. He is also the Scientific Leader of the Anesthesiology, Perioperative Medicine, and Surgical Research Group at the Population Health Research Institute. A full Professor in the Departments of Health Research Methods, Evidence, and Impact (HEI) and Medicine at McMaster University. He has published over 330 peer reviewed papers and over 80 book chapters, editorials, and commentaries. He has given over 900 lectures and research presentations in 40 countries. He is supported by the McMaster University/ Hamilton Health Sciences Chair in Perioperative Care and a Tier 1 Canadian Research Chair in Perioperative Medicine. He's also the President of the Society of Perioperative Research and Care.

This piece is a chance to hear more about the work of our guest, who made a big impact as a guest on a recent edition of TopMedTalk: https://www.topmedtalk.com/topmedtalk-computer-gamer-to-life-saver/ The Perioperative Quality Initiative (POQI) is here: www.poqi.org This piece covers cerebral oximetry with near-infrared spectroscopy (NIRS), often used during the perioperative period of cardiovascular operations. Article here: "American Society for Enhanced Recovery and Perioperative Quality Initiative Joint Consensus Statement on the Role of Neuromonitoring in Perioperative Outcomes" https://journals.lww.com/anesthesia-analgesia/Abstract/9000/American_Society_for_Enhanced_Recovery_and.95500.aspx We're celebrating Evidence Based Perioperative Medicine's (EBPOM) Dingle conference which holds a special place in the hearts of TopMedTalk listeners. We've covered it for the last few years in detail, making many hours of valuable educational information accessible to a global audience of thousands of medical professionals each week. If you'd like to find out more about EBPOM's groundbreaking online proposition please checkout www.ebpom.org Presented by Desiree Chappell and Monty Mythen with their guest Robert Thiele, Associate Professor, Departments of Anesthesiology and Biomedical Engineering, Division Chief, Critical Care Anesthesiology, Board of Directors, University Physicians Group, University of Virginia School of Medicine. He has a background in engineering and has been using technology to improve education since his residency in 2008. He is co-founder of www.OpenAnesthesia.org which lead to the development of Self-Study, and also authored one of the first iBooks focused on cardiac and critical care ultrasound.

This piece explores the current thinking on hemodynamics, get ready for a deep dive into the conversation and controversies. Originally streamed live from www.topmedtalk.com as part of our coverage of The EBPOM USA Dallas Master's Course 2019. This panel discussion is chaired by Desiree Chappell, CRNA from Louisville Kentucky and Board Member of ASER. It features Monty Mythen, TopMedTalk Editor In Chief, Smiths Medical Professor of Anaesthesia and Critical Care at University College London, Tim Miller, from Duke University Medical Centre and Dr Simon Davies, Consultant Anaesthetist at York Teaching Hospital NHS Foundation Trust.

This piece ploughs into some of the academic papers that have provoked discussion in the perioperative community. We discuss the following papers: Risk factors for opioid-induced respiratory depression in surgical patients: a systematic review and meta-analyses. https://www.ncbi.nlm.nih.gov/pubmed/30552274 Increased Postoperative Glucose Variability Is Associated with Adverse Outcomes Following Total Joint Arthroplasty. https://www.ncbi.nlm.nih.gov/pubmed/29975266 Effect of A1C and Glucose on Postoperative Mortality in Noncardiac and Cardiac Surgeries. https://www.ncbi.nlm.nih.gov/pubmed/29440113 Frailty as a Predictor of Death or New Disability After Surgery: A Prospective Cohort Study. https://www.ncbi.nlm.nih.gov/pubmed/30048320 Presented by Desiree Chappell and Monty Mythen with their guest Paul Grant, Hospitalist and Director of Perioperative and Consultant Medicine at the University of Michigan.

This piece took a look at the San Diego front line of the global fight against COVID 19 on March the 30th at the start of the crisis. What unique pressures were there; 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? 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.

This piece is a conversation with friends of ours at Medtronic. Now is an interesting and resource-scarce time for everyone in medicine; Medtronic made huge waves here with their support of the Ventilator Training App, today we ask them about where it's at and how things are changing in the world of medical technology. How does product development actually work these days? How important have standards of proof become? Should we celebrate the fact hardware appears to be being pushed toward a similar evidence standard needed to take a new drug to market? How are research and development administered? How can we make a clinical and economic argument that makes sense to everyone? Also, how has the Covid Crisis galvanized the medical industry and shown them that things can be achieved at speed in our profession? The Ventilator Training App episode we reference is here: https://www.topmedtalk.com/covid-19-the-ventilator-training-alliance-app/ Presented by Desiree Chappell and Monty Mythen with their guests, Vafa Jamali, Senior Vice President and President of Respiratory, Gastrointestinal & Informatics (RGI) within Medtronic's Minimally Invasive Therapies Group (MITG) and Jennifer Doyle, Global Vice President, Medical Affairs - Respiratory, Gastrointestinal & Informatics and MITG at Medtronic.

"The more I learn about this, the more my eyes are opened to how much opportunity we have to improve in this area" This piece covers the "perennial topic" of whether paralysis is bad for breathing, here with a focus upon outcome criteria associated with residual neuromuscular blockade. It's a piece based in part upon a recent talk at the American Association of Nurse Anesthetists annual conference which was this year held virtually. Presented by Desiree Chappell with her guest Brent Dunsworth, CRNA, DNP, Director of Advanced Practice for the Department of Anesthesiology at Vanderbilt University Medical Center.

"Just having more staff doesn't always equate to better care, especially when the staff do not have the skills required." Perioperative medicine has the opportunity to lead the way in advanced practice; the extended role of the practitioner within the perioperative pathway can be done with nurses, allied health professionals or physician associates. As we evolve these roles, we must be mindful and recognise not all services will be the same. How can you tailor your service to your specific needs? How do you construct a business case which provides a better quality of value based care within your institution? Could this help by giving the practitioner role focus and allowing you to measure their effectiveness? For more information about Guy's and St Thomas's practice we suggest you look at their website, an excellent information resource, here: https://www.guysandstthomas.nhs.uk/our-services/ageing-and-health/specialties/pops/overview.aspx Presented by Jason Cross, Advanced Nurse Practitioner, Department of Aging and Health, Guy's and St Thomas's, London.

This vital piece deals with a variety of issues related to COVID-19; what we know and what we know we do not know: - Similarities and differences between COIVD-19 and Aqute Respiratory Distress Syndrome (ARDS) - The most useful information observed by practitioners at the bedside, conscious of the lack of Randomised Controlled Trials (RCTs) in this area - The controversy regrading early invasive ventilation versus non-invasive ventilation - What are the aerosolization risks? - Pragmatic patient prioritization - The role of anti-coagulation - The role of continuous positive airwave pressure (CPAP) - who benefits and why? Presented by Professor Mervyn Singer, Intensive Care Medicine at University College London.

"It's all about safety and recovery, it's not about speed"; this conversation focuses on enhanced recovery, are we getting it right and where are people getting it wrong? How reliable and well understood is the data behind it? Also, what are the current thoughts on perioperative steroids? How do we refocus and move back to enhanced recovery after surgery rather than "enhanced discharge" after surgery. Presented by Monty Mythen and Desiree Chappell with Sol Aronson, tenured Professor at Duke University, and their guests Henrik Kehlet, a gastrointestinal surgeon and former professor of surgery, Copenhagen University, and now professor of perioperative therapy and Head of Section of Surgical Pathophysiology, Rigshospitalet, Copenhagen University and Nick Scott, an early proponent of Enhanced Recovery in the UK who has spent the last six years as the Vice Chairman of Anesthesia and Perioperative Medicine at Hamad Medical Corporation in Qatar.

TopMedTalk has recently engaged with a large number of new listeners, we are delighted to have you join our family of perioptimists! This piece works as a primer, it explains what lies at the core of the world's favorite perioperative medicine podcast; enhanced recovery. What is it? How do you implement it? What are its core principles? If you've never heard TopMedTalk before but you are a medical practitioner this piece is a great place to start; if you're already onboard it will be a welcome refresher regarding the ideas we all gather around daily. How widespread is enhanced recovery after surgery and, perhaps more importantly, how widespread are its principles? Are patients living the drinking, eating and mobilising early on and so "living the (drink, eat, mobilise) dream?". The "POWER" study "Association Between Use of Enhanced Recovery After Surgery Protocol and Postoperative Complications in Colorectal Surgery: The Postoperative Outcomes Within Enhanced Recovery After Surgery Protocol (POWER) Study" is here: https://pubmed.ncbi.nlm.nih.gov/31066889/ The App Store has our app here: https://apps.apple.com/gb/app/topmedtalk/id1438159784 Google Play has it here: https://play.google.com/store/apps/details?id=com.topmedtalk.android.medtalk&hl=en_GB There is a recent conversation with Henrik Kehlet here: https://www.topmedtalk.com/topmedtalk-henrik-kehlet-and-nick-scott/ There's also a recent one with Angela Bader here: https://www.topmedtalk.com/covid-19-angela-bader-the-need-for-end-of-life-conversations/ Our famous Bill Clinton piece is here: https://www.topmedtalk.com/sunday-special-bill-clinton-at-the-world-patient-safety-science-technology-summit-2/ The excellent Chris Snowden piece we mention is here: https://www.topmedtalk.com/dingle-2019-the-opportunity-in-variability/ (Enhanced Recovery After Surgery) ERAS Guidelines are here "Guidelines for Perioperative Care in Cardiac SurgeryEnhanced Recovery After Surgery Society Recommendations" : https://jamanetwork.com/journals/jamasurgery/fullarticle/2732511?guestAccessKey=04f7090d-122c-4e94-a46f-22e49dab7c51 The Perioperative Quality Initiative is here: https://thepoqi.org/ Presented by Desiree Chappell and Monty Mythen.

This piece explores perioperative shared decision making from a variety of angles. Where is the latest research? Is it something we can reasonably out source? Does it always play in the favour of the patient or do we as practitioner benefit from this process also? How do we implement it without 'bulldozing' through years of experience? Link to video featuring patient "Doug": http://www.petermac.org/sdm Presented by Desiree Chappell and Ross Kerridge, "The Father of Perioperative Medicine", Debra Leung, Anaesthesiologist , Peter MacCallum Cancer Centre, Melbourne, Aisling Fleury, Geriatrician at Logan Hospital, Brisbane, Jon Gani, Conjoint Professor of Surgery at the University of Newcastle and an Honorary Medical Officer at John Hunter and Belmont District Hospitals, Pragya Ajitsaria is a staff Specialist Anaesthetist at John Hunter Hospital, Conjoint Lecturer at the University of Newcastle.

2020 was a big year for prehabilitation, the advent of a global pandemic has only increased the importance of this exciting field of medicine. Various questions from EBPOM 2020 attendees were tackled by the panel: Can you use "Timed Up and Go" (TUG) and The Duke Activity Status Index (DASI) to screen out unnecessary cardio-pulminary exercise testing (CPET)? What exactly is prehabilitation and what's its natural scope? How important is nutrition? Is it possible to standardise these areas more? What areas are being significantly worked on in prehabilitation medicine in the UK this year? What about - in these COVID 19 times - remote screening and assessment? Also, what about the possibilities regarding aerosolisation, particularly of COVID-19, during CPET? Can prehabilitation work to minimise time spent in hospital? Presented by Mike Grocott, Professor of Anaesthesia and Critical Care Medicine at the University of Southampton with Karen Kerr, Consultant Anaesthetist, Departmental Lead for CPET, Sheffield Teaching Hospitals (STH) and featuring panelists; Denny Levett, Professor in Perioperative Medicine and Critical Care at the University of Southampton and a Consultant in Perioperative Medicine at Southampton University Hospital NHS Foundation trust (UHS), June Davis, Director of Allied Health Solutions, Allied Health Professions Advisor (part time) for Macmillan Cancer Support and a professional advisor to the Care Quality Commission and Steve Wootton, OBE, Associate Professor in Nutrition at the University of Southampton with an honorary appointment with University Hospital Southampton in Clinical Nutrition.

"My first thought was - why can't we do this here?" What is ketamine, what sort of drug is it and how is it used? How was it first synthesized? Was it intentionally found or another of science's happy accidents? This piece is a fascinating look into the history and future of ketamine with a focus on outpatient infusion centers. Could this unusual and "dirty" drug - meaning it acts on many parts of the body and is not fully understood - have incredibly useful consequences for people who face the grueling task of handling depression or a post traumatic stress disorder? We look at the research and evidence base regarding ketamine, how it is effective for different disease processes and how the drug might be more widely used in the future. It appears to have come into something of a renaissance, "thank you for getting the word out about ketamine". Check out the clinic here: https://www.neuromendcenter.com/ Presented by Desiree Chappell and Monty Mythen with Tracy Young, MSNA, MBA, CRNA, CEO of YPS Anesthesia, he also a two time past State President for the Louisiana State Association of Nurse Anesthetists as well as currently sitting on several other boards.

How do we manage our operating room capacity and restore elective surgery in a post-COVID19 world? A world where conditions change week by week, sometimes day by day. Managing capacity was always a challenge but now we need to think differently in order to stay resilient and agile. How has COVID19 changed the landscape now? What are the tools that exist to handle it? What are the systems and best practice guidelines that are helping institutions cope? How do we look at supply and demand within the constraints of what's available to us? Finally the possibility of a "second wave" is investigated, how should it be tackled should it arise? Presented by Sanjeev Agrawal, President, LeanTaas.

"Oxygen is the commonest drug that we give to our patients today during surgery and the general anaesthetic" but what do we really know and understand about it from a perioperative perspective? This talk illustrates why, even with some of the evidence and background physiology that we have at our fingertips today, the following questions are still perplexing: How much is too little oxygen? How much is too much oxygen? And how much is just the right amount of oxygen? Presented by Daniel Martin, OBE, Professor of Perioperative and Intensive Care Medicine, University of Plymouth and the Royal Free Hospital, London.

This talk aims to answer four major questions: How much fluid should you give perioperatively? Does hypotension matter? Should you use advanced hemodynamic monitoring, and do colloids have any advances over crystalloids? Using high quality studies and a data based approach in all four categories, a lot of which has come from conversations that have had happened at Evidence Based Perioperative Medicine (EBPOM) meetings, this talk draws some interesting conclusions. The American Society of Enhanced Recovery (ASER) is here: https://www.aserhq.org/web/ The Perioperative Quality Initiative (POQI) is here: https://thepoqi.org/ Presented by Tim Miller, Associate Professor of Anesthesiology from Duke University Medical Centre.

"As Anaesthetists the ultimate goal of almost all of our interventions and monitoring is to support cell energy production to provide mitochondria with the oxygen and the fuel they need to produce enough adenosine triphosphate (ATP) to power cell function and integrity". How human cells produce energy, how this changes in response to stress and how this may influence survival; this piece focuses what we know about how our bodies get the fuel they need to survive surgery and thrive as a result, providing a positive long term outcome. This is not a piece about nutrition, it's a provocative session exploring concepts designed to provide food for thought. Presented by Helen McKenna, is in the final year of her PhD at University College London, investigating bioenergetic and redox function in critically ill patients.

This piece covers the PREP-WELL project which is a community based prehabilitation program in South Tees, in the North of England: "We established the following guiding principles; we wanted to provide patient centered care under one roof with facilitated self management; we wanted to work as a cross sector collaborative, by that I mean primary care, secondary care and public health; all working together to try and improve on the fragmented service provision and sign work that we often see in our health care services; we wanted to provide a community based facility for patients; and I'll come to the reasons for this". See the PREP-WELL team here: https://www.southtees.nhs.uk/services/prepwell-project/meet-the-prepwell-team/ The links mentioned in the talk are here: Home exercises: https://www.southtees.nhs.uk/services/prepwell-project/home-exercises/ Nutrition: https://www.southtees.nhs.uk/services/prepwell-project/nutrition/ Pdf download: https://bmjopenquality.bmj.com/content/bmjqir/9/1/e000898.full.pdf We've been following the groundbreaking success of the PREP-WELL project for some time now here on TopMedTalk, why not check out this piece here, the first part in our most recent "P.O.E.T - Perioperative Enhancement Teams" series; https://www.topmedtalk.com/poet-2-01-the-uks-prepwell-initiative/ This piece was originally part of EBPOM 2020 - Live from London, our groundbreaking virtual conference; find out more about Evidence Based Perioperative Medicine (EBPOM) here: www.ebpom.org Presented by Gerard Danjoux, consultant in Anaesthesia and Sleep Medicine at South Tees Hospitals NHS Foundation Trust.

"We have to create the culture of learning; the culture of having a safe space, the culture of wanting to do better and learning those conditions in which we do do better" This powerful talk looks directly at how a clear approach to patient safety really can improve the standard of care where you work. What is the culture of quality and safety that you're trying to embed, can you actually do better? Learn why it's important to focus on psychological safety; "if people start being scared, everyone gets scared then it expands". Learn how an evidence based approach can allow us to tackle these issues rather than shy away from them; "what factors are maintaining safety? How do we get to good outcomes? What are the things working well? How do we understand human variation?". Presented by Lee Fleisher, Emeritus Professor of Anesthesiology and Critical Care, University of Pennsylvania.

Pain is a subjective experience that affects all segments of the population. However, there are inter-individual differences in pain. The biopsychosocial model proposes that the intersection of biological, psychological, and social factors create a pain experience and pain outcomes that differ by sex, race, and socioeconomic status. "The minority stress theory ... the idea that for racial minorities, especially blacks, they are exposed to chronic stress; the stress of daily racism" Could epigenetics hold the key to understanding how social factors compound differences between patients? How does this impact on you and your practice? Further reading is to be found here: https://pubmed.ncbi.nlm.nih.gov/19411059/ https://pubmed.ncbi.nlm.nih.gov/32487870/ https://pubmed.ncbi.nlm.nih.gov/30863142/ Presented by Desiree Chappell and Monty Mythen with Edwin N. Aroke, Ph.D., CRNA, Assistant Professor, Associate Scientist, Minority Health and Health Disparities Research Center, Associate Scientist, Comprehensive Arthritis, Musculoskeletal, Bone, & Autoimmunity Center, The University of Alabama, Birmingham, US.

This piece was recorded at the start of the year, to celebrate the launch of Tom Woodcock's book Fluid Physiology, A Handbook for Anaesthesia and Critical Care Practice: https://books.google.co.uk/books?id=F-m4DwAAQBAJ&printsec=copyright&redir_esc=y#v=onepage&q&f=false The editorial team here at TopMedTalk recently (08/12/2020) reflected upon the fact that Tom's 'big areas to watch in 2020' have proven to be remarkably prescient. The 13 Minutes To The Moon podcast is here: https://www.bbc.co.uk/programmes/w3csz4dn Presented by Monty Mythen with Desiree Chappell and their guest Tom Woodcock, author and independent consultant in patient safety, medical law and ethics.

This piece considers the need to understand the patient having surgery and the complexity with which they present so we can match our skills to them. Developing these skills requires new approaches; to education and training at undergraduate and postgraduate level; to challenge the old ways of delivering perioperative care. This requires new ways of working, the breaking down of silos, a rethink of the financial support that is required and that we share good practice rather than 'reinventing the wheel'. It also means ensuring that we continue to gain evidence from the real world of clinical medicine, whether that's through original research or through employing quality improvement and implementation science. More on Proactive care for Older People undergoing Surgery (POPS) here: https://www.guysandstthomas.nhs.uk/our-services/ageing-and-health/specialties/pops/overview.aspx If you enjoy this piece you'll love our series here: "POPS Part 1| TopMed talk at Guy’s and St Thomas’s Hospital in Central London" - https://www.topmedtalk.com/pops-part-1-topmed-talk-at-guys-and-st-thomass-hospital-in-central-london/ Presented by Jugdeep Dhesi, Clinical Lead for "Proactive care for Older People undergoing Surgery" (POPS) and Consultant Geriatrician, Guys and St Thomas' NHS Trust.

This piece looks at some of the advantages to having a perioperative interdisciplinary team reducing complications, understanding and discussing risk, facilitating better shared decision making and increased patient satisfaction, even among those who - as part of this process - decide not to go ahead with an operation. It also incorporates evidence regarding what we know about COVID-19; "The risks ... of the COVID-19 virus is that if people contract it during or after their surgery, they have a much worse result with perhaps 51% pulmonary complications or 24% mortality". The World Health Organisation report mentioned in this piece, "Smoking greatly increases risk of complications after surgery", is here: https://www.who.int/news/item/20-01-2020-smoking-greatly-increases-risk-of-complications-after-surgery The Montgomery ruling is covered on a previous TopMedTalk in more detail in "Sunday Special | Being on the right side of the law" here: https://www.topmedtalk.com/sunday-special-being-on-the-right-side-of-the-law-2/ The Centre for Perioperative Care website is an excellent resource, here is the section specifically for your patients: https://www.cpoc.org.uk/patients The Royal College of Surgeons is here: https://www.rcseng.ac.uk/ Our presenter has a website dedicated to her work here: http://www.scarlettmcnally.co.uk/ And she maintains a twitter feed - focused on medical issues - here: https://twitter.com/scarlettmcnally Presented by Scarlett McNally, Deputy Director of The Centre for Perioperative Care (CPOC) consultant Orthopaedic Surgeon, Eastbourne DGH, UK.

"We did not have a concensus view on the very basic subject of fluid physiology and I needed to write a book". Recorded at the start of the year this piece builds on our previous look at Fluid Physiology, which you can find here: https://www.topmedtalk.com/topmedtalk-tom-woodcock/ We also make reference to the book "Fluid Physiology" which is available now, check out the website here: http://fluidphysiology.org/ Tom's always entertaining twitter feed is here: https://twitter.com/thomaswoodcock Presented by Monty Mythen and Desiree Chappell with their guests Sol Aronson a tenured professor at Duke University and Executive Vice Chairman in the Department of Anesthesiology and Tom Woodcock author and independent consultant in patient safety, medical law and ethics. Like this, want more? Tom Woodcock appears frequently on TopMedTalk: https://www.topmedtalk.com/?s=tom+woodcock

"We, who physically will be elsewhere in the world, for example, in London and in Southampton, are going to - within what we're allowed to do - get together in a bubble probably at work, and set aside the time to watch the meeting together, and to share some food and maybe share some diet coke and talk about what we've been looking at what we've been learning. So that's the start of the hybrid events - and we hope that by the time we get to the World Congress of Perioperative Care, which used to be known as the London meeting, we are going to have 10's if not hundreds, if not 1000's of hybrid venues around the world..." Listen to the end to find out more about the ambitious plans for COVID conscious "hybrid meetings" in 2021. Email us if you think you can help arrange a hybrid zone breakout space: admin@ebpom.org Recollections regarding Evidence Based Perioperative Medicine's (EBPOM) Chicago virtual meeting begin the piece, as the TopMedTalk team look back over the final part of the year. The Toby Richards piece mentioned is here: https://www.topmedtalk.com/topmedtalk-iron-man-vs-anemia/ The entertaining discussion between Angela Bader and Gina Blitz will be available in a forthcoming episode of TopMedTalk. It has been heard already by EBPOM Chicago attendees under the title: "Brain Health: Frailty, Delirium, POCD". This talk will be available for free in full on TopMedTalk in the future. For more details of the next EBPOM 'hybrid' meeting please visit www.ebpom.org The music of Jeremy Sassoon - part of the EBPOM Chicago entertainment offering - is available to enjoy here: https://www.youtube.com/watch?v=D_baYCXTdY8 The Dingle lectures will also form part of TopMedTalk's programming next year, make sure you hit the subscribe button on whichever platform you receive us on. Presented by Desiree Chappell and Monty Mythen with TopMedTalk producer Nick Margerrison.

The team enjoy reflecting on 2020 as we appreciate the fact that there were the green shoots of hope during the middle part of the year. The patient facing Macmillan Cancer Care podcasts are here: https://www.topmedtalk.com/?s=topmedtalk+%26+macmillan The POCAPALOOZA is here: https://www.topmedtalk.com/?s=pocapalooza Find out more about the African Surgical Outcomes Study (ASOS) and the African Perioperative Research Group (APORG) here: https://www.topmedtalk.com/pocapalooza-cape-town/ Guy Ludbrook's interview and talk will be available on TopMedTalk in the new year. Our friend and collaborator Jeremy Sassoon is here: https://www.facebook.com/watch/jeremysassoon/ The highlighted piece from the American Association of Nurse Anesthetists is here: https://www.topmedtalk.com/aana-e-cigarettes-and-their-impact-on-patients-undergoing-anesthesia-2/ Presented by Monty Mythen and Desiree Chappell with producer Nick Margerrison. Happy Holidays and - if you celebrate it - Merry Christmas from everyone here at TopMedTalk!

The annual TopMedTalk Holiday Special series this year takes a look back at COVID19 and the first year we had to live with it. Listen to the full conversations used in this piece: TopMedTalk | Henrik Kehlet and Nick Scott https://www.topmedtalk.com/topmedtalk-henrik-kehlet-and-nick-scott/ TopMedTalk | Silent pandemic of surgical complications https://www.topmedtalk.com/topmedtalk-silent-pandemic-of-surgical-complications/ COVID 19 | An update on patient, Professor Monty Mythen https://www.topmedtalk.com/8381-2/ COVID 19 | “You must learn the epidemiology” https://www.topmedtalk.com/covid-19-you-must-learn-the-epidemiology/ COVID 19 | Disruptive Innovation https://www.topmedtalk.com/covid-19-disruptive-innovation/ COVID 19 | Bring on the vaccine! https://www.topmedtalk.com/covid-19-bring-on-the-vaccine/ Presented by Monty Mythen and Desiree Chappell with producer Nick Margerrison.

"I cannot sleep. It's like, I wake up at 1am and my mind's going crazy ... if you had someone come to you and say; 'I'm really struggling right now, I'm having a lot of anxiety, with work with family, with kids with whatever'; what are some of the top things that you want to share with them?" How can a regular yoga practice bring you into a deeper union with what you do and help improve your performance? Why is it that people in the caring profession sometimes leave self care at the bottom of their priority list? What resources can professional bodies offer you? With special thanks to the American Association of Nurse Anesthetists (AANA) for their help with this piece, their excellent website is here: www.aana.com/covidwellness The help number mentioned is: 1-800 654 5167 The Breathing App is here: https://eddiestern.com/the-breathing-app/ The book "Why we sleep" is here: https://www.amazon.co.uk/Why-We-Sleep-Science-Dreams/dp/0141983760 "Insight Timer" is here: https://insighttimer.com/ Presented by Desiree Chappell with her guests Bridget Petrillo, CRNA at The Mayo Clinic in Phoenix Arizona, volunteer member for the AANA Peer Assistance Advisors Committee, State Peer Advisor for the Arizona Association of Nurse Anesthetists (AZANA), member of the Wellness Committee for AZANA and Jessica Switzman, CRNA, MSN, Johns Hopkins, also served on the AANA Wellness Committee and AANA Peer Advisors Committee, State Peer Advisor for MANA and has been teaching Yoga since 2007.

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.

"I think you're now famous in the CRNA community for being one of the first people in Fargo to receive the the COVID vaccine" This piece sees us catching up with Certified Registered Nurse Anesthetists (CRNA's) who have just been vaccinated for COVID-19. Their story reminds us that even now some practitioners are facing their first real wave of the pandemic in their area: "We had a kind of trickle in, so to say, of COVID patients, and then this in this fall, the middle of November was really when it hit us pretty hard". Presented by Desiree Chappell with Jordan Rohrich CRNA, Anesthesiology, Fargo, North Dakota and Jordi Idso MS, CRNA, Sanford Health in Fargo.

What happens when cutting edge computer game creators, fresh from working on top titles in their industry such as 'Hunger Games' and 'Mission Impossible', use their skills to simulate high stress moments from the real world of anesthesia and surgery? Using "the neuro-science of game design" to help accelerate learning within the profession: "The motivation for starting Level Ex, what if we actually took the top game designers and developers in the industry? We're talking the executive producer of "Mortal Kombat", the creative director of "Call of Duty", the marketing director of "Words with Friends"; put them with top physicians from multiple specialties, to capture the challenges of the practice of medicine using video game mechanics". "This doesn't recreate the mannequin, what this does replace is the five hundred live patients you need to train on in order to encounter those five to ten rare scenarios because we can recreate the rare and the difficult and then we can help you train your visualization skills, your recognition skills, your deductive reasoning skills, on those cases." The key point here is not that motor function is being copied by a screen interactive experience but instead the aim is to "optimise cognitive load" and recreate the thought process alongside an emotional experience. "We're not introducing you to how to do a fiber optic intubation, we're going to present dozens of rare difficult challenging once in a lifetime cases". Here computer games can currently excel in their teaching ability, "it's a cognitive skill, it's a decision making algorithm". As time ticks by in the simulation "you do get to a point where there's no return and you have like three minutes to do this successfully and so your algorithm and decision making is absolutely crucial". It's about taking in data and making decisions in a way that is not possible on a mannequin or ethical on a live patient. "Everything that goes into the app is peer reviewed" and, with any computer game you can earn points as you go along; this game though gives you (Continuing Medical Education) CME points. Google Play: https://play.google.com/store/apps/details?id=com.levelex.airwayex&hl=en_GB Apple: https://apps.apple.com/us/app/airway-ex/id1154656060 Open Anesthesia is here: https://www.openanesthesia.org/ Presented by Desiree Chappell and Monty Mythen with their guests. Sam Glassenberg, CEO and Founder of Level Ex, before which he was CEO of the leading independent game publisher in Hollywood, releasing games based on popular films, including The Hunger Games and Mission: Impossible, he also led the DirectX graphics team at Microsoft, where he accepted a Technical Emmy on behalf of his team for advancing the visual realism of video games across the industry. His career began at LucasArts, creating Star Wars games for PlayStation and Xbox. Sam serves on numerous industry advisory boards and speaks internationally on video games in medicine. Robert H. Thiele, Associate Professor, Departments of Anesthesiology and Biomedical Engineering, Division Chief, Critical Care Anesthesiology, Board of Directors, University Physicians Group, University of Virginia School of Medicine. He has a background in engineering and has been using technology to improve education since his residency in 2008. He is co-founder of www.OpenAnesthesia.org which lead to the development of Self-Study, and also authored one of the first iBooks focused on cardiac and critical care ultrasound.

"You've given us all a lot to think about" - a randomized controlled trial regarding intravenous iron does not go 'as expected'. "I mean, look, I've built my entire career on thinking this was the best thing since sliced bread, the silver bullet, the magic wand ..." A great scientist follows accurate data to wherever it may lead, what now? More trials, more time, more questions? How common is anemia? Are there any nuggets of hope buried within these data? What have we learned? Evidence Based Perioperative Medicine sticks to the facts and there's nothing more important than data; make sure you listen to the end, there are interesting details that give many a sense of optimism. Preoperative intravenous iron to treat anaemia before major abdominal surgery (PREVENTT): a randomised, double-blind, controlled trial is here: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)31539-7/fulltext Toby is a popular contributor to TopMedTalk - check out his earlier piece here: https://www.topmedtalk.com/prato-2019-toby-richards/ Presented by Monty Mythen and Mike Grocott with their guest Toby Richards, Professor, Anaesthesia Teaching & Research Faculty of Medicine, Nursing and Health Sciences Central Clinical School, Monash University.

How can we align personalised care with prehabilitation? "Personalised care is where people have more choice and control over how their health and care needs are met" where we recognise "people themselves can sometimes be the best integrators of health and care". In this context our role is to support them to "live as independently as they wish". With shared decision making and personal choice at the heart of this we allow patients to be "experts in their own lives, health and care". The increase in life expectancy means more long term conditions and comorbidities in patients, what opportunities does this present? How do we hone in on what matters to patients and help them manage the cumulative burden of long term health difficulties? How comfortable are healthcare practitioners when talking about physical activity? Is it possible that personalised care could eventually be business as usual? The NHS Long Term Plan has a website which you can see here: https://www.longtermplan.nhs.uk/ The NHS website is here: www.england.nhs.uk Presented by Anna Lowe, Programme manager, National Centre for Sport and Exercise Medicine, Lead Allied Health Physical Activity Clinical Champion at Public Health, England.

After working at a Veterans Affair Medical Center, hear how our guests moved into the field of emergence delirium: "upon emergence our patients were swinging and very aggressive ... there must be some way to prevent this". This fascinating piece enjoys an engaging discussion about an important topic for both patients and practitioners; how important is it for you to know a patient may suffer from post traumatic stress disorder? Do different anesthetics promote or avoid emergence delirium? Can emergence delirium cause further long term trauma? How do we deal with US military veterans specifically? Patient Health Questionnaire 9 (PHQ-9) is here: https://patient.info/doctor/patient-health-questionnaire-phq-9 The State Trait Anxiety Inventory is here: https://www.advancedassessments.co.uk/resources/Mental-Health-Test.pdf Presented by Desiree Chappell and Monty Mythen with Kristen Roman, MSN, MFA, SRNA, Ignacio Diaz, BSN, SRNA and Jena Borgonia, BSN, SRNA, student registered nurse anesthetists (SRNAs) at The University of Southern California.

"It's useful to reflect on what SNAP-2 EPICCS might offer us in the brave new world that we find ourselves in with Coronavirus" The 2nd Sprint National Anaesthesia Project: Epidemiology of Critical Care after Surgery (SNAP-2 - EPICCS) study launched in March 2017 around the UK. More than 2,200 investigators at more than 250 sites across the UK were signed up to take part. The observational study collected data on all patients undergoing inpatient surgery during a one-week period (21 March to 27 March) in UK NHS hospitals. What is the scale of the problem; when it comes to cancellation of inpatient surgery surgery, with a specific lens on critical care capacity? What about the value of higher levels of post operative care for high risk surgical patients? What are the essential ingredients for higher intensity post operative care? Also, learn about some of the organically developed solutions that have come around to capacity issues for high risk surgical patients in the NHS and overseas. As well as this hear how we might select patients to be admitted to higher levels of care; the methods that we might use for risk stratification of inpatient surgical patients and what we think the potential benefits of post operative high levels of care could be. Do we have any data to support the notion that critical care confers benefits on post surgical patients? The website is here: https://www.niaa-hsrc.org.uk/SNAP-2-EpiCCS More on SNAP-2 is here: https://www.topmedtalk.com/what-is-snap-2/ Presented by Ramani Moonesinghe, Professor of Perioperative Medicine at University College London (UCL), Hon Consultant in Anaesthesia, UCLH.

"Critical Care has a moment in time, a moment where we can make some big changes, a moment of opportunity" This uncompromising and informative talk from the technical lead for critical care in the Getting It Right First Time (GIRFT) project takes us through how services can improve and work alongside perioperative care to improve standards and outcomes for patients. Sharing best practice between trusts GIRFT identifies changes that help improve and change an institution’s procedures and cost savings, this is a vital talk and one of the highlights of the hugely successful EBPOM London 2020 virtual conference. For more details on up coming events from Evidence Based Perioperative Medicine EBPOM at www.ebpom.org The GIRFT website is here – https://gettingitrightfirsttime.co.uk/ Further listening regarding GIRFT can be found here: https://www.topmedtalk.com/rcoa-13-the-girft-getting-it-right-first-time-project/ Presented by Anna Batchelor, MB ChB, FRCA, FFICM, Consultant Anaesthetist - Intensive Care Medicine, Newcastle upon Tyne. She is the technical lead for critical care in the 'Getting It Right First Time' (GIRFT) programme.

From a UK perspective this piece covers variation in access to critical care, behaviors and decisions regarding its use. With reference to how, over the last 20 years, efforts have been made in Torbay to improve access to critical care we look at what can be done and what works. Finally there's a summary of where we are on this issue today. Getting it right first time (GIRFT) is here: https://www.gettingitrightfirsttime.co.uk/ Presented by Mike Swart, Consultant in Anaesthesia and Critical Care Medicine at Torbay Hospital and advisor to the UK Department of Health for the Enhanced Recovery Programme.

This piece provides an update on the Perioperative Exercise, Testing and Training Society (POETTS); "established back in 2017, in the context, in the United Kingdom, of cardiopulmonary exercise testing becoming much more common in the preoperative period". Now, more than half of acute hospital trusts in the United Kingdom have a cardiopulmonary exercise testing service to evaluate their patient's functional capacity prior to surgery. Furthermore exercise interventions to optimise a patient's fitness before surgery have seen a sudden and growing interest. With just over 400 members POETTS exists to help standardize education and training in the field, develop consensus clinical guidelines, look after patients around the time of surgery and help club together acute hospital trusts across the UK, so that they can do collaborative research. Their website is here: https://www.poetts.co.uk/ Presented by Denny Levett, Professor of Perioperative Medicine at the University of Southampton and President of the Perioperative Exercise, Testing and Training Society (POETTS).

"Obstetric anaesthesia" - originally streamed live from The Institute of Engineering and Technology (IET) in London during EBPOM 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: https://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 Carolyn Johnston, consultant Anaesthetist in St Georges hospital in London and Improvement lead for the National Emergency Laparotomy Network (www.NELA.org.uk).

This piece presents an invaluable wealth of first hand experience in setting up various business cases in relation to perioperative medicine in the UK. At University College London (UCL) cardiopulmonary exercise testing (CPET) was set up as a research tool "but then clinicians came, became interested in the results of the tests and started to ask for tests to be done on their patients for clinical evaluation". An external contractor model, using a charitable organisation, enabled them to charge the NHS for these tests; as the service expanded they were able to expand to other clinical sites connected with UCL, published early data on outcomes and obtained grant funding to look at a robust evaluation model. Hear how this model was refined and the idea has evolved during its growth within the UK's National Health Service (NHS). Also, consider what other models could apply this thought process; learn how new perioperative care pathways offer interesting opportunities in these areas. This piece is further enhanced by the discussion we released recently on the same topic: https://www.topmedtalk.com/ebpom-london-2020-the-business-case-for-prehabilitation/ Presented by Kay Mitchell, Senior Research Manager for Critical Care Research, NIHR Biomedical Research Center, University Hospital, Southampton, UK.

The electronic cigarette market is a $14 billion industry worldwide. As of August 2019, 215 cases of severe pulmonary illness related to e-cigarette use are being investigated in the United States. The known hazards of e-cigarette use are rapidly coming to light with the sudden onset of serious bronchiolitis-related pulmonary disease in otherwise healthy people who were known to use e-cigarettes. Learn also how COVID 19 has increased these dangers. Presented by Desiree Chappell with Monty Mythen and Bernard Gilligan, III, DNP, CRNA, APRN, Program Assistant Director, Assistant Professor, Cedar Crest College Nurse Anesthesia Program, Allentown, PA.

"In the elective surgical domain 20% of people who are scheduled to have surgery are not ready for surgery" The road towards economic reality is paved with data; this talk, confidently assertive in tone, provides you with a number of useful facts and reassurances which can be transformed into reasons why you and your patients can enjoy the benefits of prehabilitation; a better value of care and a higher standard of good quality outcomes. This piece works well in tandem with this debate here: https://www.topmedtalk.com/ebpom-london-2020-the-business-case-for-prehabilitation/ Presented by Sol Aronson, tenured Professor, Duke University, Durham, North Carolina.

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 cancellation 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.

What are the aims of The International Prehabilitation Society? Its vision is about "bringing together international multidisciplinary expertise, across healthcare and beyond, creating a platform of shared learning, research and education for the benefit of patients". This piece updates you on the current board members, the roles of committee members, conferences that the society has previously supported alongside those being planned for the future. Also there's an update on some exciting new sponsorship news and a brief overview of future plans. The society's website is here: https://prehabsociety.com/ Presented by Gerard Danjoux, consultant in Anaesthesia and Sleep Medicine at South Tees Hospitals NHS Trust.

This piece gives you the evidence base required to deliver an even higher standard of perioperative medicine where you work. Hear about the "Fit 4 surgery" studies; the "fit 4 surgery consortium", the ongoing e-studies, key findings, recent studies and the set up in Southampton. Physical fitness is greatly affected by chemotherapy; poor outcomes are significantly linked to physical fitness; learn how preoperative cardio-pulmonary exercise testing and training can monitor and track this potentially dangerous spiral. Hear how multiple studies are now providing a clear evidence base for this exciting area of perioperative care. Could more such targeted interventions, alongside shared decision making, provide a real difference to outcomes for your patients and a higher standard of value based care in your institution? For more on this go here: http://wesfit.org.uk/ Read more about the great work being done by MacMillan Cancer Trust here: https://www.macmillan.org.uk/ The video version of this presentation, along with slides, was presented to the many thousands of people who attended the hugely successful Evidence Based Perioperative Medicine (EBPOM) virtual conference, "Live from London". For more details on this and future conferences please visit www.ebpom.org Presented by Professor Sandy Jack, PhD, Consultant Clinician Scientist in The Anaesthesia and Critical Care Research Unit at University Hospital Southampton NHS Foundation Trust, Honorary Senior Lecturer at the University of Liverpool, University of Southampton and University College London.

"The people of Wales are particularly unfit", there is a high incidence of smoking, physical inactivity, and alcohol intake. Grim news from one angle but on the other hand it's a huge opportunity to make a massive difference in the prehabilitation stage of the perioperative process. Hear how cancer outcomes are being dramatically improved as a clear pathway of optimisation is rolled out. Presented by Rachael Barlow, National Lead, Enhanced Recovery, Prehabilitation and Optimisation, at Cardiff and Vale health board, Wales.

This piece looks at the most recent guidance regarding prehabilitation for cancer, developed and published in 2009 by Macmillan Cancer Care. Extremely well received across the UK, and internationally, here we look at the details and some context in terms of UK national policy. From an NHS England point of view the desire is to ensure that all patients and participants have personalized care embedded into everyday NHS services. Work around streamlining multidisciplinary team meetings for cancer include the opportunity to discuss the needs of people with cancer and the importance of preparing people in advance and during treatment. Furthermore you will hear elements of the principles of rehabilitation, as well as the importance of earlier and faster diagnosis, the importance of perioperative medicine and prehabilitation before surgery. Further reading here "Principles and guidance for prehabilitation": https://www.macmillan.org.uk/about-us/health-professionals/resources/practical-tools-for-professionals/prehabilitation.html Originally part of the hugely successful EBPOM Live from London 2020 conference this piece is nicely complimented by the panel discussion which TopMedTalk has also released free of charge here: https://www.topmedtalk.com/ebpom-london-2020-prehabilitation-update/ Presented by June Davis, Director of Allied Health Solutions, Allied Health Professions Advisor (part time) for Macmillan Cancer Support and a professional advisor to the Care Quality Commission.

Pediatric patients can present quite a challenge when emerging from anesthesia. Here we discuss ways to “ACE” your transition to PACU! “A”void Emergence Agitation, and discover the latest evidence about “C"riteria for “E”xtubation in this challenging population. How do the protocols and standard of care compare between the UK and US. What does the evidence tell us? Also, how is Enhanced Recovery After Surgery progressing in pediatrics? Presented by Desiree Chappell and Monty Mythen with their guest Kristin Henderson, DNAP, CRNA, CHSE, CPT, USAR Assistant Professor, Wake Forest School of Medicine, Nurse Anesthesia Program.

It's widely understood that high value care during, before and immediately after surgery is optimal whereas poor quality care in the perioperative period produces long term difficulties which are compounded by the acute stresses produced during and immediately after a procedure. This talk covers three main areas; surgical care for patients in Greater Manchester, "ERAS+"; prehabilitation for cancer, for the population of Greater Manchester; how Manchester has supported patients during the time of COVID19. This piece is mentioned in the introduction and serves as a useful compliment to the talk, "Implementing a system-wide cancer prehabilitation programme: The journey of Greater Manchester's ‘Prehab4cancer’": https://www.ejso.com/article/S0748-7983(20)30438-8/fulltext Find out more about the work in Greater Manchester here: https://gmcancer.org.uk/our-areas-of-work/prehab4cancer-2/ Also the Perioperative Quality Improvement Programme is here: https://pqip.org.uk/content/home Presented by Dr. John Moore, Clinical Director for Intensive Care at Manchester Royal Infirmary and Medical Lead for Enhanced Recovery After Surgery.

What do we mean by "nutritionally fit" and why does it matter? How do we identify those most at risk in terms of screening and assessment and what's the difference between these two processes? How can we use screening and assessment to triage patients into care? Also, in the time of COVID19, are there ways we can perform some tasks related to these processes remotely? Presented by Steve Wooton, Senior Lecturer in Human Nutrition within Medicine at the University of Southampton.

"The main challenge around the variability in the perioperative period is nomenclature, definitions and standardized endpoints. Well designed and well conducted randomized control trials determine effectiveness to an unbiased comparison of outcomes, events, or endpoints between intervention groups". If data is destiny it is to this that we must look if we want to understand what the future may hold for prehabilitation. This piece takes a pragmatic approach toward the task of ensuring information and datasets are widely applicable, as free from bias as possible and ultimately standardised by consistent definitions and terminology alongside a methodology which produces clear outcomes. Find out more about the Comet Initiative here: https://www.comet-initiative.org/ Find more about the 'Standardised Endpoints in Perioperative Medicine-Core Outcome Measures in Perioperative and Anaesthetic Care (StEP-COMPAC) Group' here: https://www.comet-initiative.org/Studies/Details/1317 Presented by Malcolm West NIHR funded Clinical Lecturer in Surgery and Honorary colorectal surgical specialist registrar at the University of Southampton.

How important is it to screen patients and measure their fitness prior to surgery? What is exercise training in the preoperative period? There is a very clear relationship between physical fitness and mortality. Importantly, when we think of prehabilitation, or exercise training, it's good to remember that you get the greatest benefit in the most unfit patients, in terms of mortality reductions. The "pandemic ... of physical inactivity worldwide" is believed to cause more than 5 million deaths annually. The advantage of fitness in terms of predicting perioperative outcomes is it is an important modifiable risk factor before major surgery; we can modify health behaviors and exercise and we can sometimes optimize comorbidities before surgery. Exercise is real medicine! Originally part of the hugely successful EBPOM Live from London 2020 conference this piece is nicely complimented by the panel discussion which TopMedTalk has also released free of charge here: https://www.topmedtalk.com/ebpom-london-2020-prehabilitation-update/ 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.

This wide ranging talk asks where and how we should focus on the needs of postoperative care patients. "Brain care has an impact way beyond the acute surgical episode"; how do we minimise the risks of a poor outcome when it comes to postoperative care? "Advanced recovery from anaesthesia and surgery" is a talk originally given at the 8th Australian and New Zealand Symposium of Perioperative Medicine Special Interest Group: “Updates in Perioperative Medicine 360” which took place between November 7th-9th 2019. Presented by Professor Jacqueline Close, Principal Research Fellow, NeuRA Conjoint Professor, UNSW Consultant Geriatrician, Prince of Wales Hospital.

This piece has been released to coincide with the first virtual International Fluid Academy Day (IFAD). TopMedTalk listeners have enjoyed following the meeting annually for some time now; we're equally as excited about their online proposition. Find out more here: https://www.fluidacademy.org/ This piece digs deep into the realities of coping with COVID 19 patients who have had their care escalated to the Intensive Care Unit (ICU); "we don't seem to be looking at our typical sepsis patients who get multiple organ failure in the classical way" and "you're surprised at how young some of the patients are...". Our guest provides us further insight; a 'household name' in the haemodynamic monitoring space; he is treating patients in a medium sized hospital (500 beds) with mostly COVID patients in Spain. How are things going there, how does it compare to Italy? How are the patients being dealt with, what can we learn about the basics here, airway, breathing, ventilation (ABC)? There is also a gripping discussion regarding dynamic arterial elastance. If you'd like to know more about that do check out our discussion here: https://www.topmedtalk.com/periop-coach-2-09-haemodynamic-monitoring/ The webinar mentioned in this piece can be found here: https://www.esicm.org/education/webinars/ Presented by Desiree Chappell and Monty Mythen with their guest Dr. Manuel Ignacio Monge García who works in an ICU in the South of Spain.

This piece has been released to coincide with the first virtual International Fluid Academy Day (IFAD). TopMedTalk listeners have enjoyed following the meeting annually for some time now; we're equally as excited about their online proposition. Find out more here: https://www.fluidacademy.org/ The Perioperative Quality Initiative (POQI) is a vital part of the process needed to more widely implement sensible practice which, using a clear evidence base, provides better value care with more positive outcomes for the patient. POQI continues to provide its work in an attempt to clarify fundamental concepts in perioperative care. The fact this one focuses upon fluid management makes it particularly appropriate. Link to the paper: https://perioperativemedicinejournal.biomedcentral.com/articles/10.1186/s13741-020-00142-8 Presented by Desiree Chappell with Monty Mythen and their guests Tim Miller, Professor of Anesthesiology from Duke University Medical Centre and Greg Martin Professor of Medicine, Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Emory University School of Medicine Like this, want more? Try our popular in depth series "Fluid Matters" http://topmedtalk.libsyn.com/fluid-matters-1 TopMedTalk provides world leading information about perioperative medicine like this every day. Dr Greg Martin's deeper dive into these issues is here: http://topmedtalk.libsyn.com/fluid-matters-3

This piece has been released to coincide with the first virtual International Fluid Academy Day (IFAD). TopMedTalk listeners have enjoyed following the meeting annually for some time now; we're equally as excited about their online proposition. This piece is a chance to hear a now famous discussion which TopMedTalk recorded at the Peroperative Quality Initiative (POQI) at Washington Duke University in Durham. The discussion is predominately about total body water, electrolytes and the movement of fluid around the body; the idea of circulation of interstitial fluid; the Starling Curve and lymphatics; sodium balance and, at the end, there's a moment when the speakers agree to disagree about whether saline is "abnormal" or not. If you would like to find out more about IFAD go here: https://www.fluidacademy.org/ Presented by Monty Mythen and Henry Howe with their guests Tom Woodcock, an independent consultant in patient safety, medical law and ethics, and Manu Malbrain, Professor at Faculty of Medicine and Pharmacology Vrije University in Brussells.

This piece focuses upon the unique 'Collaborative Clinical Trials in Anaesthesia biennial conference', of which this was the fifth, organised in Prato, Italy, by Monash University. TopMedTalk was given the chance to listen in on this cutting edge gathering of trialists, academics and practitioners as it happened. We take a deeper dive on the history behind this very special meeting, how it works and special moments from the meeting. Learn how some of the big trials gather pace and how major studies get established. The ANZCA Clinical Trials Network is here: http://www.anzca.edu.au/ctn More detail on the African Surgical Outcomes Study - 2 (ASOS-2) here: https://www.asos.org.za/index.php/about-the-study Presented by Desiree Chappell with Monty Mythen and their guest Paul Myles, Director, Anaesthesiology and Perioperative Medicine, Alfred Hospital and Monash University. - Like this, want more? Bruce Biccard is interviewed here: https://www.topmedtalk.com/prato-2019-bruce-biccard/

This piece focuses upon goal directed fluid therapy, with an automated system, for decision support; "a step between a simple monitor and a fully automated system". The "proof of concept" paper we highlight towards the end of the podcast, "Feasibility of closed-loop titration of norepinephrine infusion in patients undergoing moderate - and high-risk surgery" has now been published and can be found here: https://bjanaesthesia.org/article/S0007-0912(19)30443-X/abstract This paper here "Perioperative goal directed therapy using automated closed-loop fluid management: the future?" is also referenced: https://www.ncbi.nlm.nih.gov/pubmed/26578397 You may also find this piece, which our guest is also part of, here interesting: https://www.ncbi.nlm.nih.gov/pubmed/29068831 Presented by Desiree Chappell and Monty Mythen with their guest Alexandre Joosten, Anesthetist at Hospital Erasme.

  "Updates in cardiac devices, Part 2" was a talk originally given at the 8th Australian and New Zealand Symposium of Perioperative Medicine Special Interest Group: “Updates in Perioperative Medicine 360” which took place between November 7th-9th 2019. This piece is focused upon transcatheter aortic valve implantation (TAVI) devices. "A balloon valvular plasti in comparison to a TAVI is 90% of the risk, 10% of the gain" you're trading one problem with another, argues our speaker. Find out more about ANZCA here: http://www.anzca.edu.au/ Presented by Dr Karl Poon, TAVI specialist at St Andrews War Memorial Hospital, Physician Proctor, Edwards LifeSciences, Senior Lecturer, University of Queensland Interventional cardiologist, The Prince Charles Hospital, Brisbane.  

"Updates in cardiac devices, Part 1" was a talk originally given at the 8th Australian and New Zealand Symposium of Perioperative Medicine Special Interest Group: “Updates in Perioperative Medicine 360” which took place between November 7th-9th 2019. This piece is a look at some of the new technology which looks set to become more widely used. A leadless pacemaker is a small implantable "bullet like" device that sends electrical pulses to the heart whenever it senses that the heartbeat is too slow. Also new implantable cardioverter defibrillators are discussed as are implantable cardiac monitors. There is also discussion regarding cardiac resynchronization therapy. The TYRX™ Absorbable Antibacterial Envelope is here: https://www.medtronic.com/us-en/healthcare-professionals/products/cardiac-rhythm/infection-control.html The CardioMEMS™ Heart Failure System: https://www.cardiovascular.abbott/us/en/hcp/products/heart-failure/cardiomems-hf-system.html Find out more about ANZCA here: http://www.anzca.edu.au/ Presented by Dr Stephen Pavia, Cardiologist and Cardiac Electrophysiologist at The Wesley Hopsital.

The POCAPALOOZA, a celebration of perioperative care that went around the world in the wake of EBPOM 2020. "Early intervention and people taking it seriously is a big thing" The conversation evolves as our guest speaks to the realities of moving internationally to pursue your career in medicine. Can a truly global perspective better position the medical community when it comes to international co-operation? The World Congress of Anaesthesiologists is here: https://www.wcaprague2020.com/ Also, what's the future of medical conferencing in the world of COVID 19 and the global pandemic? Presented by Desiree Chappell and Monty Mythen with Mike Irwin, Professor, Head and Chief of Service, Anaesthesiology Hong Kong University, Gleneagles Hospital.

"4-10% of opioid naïve patients will continue to use opioids more than 90 days after surgery" Opioids are good for pain control but there's another issue, they also numb emotional pain. How do we responsibly deal with this? It's important to remember: "When you give patients high doses, you're putting them at risk". Long term listeners will recall TopMedTalk spent the best part of our launch year on this topic. If you're one of our many new listeners please use this huge resource of podcasts to help update your practice and cut down unnecessary risk: https://www.topmedtalk.com/?s=opioid "We should be minimizing opioids every chance we can", if you want to cut straight to our groundbreaking talk on opioid free anesthesia please go here: https://www.topmedtalk.com/ebpom-2019-opioid-free-anaesthesia-2/ Presented by Desiree Chappell and Monty Mythen with their guest Jennifer Lanzillotta-Rangeley, CRNA, PhD, Assistant Professor, College of Nursing, University of Cincinnati, Cincinnati, Ohio.

"It was successful early on within the National Health Service.. [because] you could eliminate the cost of some unhelpful, unnecessary tests... referrals to other "-ologists"... in our system that works, because more work is just more work. It's not more money." Is the business case for prehabilitation a "slam dunk", as some enthusiasts claim? If so how do you measure value versus volume, is value always a subjective term and can the balance between the two be addressed? How does the NHS's "internal market" compare to the US's fee for service environment? Furthermore, where are the sensible limits of prehabilitation, how far do we take it before we move forward to an operation? This piece has been available to EBPOM London attendees since it was first recorded in the earlier part of the year. For exclusive access to other similar pieces now and in the future please visit www.ebpom.org Presented by Monty Mythen and Kay Mitchell, Senior Research Manager for critical care research, NIHR Biomedical Research Centre, University Hospital Southampton, UK, with their guests, David Selwyn, Deputy Medical Director at Nottingham University Hospitals NHS Trust and Director of The Centre for Perioperative Care (CPOC), Sol Aronson, tenured Professor, Duke University and Jeff Vender, Emeritus, Harris Family Foundation Chairman of the Department of Anesthesiology at NorthShore University Health System, Evanston, Illinois and Clinical Professor at the University Of Chicago Pritzker School Of Medicine in Chicago, Illinois

This piece focuses on intensive care, the use of data and the future of fluid therapy research and its related physiological outcomes. The article mentioned in this podcast is here: "Perioperative haemodynamic therapy for major gastrointestinal surgery: the effect of a Bayesian approach to interpreting the findings of a randomised controlled trial" https://bmjopen.bmj.com/content/9/3/e024256 Presented by Desiree Chappell and Monty Mythen with their guest Maurizio Cecconi, Head of the Anaesthesia and Intensive Care Department at Humanitas Research Hospital; President-elect of the European Society of Intensive Care Medicine (ESICM) for 2020-2021, Chair Division of Scientific Affairs at ESICM; Director of the Master in Patient Blood Management at Humanitas University. -- Like this, want more? Rupert Pearse, one of the co-authors of the above article, was interviewed on TopMedTalk here: https://www.topmedtalk.com/anaesthesia-2019-rupert-pearse/

"Cognitive testing has been in the news ... there are recommendations for keeping pets mentally sound by implementing nutritional modifications, regular exercise and mental stimulation, we should certainly think about providing the same support to our geriatric patients." What does the latest research say about this vital issue? How is frailty defined? What's the clinical impact of preoperative cognitive dysfunction? Presented by Angela Bader, MD, MPH Professor of Anesthesia at Harvard Medical School and Vice Chair for Perioperative Medicine in the Department of Anesthesiology, Perioperative and Pain Medicine at Brigham and Women’s Hospital. She is also the founding director of the Weiner Center for Preoperative Evaluation. For more on this subject check out this piece here: https://www.topmedtalk.com/poet-3-04-is-paternalism-always-bad/

The 2nd Sprint National Anaesthesia Project: Epidemiology of Critical Care after Surgery (SNAP-2 - EPICCS) study launched in March 2017 around the UK. More than 2,200 investigators at more than 250 sites across the UK were signed up to take part. The observational study collected data on all patients undergoing inpatient surgery during a one-week period (21 March to 27 March) in UK NHS hospitals. The website is here: https://www.niaa-hsrc.org.uk/SNAP-2-EpiCCS?newsid=1710 This talk explains the study and its far reaching implications. Another talk on SNAP-2 is available here: https://www.topmedtalk.com/what-is-snap-2/ Presented by Ramani Moonesinghe, Professor of Perioperative Medicine at University College London (UCL).  

"Studies suggest that even three fourths of patients may be anemic when they present for surgery and many of these patients are previously undiagnosed" This common problem is known to cause issues both within the perioperative period and beyond. How can we manage this condition and where does the latest data lead us? Following a presentation there is a panel discussion featuring questions from the EBPOM Chicago audience. Check out www.ebpom.org to find out how you can attend our online conferences. Make sure you also check out the article mentioned in this piece here: https://pubs.asahq.org/anesthesiology/article/133/1/109/109133/An-Effective-and-Efficient-Testing-Protocol-for If you enjoyed this piece we suggest you go here next: TopMedTalk | Iron Man vs Anemia https://www.topmedtalk.com/topmedtalk-iron-man-vs-anemia/ Presented by Monty Mythen with Bobbie Jean Sweitzer, Professor of Anesthesiology and Associate Chair for Perioperative Clinical Practice at Northwestern University and Jeanna Blitz, Associate Professor of Anesthesiology, Director of the Preoperative Anesthesia and Surgery Screening Clinic, Director of Perioperative Medicine Fellowship at Duke University School of Medicine, Durham, North Carolina.

This talk examines the rationale for using methadone in our surgical patient population, reviews clinical trials that assess the effect of intraoperative methadone on post operative outcomes and discusses some unanswered questions related to the administration of this long acting opioid in the perioperative period. Presented by Glenn Murphy, Jeffery S. Vender Chair of Anesthesiology Research and Education and Director of Cardiac Anesthesia and Clinical Research at NorthShore University HealthSystem, a hospital affiliated with the University of Chicago Pritzker School of Medicine. For more on the "opioid sparing opioid" go here: https://www.topmedtalk.com/ebpom-2019-methadone-the-overlooked-opiate-2/

This piece is a much needed contribution to a conversation about how we should be caring for the transgender patient within the scope of perioperative care. Our guest's excellent article, “Anesthesia Inclusive Practices Amidst Adversity: Caring for the Transgender Patient”, is here: https://cms.aana.com/docs/default-source/pr-aana-com-web-documents-(all)/anesthesia-inclusive-practices-amidst-adversity-caring-for-the-transgender-patient-may-2019.pdf?sfvrsn=d810a34d_4 The NHS's guidelines are here: https://www.nhs.uk/conditions/gender-dysphoria/guidelines/ Presented by Desiree Chappell and Monty Mythen with Jose Castillo, PhD, CRNA Faculty, Texas Wesleyan University, AANA Diversity and Inclusion Committee.

How does an experienced physician, health service changer, improver and researcher see the process of re-engineering perioperative care pathways? What are the challenges we face when we try to rework or improve the culture of an institution? How do we tackle common issues, which nowadays seem less acceptable, such as delirium? This piece is part of a series of talks regarding "re-engineering perioperative care pathways" which were given during the 8th Australian and New Zealand Symposium of Perioperative Medicine Special Interest Group: “Updates in Perioperative Medicine 360” which took place between November 7th-9th 2019 Presented by Professor Alison Mudge, Conjoint Professor of Medicine, Royal Brisbane Clinical Unit, Faculty of Medicine.

Smoking is bad for you, there's little debate about that, even among users of the drug. However, further to the widely known consequences, the bottom line in the perioperative period is that smokers are 40% more likely to die after major surgery. Do patients also know this? Tissue healing, increased risk of infection and increased possiblities of complications with the anaesthetic; with these risks in mind how do we cut through the ubiquitous, but often ignored, government health risk messaging and get patients to understand the increased risk for those undergoing surgery? How do we use smoking cessation techniques in the perioperative setting? How do we manage to start, ideally, six weeks before surgery? What is the latest thinking on the neuro psychiatric consequences of smoking cessation? How useful is the Fagerstrom test of nicotine dependence? What about "vaping", is it better than smoking from a perioperative perspective? Presented by David Yates, Consultant in Anaesthesia and Critical Care Medicine at York Teaching Hospital, set up one of the UK’s first Perioperative Medicine Services in York, Anaesthesia, Perioperative Medicine and Pain Clinical Lead for the Yorkshire & Humber Comprehensive Research Network.

"Excellent teamwork"; the key to good outcomes. This piece features an in depth discussion of post operative acute kidney injury (AKI), are there fresh approaches we can take? Could more data help us? The conversation then moves to myocardial injury after noncardiac surgery (MINS). What should our thoughts be as regards postoperative troponin levels? Presented by Desiree Chappell and Monty Mythen with their guest Michelle Chew, Professor, Senior Consultant, Faculty of Medicine, Linköping University; Associate Professor, Faculty of Health and Medical Sciences, UCPH; Associate Professor, Consultant, Department of Anaestheisa and Intensive Care Medicine, Hallands Sjukhus Halmstad.

This piece focuses on the work of our guest and her impact upon the crucial area of gender and racial diversity in the US Anesthesia and Critical Care Workforce. How can we advocate for diversity within this field? What do we make of the Athena SWAN (Scientific Women's Academic Network) charter? Can social media help to raise awareness and build communities that can tackle these issues? Also in this piece we discuss Implementation Science, the study of methods to promote the adoption and integration of evidence-based practices, interventions and policies into routine health care and public health settings. More about Athena SWAN (Scientific Women's Academic Network) here: https://www.ecu.ac.uk/equality-charters/athena-swan/ Presented by Desiree Chappell with Monty Mythen and their guest Meghan Fall-Lane, Assistant Professor of Anesthesiology and Critical Care at the Perelman School of Medicine; Co-Director of the Penn Center for Perioperative Outcomes Research and Transformation; and Senior Fellow at the Leonard Davis Institute of Health Economics, University of Pennsylvania.

“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 an edited highlight of a fascinating conversation with a TopMedTalk favorite. 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.

How do we convince patients that prehabilitation is safe? What forms of certification are available for the accreditation of a balanced multidisciplinary team? How do you monitor home based patients? How do we tap into the wider 'exercise industry' on behalf of perioperative prehabilitation? Panel discussion, featuring; Daniel Santa Mina, Assistant Professor at University of Toronto & Scientist in ELLICSR at the Princess Margaret Cancer Centre; Stefan van Rooijen, surgical resident in Maxima Medical Center, The Netherlands, lecturer at the first Health Innovation School (Ministry of Health, Welfare and Sport and Reshape innovation), Surgical resident, Department of Surgery at Maxima Medical Center (ANIOS); Gerard Danjoux, Consultant in Anaesthesia and Sleep Medicine at South Tees Hospitals NHS Foundation Trust; Ken Van Someren, Director KvS Performance Ltd. This piece follows on from the presentation to be found here: http://www.topmedtalk.com/ebpom-2019-the-science-of-high-performance-insights-from-elite-sport-2/

"I know how to manage pain medication [...] addiction was the absolute last thing that would happen to me". This podcast helps tackle the difficult subject of Substance Use Disorder in healthcare practitioners. How do we, from a caring and helpful perspective, address this issue either within ourselves or others? 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/ The Peer Assistance section of the AANA's website is here: http://peerassistance.aana.com/directory.asp?State=All The phone number we share in the podcast is: (800) 654-5167 Furthermore there is an interesting article about Parkdale here: https://www.aana.com/docs/default-source/wellness-aana.com-web-documents-(all)/aana-parkdale-partnership-jan-2019.pdf?sfvrsn=bd8f51b1_2 Presented by Desiree Chappell and Monty Mythen with their guests, Linda Stone, DNP, CRNA Assistant Program Director at Raleigh School of Nurse Anesthesia and Rodrigo Garcia, CEO Parkdale; APN, MSN, CRNA, MBA.

The Perioperative Quality Initiative (POQI) is a vital part of the process needed to more widely implement sensible practice which, using a clear evidence base, provides better value care with more positive outcomes for the patient. POQI continues to provide its work in an attempt to clarify fundamental concepts in perioperative care. The fact this one focuses upon fluid management makes it particularly appropriate in these times. Link to the paper: https://perioperativemedicinejournal.biomedcentral.com/articles/10.1186/s13741-020-00142-8 Presented by Desiree Chappell with Monty Mythen and their guests Tim Miller, Professor of Anesthesiology from Duke University Medical Centre and Greg Martin Professor of Medicine, Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Emory University School of Medicine Like this, want more? Try our popular in depth series "Fluid Matters" http://topmedtalk.libsyn.com/fluid-matters-1 TopMedTalk provides world leading information about perioperative medicine like this every day. Dr Greg Martin's deeper dive into these issues is here: http://topmedtalk.libsyn.com/fluid-matters-3

We begin with a conversation about The UK Perioperative Medicine Clinical Trials Network, their website is here: https://www.pomctn.org.uk/ This piece focuses on the Optimising Shared decision-makIng for high-RIsk major Surgery (OSIRIS) programme. Shared decision making can be very challenging when we're not sure what the risks are and older patients with chronic diseases often make very different decisions when informed. How do we make this process more evidence based? How do we better understand this group and communicate with them? Are there technological answers to these questions? If you'd like to see the OSIRIS section there here's the link: https://www.pomctn.org.uk/OSIRIS You can find the OSIRIS website here: https://osiris-programme.org/ Recorded at Anaesthesia 2019; where world-renowned experts presented the latest advances in perioperative medicine, critical care and pain medicine. Presented by Monty Mythen with Mike Grocott, Professor of Anaesthesia and Critical Care Medicine, University of Southampton and Rupert Pearse, Professor of Intensive Care Medicine at Queen Mary, University of London.

How have we adapted in our views on the use of video laryngoscopy during the Covid-19 pandemic? Who is best suited to intubate? Are we seeing "a poorly managed first wave"? How are practitioners changing their approach in light of the possibility of infections? What lessons are being learned by practitioners in the midst of the COVID crisis? This piece was generously supported by Medtronic.com Presented by Desiree Chappell with Monty Mythen and her guests, Patrick Schoettker, Professor of Anesthesia and Emergency Medicine at Lausanne University Hospital, Sol Aronson, tenured Professor, Duke University, Henry Howe, Junior Doctor, NHS England and TopMedTalk team member.

Why has 'prehabilitation' suddenly picked up pace in terms of both practice and interest? This piece takes a serious look at the widening interest in an idea familiar to many sportsmen. Learn how the marginal gains we get through the application of science to optimise the moment of surgery as a real opportunity to apply everything we know. Also; what are ketones and how can they be used to promote health? Presented By Desire Chappell and Monty Mythen with their guests Gerard Danjoux, consultant in Anaesthesia and Sleep Medicine at South Tees Hospitals NHS Trust and Ken Van Someren, Director KvS Performance Ltd.

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.

In the UK community based prehabilitation is being spearheaded by the Prepwell Initiative, supported by a grant from Sports England. Their pioneering work is a great example of the way in which prehabilitation is gathering pace at the moment. The “PREP: Preoperative Risk Education Package” website is here: https://www.prepwell.co.uk/ What are the economics of such a programme? Why did the project start to get referrals from initially sceptical surgeons? How did the programme impact the lives and treatment of patients? Presented by Gerard Danjoux, Consultant in Anaesthesia and Sleep Medicine at South Tees Hospitals NHS Foundation Trust.

"The more I learn about this, the more my eyes are opened to how much opportunity we have to improve in this area" This piece covers the "perennial topic" of whether paralysis is bad for breathing, here with a focus upon outcome criteria associated with residual neuromuscular blockade. It's a piece based in part upon a recent talk at the American Association of Nurse Anesthetists annual conference which was this year held virtually. Presented by Desiree Chappell with her guest Brent Dunsworth, CRNA, DNP, Director of Advanced Practice for the Department of Anesthesiology at Vanderbilt University Medical Center. -- You heard Desiree correctly! We have passed the million downloads mark! An incredible achievement and a reflection of the global reach and power of our message. Thank you for your support, thanks to those listeners who have gone above and beyond the cause to promote TopMedTalk for us on their social media and in their talks and presentations, thanks also to our sponsors who have allowed us to keep this vital information free to all; wherever in the world you are Perioperative Medicine is the safest way to cut reduce unnecessary surgery, improve outcomes and reduce the time spent in hospital by our patients.

Burn out and stress management have been an important theme on TopMedTalk recently, here we have a top medical professional sharing their story in relation to the topic. How do we describe "burn out", are certain words a barrier to discussion? How do we cut through to people who are most likely to suffer from this incredibly dangerous condition? Is the medical profession finally making progress here? Our interview with Sasha Shillcut is here "Sunday Special | Burn out": https://www.topmedtalk.com/sunday-special-burn-out/ This piece was originally streamed live 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

This panel discussion covers essential ground for any institution that is trying to make real and lasting change. What do we need to know? What do our patients need to know? Who is responsible for questions of safety? How important are checklists? What about "patient advocates"? This piece was generously supported by Massimo.com it follows on from this piece here: https://www.topmedtalk.com/ebpom-chicago-patient-safety-how-do-you-make-the-changes-that-change-culture/ Presented by Sol Aronson with Mike Ramsey, Chair of the department of Anesthesia and pain management at the Baylor University Medical Center in Dallas and Board Chair of the Patient Safety Movement Foundation, Lee Fleisher, CMO and director for the Center for Clinical Standards and Quality for the centers of Medicare and Medicaid, Sarah Lenz Lock, Senior Vice President for Policy Research and International Affairs for the AARP, Lili Brillstein, Director of Specialty Care Value Based Models for Horizon Blue Cross Blue Shield of New Jersey and Monty Mythen, Smiths Medical Professor of Anaesthesia and Critical Care at University College London.

In this piece you can hear the co-editors of the Journal of Perioperative Medicine describing this year's "Editor's Picks"; the best manuscripts, literature and lessons learned in the last year in the space of perioperative medicine. "Functional performance and 30-day postoperative mortality after emergency laparotomy—a retrospective, multi-center, observational cohort study of 1084 patients" is here: https://perioperativemedicinejournal.biomedcentral.com/articles/10.1186/s13741-020-00143-7 There is more information about the Eastern Cooperative Oncology Group (ECOG) here: https://ecog-acrin.org/resources/ecog-performance-status "A randomised trial of non-invasive cardiac output monitoring to guide haemodynamic optimisation in high risk patients undergoing urgent surgical repair of proximal femoral fractures (ClearNOF trial NCT02382185)" is here: https://perioperativemedicinejournal.biomedcentral.com/articles/10.1186/s13741-019-0119-x "The effect of virtual reality technology on preoperative anxiety in children: a Solomon four-group randomized clinical trial" is here: https://perioperativemedicinejournal.biomedcentral.com/articles/10.1186/s13741-019-0116-0 Presented by Mike Grocott, Professor of Anaesthesia and Critical Care at the University of Southampton and a Consultant in Critical Care Medicine at University Hospital Southampton NHS Foundation Trust with his guests Clifford Ko, Professor of Surgery at UCLA, Director of the Division of Research and Optimal Patient Care at the American College of Surgeons and Lee Fleisher, Professor of Anesthesiology and Critical Care, University of Pennsylvania. Originally part of the hugely successful EBPOM 2020 Chicago this piece is introduced by Sol Aronson, tenured Professor at Duke University.

Why does the US have the highest maternal mortality rate of any developed country? This piece tackles a very controversial issue in healthcare head on, could the problem be due to racism? The chances of a serious issue is "substantially higher if you come from a minority group, in particular if you are African-American". We also cover the issue of postpartum hemorrhage, what are the key signs that a patient is at risk? Furthermore, how are quality care initiatives and standardization of care helping improve the field of obstetrics? Also, what is the latest thinking on home births, are they a financial decision for some? The California Maternal Quality Care Collaborative is here: https://www.cmqcc.org/ For more info on the Society for Obstetric Anesthesia and Perinatology (SOAP) go to www.soap.org Presented by Desiree Chappell and Monty Mythen with their guest Alexander J Butwick, Obstetric Anesthesiologist and Researcher in maternal hemorrhage, pain relief in labor, and obstetric epidemiology at Stanford University. -- Like this, want more? On the subject of obstetrics find out more here: EBPOM Highlight 1.27 | Obstetric anaesthesia - https://www.topmedtalk.com/ebpom-highlight-1-27-obstetric-anaesthesia/ ASA 2018 San Francisco | Smith’s Medical Symposium on Enhanced Recovery – Part 5 - https://www.topmedtalk.com/asa-2018-san-francisco-smiths-medical-symposium-on-enhanced-recovery-part-5/ Periop Coach 4.10 | Enhanced Recovery for obstetrics https://www.topmedtalk.com/periop-coach-4-10-enhanced-recovery-for-obstetrics/

This piece is taken from the free papers presentations given at EBPOM 2019. Malnutrition and functional capacity; what is the effect of multimodal prehabilitation? What can the six minute walk test really show us? Does nutritional status predict preoperative change in a six minute walk test in colorectal cancer patients following a prehabilitation programme? Presented by Lauren Richer, Director, Nutritional Services, Keyto, Registered Dietician, Greene Family Medicine Clinic and Montreal General Hospital, Montreal, Quebec.

This piece deals with the prediction of opioid induced respiratory depression for our inpatients on hospital wards, could a change in monitoring practices help? The postoperative period seems to be critical, the thirty day period immediately after anesthesia being a key area. 7.7% of postoperative deaths are in this period, according to The Lancet here; https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(18)33139-8/fulltext What is happening in the post operative period? How do we find out more? Are hospital general care wards the safe haven we expect them to be? What should we monitor and how do we avoid "alarm fatigue"? More on the "PRediction of Opioid-induced Respiratory Depression In Patients Monitored by capnoGraphY (PRODIGY)" trial here: https://clinicaltrials.gov/ct2/show/NCT02811302 The official STOP BANG score website is here: http://www.stopbang.ca/osa/screening.php This piece was sponsored by Medtronic. This is part 1 of a two part piece. Presented by Monty Mythen with Desiree Chappell and Ashish Khanna, Associate Professor, Section Head for Research, Department of Anesthesiology, Section on Critical Care Medicine,Wake Forest School of Medicine. If you loved this piece you'll also enjoy this piece here: Desiree’s Roundtable | Can you bite your upper lip? Assessing patients to reduce post-op respiratory complications http://www.topmedtalk.com/desirees-roundtable-can-you-bite-your-upper-lip-assessing-patients-to-reduce-post-op-respiratory-complications-2/

"Data is destiny"; this piece looks at way we can unlock it for Anesthetists. The Open-Source Anesthesia Electronic Medical Record (OSAEMR) was developed specifically for Nurse Anesthetists. Its focus is on solo or small-practice nurse anesthetists operating in environments with limited or no network and computing resources other than an iPad. One patient, one nurse anesthetist, and one iPad. It can now be scaled to larger multi-provider practices outside of CRNAs. Hear how this innovation came about. 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/ The Open-Source Anesthesia Electronic Medical Record (OSAEMR) website is here: https://www.osaemr.com/ Presented by Monty Mythen and Desiree Chappell with John T. "Jack" Hitchens, CRNA, BA, ARNP, partner in a CRNA owned and operated Anesthesia Practice, Watchful Care and Dan Simonson, CRNA, MHPA retired as Chief CRNA and managing partner of the Spokane Eye Surgery Center, adjunct faculty at the Washington State University College of Nursing’s Department of Health Policy and Administration.

Patient safety, as a priority, is assumed to be at the heart of medical practice. Yet still, preventable harm and death occurs in our profession, how do we change this and how do we make the changes we implement last? Can safety and avoidable harm be somehow hardwired into the culture of what we do in a way similar to that of the airline industry? This popular and refreshing talk is presented here after it was a big hit at the Chicago 2020 conference organised by Evidence Based Perioperative Medicine (EBPOM). For more check out www.ebpom.org Presented by Mike Ramsey, Chair of the Board of Directors of the Patient Safety Movement Foundation (PSMF), Chair of the Department of Anesthesiology at Baylor University Medical Center in Dallas, Texas.

Patients with physiological and psychological resilliance have a clear advantage in surgery. The Wessex Fit-4-Cancer Surgery Trial (WesFit) is attempting to determine the effects of multi-modal physical and psychological prehabilitation. This piece gives you the detail and ends with a short informative question and answer session. Presented by Samantha Leggett, Study Director, University Hospitals Southampton NHS Foundation Trust.

"At the moment perioperative care in the UK doesn't really have the profile that I think it needs; now I suspect that COVID-19 has raised it up the agenda" If you enjoyed Monty's explanation regarding the UK's perioperative journey you may find this link interesting: Evidence submitted by the Improving Surgical Outcomes Group (ISOG) (NICE 75): https://publications.parliament.uk/pa/cm200607/cmselect/cmhealth/503/503we35.htm "Now we're here at this Pocapalooza" - POC, standing for Perioperative Care and "apalooza" being an extravagant event. However, as one of our guests suggests, perhaps we should call this one a "CPOC-apalooza!" as a lot of our focus is on The CPOC (Centre for Perioperative Care). The International Board of Perioperative Medicine is essential for anyone listening to this podcast: https://www.internationalboardpom.org/ Presented by Desiree Chappell with Monty Mythen, and their guests Mike Grocott - a frequent TopMedTalk anchor - and Professor of Anaesthesia and critical care at the University of Southampton and David Selwin, Medical Director at Sherwood Forest Hospitals NHS Foundation Trust. For more information on these topics look for the next POCAPALOOZA and get the US perspective!

"It also must start and end in primary care" This piece is a fascinating in-depth conversation moving through various medical perspectives on perioperative medicine from Australia and New Zealand. A real highlight of the festival. How has perioperative medicine evolved over the years around the world? What's the status of Perioperative Care as a specialty? How does one specialise in this area, in terms of education? Discussing the development of the International Board:- "We decided perioperative education should not only be available for developed countries". We hear that TopMedTalk engaging with the African Perioperative Research Group (APORG) has helped move the cause of perioperative care forward, both in Africa and elsewhere. The conversation further evolves: Once educated how do we demonstrate the value of perioperative practice? How do we launch projects that will really make a difference? Where, from a research perspective, do the more fruitful areas of investigation present themselves? Would a minimum data set help? Moving to clinical trials we hear how research is being conducted, both the challenges and the sources of success. "Perioperative medicine is a team sport" - how do we use the interdisciplinary aspect of what we do to enhance our educational options? Regular listeners to TopMedTalk may recall the series we did about the Perioperative Special Interest Group (SIG) - if you want more details of http://www.anzca.edu.au/fellows/special-interest-groups/perioperative-medicine The ANZCA Clinical Trials Network can be found at http://www.anzca.edu.au/ctn Also, The International Board of Perioperative Medicine is here: https://www.internationalboardpom.org/ Further, make sure you check out https://www.periopmedicine.org.uk/ for more information on the perioperative medicine short course we discuss. And Perioperative Medicine for The Junior Clinician is available here: https://www.amazon.co.uk/Perioperative-Medicine-Junior-Clinician-Symons/dp/1118779169 Presented by Desiree Chappell alongside co-host Ross Kerridge, Anaesthetist from Newcastle in Australia - sometimes called the 'Father of Perioperative Medicine'. Guests are Jill Van Acker, Staff Specialist Anaesthetist and Clinical Lead Perioperative Services, Canberra Hospital, and Chair of the ANZ Perioperative Special Interest Group; Vanessa Beavis, President, Australian & New Zealand College of Anaesthetists, & until recently Director of Perioperative Services, Auckland District Health Board; Prof. Jackie Close Orthogeriatrician at the Prince of Wales Hospital in Sydney and Clinical Director of the Falls, Balance and Injury Research Centre at Neuroscience Research Australia; Prof. Dave Story, Head of the ANZCA Clinical Trials Network, and Chair of the Anaesthesia, Perioperative and Pain Medicine Unit within the University of Melbourne Medical School. Joel Symons, Anaesthetist at the Alfred Hospital in Melbourne and Senior Lecturer at Monash University, Leader in the development of Educational Programs based at Monash University and member of International Board of Perioperative Medicine.

This piece focuses on The Balanced Anesthesia Study, 'A Prospective Randomized Clinical Trial of Two Levels of Anesthetic Depth on Patient Outcome After Major Surgery'. How can delerium be measured and standardised in a multi-centre trial? More on the study here: https://journals.lww.com/anesthesia-analgesia/FullText/2015/08000/Rationale_and_Design_of_the_Balanced_Anesthesia.14.aspx More on the Confusion Assesment Method here: https://www.guysandstthomas.nhs.uk/resources/our-services/acute-medicine-gi-surgery/elderly-care/cam-diagnostic-algorithm.pdf The Hospital Elder Life Program (HELP) for Prevention of Delirium is here: https://www.hospitalelderlifeprogram.org/ We discuss the ENGAGES trial here: https://www.topmedtalk.com/journal-club-1-14-jama-the-engages-randomized-clinical-trial/ More on the Women in Anaesthesia Research, a BJA Symposium, here: https://www.periopmedicine.org.au/2019prato Presented by Desiree Chappell and Monty Mythen with Lis Evered, neuroscientist and Head of Research in the Department of Anaesthesia and Acute Pain Medicine, St Vincent’s Hospital, Melbourne. She has led an international group to standardise nomenclature for cognitive change associated with anaesthesia and surgery. She is an Editorial Board member of British Journal of Anaesthesia. - Like this, want more? Lis Evered also features on TopMedTalk here: https://www.topmedtalk.com/sunday-special-the-perioperative-cognition-workshop-part-1/

After a short overview of the history of the Society of Cardiovascular Anesthesiologists (SCA) this conversation zones in on some of the hot topics that are being discussed in the field; devices and extracorporeal membrane oxygenation (ECMO) machines, as well as trans-esophageal echocardiography and how the practice has evolved. The conversation ends with a discussion about pre-habilitation in a resource stretched environment. Presented by Desiree Chappell with Sol Aronson and Jamie Ramsey, Medical Director Cardiac ICU at UCF and Gerald Levy, MD at Duke University.

This piece focuses on the Preoperative Intravenous Iron To Treat Anaemia in major surgery (PREVENTT) trial; a randomized double-blind controlled phase III study to compare the efficacy and safety of intravenous ferric carboxymaltose with placebo in patients with anaemia undergoing major open abdominal surgery. The main question is if we properly mobilize our patients, feed them and correct their anemia, do they do better? How can we get a patient fitter for surgery? Can we correct anemia before surgery? "We took people prior to major open abdominal surgery [...] and our question was, in two weeks prior to surgery, if we give them intravenous iron and treat the anemia, at operation do they receive less blood transfusion and post operatively recover without as many complications?". Also, Are you a woman and anemic? Should you be taking iron supplements? Could you do with a dose of I.V. iron? The Iron Clinic is here: https://www.theironclinic.com/ The PREVENTT website is here: https://preventt.lshtm.ac.uk/ Our guest also featured in the press where they dubbed him "Iron Man": https://www.dailymail.co.uk/femail/article-3932602/Hugely-popular-Australia-s-just-come-menopausal-women-benefit-iron-drip-stop-feeling-tired-time.html Presented by Desiree Chappell with Monty Mythen and their guest Toby Richards, Professor, Anaesthesia Teaching & Research Faculty of Medicine, Nursing and Health Sciences Central Clinical School, Monash University.

This panel discussion includes questions such as: In a prehabilitation service what screening tools should we use to assess nutritional risk? What tools are there related to patient self management? What advice would you give a patient about cannabis smoking cessation? Should denial of surgical procedures be used as a motivator for lifestyle change? Can the questions used in interventions sometimes be open to misinterpretation by patients? How do we assess and treat sleep disorders? If not a psychologist, what team members might handle psychological behaviour change? Does immunonutrition work? Are there sensitive approaches to addressing weight loss, physical activity and diet that the panel reccomend? Panel discussion chaired by Sandy Jack and Daniel Santa Mina, featuring, David Yates, Consultant in Anaesthesia and Critical Care Medicine at York Teaching Hospital, Chloe Grimmett, National Institute of Health Research (NIHR) post-doctoral Research Fellow and Senior Research Fellow for the Macmillan Survivorship Research Group at the University of Southampton, Chris Snowden, Consultant Anaesthetist, Freeman Hospital, Newcastle upon Tyne and Senior lecturer at the Institute of Cellular Medicine at Newcastle University, Chelsia Gillis, Registered Dietitian, Canadian Vanier Scholar, and PhD Candidate in Epidemiology at the University of Calgary, Canada, she is leading the first prehabilitation program for colorectal surgery in Alberta.

"ERAS in Colorectal Surgery" - was originally streamed live from the Charles Sammons Cancer Center, Dallas, during EBPOM-USA 2019 on www.topmedtalk.com If you'd like to attend an event like this ensure your next click is here: www.ebpom.org/meetings If you have any comments or questions you'd like to send to the team email: 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.  

This piece focuses upon the African Surgical Outcomes Study (ASOS-2). More than a thousand people across Africa have combined forces to make this research into perioperative medicine in a resource limited environment happen. We know patients in Africa are twice as likely to die following surgery when compared to the global average, why is this? How does "failure to rescue" play into this? The website mentioned in this piece for more details: https://www.asos.org.za Presented by Desiree Chappell with Monty Mythen and their guest Bruce Biccard, consultant anaesthetist at the University of Kwazulu-Natal, Director, Perioperative Research Unit, Department of Anaesthetics, Nelson R Mandela School of Medicine from

"There seems to be a little extra buzz in the cardiac community". This conversation focuses upon the psychology of change, specifically regarding the leadership role presented within perioperative medicine to anaesthesiologists. How can perfectionism, as a barrier to change, be overcome? How do practitioners build the confidence to make a difference? Furthermore, how do we engage in 'internal marketing' where we promote success within our own institutions? More information on The Morpheus Consortium here: http://morpheusconsortium.org/ Check out the article here: https://jamanetwork.com/journals/jamasurgery/fullarticle/2732511 Find out more about NorthStar here: https://northstaranesthesia.com/ The "Masters of Scale" podcast is here: https://mastersofscale.com/ This piece was originally released live from "ERAS cardiac: Center of excellence training conference", an Edwards Life Sciences sponsored conference in North Carolina. Presented by Monty Mythen and Desiree Chappell with their guest Bob Booth, Regional Chief Medical Officer, Vice President of Physician Operations at NorthStar Anesthesia, P.A. Like this, want more? Brian Woods from NorthStar features on TopMedTalk here: https://www.topmedtalk.com/topmedtalk-the-goal-is-more-important-than-the-role/

This hugely important talk was the centerpiece of EBPOM 2019 and, appropriately enough, it focuses on a big topic for us here at TopMedTalk; the future of fluid therapy. Originally given as the EBPOM 2019 Ernest Henry Starling plenary lecture the talk is complimented by this piece which was recorded on the same day: https://www.topmedtalk.com/desirees-roundtable-fluids-in-the-2020s/ Where is the latest thinking on fluid therapy, what new evidence and understandings do we now have? Presented by Dr Andrew Shaw, Chairman, Department of Anesthesiology and Pain Medicine at The University of Alberta, Edmonton, Alberta and Zone Clinical Department Head for Anesthesia, Alberta Health Services Edmonton Zone. He is also a Fellow of the Royal College of Anaesthetists (UK), the American College of Critical Care Medicine and the Faculty of Intensive Care Medicine (UK).

Dingle 2020 is now on! Make sure you check out www.ebpom.org for more details. Today's TopMedTalk is another sampler from the conference, made available because this vital piece deals with a variety of issues related to COVID-19; what we know and what we know we do not know: - Similarities and differences between COIVD-19 and Aqute Respiratory Distress Syndrome (ARDS) - The most useful information observed by practitioners at the bedside, conscious of the lack of Randomised Controlled Trials (RCTs) in this area - The controversy regrading early invasive ventilation versus non-invasive ventilation - What are the aerosolization risks? - Pragmatic patient prioritization - The role of anti-coagulation - The role of continuous positive airwave pressure (CPAP) - who benefits and why? Presented by Professor Mervyn Singer, Intensive Care Medicine at University College London. Don't miss out on our next conference, make sure you go now to www.ebpom.org

What are some of the major issues regarding billing? What are the most common mistakes when it comes to documentation? How do we keep the focus on great healthcare, as well as good book keeping? How does "the false claims act" impact on billing? If you find a mistake or an issue in your note keeping the advice here is clear; deal with it the moment it is discovered. Also, under recording is an obvious issue, can the same be said of 'excessive documentation'? The bottom line is that practitioners must remain educated, stay aware of what is going on and rely on the fact that patient care is crucial and has to remain at the heart of any healthcare practice. This piece was part of our coverage of The American Association of Nurse Anesthetists (AANA) 2019 Annual Congress in Chicago, Illinois. Check out the AANA here: https://www.aana.com/ If you would like to contact our guest he has allowed us to post his email here: msilberman@beneschlaw.com Presented by Desiree Chappell and Monty Mythen with Sol Aronson, a tenured professor at Duke University and Executive Vice Chairman in the Department of Anesthesiology and their guest, Mark Silberman, Partner, Benesch Law Chair, White Collar, Government Investigations, & Regulatory Compliance Vice-Chair, Health Care.

This piece is a chance to hear more about the work of our guest, who made a big impact as a guest on a recent edition of TopMedTalk: https://www.topmedtalk.com/topmedtalk-computer-gamer-to-life-saver/ The Perioperative Quality Initiative (POQI) is here: www.poqi.org This piece covers cerebral oximetry with near-infrared spectroscopy (NIRS), often used during the perioperative period of cardiovascular operations. Article here: "American Society for Enhanced Recovery and Perioperative Quality Initiative Joint Consensus Statement on the Role of Neuromonitoring in Perioperative Outcomes" https://journals.lww.com/anesthesia-analgesia/Abstract/9000/American_Society_for_Enhanced_Recovery_and.95500.aspx We're celebrating Evidence Based Perioperative Medicine's (EBPOM) Dingle conference which holds a special place in the hearts of TopMedTalk listeners. We've covered it for the last few years in detail, making many hours of valuable educational information accessible to a global audience of thousands of medical professionals each week. If you'd like to find out more about EBPOM's groundbreaking online proposition please checkout www.ebpom.org Presented by Desiree Chappell and Monty Mythen with their guest Robert Thiele, Associate Professor, Departments of Anesthesiology and Biomedical Engineering, Division Chief, Critical Care Anesthesiology, Board of Directors, University Physicians Group, University of Virginia School of Medicine. He has a background in engineering and has been using technology to improve education since his residency in 2008. He is co-founder of www.OpenAnesthesia.org which lead to the development of Self-Study, and also authored one of the first iBooks focused on cardiac and critical care ultrasound.

The American Associaton of Retired People (AARP), an organisation with a membership almost equal to the entire voting population of the United Kingdom, are focusing on brain health, in response to the demands of their members. Further conversation includes how practitioners both explain the risks of surgery and also calm possible misunderstandings or fears regarding them, as well as wider reflections on 'The Brain Health Initiative'. Presented by Desiree Chappell with Mike Grocott and their guests Lee Fleisher, Professor of Anesthesiology and Critical Care, University of Pennsylvania and Sarah Lock, Senior Vice President for policy at the American Association of Retired People (AARP) and the director of 'The Global Council on Brain Health'.

Joff and his guests visit the hallowed turf that is the Boston Ether Dome, in the Bulfinch Building, Massachusetts General Hospital. How have times moved on since those early pioneering days when the relatively young profession of Anaesthesia was born? Back then the word wasn't as widely used and the gentlemen in question described their activities as "rendering people insensible using sulphuric ether for the conduct of surgery". Remember - if you've not yet subscribed to our mailing list you're only getting half of the TopMed talk experience, go to our website now: www.topmedtalk.com Recorded last year this piece has Dr Joff Lacey paying tribute to the birthplace of Anaesthesia. Joined by Dr Liam Brennan, President of The Royal College of Anaesthetists (RCoA) and Dr Andy Bailey, Addenbrooke's Hospital, Cambridge.

On the morning of the first day of the 2018, annual conference, of the American Society of Anesthesiologists (ASA) Monty Mythen and Desiree Chappell were lucky enough to get an exclusive interview with Professor Henrik Kehlet. Henrik Kehlet is a gastrointestinal surgeon and former professor of surgery, Copenhagen University, and now professor of perioperative therapy and Head of Section of Surgical Pathophysiology, Rigshospitalet, Copenhagen University. He has published more than 650 articles within perioperative pathophysiology, pain relief and surgical outcome summarized into the concept of 'fast-track surgery', which also includes a focus on perioperative fluid management.

This piece is a reflection upon and celebration of conversations that were made possible by both The American Society of Anesthesiologists and Edwards Life Sciences, a key sponsor for TopMedTalk. If you would like to hear these conversations in full please follow the links below: Greg Fischer, Chairman, Department of Anesthesiology & Critical Care Medicine at Memorial Sloan Kettering Cancer Center: https://www.topmedtalk.com/anes19-greg-fischer/ Tim Miller, Associate Professor of Anesthesiology from Duke University Medical Centre: https://www.topmedtalk.com/anes19-tim-miller/ The Perioperative Quality Initiative (POQI) is here: https://thepoqi.org/ Michael Scott, Professor and Division Director, Critical Care Anesthesiology- Virginia Commonwealth University: https://www.topmedtalk.com/anes19-michael-scott/ Also - congratulations to the American Society of Anesthesiologists on the success of this year's online proposition, find out more at www.asahq.org And don't forget Evidence Based Perioperative Medicine are continuing the momentum of the hugely successful Chicago and London, online meetings - check out www.ebpom.org for more details.

Recorded at the American Society of Anesthesiologists' Annual General Meeting in 2019; "The Power of The Interdisciplinary Team"; introducing the Enhanced Recovery team from Keck Medical Center at The University of Southern California (USC). Our guests kindly share an email address you can contact them on: Enhanced.Recovery@med.usc.edu Presented by Desiree Chappell and Monty Mythen with their guests Professor Carol Peden, Robin Cresner, CCRN, Dr Shane Dickinson, anesthesiologist and Snow Shoo Son; The Enhanced Recovery Team from Keck Medical Center at USC. -- Like this, want more? There's a fascinating conversation with Carol Peden here: https://www.topmedtalk.com/talks-to-carol-peden/

A discussion about oxygen and the Xtreme Everest research studies into human adaptation to hypoxia. How does the human body adapt to extreme conditions? We assume it will inevitably cause damage but this is not always the case. How do people who have inherited a tolerance for low levels of oxygen manage? Monty Mythen, Mike Grocott and Joff Lacey are joined by special guest Dr Dan Martin OBE, Consultant in Intensive Care and Everest summiteer.

Where is perioperative medicine as a specialty in the US? How do frail patients benefit from the perioperative process? Age and physical fitness are important factors when deciding if you're going to put a patient through major surgery, how do these factors allow us to differentiate between those who are likely to have a poor outcome? How common is cardiopulmonary exercise testing (CPET) in the US? Presented by Desiree Chappell and Monty Mythen with their guest Bobbie Jean Sweitzer, Director of Perioperative Medicine at Northwestern. Our guest's excellent book is here: https://www.amazon.co.uk/Preoperative-Assessment-Management-BobbieJean-Sweitzer-ebook/dp/B07DWLNW8Y

"We need to work together more, it needs to be multidisciplinary" A fascinating and still essential discussion - from a truly global perspective - featuring guest presenter Dr Liam Brennan, President of the Royal College of Anaesthetists and his guests; Dr Gonzalo Barreiro, President of the World Federation of Societies of Anaesthesiologists (WFSA), Julian Gore-Booth, CEO of WFSA and Dr Paul Clyburn, President of the Association of Anaesthetists of Great Britain and Ireland, to discuss the unmet global need for safe and accessible anaesthesia.

How do new technologies impact the postoperative elements of Enhanced Recovery? We discuss ward monitoring 3.0 and the technology available, or in the pipeline, to improve outcomes. How do we best use this information and these innovations? There is also a refreshing conversation about Artificial Intelligence (AI) alongside discussion about "bed sensors" and "facial recognition". Some dementia units are using new technology to monitor patient movement both in and out of their beds, how does this tie into the issue of early mobilisation? Furthermore - what will the consequences be when facial recognition and monitoring is ubiquitous within institutions? 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 piece is a deep dive into regional anaesthesia for Enhancing Recovery. Hear how paravertebral nerve blocks can be used in breast cancer surgery, how does this effect long term outcomes for patients? There is then further discussion regarding regional anaesthesia for Ambulatory Surgery. There is also a long form discussion of electromyographic (EMG) objective monitoring on a neuromuscular blockade. How can this help reduce and discover potential poor outcomes? Further questions from the online audience are addressed such as "can you send knee surgery patients home on the day of surgery, how do you manage pain?" Since this piece was recorded it's worth nothing that these important studies were subsequently finished and published: "Recurrence of breast cancer after regional or general anaesthesia: a randomised controlled trial " https://pubmed.ncbi.nlm.nih.gov/31645288/ "Influence of perioperative anaesthetic and analgesic interventions on oncological outcomes: a narrative review " https://pubmed.ncbi.nlm.nih.gov/3125529/ "How Anesthetic, Analgesic and Other Non-Surgical Techniques During Cancer Surgery Might Affect Postoperative Oncologic Outcomes: A Summary of Current State of Evidence" https://pubmed.ncbi.nlm.nih.gov/31035321/ Presented by Desiree Chappell and Monty Mythen with their guest Professor Stuart Grant, MB ChB, FRCA Director, Medical Student Education, Duke University School of medicine.

This piece is a look at the very beginnings of your favorite medical podcast. Today we celebrate the American Society of Anesthesiologists (ASA) and their annual general meetings, which we have covered every year since 2017. Find out how TopMedTalk pioneered its first live transmissions from that meeting in Boston and began providing free medical information for an ever growing online audience. This piece features a timeless conversation about the profession of Anesthesia, from its inception to the diverse and exciting role we find today. Are we right to say that its a role which is rightly evolving toward a broader focus on perioperative medicine? Can we be sure that those in this profession are right to take a leadership role as evidence of the life saving benefits of the perioperative method become recognised internationally? Presented by Monty Mythen, Smiths Medical Professor of Anaesthesia and Critical Care at University College London and TopMedTalk's Editor in Chief, with, Mike Grocott, Professor of Anaesthesia and Critical Care Medicine at the University of Southampton, Joff Lacey, now a Consultant Anaesthetist at St George's Hospital in South West London and Sol Aronson, tenured Professor at Duke University. Please check out the ASA's website here: www.asahq.org The fuller conversations from this podcast are available here: Podcast 1: Live from Boston ASA 2017 – Anaesthesia and the Perioperative Medicine movement https://www.topmedtalk.com/podcast-1-live-from-boston-asa-2017-anaesthesia-and-the-perioperative-medicine-movement/ Live from Boston ASA 2017 - Perioperative Medicine in USA https://www.topmedtalk.com/live-from-boston-asa-2017-perioperative-medicine-in-the-usa/

This piece tackles "prehabilitation", TopMedTalk's word of the year. What is it, why is it so important, who is doing it and why are some people reticent about something that is so obviously good for their health? Furthermore, what are the transatlantic nuances to this debate? Presented by Desiree Chappell with Sol Aronson, tenured professor at Duke University and Executive Vice Chairman in the Department of Anesthesiology, and their guest Mike Grocott, Professor of Anaesthesia and critical care at the University of Southampton. Recorded at Anesthesiology 2019 at the Orange County Convention Center in Orlando, over 14,000 delegates, clinicians, thought leaders and professionals; the largest gathering of Anesthesiologists and Anesthesia providers in the world. The ASA has gone virtual, check them out here: www.asahq.org -- Like this, want more? Sol Aronson's excellent talk "EBPOM 2018| Perioperative medicine is Population Health Management" is here: https://www.topmedtalk.com/ebpom-2018-perioperative-medicine-is-population-health-management/ And Mike Grocott co-chair's a gripping debate about prehabilitation, "EBPOM 2019 | System wide change for prehabilitation", is here: https://www.topmedtalk.com/ebpom-2019-system-wide-change-for-prehabilitation/  

Emotional intelligence is the ability to perceive, integrate, understand and utilize emotions in an effective and meaningful way in order to cope and adapt to the situation. It's a hot topic at the moment, here we speak with the first CRNA to be certified in emotional intelligence. Stress and burn out is a common problem in the CRNA community, handling that could have a real impact on performance and outcomes. Our guest mentions the Mayer-Salovey-Caruso Emotional Intelligence Test™ which can be found here: https://www.mhs.com/ She also advocates "The Student EQ Edge: Emotional Intelligence and Your Academic and Personal Success: Student Workbook" which can be found on Amazon here: https://www.amazon.co.uk/Student-EQ-Edge-Emotional-Intelligence/dp/1118094603 Our guest kindly allowed us to share her email with you: andrea.bittinger@beaumont.org Presented by Desiree Chappell and Monty Mythen with their guest, Andrea Bittinger, CRNA at William Beaumont Hospital.

This panel discussion is an honest and challenging look at blood pressure management. Questions include but are not limited to: How should practitioners maintain blood pressure in patients and where is the threshold? How much precaution is inspired by eminence rather than actual evidence? What is the best and safest way to attenuate sympathetic responses intraoperatively? If harmful hypotension occurs between induction and incision should we refuse to induce anaesthesia until the surgeon is scrubbed and ready? If we had better, more specific or sensitive ways to monitor tissue perfusion rather than blood pressure and now - almost discounted - urine output, would this lead to better care? Is it the case that minimally invasive cardiac output technology may be of much greater value in the ward than in theatre? Presented by Desiree Chappell with Monty Mythen and Dr Simon Davies, Consultant Anaesthetist at York Teaching Hospital NHS Foundation Trust with Timothy Miller, Associate Professor of Anaesthesiology from Duke University Medical Centre.

This piece gives you clear practical suggestions which you might want to include in your practice and institution. How do we improve the physiological reserve of patients? Is there a way to do enhanced recovery with an extra edge? Specifically, how do we reduce pulmonary complications? What is 'surgery school'? How does 'icough' fit into this? How can practitioners and admin staff help to reduce anxiety as surgery comes closer? Visit the I COUGH UK website here: https://mft.nhs.uk/mri/services/i-cough-uk/ Make sure you check out the surgery school on the ERAS+ website here: https://www.erasplus.co.uk/How/SurgerySchool Presented by Dr Daniel Conway, consultant in anaesthesia and critial care at University Hospitals Manchester.

This year was always expected to be a big one for prehabilitation, the advent of a global pandemic has only increased the importance of this exciting field of medicine. Various questions from EBPOM 2020 attendees were tackled by the panel: Can you use "Timed Up and Go" (TUG) and The Duke Activity Status Index (DASI) to screen out unnecessary cardio-pulminary exercise testing (CPET)? What exactly is prehabilitation and what's its natural scope? How important is nutrition? Is it possible to standardise these areas more? What areas are being significantly worked on in prehabilitation medicine in the UK this year? What about - in these COVID 19 times - remote screening and assessment? Also, what about the possibilities regarding aerosolisation, particularly of COVID-19, during CPET? Can prehabilitation work to minimise time spent in hospital? Presented by Mike Grocott, Professor of Anaesthesia and Critical Care Medicine at the University of Southampton with Karen Kerr, Consultant Anaesthetist, Departmental Lead for CPET, Sheffield Teaching Hospitals (STH) and featuring panelists; Denny Levett, Professor in Perioperative Medicine and Critical Care at the University of Southampton and a Consultant in Perioperative Medicine at Southampton University Hospital NHS Foundation trust (UHS), June Davis, Director of Allied Health Solutions, Allied Health Professions Advisor (part time) for Macmillan Cancer Support and a professional advisor to the Care Quality Commission and Steve Wootton, OBE, Associate Professor in Nutrition at the University of Southampton with an honorary appointment with University Hospital Southampton in Clinical Nutrition.

Trainees with an interest in perioperative medicine (TRIPOM) is an ever growing organisation set to continue the global push for perioperative care. This high energy podcast gives you a taste of the enthusiasm people pick up as they learn more about the value of these ideas. Moving more obviously into the perioperative period this piece continues on from last week's talk regarding mitochondrial health where 'healthy ageing' was the focus. The panel now draw the conversation into areas such as nutrition, the impact of frailty on outcomes regarding surgery and patient assessment. How does this gripping research impact upon our work during the perioperative period? Presented by John Whittle, assistant Professor at Duke University Medical Centre and one of the founders of TRIPOM, with a panel including, Mike Grocott, Professor of Anaesthesia and critical care at the University of Southampton, Dr Brant Inman, Urologist at Duke University Medical Center, Dr Amy Pastva, immunologist, physiologist and researcher at Duke University School of Medicine, Dr Paul Wishmeyer, Professor of the Department of Anesthesiology, Duke University.

How do we manage our operating room capacity and restore elective surgery in a post-COVID19 world? A world where conditions change week by week, sometimes day by day. Managing capacity was always a challenge but now we need to think differently in order to stay resilient and agile. How has COVID19 changed the landscape now? What are the tools that exist to handle it? What are the systems and best practice guidelines that are helping institutions cope? How do we look at supply and demand within the constraints of what's available to us? Finally the possibility of a "second wave" is investigated, how should it be tackled should it arise? Presented by Sanjeev Agrawal, President, LeanTaas.

What are the hot topics in the cardiac world at the moment? This piece tackles; the need for gender balance when composing panels and building a successful event; the need to do what we know and do it well; how quality improvement benefits from simplicity; the need to keep younger practitioners involved and finally the need for a fuller engagement with the multidisciplinary aspect of cardiac care. Presented by Desiree Chappell and Monty Mythen with Sol Aronson, tenured Professor at Duke University and Executive Vice Chairman in the Department of Anesthesiology and Michael Eaton, Professor and Chair of Anesthesiology and Perioperative Medicine at the University of Rochester, New York.

This piece tells the story of two different innovators in the field of an anesthesia. The first is, The Pediatric Device for Induction of Anesthesia (PeDIA), a mask-free anesthesia delivery system designed for kids. The second is the Error Recovery and Mitigation Aide (ERMA), a reworking of the traditional needle box whereby a clear reservoir is inserted between the re-entry proof top and opaque terminal disposal portion, allowing practitioners to have visualization of all the syringes and vials used during the course of a procedure. At the end of a single procedure, a trap door in the bottom of the reservoir is released to allow those sequestered vials and syringes to drop into the bottom of the needle box for terminal disposal. This allows providers to recognise, check and confirm possible errors in a timely fashion. Also during this piece there is a wide ranging and fascinating discussion about patents and patenting. How does the process work, how can you patent your ideas and how does the advent of block chain technology potentially change this forever? Google Patents is here: https://patents.google.com/ Check out the PeDIA website here: https://www.pediallc.com/ For more information about ERMA go here: https://ii4change.com/how-we-innovate/products/error-recovery-and-mitigation-aide/ The Facebook Group "CRNA Inventors and Innovators" mentioned in this piece is here: https://www.facebook.com/groups/2150893568464906/ This piece was part of our coverage of The American Association Nurse Anesthetists (AANA) 2019 Annual Congress in Chicago, Illinois. Check out the AANA here: https://www.aana.com/ Presented by Desiree Chappell and Monty Mythen with their guests Diane Miller, Pediatric Devices for Induction of Anesthesia | Product Development | PeDIA, LLC and Jean Snyder, CRNA Inc. Co-owner Goodwin and Snyder Anesthesia Associates, PLLC.  

This piece features a short informative presentation from our Editor in Chief Monty Mythen regarding Artificial Intelligence and the HPI Monitor developed by Edwards Life Sciences. It is followed by question and answer session faciliated by both our online presence, studio audience and invited guests. The "Perioperative Quality Initiative consensus statement on the physiology of arterial blood pressure control in perioperative medicine" piece mentioned is here: https://bjanaesthesia.org/article/S0007-0912(19)30047-9/fulltext Presented by Desiree Chappell and Monty Mythen with, Feras Hatib, Phd, Director, Research and Development, Algorithms and Signal Processing at Edwards Lifesciences.

Discussion begins with thoughts about University College London (UCL)'s Masters Course in Perioperative Medicine, moving further to the various ways in which people can learn more about the specialty The wider conversation reaches out into the field of anaesthesia and the constant shortage of practitioners that there is in the UK and more widely around the world. Also, if you're intrigued, here's the link to the free 4 week course discussed in this podcast: https://www.ucl.ac.uk/lifelearning/courses/perioperative-medicine Presented by Desiree Chappell and Monty Mythen with their guests David Walker, Professor in Anaesthesia and Critical Care Medicine, University College London Hospitals, Honorary Senior Lecturer UCL and Dr Rob Stephens, Consultant in Anaesthesia, UCLH, Hon Senior Lecturer in Anaesthesia, UCL.

"PQIP Pain: from individual case to systems management" - originally streamed live from The Institute of Engineering and Technology (IET) in London during EBPOM 2018 on www.topmedtalk.com If you're looking for the talk mentioned here featuring Paul Wishmeyer it is here: https://www.topmedtalk.com/topmedtalks-to-dr-paul-wischmeyer/ If you have any comments or questions you'd like to send to the team email: contact@topmedtalk.com Presented by Dr Natasha Curran, consultant in anaesthesia and pain management University College London Hospital (UCLH) and Medical Director at the Health Innovations Network, South London. -- EBPOM | Dingle - the hottest tickets in anaesthesia and perioperative medicine - go now to the website: https://www.ebpom.org/

Trainees with an interest in perioperative medicine (TRIPOM) is an ever growing organisation set to continue the global push for perioperative care. This high energy podcast gives you a taste of the enthusiasm people pick up as they learn more about the value of these ideas. The focus here is on promoting healthy aging across two primary domains: cognitive function and physical ability. Discover how multiple features of aging—including physical and cognitive decline—are strongly associated with the bioenergetic profiles of circulating cells. Could the ability to diagnose mitochondrial health address central challenges in geriatric medicine, such as the need for personalized health care based on an individual’s unique physiology and “biological age”? How does this gripping research impact upon our work during the perioperative period? Co-Presented by Rob Schiller MD, Temple University School of Medicine and Anaeshesia, resident at Duke University and Vice-Chair of TRIPOM USA and Bridger Back MD, University of Utah School of Medicine and Anaesthesia resident at Duke University and Chair of TRIPOM USA. This podcast features a talk from Anthony J. Molina, PhD, Associate Professor, Gerontology and Geriatric Medicine. It also contains a contribution from John Whittle, assistant Professor at Duke University Medical Centre and one of the founders of TRIPOM.

"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. -- EBPOM | Dingle - the hottest tickets in anaesthesia and perioperative medicine - go now to the website: https://www.ebpom.org/

What are the latest developments in quality improvement programs that help operative teams around the world take what they do to the next level? When does the surgical journey begin? How has a focus upon patients prior to surgery improved outcomes? What are "the five phases of care"? How has data collection and management helped us to continually improve a patient's surgical journey? This piece is a talk which was given during the 8th Australian and New Zealand Symposium of Perioperative Medicine Special Interest Group: “Updates in Perioperative Medicine 360” which took place between November 7th-9th 2019 Presented by Clifford Ko, Professor of Surgery at UCLA, Director of the Division of Research and Optimal Patient Care at the American College of Surgeons.

"4-10% of opioid naïve patients will continue to use opioids more than 90 days after surgery" Opioids are good for pain control but there's another issue, they also numb emotional pain. How do we responsibly deal with this? It's important to remember: "When you give patients high doses, you're putting them at risk". Long term listeners will recall TopMedTalk spent the best part of our launch year on this topic. If you're one of our many new listeners please use this huge resource of podcasts to help update your practice and cut down unnecessary risk: https://www.topmedtalk.com/?s=opioid "We should be minimizing opioids every chance we can", if you want to cut straight to our groundbreaking talk on opioid free anesthesia please go here: https://www.topmedtalk.com/ebpom-2019-opioid-free-anaesthesia-2/ Presented by Desiree Chappell and Monty Mythen with their guest Jennifer Lanzillotta-Rangeley, CRNA, PhD, Assistant Professor, College of Nursing, University of Cincinnati, Cincinnati, Ohio. -- EBPOM | Dingle - the hottest tickets in anaesthesia and perioperative medicine - go now to the website: https://www.ebpom.org/

  A quick surprising poll of perioperative practitioners sets the tone for a robust advocation of the responsibility of surgeons and practitioners to do surgery right; as opposed to being inclined to feeling it must be done "right now!". A data driven approach combined with a patient focused attitude are at the centre of the argument. How do these factors combine to produce a business case which all institutions, practitioners and patients can understand? In terms of time spent, what do we mean when we say "delay"? How do we overcome a patient's attitudes towards healthcare professionals, if they feel there has already been a delay in 'getting treatment'? How can the pathways from diagnosis to recovery be shortened or made more flexible? Can a case manager help this process? Is eight weeks an acceptable waiting time, can we reasonably expect it to be less than that? Presented by Gerrit Slooter, MD, PhD, Surgical Oncologist, Maxima Medical Centre, The Netherlands.  

What insights does a history of working in military healthcare bring? How do we cut back on readmissions to hospital after time spent in the intensive care unit? How serious an issue is 'burn out' within healthcare? How did standardisation help when designing an award winning patient transfer bag? What's the best way to transfer a patient from ward to ward or from institution to institution? How do we handle data during this period? What do we think about remote supervision and monitoring? Could a dedicated transfer team be useful? Could a new anaesthesia drug be on the way for the NHS soon? How can training in ultrasound be improved? And lastly, will improvements in artificial intelligence ultimately cost us our jobs? Recorded live at the Association of Anaesthetists' Winter Scientific Meeting 2020, from The Queen Elizabeth II Centre, London, UK. This piece follows on from part one, which you can find here: https://www.topmedtalk.com/topmedtalk-matt-wiles-and-marcus-peck-live-from-london/ Presented by Monty Mythen featuring guests, Gezz Van Zwanenberg, Nurse and Project Lead North West London Critical Care Network, Matt Wiles, Consultant Anaesthetist & Senior Clinical Lecturer at Sheffield Teaching Hospitals NHS Trust and University of Sheffield and Marcus Peck, NHS Consultant in Anaesthesia and Intensive Care Medicine at Frimley Park Hospital and Chair of Focused Intensive Care Society’s (FICE) Committee. -- EBPOM | Dingle - the hottest tickets in anaesthesia and perioperative medicine - go now to the website: https://www.ebpom.org/

Recorded live at the Association of Anaesthetists' Winter Scientific Meeting 2020 in the centre of London from The Queen Elizabeth II Centre. Hear the conversation and questions asked by our online audience. In our online world is there still a place for a paper based journal? What are the big stories and hot topics of 2020 going to be? What about hyperoxia? How does what we do effect the environment? What are the latest thoughts about 'depth of anaesthesia'? The podcast mentioned in this piece is here: https://www.topmedtalk.com/anes19-timothy-short-and-kate-leslie/ This link takes you to the trial: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(19)32315-3/fulltext Is there a future for volatile anaesthesia? What's the future for pediatric intensive care units? How can we use ultrasound technologies to enhance patient care? Will the iconic stethoscope end up with dust on it? What's the future for ultrasound in the intensive care unit? Presented by Monty Mythen with his guests Matt Wiles, Consultant Anaesthetist & Senior Clinical Lecturer at Sheffield Teaching Hospitals NHS Trust and University of Sheffield and Marcus Peck, NHS Consultant in Anaesthesia and Intensive Care Medicine at Frimley Park Hospital and Chair of Focused Intensive Care Society’s (FICE) Committee.

How can we learn more by seeing more? This fascinating piece looks at how learning and the zone of proximal development (ZPD) of a student can be used to help the process. We are learning about learning, thanks partly to the use of algorithms that monitor our progress and performance. This talk asks challenging questions; "In terms of performance, just think technical procedures at the moment, is there such a thing as an 'expert performance' of any of the techniques we do daily"? How do we get training to produce clinically meaningful performances? The articles mentioned in this piece are here: "Looking and seeing" by Roger Kneebone: https://www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736(19)30507-0.pdf "Machine Learning Identification of Surgical and Operative Factors Associated With Surgical Expertise in Virtual Reality Simulation", published by The Journal of the American Medical Association (JAMA) is here: https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2740782 And, "Proficiency-based progression training: an ‘end to end’ model for decreasing error applied to achievement of effective epidural analgesia during labour: a randomised control study" is here: https://bmjopen.bmj.com/content/8/10/e020099 This talk, originally titled "Recent research articles in medical education", presented by George Shorten, Professor, Anaesthesiology and Intensive Care Medicine and Consultant Anaesthesiologist at Cork University Hospital, at last year's "21st Current Controversies in Anaesthesia & Peri-Operative Medicine and SIAA Autumn Congress" at the Dingle Skellig Hotel, Ireland. -- EBPOM | Dingle - the hottest tickets in anaesthesia and perioperative medicine - go now to the website: https://www.ebpom.org/

What happens when cutting edge computer game creators, fresh from working on top titles in their industry such as 'Hunger Games' and 'Mission Impossible', use their skills to simulate high stress moments from the real world of anesthesia and surgery? Using "the neuro-science of game design" to help accelerate learning within the profession: "The motivation for starting Level Ex, what if we actually took the top game designers and developers in the industry? We're talking the executive producer of "Mortal Kombat", the creative director of "Call of Duty", the marketing director of "Words with Friends"; put them with top physicians from multiple specialties, to capture the challenges of the practice of medicine using video game mechanics". "This doesn't recreate the mannequin, what this does replace is the five hundred live patients you need to train on in order to encounter those five to ten rare scenarios because we can recreate the rare and the difficult and then we can help you train your visualization skills, your recognition skills, your deductive reasoning skills, on those cases." The key point here is not that motor function is being copied by a screen interactive experience but instead the aim is to "optimise cognitive load" and recreate the thought process alongside an emotional experience. "We're not introducing you to how to do a fiber optic intubation, we're going to present dozens of rare difficult challenging once in a lifetime cases". Here computer games can currently excel in their teaching ability, "it's a cognitive skill, it's a decision making algorithm". As time ticks by in the simulation "you do get to a point where there's no return and you have like three minutes to do this successfully and so your algorithm and decision making is absolutely crucial". It's about taking in data and making decisions in a way that is not possible on a mannequin or ethical on a live patient. "Everything that goes into the app is peer reviewed" and, with any computer game you can earn points as you go along; this game though gives you (Continuing Medical Education) CME points. Google Play: https://play.google.com/store/apps/details?id=com.levelex.airwayex&hl=en_GB Apple: https://apps.apple.com/us/app/airway-ex/id1154656060 Open Anesthesia is here: https://www.openanesthesia.org/ Presented by Desiree Chappell and Monty Mythen with their guests. Sam Glassenberg, CEO and Founder of Level Ex, before which he was CEO of the leading independent game publisher in Hollywood, releasing games based on popular films, including The Hunger Games and Mission: Impossible, he also led the DirectX graphics team at Microsoft, where he accepted a Technical Emmy on behalf of his team for advancing the visual realism of video games across the industry. His career began at LucasArts, creating Star Wars games for PlayStation and Xbox. Sam serves on numerous industry advisory boards and speaks internationally on video games in medicine. Robert H. Thiele, Associate Professor, Departments of Anesthesiology and Biomedical Engineering, Division Chief, Critical Care Anesthesiology, Board of Directors, University Physicians Group, University of Virginia School of Medicine. He has a background in engineering and has been using technology to improve education since his residency in 2008. He is co-founder of www.OpenAnesthesia.org which lead to the development of Self-Study, and also authored one of the first iBooks focused on cardiac and critical care ultrasound.

EBPOM Chicago is now underway - go to www.EBPOM.org now and discover all the latest conversation in the global perioperative sphere.

"You've given us all a lot to think about" - a randomized controlled trial regarding intravenous iron does not go 'as expected'. "I mean, look, I've built my entire career on thinking this was the best thing since sliced bread, the silver bullet, the magic wand ..." A great scientist follows accurate data to wherever it may lead, what now? More trials, more time, more questions? How common is anemia? Are there any nuggets of hope buried within these data? What have we learned? Evidence Based Perioperative Medicine sticks to the facts and there's nothing more important than data; make sure you listen to the end, there are interesting details that give many a sense of optimism. Preoperative intravenous iron to treat anaemia before major abdominal surgery (PREVENTT): a randomised, double-blind, controlled trial is here: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)31539-7/fulltext Toby is a popular contributor to TopMedTalk - check out his earlier piece here: https://www.topmedtalk.com/prato-2019-toby-richards/ Presented by Monty Mythen and Mike Grocott with their guest Toby Richards, Professor, Anaesthesia Teaching & Research Faculty of Medicine, Nursing and Health Sciences Central Clinical School, Monash University.

"We take care of the world but we don't take care of ourselves" This piece is focused on suicide and emotional stress, the latter has been a theme on TopMedTalk for some time now. Here you'll find out how to tackle this significant health concern, how to identify it, what the warning signs are, how to develop emotional intelligence and information regarding drug free novel therapies including the arts and music. It features conversations from the following pieces: AANA 2020 | Suicide Prevention in Anesthesia: CRNAs and SRNAs https://www.topmedtalk.com/aana-2020-suicide-prevention-in-anesthesia-crnas-and-srnas/ This piece featuring Catherine Horvath DNP, CRNA, Assistant Professor and Program Director of the Doctor of Nursing Practice Nurse Anesthesiology Track at Johns Hopkins School Of Nursing, Baltimore MD, Chuck Griffiths, PhD, CRNA, USC, Assistant Clinical Professor at the UCLA School of Nursing, Faculty, USC Doctor of Nurse Anesthesia Practice Program and Fara Lekhnych, MSN, CRNA, The Johns Hopkins Hospital, Baltimore. AANA 2019 | Emotional Intelligence and Occupational Stress: https://www.topmedtalk.com/aana-2019-emotional-intelligence-and-occupational-stress/ This piece features Andrea Bittinger, CRNA from William Beaumont Hospital. TopMedTalk | WHO is looking at the arts and health? https://www.topmedtalk.com/topmedtalk-who-is-looking-at-the-arts-and-health/ This features Katherine Taylor, Clinical psychologist, Arts & Mental Health Innovation Programme Manager at GMiTHRIVE. World Suicide Prevention Day is covered in more detail here: https://www.iasp.info/wspd2020 There's also an interesting resource on the World Health Organisation website here: https://www.who.int/mental_health/prevention/suicide/wspd/en/ The AANA has a page with more information about Jan Stewart here: https://www.aana.com/practice/health-and-wellness-peer-assistance/about-health-wellness/wellness-and-substance-use-disorder-education/jan-stewart-memorial-wellness-lecture-series/jan-stewart-in-memoriam The Social Prescribing Network is here: https://www.socialprescribingnetwork.com/ AANA Peer Assistance Helpline: 1 800 654 5167 US National Suicide Hotline: 1-800-273-talk (8255) Depression and Suicidal Ideation is tackled further on the AANA website here: https://www.aana.com/practice/health-and-wellness-peer-assistance/about-health-wellness/emotional-and-mental-well-being/depression-and-suicidal-ideation Presented by Nick Margerrison with interviews also conducted by Desiree Chappell and Monty Mythen.

The Patient Safety Movement Foundation (PSMF) has ambitious targets to limit preventable deaths in healthcare, this piece explains how they intend to reduce them down to zero. They need your help, this is a global movement with an action plan to improve the world in an important but achievable way. Their website is here: https://patientsafetymovement.org/ Monty Mythen and Desiree Chappell speak with their guest Michael Ramsay, Chairman, Department of Anesthesiology and Pain Management, Baylor University Medical Center, and President of Baylor Scott & White Research Institute.

"Coming out of this pandemic, and this crisis, I think the future for perioperative medicine is very bright and we should definitely take the opportunity and really build on that now..." The two co-vice presidents of The International Board of Perioperative Medicine join Desiree's POCAPALOOZA; this conversation is global in its context, with perceptive reflections upon the US healthcare market specifically. "Towards high‐quality peri‐operative care: a global perspective" - the paper we begin by discussing - is here: https://onlinelibrary.wiley.com/doi/full/10.1111/anae.14921 As anesthesiologists "we are part of teams" how can innovations like tele-medicine help us to do better? Are we right to be optimistic about our specialty in this difficult time? What are "the four M's"? The International Board for Perioperative Medicine is here: https://www.internationalboardpom.org/ The Global Health Data @ Work team - which both our guests contribute to - are an invaluable resource; visit them here: https://ghdatwork.com/team The Hartford Foundation is here: https://www.hfpg.org/ "Perioperative medicine journal" is here: https://perioperativemedicinejournal.biomedcentral.com/ Listeners will also doubtless enjoy this paper - highlighted in the conversation - here: "The Brain-Heart Connection: GCBH Recommendations to Manage Cardiovascular Risks to Brain Health" - https://www.aarp.org/content/dam/aarp/health/brain_health/2020/02/gcbh-heart-health-report-english.doi.10.26419-2Fpia.00099.001.pdf Presented by Desiree Chappell with Lee Fleisher, Professor and Chair of Anesthesiology and Critical Care, University of Pennsylvania and 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). If you loved this piece please enjoy another episode of TopMedTalk featuring Lee Fleisher here: https://www.topmedtalk.com/ebpom-2019-brain-health-peri-operative-quality-initiative-poqi-6-what-can-we-do-tomorrow-2/ Or check out some more of Carol Peden's work here: https://www.topmedtalk.com/women-in-anaesthesia-part-6-carol-peden/ Attentive listeners will also recall that we mention the impressive work of Maurizio Cecconi; we profile him here: https://www.topmedtalk.com/topmedtalks-to-maurizio-cecconi/ And finally we mention change management, a theme on TopMedtalk. Check out this classic piece here: ERAS Team Working and managing change - https://www.topmedtalk.com/eras-team-working-and-managing-change/

"Patients undergo surgery for important reasons, we need to improve surgical outcomes to the point where anyone can have surgery - and I believe that is do-able; we need to implement what we know, we need to avoid missed opportunities and we need to conduct more research. We should learn from the history of anesthesiology and how intraoperative care so dramatically improved outcomes" This powerful data based talk sets a bold standard for the year, a highlight from the momentous (Evidence Based Perioperative Medicine) EBPOM 2020 - Live From London, it featured as this year's Ernest Henry Starling Plenary Lecture, entitled: "Perioperative Care: A new paradigm for the next decade". Introduced by Mike Grocott and presented by P.J. Devereaux, MD, PhD, FRCP(C), McMaster University, cardiologist, clinical epidemiologist, and perioperative care physician. Director of the Division of Perioperative Care at McMaster University he is the Associate Deputy Director of the Population Health Research Institute. He is also the Scientific Leader of the Anesthesiology, Perioperative Medicine, and Surgical Research Group at the Population Health Research Institute. A full Professor in the Departments of Health Research Methods, Evidence, and Impact (HEI) and Medicine at McMaster University. He has published over 330 peer reviewed papers and over 80 book chapters, editorials, and commentaries. He has given over 900 lectures and research presentations in 40 countries. He is supported by the McMaster University/ Hamilton Health Sciences Chair in Perioperative Care and a Tier 1 Canadian Research Chair in Perioperative Medicine. He's also the President of the Society of Perioperative Research and Care.

What are the two prime components of any good nutrition programme? How is avoiding malnutrition different from supporting anabolism? What's the best way to screen patients for malnutrition risk? How can a patient's anthropomitry be assesed alongside their stated needs and preferred outcomes? How important are protein supplements? What are the wider benefits of a good diet? How do we devise nutrition care plans for malnurished patients who need a more aggressive approach? Is it fair to say that everybody can benefit from some nutritional consultation day a dietician? What are the data and studies which support prehabilitation nutritional programmes? Presented by Chelsia Gillis, Registered Dietitian, Canadian Vanier Scholar, and PhD Candidate in Epidemiology at the University of Calgary, Canada, she is leading the first prehabilitation program for colorectal surgery in Alberta.

What is TopMedTalk and how did it come about? Why is perioperative medicine such an inspiration to us? Why is our Editor in Chief such an advocate? What is the opioid crisis? Broadcaster Nick Margerrison speaks with Monty Mythen our Editor in Chief about TopMedTalk and perioperative medicine. We regularly enjoy reading your feedback: contact@topmedtalk.com

Is methadone "the opioid sparing opioid"? This talk looks at where we are at as regards opioids, in the shadow of a national crisis for the USA; is it possible that methapone might offer us answers? This piece looks at the idea that methadone might be a way to deliver a better more effective, multimodal, opioid sparing, analgesia with a reduced chance of a post operative repiratory events and decreased post-operative pain. This talk is complimented well by our consersation, live from the conference, which you can find here: https://www.topmedtalk.com/prehab-periop-world-congress-evan-kharasch/ The World Health Organisation's analgesic ladder is here: https://www.who.int/cancer/palliative/painladder/en/ Presented by Evan Kharasch, MD, PhD, Professor and Vice Chair for Innovation in the Department of Anesthesiology at Duke University, Director of Academic Entrepreneurship, Duke University School of Medicine.

What can the experiences of a team who helped to introduce pre-operative assesment and prehabilitation to Barcelona teach us about how to most effectively implement and sustain similar programmes where we are? How and why is prehabilitation helpful in terms out outcomes and value based care? How long can the benefits of prehabilitation be maintained? What is the value of nutritional consultation, how important is it to asses your patients pre-operative protien intake? Would it help to offer all of your patients mindfullness sessions? How important is it to include patient's partners or carers in sessions? Also, is it possible for you to tap into and harness the enthusiasm of sporting professionals? Presented by Graciela Martinez-Palli, Consultant in the Department of Anaesthesia and Perioperative Care at Hospital Clinic, Barcelona. She attends as anaesthesiologist for oncologic digestive surgery and liver transplantation.

The International PREHAB trial. This short piece explains the trial's protocol and the scope of the study. Presented by Charlotte Molenaar, PhD Candidate, multimodal prehabilitation in colorectal cancer care, BIJ Maxima Medisch Centrum, Coordinator of the international PREHAB trial.

EBPOM might be over but the global perioperative festival, the POCAPALOOZA, continues. Either we've locked our team in their rooms and forced them to continue broadcasting or they're driven by a raw enthusiasm for the results of perioperative care to be shared around the world, either way this piece is our penultimate installment before we return to Cape Town. What's the situation like, in terms of medicine, in Hong Kong at the moment in the wake of COVID 19? "Early intervention and people taking it seriously is a big thing" The conversation evolves as our guest speaks to the realities of moving internationally to pursue your career in medicine. Can a truly global perspective better position the medical community when it comes to international co-operation? The World Congress of Anaesthesiologists is here: https://www.wcaprague2020.com/ For more about the African Perioperative Research Group (APORG) start here: https://onlinelibrary.wiley.com/doi/epdf/10.1111/anae.14934 Also, what's the future of medical conferencing in the world of COVID 19 and the global pandemic? Presented by Desiree Chappell and Monty Mythen with Mike Irwin, Professor, Head and Chief of Service, Anaesthesiology HKU, Gleneagles Hospital

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.  

Insights and perspectives on the science of prehabilitation from a very different angle. It's often said on TopMedTalk that preparing for an operation is not unlike getting ready for a marathon; how do the insights of professionals who work with elite sports men and women to ensure they are fully prepared to do their physical best, on the world stage? Also, what about the teamwork inherent in such activities as the pitstop of a formula one car? Athletes, coaches and a wide number of different experts come into play ensuring a multidisciplinary team converge with essentially the same end in sight as a perioperative prehabilitation team; optimum performance at a crucial time. Challenges are similar between the two disciplines; how do we foster a culture of learning and teamwork in a high pressure environment where the bottom line carries enormous life changing consequences? Regular listeners to TopMedTalk may recall the unofficial preamble to this talk, "Prehab Periop World Congress: Gerard Danjoux, Ken Van Someren": https://www.topmedtalk.com/prehab-periop-world-congress-gerard-danjoux-ken-van-someren/ Presented by Ken Van Someren, Director KvS Performance Ltd.

What are the opportunities presented to a perioperative practitioner when political devolution becomes a reality? What can we learn from the experiences of a team leading the introduction of ERAS+ and prehabilitation across Greater Manchester with a 'Spread and Scale innovation grant' from the Health Foundation? How do you demonstrate benefits which patients and fee payers can understand? How do you go about leading a prehab transformation program, which aims to provide prehab for more than 2000 patients affected by cancer, over 2 years? The GM teams are very happy to host teams in Manchester who may want to visit MFT and see Surgery School in action and show colleagues what they are aiming to achieve with GM Cancer Prehab. Email John on John.moore@mft.nhs.uk or john.moore@erasplus.co.uk ERAS+ website is here: https://www.erasplus.co.uk/ NHS Innovation Accelerator website: https://nhsaccelerator.com/ GM Active are here: https://www.gmactive.co.uk/ Presented by John Moore, consultant in anaesthetics and critical care medicine from Manchester, UK, Clinical Head of the Division of Anaesthetics, Peri-operative medicine and Critical Care at Manchester University Hospital NHS Foundation Trust.

This piece gives us a look at some of the latest thinking on Post Operative Nausea and Vomiting (PONV). It includes a discussion about Amisulpride and discusses new, yet to be published, consensus guidelines for PONV. The original guidelines are here: https://www.ncbi.nlm.nih.gov/pubmed/24356162 Also, you may like to check out the details of this paper here: Amisulpride: A New Dopamine Antagonist for Treatment of Postoperative Nausea and Vomiting https://www.ncbi.nlm.nih.gov/pubmed/31094771 Presented by Desiree Chappell and Monty Mythen with their guest Tong Joo (TJ) Gan, Professor and Chairman at Stoney Brook in New York. --- Like this, want more? Check out TJ Gan's masterful presentation "EBPOM USA Part 5| Practical realities; How and why multimodal Analgesia matters" here: https://www.topmedtalk.com/ebpom-usa-part-5-a-perioperative-practicum-with-tj-gan/

Is it fair to say that prehabilitation is the new direction for practitioners of Enhanced Recovery After Surgery (ERAS)? Discussion expands into patient awareness initatives, The Macmillan Cancer Support, Principles and guidance for prehabilitation guide mentioned is here: https://www.macmillan.org.uk/about-us/health-professionals/resources/practical-tools-for-professionals/prehabilitation.html Age care naturally follows as the roundtable discussion continues. This piece gives a truly pan-national perspective with informed comment from prominent perioperative opinion leaders from The UK, Australia and America. How do those different systems work and what can they each learn from the others? The journal article mentioned in this piece is here: https://jamanetwork.com/journals/jamasurgery/fullarticle/2732511 Presented by Desiree Chappell with Monty Mythen and Lee A. Fleisher, Professor and Chair of Anesthesiology and Critical Care, University of Pennsylvania and Ross Kerridge, John Hunter Hospital, Newcastle, Australia, often cited as 'the father of Modern Perioperative Medicine'.

This piece focuses upon patient safety and the work of our guest. How does perioperative medicine fit into the picture, are anesthetists right to take the lead in this field? You can find the Anesthesia Patient Safety Foundation here: https://www.apsf.org/ Learn more about the Perioperative Surgical Home here: https://www.asahq.org/psh Presented by Desiree Chappell with Monty Mythen and Henry Howe alongside their guest Mark Warner, Annenberg Professor of Anesthesiology at the Mayo Clinic in Rochester, 2019 American Society of Anesthesiologists (ASA) recipient of 'The Distinguished Service Award' and President of the Anesthesia Patient Safety Foundation (APSF).

"POETTS 2018 | The evolution of a community-based Prehabilitation service" - 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 Gerard Danjoux, consultant in Anaesthesia and Sleep Medicine at South Tees Hospitals NHS Trust.

The focus for the first part of this POCAPALOOZA was Duke University's PASS clinic. Find out more about the PASS clinic: https://www.dukehealth.org/locations/duke-pre-anesthesia-testing-center-clinic-2d "So it's a new approach to really changing the paradigm from just evaluating a patient and sort of passing that information forward to the receiving team [...] rather we take a much more proactive progressive approach to identify those chronic co-morbid conditions and try to bend that curve, we try to modify that which may be modifiable" If you've heard Sol's passion and want to transform your practice get more detail from these two excellent pieces from Anesthesia and Analgesia here: Roadmap for Transforming Preoperative Assessment to Preoperative Optimization https://journals.lww.com/anesthesia-analgesia/Abstract/2020/04000/Roadmap_for_Transforming_Preoperative_Assessment.4.aspx?context=FeaturedArticles&collectionId=4 Preoperative Optimization: A Continued Call to Action https://journals.lww.com/anesthesia-analgesia/Citation/2020/04000/Preoperative_Optimization__A_Continued_Call_to.3.aspx There follows an engaging conversation about prehabilitation, "it's like Rocky Balboa training to get in the ring". For more resources here please check this website from the Choosing Widely campaign: https://www.choosingwisely.co.uk/about-choosing-wisely-uk/ Also - regular listeners will be excited to hear our lead presenter Desiree Chappell's news towards the end of the podcast! Presented by Desiree Chappell with Monty Mythen and Sol Aronson, tenured Professor at Duke University and their guests Jeanna D. Blitz, Associate Professor of Anesthesiology, Medical Director, Duke PASS Clinic Director, Perioperative Medicine Fellowship, Denny Levett, Professor in Perioperative Medicine and Critical Care, Consultant in Perioperative Medicine, Southampton University Hospital NHS Foundation trust (UHS), President of the Perioperative Exercise Testing and Training Society (POETTS) and Mike Grocott Professor of Anaesthesia and critical care at the University of Southampton.

Some of the big questions: Is the pulmonary artery catheter back? What have been some of the big take aways in nutrition? Why should you feed a cold and starve a fever? More Protein or less? Finally, ‘humanizing intensive care’ is discussed, do we need more ITU pets? Presented by Desiree Chappell and Monty Mythen confer on the events of the day with their guest Hugh Montgomery, Intensive Care Society Board Member and, Professor of Cardiovascular Genetics and Critical Care University College London.

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.

Care of older people in surgery (COPS). Are you properly assesing your patients for cognition? Surgery can be appropriate for some to reduce pain in palliative care, how do we make decisions regarding a possible intervention? How important is frailty in this process? The slides from this talk are here: http://www.anzca.edu.au/documents/03-jacqueline-close_care-of-older-people-in-surger.pdf Presented by Professor Jacqueline Close, Geriatrician, Prince Of Wales Hospital, Clinical Director, Falls, Balance and Injury Research Centre -- 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 discussion begins with a focus upon some of the networking and information sharing events that go on in our field; The Society for Perioperative Assessment and Quality Improvement (SPAQI, website here: https://www.spaqi.org/2020/ ) The 17th World Congress of Anaesthesiologists, September 5-9, 2020, Prague, Czech Republic (website: https://www.wcaprague2020.com/ ). Discussion then moves to specific "The SQUEEZE Study"; A prospective multi-centre international observational study of postoperative vasopressor use (website: https://www.esahq.org/research/clinical-trial-network/planned-trials/squeeze/ ) Presented by Desiree Chappell and Monty Mythen with their guest Konstantin Balonov, Anesthesiologist; Vice Chair for Perioperative Medicine; Chair, Competency Committee; Assistant Professor, Tufts University School of Medicine. Like this, want more? "The Perioperative Medicine Summit", organised by The Society for Perioperative Assessment and Quality Improvement (SPAQI), is covered in detail here: https://www.topmedtalk.com/desirees-roundtable-what-is-the-perioperative-medicine-summit/

"It's like running an election campaign..." Perioperative hemodynamic management; how do you make it really work within an institution? With extensive reference to real life experience hear first hand stories from our guest and Editor in Chief's experience of doing just that. How do you get people both in and outside of the team to understand the importance of it? Hear about new developments in Enhanced Recovery After Surgery (ERAS) and perioperative haemodynamic management. Find out how new technologies, techniques and information are being applied in this piece. Also, when dealing with an institution, how important is the value proposition? "Are they up on the deal?" We discuss The RELIEF trial in more detail here: https://www.topmedtalk.com/ebpom-highlight-1-30-visiting-professor-plenary-lecturer-results-of-the-relief-trial/ We discuss the INPRESS trial in more detail here: https://www.topmedtalk.com/ebpom-london-2018-any-answers-part-3-the-big-trials/ Presented by Desiree Chappell and Monty Mythen with Michael Scott, M.B., Ch.B. Professor of Anesthesiology at the University of Pennsylvania.

The POCAPALOOZA story begins with our fascination with The African Surgical Outcomes Study. Over the last year regular listeners have heard key parts of the narrative fall into place during TopMedTalk interviews and discussions. Learn how the European Surgical Outcomes Study (EUSOS), presented at a previous Evidence Based Perioperative Medicine (EBPOM) conference, helped to inspire the African Surgical Outcomes Study ASOS which then went on to inspire us all; after an international gathering in Prato. A truly global community - the perioperative medical community - has now been galvanised into action. Determined to further the research and increase the data at the last count we have all helped to raise over £7,000! Thank you for your help. This piece was the first of our Pocapalooza specials; "Poc" standing for "perioperative care" and "palooza" meaning festival. This piece is an update on The African Surgical Outcomes Study (ASOS) and the African Perioperative Research Group (APORG): "Everybody in the audience was overwhelmed by the quality and importance of the work being done ... in the African study"; "Finding African solutions to the problems that we're having" You will also find a discussion regarding the Prato conference we covered extensively here on TopMedTalk, a fascinating gathering of people interested in international collaborative trails, and we cover The UK Perioperative Medicine Clinical Trials Network, see link below, before moving on to ASOS in detail. The Perioperative Medicine UK Clinical Trials Network is here: https://pomctn.org.uk/home Presented by Desiree Chappell with Monty Mythen and their guests Paul Myles, Director, Anaesthesiology and Perioperative Medicine, Alfred Hospital and Monash University, Bruce Biccard consultant anaesthetist at the University of Kwazulu-Natal, Director, Perioperative Research Unit, Department of Anaesthetics, Nelson R Mandela School of Medicine and Salome Maswime Obstetrician and Gynaecologist and Professor of Global Surgery at the University of Cape Town. If you enjoyed this piece please find more Bruce Biccard here: https://www.topmedtalk.com/topmedtalk-african-surgical-outcomes-study-asos-2/ We discuss Rupert Pearse in this podcast, it's worth listening to this piece with him discussing the Clinical Trials Network here: https://www.topmedtalk.com/anaesthesia-2019-the-clinical-trials-network-and-optimising-shared-decision-making/ Paul Myles is a firm favourite on TopMedTalk, enjoy more of his incisive observations here: https://www.topmedtalk.com/prato-2019-paul-myles/

Pediatric patients can present quite a challenge when emerging from anesthesia. Here we discuss ways to “ACE” your transition to PACU! “A”void Emergence Agitation, and discover the latest evidence about “C"riteria for “E”xtubation in this challenging population. How do the protocols and standard of care compare between the UK and US. What does the evidence tell us? Also, how is Enhanced Recovery After Surgery progressing in pediatrics? Presented by Desiree Chappell and Monty Mythen with their guest Kristin Henderson, DNAP, CRNA, CHSE, CPT, USAR Assistant Professor, Wake Forest School of Medicine, Nurse Anesthesia Program

After working at a Veterans Affair Medical Center, hear how our guests moved into the field of emergence delirium: "upon emergence our patients were swinging and very aggressive ... there must be some way to prevent this". This fascinating piece enjoys an engaging discussion about an important topic for both patients and practitioners; how important is it for you to know a patient may suffer from post traumatic stress disorder? Do different anesthetics promote or avoid emergence delirium? Can emergence delirium cause further long term trauma? How do we deal with US military veterans specifically? Patient Health Questionnaire 9 (PHQ-9) is here: https://patient.info/doctor/patient-health-questionnaire-phq-9 The State Trait Anxiety Inventory is here: https://www.advancedassessments.co.uk/resources/Mental-Health-Test.pdf Presented by Desiree Chappell and Monty Mythen with Kristen Roman, MSN, MFA, SRNA, Ignacio Diaz, BSN, SRNA and Jena Borgonia, BSN, SRNA, student registered nurse anesthetists (SRNAs) at The University of Southern California.

The electronic cigarette market is a $14 billion industry worldwide. As of August 2019, 215 cases of severe pulmonary illness related to e-cigarette use are being investigated in the United States. The known hazards of e-cigarette use are rapidly coming to light with the sudden onset of serious bronchiolitis-related pulmonary disease in otherwise healthy people who were known to use e-cigarettes. Learn also how COVID 19 has increased these dangers. Presented by Desiree Chappell with Monty Mythen and Bernard Gilligan, III, DNP, CRNA, APRN, Program Assistant Director, Assistant Professor, Cedar Crest College Nurse Anesthesia Program, Allentown, PA.

Pain is a subjective experience that affects all segments of the population. However, there are inter-individual differences in pain. The biopsychosocial model proposes that the intersection of biological, psychological, and social factors create a pain experience and pain outcomes that differ by sex, race, and socioeconomic status. "The minority stress theory ... the idea that for racial minorities, especially blacks, they are exposed to chronic stress; the stress of daily racism" Could epigenetics hold the key to understanding how social factors compound differences between patients? How does this impact on you and your practice? Further reading is to be found here: https://pubmed.ncbi.nlm.nih.gov/19411059/ https://pubmed.ncbi.nlm.nih.gov/32487870/ https://pubmed.ncbi.nlm.nih.gov/30863142/ Presented by Desiree Chappell and Monty Mythen with Edwin N. Aroke, Ph.D., CRNA, Assistant Professor, Associate Scientist, Minority Health and Health Disparities Research Center, Associate Scientist, Comprehensive Arthritis, Musculoskeletal, Bone, & Autoimmunity Center, The University of Alabama, Birmingham, US.

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 1, to find Part 2 go 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/ 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

"My first thought was - why can't we do this here?" What is ketamine, what sort of drug is it and how is it used? How was it first synthesized? Was it intentionally found or another of science's happy accidents? This piece is a fascinating look into the history and future of ketamine with a focus on outpatient infusion centers. Could this unusual and "dirty" drug - meaning it acts on many parts of the body and is not fully understood - have incredibly useful consequences for people who face the grueling task of handling depression or a post traumatic stress disorder? We look at the research and evidence base regarding ketamine, how it is effective for different disease processes and how the drug might be more widely used in the future. It appears to have come into something of a renaissance, "thank you for getting the word out about ketamine". Check out the clinic here: https://www.neuromendcenter.com/ Presented by Desiree Chappell and Monty Mythen with Tracy Young, MSNA, MBA, CRNA, CEO of YPS Anesthesia, he also a two time past State President for the Louisiana State Association of Nurse Anesthetists as well as currently sitting on several other boards.

"4-10% of opioid naïve patients will continue to use opioids more than 90 days after surgery" Opioids are good for pain control but there's another issue, they also numb emotional pain. How do we responsibly deal with this? It's important to remember: "When you give patients high doses, you're putting them at risk". Long term listeners will recall TopMedTalk spent the best part of our launch year on this topic. If you're one of our many new listeners please use this huge resource of podcasts to help update your practice and cut down unnecessary risk: https://www.topmedtalk.com/?s=opioid "We should be minimizing opioids every chance we can", if you want to cut straight to our groundbreaking talk on opioid free anesthesia please go here: https://www.topmedtalk.com/ebpom-2019-opioid-free-anaesthesia-2/ Presented by Desiree Chappell and Monty Mythen with their guest Jennifer Lanzillotta-Rangeley, CRNA, PhD, Assistant Professor, College of Nursing, University of Cincinnati, Cincinnati, Ohio.

"Our job is to tell them; there is another solution ... there's another way to solve this problem and I can help you" This piece takes a bold and honest look at suicide in anesthesia, although it has a US set of contributors the issues here are to do with everyone in healthcare. TopMedTalk is keen to promote the fact help is available, please seek it out if you are concerned you might be affected by these issues. AANA Peer Assistance Helpline: 1 800 654 5167 National Suicide Hotline: 1-800-273-talk (8255) How does the tactic of Question Persuade Refer (QPR) work? Should we directly discuss suicide with colleagues? What are the basic causes of this complicated problem? Can we simplify our approach by being more direct and honest? What does the evidence tell us is the best way to deal with the situation? Presented by Desiree Chappell with her guests Catherine Horvath DNP, CRNA, Assistant Professor and Program Director of the Doctor of Nursing Practice Nurse Anesthesiology Track at Johns Hopkins School Of Nursing, Baltimore MD, Chuck Griffiths, PhD, CRNA, USC, Assistant Clinical Professor at the UCLA School of Nursing, Faculty, USC Doctor of Nurse Anesthesia Practice Program and Fara Lekhnych, MSN, CRNA, The Johns Hopkins Hospital, Baltimore.

How do you become well known in the NHS for being innovative, particularly in the perioperative area regarding evaluation and communication of risk? How can cardiopulmonary exercise testing lead to shared decision making? Hear how aortic aneurysms are dealt with by a world class professional perioperative physician. Learn how that process and its success then spread out into other areas of healthcare within his institution. Do you need to develop a broad knowledge of all surgery and medicine so that you understand what is going on within the different surgical specialities?   Following this discussion is had about the GIRFT (Getting It Right First Time) project. The stated aim is 'to help improve the quality of care within the NHS by reducing unwarranted variations, bringing efficiencies and improving patient outcomes'. This piece gives you the detail from one of the joint clinical leads.   Presented by Monty Mythen, Joff Lacey and Desiree Chappell with their guest Dr Michael Swart, Consultant in Anaesthesia and Critical Care Medicine at Torbay Hospital and advisor to the UK Department of Health for the Enhanced Recovery Programme.

This piece looks at innovations in our field, through the lens of the Hypotension Prediction Index (HPI). Innovations in medicine are always exciting, "neuro-monitoring" is discussed "if you told me two years ago that I was going to be able to understand an EG waveform I would have laughed at you". "Data is what drives any change", how can new insights regarding hypotension potentially revolutionize your practice? Adoption of any new technology is complicated, how do you handle resistance to such innovations? When it comes to change management, if the new change takes more than "300 seconds" then, "unless there is an emotional tug ... it is hard". The value proposition has to be strong, what's the verdict on the H.P.I. monitor? This piece is part of our coverage of Anesthesiology 2019 at the Orange County Convention Center in Orlando. With over 14,000 delegates, clinicians, thought leaders and professionals, it's the largest gathering of Anesthesiologists and Anesthesia providers in the world. Presented by Desiree Chappell and Sol Aronson with their guest Neal Fleming, Professor, Anesthesiology and Pain Medicine, UC Davis.

"Perioperative nutrition should be a key part of Enhanced Recovery" - 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 Paul Wischmeyer, Professor of the Department of Anesthesiology, Duke University.

"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.