Editor's Top Picks

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

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.

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/

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? With thanks to our sponsor Biomerieux, who helped bring this podcast to you for free, in advance of 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. 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.

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 Anesthesiology and Pain Medicine at The University of Alberta, Alberta and Zone Clinical Department Head for Anesthesia, Alberta Health Services Edmonton Zone, a 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.

"Kidney disease ... is clearly a public health concern" 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.live.ebpom.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.

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.live.ebpom.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).

This piece is the first of a four part series (supported by ACACIA) 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? This piece is released in anticipation of the annual general meeting of The American Society of Anesthesiologists (ASA)- ANESTHESIOLOGY 2021. TopMedTalk will be bringing you live coverage of the event via LIVE.EBPOM.ORG 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

"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 Presented by Desiree Chappell and Monty Mythen with their guest Tricia Meyers, PharmD, adjunct Professor, Texas A&M, College of Medicine.

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? This piece is generously supported by Acacia Anesthesia. 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.

"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? 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.

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.

"I think it really comes down to teamwork" How rapidly should you perform a tracheotomy? 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.

"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.

"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.

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

"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 live.ebpom.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.

Mentorship, diversity and inclusion are key parts of any socially responsible institution's practice. This piece speaks to how we make medicine more diverse and inclusive overall, there is much work to be done but an active focus coupled with mentorship programmes is shown here to be an effective way forward. This piece was part of our coverage of The American Association of Nurse Anesthetists (AANA) 2019 Annual Congress in Chicago, Illinois. Check out the AANA here: https://www.aana.com/ Presented by Desiree Chappell and Monty Mythen with their guests Debra Diaz, DNP, CRNA, APRN, CDR, AANA Board of Directors, Lena Gould, CRNA, Founder, Diversity in Nurse Anesthesia Mentorship Program, John Bing, Owner, JBing and Assoc Anesthesia Services, AANA Board of Directors.

Lessons learned from the Enhanced Peri-Operative Care for High-risk patients (EPOCH) trial. This conversation focuses upon the challenges of quality improvement programmes; how do we keep track of patients and improve follow up questions after surgery? How do we clearly show Quality Improvement Programmes work for the patient? Further discussion encompasses innovation and utilization in practice. Presented by Monty Mythen and Desiree Chappell with their guest 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). For more on EPOCH look here: https://www.topmedtalk.com/?s=EPOCH

Does perioperative medicine allow institutions to take a broader view? Population health has been a theme on TopMedTalk, is it a logical extension of the perioperative process? How do we manage specialist care for the elderly and ensure high quality shared decision making? What lies behind the mindset change needed for some to accept surgery is not always the answer? Should we expect medical students to be taught the principles of perioperative medicine? What are some of the unique tensions in the US system that can frustrate the adoption of a truly perioperative practice? Presented by Desiree Chappell and Monty Mythen with their guest Angela Bader, Vice Chair of Perioperative Medicine at Brigham and Women's Hospital.

This piece focuses on the question of looking after yourself as a practitioner and interlinking into your team. How important is it to listen to your team? What is "burn out"? How does it express itself in people? What signs should we look for in our friends and colleagues? Presented by Desiree Chappell, Sol Aronson and Monty Mythen with their guest Sasha Shillcutt, Vice Chair of Strategy and Innovation, Department of Anesthesiology, UNMC Founder, Brave Enough LLC. Find Sasha's excellent website (and podcast) here: https://www.becomebraveenough.com/

Discussion begins with a hugely successful Enhanced Recovery program at a large community hospital, continued improvements and service line expansion. Learn about both the advantages and the challenges of a perioperative practice here.   Presented by Desiree Chappell and Monty Mythen with their guests Kim Duggan, Perioperative Surgical Home (PSH) - Enhanced Recovery After Surgery (ERAS) Manager, New Hanover Medical Centre and Robin Davis, Clinical Education Specialist II at New Hanover Regional Medical Center.

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 is the first of TopMedTalk's 'as live' coverage from the 5th Collaborative Clinical Trials in Anaesthesiology Meeting, Prato, Italy. It's your chance to get virtual a place at one of the most influential gatherings of its kind in the world. Please go to 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.

Speaking with a legend in the world of anaesthesia; this piece allows us to explore some of the bigger issues and milestones in the profession. How has it evolved, particularly in relation to the simultanious evolution of perioperative practice? Where are we now and where do things look set to go in the future?   This piece was originally streamed live on www.TopMedTalk.com under the title: "Educational Dinner Symposium:  In God we trust, all others must bring data" as part of the EBPOM USA Dallas Master's Course.   Presented by Monty Mythen with Rick Dutton, Chief Quality Officer at United States Anesthesia Partners Baltimore, Maryland Area with questions from both conference delegates and online listeners.

Global health is something TopMedTalk listeners are naturally passionate about; here you can listen to the keynote address from the 42nd President of The United States, Bill Clinton, to the World Patient Safety, Science & Technology Summit. 273,077 lives have been saved over the last 7 years with over 90,000 of those in just the last year alone. 4,700 hospitals around the world that are part of this effort. 89 technology companies have committed to share data to help develop algorithms and predict dangerous trends. The patient safety movement now has 35 regional chairs leading local networks across 50 countries. This movement is growing rapidly now, PSMF would like to encourage further support. Their website is here: https://patientsafetymovement.org Presented by Bill Clinton, 42nd President of The United States and founder of The Clinton Global Initiative. He is introduced by Joe Kiani, Founder, Chairman & CEO of Masimo, Cercacor & the Patient Safety Movement Foundation.

"The predominant emotion was fear..."; this piece is essential listening for every TopMedTalk listener who cares about the experience of their patients. Hear what it was like to participate in the pioneering, tailored exercise training programme, The Encourage Trial. "On the day of the operation I was feeling quite calm ... I don't think we could have done anything more to put us into the best possible position for today". Also, find out about "the Buddy Scheme" and how becoming a member of a local support group: SPICOS (Support for People Impacted by Cancer of the Oesophagus and Stomach) led to it. Could a 'Buddy', volunteers who have been in a similar situation and have agreed to be a point of contact for patients and their families, be able to offer reassurance and support at your practice? Someone your patient can rely on who can honestly say; 'Yes, I know exactly what you mean, I know exactly how that feels'. The Macmillan Cancer Support website is here: https://www.macmillan.org.uk/ Presented by Mo Cottrell, a retired nurse who underwent a 5 week course of chemoradiotherapy followed by successful surgery for Oesophageal Cancer at Southampton General Hospital in January 2017.

The debate 'Direct laryngoscopes should be consigned to history', was hosted by The Royal College Of Anaesthetists and carried out by our two guests on this piece. Here we get into the advantages and challenges behind the two techniques; video laryngoscopy and direct laryngoscopy. The conversation explores the fact that these skills are a key part of the job of practitioners, are we "de-skilling" the profession in an overly enthusiastic race toward new technology or are some resisting it simply because it's not what they are used to? Where do you stand on this fascinating debate? Send us your thoughts on email: contact@topmedtalk.com Presented by Joff Lacey and Monty Mythen with their two guests; Professor Tim Cook, Consultant in Anaesthesia and ICM, Royal United Hospitals, Bath and Dr William Harrop-Griffiths, St Mary's Hospital, Imperial College Healthcare NHS Trust.

Everything you ever wanted to know about CPET (Cardio Pulmonary Exercise Testing) but were too afraid to ask; this conversation is a fascinating deep dive into the topic with two experts in the field. Discover how widely practiced this technique is across the UK, hear about the advantages people who use it have in terms of outcomes and patient safety. Also, what do institutions then do with the data and how does that increase our understanding of the human body? Some of the UCL podcasts mentioned in the piece are available here: Introduction to Cardio Pulmonary Exercise Testing - https://www.youtube.com/watch?v=U_0Gi0gozgU Cardio Pulmonary Exercise Testing: Setup - https://www.youtube.com/watch?v=qW9KFo0kiMk Check out their YouTube channel for more: https://www.youtube.com/channel/UC_NlyaSqWQngSCFF1LLHW8w The POETTS website is here: https://poetts.co.uk/ Finally, our excellent Xtreme Everest podcast archive is here: https://www.topmedtalk.com/category/conferences/xtreme-everest/ Presented by Desiree Chappell with Monty Mythen and their guests Jeroen Molinger, Clinical Medical Exercise Physiologist at Duke University Medical Center, Department of Anesthesiology & ICU and John Whittle, assistant Professor at Duke University Medical Centre.

Live from "ERAS cardiac: Center of excellence training conference", an Edwards Life Sciences sponsored conference in North Carolina. The first article, Enhanced recovery after cardiac surgery program to improve patient outcomes, mentioned in the piece is here: https://journals.lww.com/nursing/Pages/articleviewer.aspx?year=2018&issue=11000&article=00007&type=Fulltext The second, One-year results from the first US-based enhanced recovery after cardiac surgery (ERAS Cardiac) program, is here: https://doi.org/10.1016/j.jtcvs.2018.10.164 Presented by Desiree Chappell with Monty Mythen and Judson Williams, WakeMed cardiovascular surgeon who specializes in treating patients with heart valve disease or structural heart disease, aortic aneurysms, and coronary heart disease, also, Vice President, Board of Directors Enhanced Recovery After Cardiac Surgery (ERACS) and Gina McConnell, BSN, RN, CCRN, WakeMed Cardiothoracic Intensive Care.