Podcasts about Perioperative medicine

SHOW NOTESWhat impact does surgery have on the body?Intentional trauma Physiological response Psychosocial impact StressWhen we think about surgery, it's essential to understand that it triggers a significant reaction in the body known as the 'stress response.' This response is a complex interplay of hormonal and metabolic changes directly linked to the degree of tissue damage during surgery. It can intensify if there are any complications after the operation. Let's break it down: The whole process starts when the hypothalamic-pituitary-adrenal axis, or HPA axis, kicks into gear. This leads to a surge in hormones like cortisol, growth hormone, glucagon and catecholamines. These hormones are important because they help the body cope with stress by boosting energy availability and adjusting other bodily functions.Ebb phase (0-48hrs)Increased catabolism of stored glycogen (glycogenolysis)Suppression of insulin secretion → transient hyperglycemiaIncreased catecholamines, cortisol, and inflammatory cytokines (IL-6, TNF-α)Flow phase (3-10 days)Hypermetabolism (increased BMR)Increased protein catabolism → muscle breakdown (to provide amino acids for tissue repair and immune function)Increased lipolysis (fat breakdown) for energySustained insulin resistance → continued hyperglycemiaEnhanced GNG Pro-inflammatory response → increased cytokines and acute-phase protein productionIn the initial stages after surgery, the body releases a wave of pro-inflammatory cytokines. These cytokines jumpstart the healing process by promoting inflammation, which is important for healing surgical wounds. However, to keep this inflammation from going overboard, the body soon follows up with anti-inflammatory cytokines.These inflammatory processes have widespread effects across the body. For example, they can influence how the hypothalamus regulates body temperature or how the liver produces certain proteins that help fight infection and aid in wound healing.But here's where it gets even more interesting: other hormones like glucagon, cortisol, and adrenaline also play a role in modulating these responses. They can affect everything from your blood sugar levels to how your cardiovascular system handles the stress.So, why is all this important? Well, by understanding and managing these responses effectively, we can significantly improve how patients recover from surgery. It's all about helping the body maintain balance during a time when it's incredibly vulnerableDisruption of Metabolic Homeostasis: Surgery often disrupts the body's normal metabolic balance, notably through insulin resistance, where cells fail to respond effectively to insulin, leading to 'diabetes of the injury.' Insulin Resistance and Hyperglycemia: Insulin resistance can cause high blood sugar levels, significantly increasing the risk of surgical complications and mortality. Post-surgery, the body may enter a catabolic state, breaking down muscle instead of fat, which impairs wound healing, weakens the immune system, and reduces muscle strength. Increased Risks for Vulnerable Groups: Elderly, diabetics, and cancer patients are particularly at risk due to their compromised metabolic and inflammatory states. These groups have less physiological reserve, leading to pronounced catabolic states and increased risk of severe post-operative complications. Impact on Recovery and Outcomes: The metabolic chaos from insulin resistance to protein loss not only delays recovery but also exacerbates risks of infection and other complications. Effective management of these changes is crucial for improving surgical outcomes and ensuring that patients thrive post-surgery.ERAS helps to mitigate these by Surgery isn't just about the physical repair or removal of tissue; it triggers a cascade of stress responses in the body that can complicate recovery. These include everything from the psychological impacts of anxiety and the physiological effects of fasting to direct tissue damage and the systemic reactions to it, such as fluid shifts and hormonal imbalances.Key Components of ERAS:Comprehensive Care: ERAS isn't just a single technique but a suite of practices designed to address every aspect of the patient's journey — before, during, and after surgery. This approach aims to minimise the stress responses by controlling pain, reducing fasting times, optimising fluid management, and promoting early mobility.Minimising Fasting: One traditional practice that ERAS revises significantly is the preoperative fasting rule. Old guidelines that required fasting from midnight before surgery are now replaced with more lenient, evidence-based practices that allow intake of clear fluids up to two hours and solids up to six hours before surgery. This change helps maintain normal blood glucose levels, reduces stress, and decreases the body's shift into a catabolic (muscle-degrading) state.Nutritional Optimisation: ERAS protocols emphasise the importance of not entering surgery in a depleted state. By allowing a carbohydrate-rich drink shortly before surgery, patients are better hydrated and less anxious, which in turn reduces insulin resistance and preserves muscle mass — critical factors in speeding up recovery post-surgery. Post-operatively, oral nutrition may be delayed by the medical team until bowel function returns, typically taking close to a week. This delay is stated to reduce postoperative complications such as abdominal distension and nausea/vomiting.For the first several days post surgery fluids of limited nutritional value such as water are provided to patient until tolerance is established leading to insufficient nutrition intake during this time increasing the risk of malnutrition. The ERAS protocol promotes early oral intake within 24 hours post surgery departing from traditional fasting practices. Research suggests that between 40-50% of surgical patients have some degree of malnutrition. Pre-operative malnutrition is an independent predictor of poor post-operative outcomes. Therefore addressing malnutrition is a key component of the ERAS protocol.Immune-Enhancing Diets: Post-surgery nutrition is just as crucial. ERAS encourages diets rich in nutrients that bolster the immune system and enhance wound healing. This includes omega-3 fatty acids, which help modulate the inflammatory response; arginine, which supports protein synthesis and tissue growth; glutamine, which is vital for cellular health and recovery; and nucleotides, which are essential for rapid cell division and immune function .Immuno-nutrition is a specialised medical nutrition therapy that has been shown to adjust the body's inflammatory response: It incorporates specific nutrients like omega-3 fatty acids, arginine, polyunsaturated fatty acids, and nucleotides. It's typically recommended starting 5-7 days before surgery and continuing post-operatively for over 7 days or until oral intake meets at least 60% of the patient's nutritional requirements.How can we use this info to optimize surgical outcomes?Patient education Early nutrition pre and post surgery - Minimise fasting time What is ERAS? How does it differ from traditional care/practice?Introduced by Henrik Kehlet in 1997, the Enhanced Recovery After Surgery (ERAS) protocol has revolutionised surgical practices by optimising perioperative care. A key aspect of ERAS is its interdisciplinary approach, involving healthcare professionals from various specialties to minimise surgical stress and facilitate recovery. What is malnutrition?Malnutrition, is defined as an involuntary reduction in body weight, muscle mass and physical capabilities, affects up to 65% of surgical patients and can worsen during hospital stays. Enhancing nutritional status and promoting functional nutrition therapy is essential, even forpatients without evident malnutrition, particularly when prolonged perioperative oral intake challenges arise. Addressing malnutrition is essential for preventing surgical complications, prolongedhospital stays and higher healthcare costs. What are the benefits of ERAS for the patient?It has been shown that the key physiological benefits include:-enhances the body's anabolic processes-promotes wound healing, which is critical for patient recovery.-Reduces the risk of nutritional depletion-Minimises insulin resistance, a common issue post-surgery, allowing for better blood sugar control and improved metabolic function.-Reduce protein catabolism-And lowers the risk of pressure injuries, which can develop due to extended immobility after surgery.What are the benefits of ERAS from a healthcare perspective? From a healthcare perspective, ERAS has been shown to-shorter length of hospital stay for patients,-Lower risk of ICU transfer rates-reduce readmission rates-And all of these improvements lead to lower healthcare costs, not just for the hospital but for the overall healthcare system, as fewer complications and shorter stays reduce the financial strain.Step 1: Screen & StrengthenIf you've lost any weight unintentionally in the lead up to surgery, or been eating poorly because of a reduced appetite, you may be at risk of malnutrition and it's really important to address this prior to surgery. Research suggests that between 40-50% of surgical patients have some degree of malnutrition. Pre-operative malnutrition is an independent predictor of poor post-operative outcomes. Addressing malnutrition is a key component of the ERAS protocol and why it's effective in improving surgical outcomes for patients.Book an appointment with a dietitian who can guide you on appropriate dietary changes to minimise muscle loss, build you up and optimise nutritional status and stores pre-op. A well-nourished body tolerates surgery better, heals faster, has a stronger immune system to fight infection, and experiences fewer complications.Step 2: Consider Immunonutrition If you're planned for major surgery, especially certain cancer and abdominal surgeries, consider the use of an immunonutrition supplement in the 5-7 days pre op. These are the supplements loaded with arginine, n3s, glutamine and nucleotides to support the immune system and reduce inflammatory responses, potentially leading to fewer infections and better recovery.Step 3: Build Your Strength & Energy Stores prior to surgery Carb load with food in the days leading up to surgery - think that big bowl of pasta a footy player would have the night before the grand final. ERAS protocols have significantly reduced or eliminated long periods of "nil by mouth" (NBM) before surgery.Ask your surgical team exactly when you need to stop eating solid food – it might be much later than you think, often around 6 hours before surgery for a light meal. For clear fluids, it could be as little as 2 hours before!We'll make the most of every second to prevent unnecessary dehydration, hunger, anxiety, and preserve your body's energyStep 4: The Pre-Surgery Carb Load using clear fluidsMany ERAS protocols include a special carbohydrate-rich drink taken a few hours before surgery. Your hospital may provide this, but if they don't, we can organise orders for you or point you in the right direction.  It's usually a clear, sweet drink. Think of it as topping off your fuel tank right before the 'race'."These have been shown to reduce post-operative insulin resistance (which can slow healing), help maintain muscle strength, can reduce nausea, and improve overall wellbeing. It basically tells your body it's in a 'fed' state, not a 'starvation' state, heading into surgery.This is best done with tailor made medical nutrition drinks as they come prepped with the correct doses of maltodextrin-polymer carbs and a lower osmolality than other solutions, which essentially means they gentler on your gut and better for gastric emptying so they don't linger in your gut during surgery. Always follow surgical instructions, but ideally we're aiming for 100 grams of carbohydrate the night before surgery and about 50 grams of carbohydrate in clear fluids approximately 2 hours before anesthesia. This might look like 4 x 200ml drinks the night before, and 2 the morning of surgery If you can't access these drinks, apple or cranberry juice are reasonable replacements.  Drop us an email or message or give us a call if you'd like advice on where to get pre-op and immunonutrition supplement drinks. Then we move on to post op and Step 5 which is aiming to eat early.  ERAS encourages starting to eat and drink as soon as it's safe after surgery – often within hours, not days!As soon as your team says it's okay, try sipping water, then progress to other clear fluids, and then light foods as tolerated. Even small, frequent amounts help. This helps to stimulates your gut to start working again, reducing the risk of ileus – a slow, sleepy bowel, provides energy for healing, and can help you feel more normal, faster.If you haven't been told you can eat or drink, keep asking the question! You are your best advocate! Another tip that can help here is step 6:  Chew GumIf your team allows it, start chewing sugar-free gum several times a day once you're able. It sounds simple, but it can be surprisingly helpful in mimicking eating even when you're not allowed to, and can stimulate your digestive system to return to usual function sooner and reduce the risk of ileus.Step 7 is to Nourish to Heal This is where we bring in our good friend protein to optimise tissue repair and recovery Include protein rich food at each meal, and chat to us if you're finding this difficult because there are plenty of hacks if you're not feeling up to chicken breast and steak! And finally step 8 is to Listen to Your BodyWhile ERAS encourages early eating, we always want you to be tuned in to your body's cues and speaking up to your medical team and us if something doesn't feel right. There are plenty of interventions that can be used to keep you comfortable while still optimising your nutrition to get the best outcomes from surgery. Weimann, A., Braga, M., Carli, F., Higashiguchi, T., Hübner, M., Klek, S., et al. (2021). ESPEN practical guideline: Clinical nutrition in surgery. Clinical Nutrition, 40(7), 4745-4761.Weimann, A., Braga, M., Carli, F., Higashiguchi, T., Laviano, A., Ljungqvist, O., et al. (2017). ESPEN guideline: Clinical nutrition in surgery. Clinical Nutrition, 36(3), 623-650.Gustafsson, U. O., Scott, M. J., Schwenk, W., Demartines, N., Roulin, D., Francis, N., et al. (2019). Guidelines for perioperative care in elective colonic surgery: Enhanced Recovery After Surgery (ERAS®) Society recommendations: 2018. Clinical Nutrition, 38(2), 576-586. (Note: The ERAS® Society website, erassociety.org, is the primary source for the most current and comprehensive suite of procedure-specific guidelines.)Ljungqvist, O., Scott, M., & Fearon, K. C. (2017). Enhanced Recovery After Surgery: A review. JAMA Surgery, 152(3), 292-298.Thiele, R. H., Raghunathan, K., Brudney, C. S., Campos, S., Candiotti, K., Chaves, S., et al. (2016). American Society for Enhanced Recovery (ASER) and Perioperative Quality Initiative (POQI) joint consensus statement on perioperative fluid management in adults. Perioperative Medicine, 5, 26. (Note: This is an example of ASER/POQI consensus; look for other relevant POQI statements on specific surgical procedures and their nutritional components.)Soon, K., Levy, G. M., Cusack, L. A., Varma, S., & Nicholson, G. A. (2020). The effect of preoperative carbohydrate loading on patient outcomes in elective surgery: A systematic review and meta-analysis. Systematic Reviews, 9(1), 254.Lewis, S. J., Egger, M., Sylvester, P. A., & Thomas, S. (2001). Early enteral feeding versus "nil by mouth" after gastrointestinal surgery: systematic review and meta-analysis of controlled trials. BMJ, 323(7316), 773-776.Osland, E. J., Hossain, M. A., Khan, S., & Memon, M. A. (2014). Effect of timing of oral feeding on patient outcomes after elective colorectal surgery: A systematic review and meta-analysis. Journal of Gastrointestinal Surgery, 18(5), 1039-1051.Braga, M., Gianotti, L., Nespoli, L., Radaelli, G., & Di Carlo, V. (2002). Nutritional approach in malnourished surgical patients: a prospective randomized study. Archives of Surgery, 137(2), 174-180.Marimuthu, K., Varadhan, K. K., Ljungqvist, O., & Lobo, D. N. (2012). A meta-analysis of the effect of combinations of enhanced recovery after surgery (ERAS) interventions on postoperative outcomes. Annals of Surgery, 255(4), 640-649.

In this piece we discuss breaking trial results with Chris Bain, a consultant anaesthetist and researcher, and Luke Perry, a trainee anaesthetist and PhD student*, both from Melbourne, Australia. We explore the effects of tissue trauma on inflammation and immune responses, and new results about the modifying effect of genetic expression with glucocorticoids. Then we delve into a pilot study on pulmonary artery catheters and cardiac surgery: one of the big questions in our specialty. The pilot study showed that a large randomised trial is feasible and has equipoise. Presented by Andy Cumpstey and Kate Leslie on location at the Annual Scientific Meeting of the Australian and New Zealand College of Anaesthetists and Faculty of Pain Medicine in Cairns, Australia, with their guests, Dr Chris Bain, Department of Anaesthesia and Perioperative Medicine, The Alfred Hospital and Monash University, Melbourne, Australia and Dr Luke Perry, an ANZCA trainee in Melbourne, a PhD student at the University of Melbourne, and Head of Research, Victorian Heart Hospital, Melbourne, Australia.

In this piece we discuss perioperative medicine with Ramani Moonesinghe, an anaesthetist and intensive care specialist from London, England, and Phuong Markman, an anaesthetist from Cairns, Australia. We explore access to and outcomes from surgery, particularly in relation to remoteness and socioeconomic deprivation. Then we talk about specific interventions to improve the patient experience, such as Sip til Send, and the challenges of implementing the program and demonstrating that it's safe with respect to aspiration. Finally we discuss whether AI and robotics can assist patients in the perioperative journey. Presented by Andy Cumpstey and Kate Leslie on location at the Annual Scientific Meeting of the Australian and New Zealand College of Anaesthetists and Faculty of Pain Medicine in Cairns, Australia, with their guests, Professor Ramani Moonesinghe, Professor of Perioperative Medicine, University College London, National Director of Patient Safety and National Clinical Director for Critical and Perioperative Care, NHS England, and Dr Phuong Markman, Consultant Anaesthetist, Cairns Hospital, Australia.

In this episode of the Becker's Healthcare Podcast, host Lukas Voss sits down with Dr. Robert C. Goldstein, Co-founder and CMO of Somnia, and Dr. Solomon Aronson, Associate CMO of Somnia, to explore the evolving landscape of anesthesia delivery and perioperative medicine. They discuss strategic opportunities in anesthesia, the financial impact of perioperative medicine and sedation, and the importance of strategic partnerships in healthcare. Tune in for valuable insights from two leaders shaping the future of anesthesia management.This episode is sponsored by Somnia.

2024 ACC/AHA guideline update, including biomarker testing, MINS, and other consulting tips Master perioperative medicine! Learn when to hold ACE inhibitors, how to manage OSA without delaying surgery, and why "NPO after midnight" is outdated. We're joined by Dr. Avital O'Glasser, our Chief of Perioperative Medicine! Claim CME for this episode at curbsiders.vcuhealth.org! Patreon | Episodes | Subscribe | Spotify | YouTube | Newsletter | Contact | Swag! | CME Show Segments Intro Case Preoperative Assessment & Consulting Tips Risk Calculators Frailty Pulmonary Considerations Cardiovascular Meds & BP Management NPO: Why Are We Still Doing This? Biomarkers & Postoperative Risk MINS Outro Credits Written and produced, show notes, cover art, CME, and infographics: Paul Wurtz MD.  Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP Reviewer: Molly Heublein MD Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP Technical Production: PodPaste Guest: Avital O'Glasser MD Disclosures Dr. O'Glasser reports no relevant financial disclosures. The Curbsiders report no relevant financial disclosures.  Sponsor: EZResus  Listeners of the Cribsiders and Curbsiders podcasts get access to a 2-month free trial,letting them use 100% of the features of the  For more information, www.ezresus.com/curbsiders and Use promo code Curbsiders Sponsor: Freed Visit Freed.ai and Usecode:CURB50 to get $50 off your first month when you subscribe. Sponsor: Mint Mobile Get 3 months of premium wireless service from Mint Mobile for $15 a month.Shop plans at mintmobile.com/curb

What happens to your body when you're under anesthesia? Guest: Dr. Alopi Patel, Associate Professor in the Department of Anesthesiology and Perioperative Medicine at Rutgers' Robert Wood Johnson Medical School Learn more about your ad choices. Visit megaphone.fm/adchoices

What happens to your body when you're under anesthesia? Guest: Dr. Alopi Patel, Associate Professor in the Department of Anesthesiology and Perioperative Medicine at Rutgers' Robert Wood Johnson Medical School The Pope is in critical condition Guest: Dr. Cristina Traina, Professor of Religious Studies and Catholic Ethics at Fordham University Inside ABC Vancouver's backroom controversies Guest: Rebecca Bligh, Former ABC Vancouver City Councillor Will Canada actually send troops to Ukraine? Guest: Dr. Robert Huish, Associate Professor in International Development Studies at Dalhousie University How should BC strengthen its economy amidst Trump's tariffs? Guest: Laura Jones, President & CEO of the Business Council of BC Will inviting Americans to Nanaimo improve political tensions? Guest: Tod Maffin, Creator of “Tod's Nanaimo Infusion” Learn more about your ad choices. Visit megaphone.fm/adchoices

Recorded at Evidence Based Perioperative Medicine (EBPOM) in London last year this presentation is part of a series of talks given under the session heading: “Implementation – what works and what doesn't?”. This piece is part one of four, with two more presentations to come and then a fascinating panel discussion to conclude. This first session focuses on the implementation of clinical trials, covering research methodologies, clinical implementations, and their challenges, and looking at the lengthy process of translating medical discoveries into clinical practice, emphasizing the ethical obligation to disseminate trial results effectively. The under-representation of certain demographics in trials, the gap between research findings and clinical practice, and the need for better communication strategies is stressed alongside solutions, including training for researchers, involving key stakeholders from the start, and the role of funders in supporting effective dissemination and implementation of research findings. Our presenter is, Joyce Yeung, Professor of Anaesthesia and Critical Care Medicine at the University of Warwick. She is Theme Lead of the Emergency, Prehospital, Perioperative and Critical Care Trials group within Warwick Clinical Trials Unit. Clinically she holds appointments as a Consultant in Critical Care Medicine at University Hospital Birmingham NHS Foundation Trust. Joyce is Director of UK Perioperative Medicine Clinical Trials Network. She is joint Clinical Speciality Lead for Anaesthesia, Perioperative Medicine and Pain for West Midlands Comprehensive Research Network. She is also the Chair of Resuscitation Council UK Immediate Life Support Subcommittee and is a member of Scientific and Education Committee at European Resuscitation Council. She serves as expert systematic reviewer and International Liaison Committee on Resuscitation taskforce member. Joyce is Chief Investigator for a major grant examining the impact of volatile versus intravenous anaesthesia in non-cardiac surgery (VITAL trial). Her research interests are applied health research and clinical trials including improving perioperative patient outcomes, chronic pain, post-operative cognitive dysfunction, and resuscitation. For more information about EBPOM and the conferences they are organising this year please go to www.ebpom.org

This piece comes from Melbourne, Australia, at the World Congress of Prehabilitation and Perioperative Medicine, held alongside the Australian ERAS+ Conference. Hear about the significance of multidisciplinary collaboration in prehabilitation and research; grants for virtual surgery schools; the impact of diet and microbiome on cancer pathways, and the future of digital prehabilitation. The conversation emphasizes the importance of optimizing patient care and reducing complications through innovative approaches in prehabilitation and perioperative medicine. Presented by Kate Leslie and Mike Grocott with their guests Bernard Riedel, an academic anaesthesiologist and the Director of the Department of Anaesthesia, Perioperative Medicine, and Pain Medicine at Peter MacCallum Cancer Centre in Melbourne, Australia, he holds a Professorial appointment at the University of Melbourne and Linda Denehy, Professor of Physiotherapy at the University of Melbourne, she has a joint appointment as Professor of Health Services Research: Allied Health at the Peter MacCallum Cancer Centre Melbourne.

In this episode, we explore the decline in trust within the U.S. health care system and discuss actionable strategies to rebuild it. Matthew Sherrer, associate professor and director of care team collaboration at the University of Alabama at Birmingham, and health care consultant Martin Nowak share insights on how relationship marketing, narrative medicine, and patient-centered care can improve health care experiences and restore confidence in the system. Learn how innovative approaches, such as leveraging technology and shifting to value-based care, can foster trust and strengthen connections between patients and providers. Matthew Sherrer is an associate professor and director of care team collaboration at the University of Alabama at Birmingham Marnix E. Heersink School of Medicine, Department of Anesthesiology and Perioperative Medicine.  He can be reached on X @MattSherrerMD and LinkedIn. He is also the co-host of the Fresh Flow podcast and has publications on PubMed. Martin Nowak is a health care consultant. They discuss the KevinMD article, "Trust in American health care: What's driving the decline?" Our presenting sponsor is DAX Copilot by Microsoft. DAX Copilot, by Microsoft, is your AI assistant for automated clinical documentation and workflows. DAX Copilot allows physicians to do more with less and turn their words into a powerful productivity tool. DAX Copilot automates clinical documentation—making it available in the EHR within minutes—and clinical workflows, including referral letters, after-visit summaries, style and formatting customizations, and more. 70 percent of physicians who use DAX Copilot say it improves their work-life balance while reducing feelings of burnout and fatigue. Patients love it too! 93 percent of patients say their physician is more personable and conversational, and 75 percent of physicians say it improves patient experiences. Discover AI-powered solutions for clinical documentation and workflows. Click here to see a 12-minute DAX Copilot demo. VISIT SPONSOR → https://aka.ms/kevinmd SUBSCRIBE TO THE PODCAST → https://www.kevinmd.com/podcast RECOMMENDED BY KEVINMD → https://www.kevinmd.com/recommended GET CME FOR THIS EPISODE → https://www.kevinmd.com/cme I'm partnering with Learner+ to offer clinicians access to an AI-powered reflective portfolio that rewards CME/CE credits from meaningful reflections. Find out more: https://www.kevinmd.com/learnerplus

Explore the critical role of civility in health care with insights from Matthew Sherrer, associate professor and director of care team collaboration at the University of Alabama at Birmingham, and Chris Turner, an emergency physician. Together, they discuss how workplace behaviors impact team dynamics, patient safety, and overall performance in health care settings. From reducing errors through quality improvement initiatives to fostering collaborative cultures that save lives, this episode uncovers the power of respect and teamwork in medicine. Matthew Sherrer is an associate professor and director of care team collaboration at the University of Alabama at Birmingham Marnix E. Heersink School of Medicine, Department of Anesthesiology and Perioperative Medicine.  He can be reached on X @MattSherrerMD and LinkedIn. He is also the co-host of the Fresh Flow podcast and has publications on PubMed. Chris Turner is an emergency physician. They discuss the KevinMD article, "The shocking impact of incivility in health care: Are your team's behaviors putting patients at risk?" Our presenting sponsor is DAX Copilot by Microsoft. DAX Copilot, by Microsoft, is your AI assistant for automated clinical documentation and workflows. DAX Copilot allows physicians to do more with less and turn their words into a powerful productivity tool. DAX Copilot automates clinical documentation—making it available in the EHR within minutes—and clinical workflows, including referral letters, after-visit summaries, style and formatting customizations, and more. 70 percent of physicians who use DAX Copilot say it improves their work-life balance while reducing feelings of burnout and fatigue. Patients love it too! 93 percent of patients say their physician is more personable and conversational, and 75 percent of physicians say it improves patient experiences. Discover AI-powered solutions for clinical documentation and workflows. Click here to see a 12-minute DAX Copilot demo. VISIT SPONSOR → https://aka.ms/kevinmd SUBSCRIBE TO THE PODCAST → https://www.kevinmd.com/podcast RECOMMENDED BY KEVINMD → https://www.kevinmd.com/recommended GET CME FOR THIS EPISODE → https://www.kevinmd.com/cme I'm partnering with Learner+ to offer clinicians access to an AI-powered reflective portfolio that rewards CME/CE credits from meaningful reflections. Find out more: https://www.kevinmd.com/learnerplus

This piece comes from Melbourne, Australia, at the World Congress of Prehabilitation and Perioperative Medicine, held alongside the Australian ERAS+ Conference. Recorded on the conference stage before an audience of guests and delegates, hear how the World Congress came to be where it is today. Presented by Mike Grocott, and Kate Leslie with 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 Gerrit Slooter, MD, PhD, Surgical Oncologist, Maxima Medical Centre, The Netherlands.

Welcome back Rounds Table Listeners!We are back this week with a special podcast episode! Dr. Mike Fralick sits down with Dr. Kevin Venus, a General Internist at Toronto Western Hospital, to chat about perioperative medicine!Questions? Comments? Feedback? We'd love to hear from you! @roundstable @InternAtWork @MedicinePods

TopMedTalk was at the American Society of Anesthesiologists (ASA) Annual General Meeting, Anesthesiology 2024. We're bringing you a series of podcasts from the conference. In this episode, we share insights into patient care, emphasizing the importance of empathy, trust, and tailored communication, especially for patients from communities with healthcare inequities. How do we handle different patient responses to monitoring technology? While remote monitoring offers potential benefits—such as allowing patients to recover at home—it raises questions about who will oversee this data and how to ensure it remains safe and effective. Presented by Desiree Chappell and Mike Grocott with their guest Ashley P. Oliver, MD MA, HS Clinical Assistant Professor, Division of Cardiothoracic Anesthesia, UCLA Department of Anesthesiology and Perioperative Medicine. -- We've been releasing more podcasts than usual here recently. Make sure you keep an eye on the TopMedTalk feed as we head towards the holidays. Like this, want more? Here's a great piece we did from the same conference: "Challenging The Big Insurance Companies"  https://topmedtalk.libsyn.com/challenging-the-big-insurance-companies-anes24

The Australian ERAS+ Conference and 2024 World Congress of Prehabilitation and Perioperative Medicine is an essential event for practitioners around the world. TopMedTalk were there and we will be bringing you a series of interviews with some of the key players and speakers. This piece is presented by Kate Leslie and Mike Grocott with their guest, David Watters, Alfred Deakin Professor of Surgery at Deakin University in Geelong, Victoria, Australia, based at the University Hospital Geelong, he is also Director of Surgery at Safer Care Victoria. -- TopMedTalk has ramped up its release schedule recently in response to growing demand for our recent conference coverage. Expect to see releases more frequently over the next few months. Ensure you are subscribed to us, so you don't miss out, and while you're here why not check out some of our new recent releases: ASA Presidents pass the baton | #ANES24 https://topmedtalk.libsyn.com/asa-presidents-pass-the-baton-anes24 The evolution of the Impella device in anesthesia, critical care, and perioperative medicine | #ANES24 https://topmedtalk.libsyn.com/the-evolution-of-the-impella-device-in-anesthesia-critical-care-and-perioperative-medicine-anes24    

The American Society of Anesthesiologists (ASA)'s annual general meeting; Anesthesiology 2024. Exclusive cutting edge conversations recorded at the conference with some of the key speakers, guests and delegates. The discussion highlights the growing use of the Impella device in anesthesia and critical care, particularly for high-risk patients with severe heart failure or cardiogenic shock. Presented by Desiree Chappell, Monty Mythen and Mike Grocott with their guest Asad Usman, Anesthesiologist, critical care specialist and physician with Penn Medicine, Pennsylvania.

A coherent and consistent approach to evaluating and optimizing surgical patients not only minimizes avoidable harm and complications but also impacts inefficiencies such as case cancellation, delayed case starts and turnover. Furthermore, avoidable complications are increasingly costly through post-acute care utilization, readmissions and never events. Facilities, surgeons, anesthesiologists, patients and families share an interest in doing better from the very beginning of the surgical journey. On today's episode of Value-Based Care Insights, Daniel Marino explores how to identify and capture opportunities to streamline care and is joined by Alex Hannenberg, former President of the American Society of Anesthesiologists and Adjunct Clinical Professor of Anesthesiology at Tufts School of Medicine, and Art Boudreaux, Professor of Anesthesiology and Perioperative Medicine at the University of Alabama, Birmingham. Gain insights into the importance of aligning and standardizing perioperative processes, and how leveraging data can help reduce inefficiencies, reduce costs, and improve patient outcomes.

Episode 113 Dr. Alex Hannenberg and Dr. Arthur Boudreaux - Addressing Perioperative Inefficiencies Through Alignment and Standardization Host Dan Marino explores how to identify and capture opportunities to streamline care and is joined by Alex Hannenberg, former President of the American Society of Anesthesiologists and Adjunct Clinical Professor of Anesthesiology at Tufts School of Medicine, and Art Boudreaux, Professor of Anesthesiology and Perioperative Medicine at the University of Alabama, Birmingham. Gain insights into the importance of aligning and standardizing perioperative processes, and how leveraging data can help reduce inefficiencies, reduce costs, and improve patient outcomes. To stream our Station live 24/7 visit www.HealthcareNOWRadio.com or ask your Smart Device to “….Play Healthcare NOW Radio”. Find all of our network podcasts on your favorite podcast platforms and be sure to subscribe and like us. Learn more at www.healthcarenowradio.com/listen

Evidence Based Perioperative Medicine (EBPOM)'s annual global conference in London was a huge success this year. TopMedTalk were there and this is one of the conversations we recorded for you. The Perioperative Quality Initiative (POQI) continues to address the implementation gap between perioperative research and clinical practice, offering clinicians synthesized, accurate recommendations. Since its inception in 2016, POQI has conducted 16 conferences, focusing on various perioperative topics like fluid management, blood pressure control, and nutrition. Presented by Andy Cumpstey with his guests Andy Shaw, Chairman, Department of Intensive Care and Resuscitation at The Cleveland Clinic, Cleveland, Ohio, 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 Imogen Fecher-Jones, lead nurse and project manager for the Perioperative Medicine Service and Preassessment at University Hospital Southampton.

More from this year's coverage of the European Society of Anesthesiology and Intensive Care (ESAIC). This piece focuses on perioperative and intensive care medicine, the importance of evidence-based guidelines over expert opinion. Why do we need a European perioperative database? How important is mentorship in medicine? How do we take the lead with leadership? Presented by Desiree Chappell and Kate Leslie with their guests Wolfgang Buhre, President of the European Society of Anaesthesiology and Intensive Care Medicine and Carolina Romero Garcia, Research Mentorship Programme Leader for the European Society of Anesthesiology and Intensive Care (ESAIC), Consultant Anesthesiologist, Consorcio Hospital General Universitario de Valencia.

Guideline evolution is driven by ongoing research; recent studies like PeriOperative ISchemic Evaluation-3 Trial (POISE-3) and trials such as OPtimisation of Peri-operaTive CardIovascular Management to Improve Surgical outcomE II (OPTIMISE II) trial may influence recommendations on hemodynamic management and the use of tranexamic acid. Future guidelines are expected to integrate machine learning models for risk prediction, addressing complex patient phenotypes and interactions. Discontinuation vs. continuation of renin–angiotensin system inhibition before non-cardiac surgery: the SPACE trial has challenged existing practices regarding the discontinuation of ACE inhibitors or ARBs, highlighting the dynamic nature of medical guidelines and the continuous incorporation of new evidence to enhance patient care. Presented by Andy Cumpstey and Joff Lacey with Mark Edwards, Consultant in Anaesthesia and Perioperative Medicine, University Hospital Southampton Honorary Senior Clinical Lecturer, University of Southampton and John Whittle, Clinical Academic working in Perioperative Translational Medicine at UCL and Honorary Consultant in Perioperative Medicine, Anaesthesia and Critical Care at University College Hospitals London. -- More on POISE-3 here: https://clinicaltrials.gov/study/NCT03505723 More on OPTIMISE II here: https://optimiseii.org/ More on the SPACE trial here: https://doi.org/10.1093/eurheartj/ehad716  

This episode underscores the evolution of perioperative medicine, the importance of innovation, teamwork, and data. The conversation reflects on past achievements and looks forward to future advancements in medical care. Our guest, a seasoned medical professional with a 40-year career, reflects on his journey from a young doctor in London to a consultant in Sydney. His plenary session at the Evidence Based Perioperative Medicine (EBPOM) congress highlighted key experiences and innovations in his career. Presented by Andy Cumpstey with Ross Kerridge, Senior Staff Anaesthetist at the John Hunter Hospital, Newcastle, Australia and Associate Professor at the University of Newcastle.

Guest: TJ Gan, MD, MBA, MHS, FRCA (UK), FRCA (lre), LicAc Guest: Dru Riddle, PhD, DNP, CRNA When it comes to postoperative nausea and vomiting (PONV) management, multimodal, antiemetic therapy based on patients' risk factors is routinely provided to minimize the incidence, but unfortunately, patients may still develop breakthrough PONV, in which an antiemetic should be administered from a different class from what's given for prevention.1 Barhemsys® (amisulpride) is an FDA-approved antiemetic for the treatment of PONV in patients who have or have not received prophylaxis.2 Learn more about this treatment option along with current management guidelines, key clinical considerations, and a real-world case study with TJ Gan, MD, MBA, MHS, and Dru Riddle, PhD, DNP. Dr. Gan is the Head of the Division of Anesthesiology and Perioperative Medicine, Critical Care, and Pain Medicine at the University of Texas MD Anderson Cancer Center in Houston, and Dr. Riddle is a certified nurse anesthetist at Texas Christian University in Ft. Worth, TX.

Guest: TJ Gan, MD, MBA, MHS, FRCA (UK), FRCA (lre), LicAc Guest: Dru Riddle, PhD, DNP, CRNA When it comes to postoperative nausea and vomiting (PONV) management, multimodal, antiemetic therapy based on patients' risk factors is routinely provided to minimize the incidence, but unfortunately, patients may still develop breakthrough PONV, in which an antiemetic should be administered from a different class from what's given for prevention.1 Barhemsys® (amisulpride) is an FDA-approved antiemetic for the treatment of PONV in patients who have or have not received prophylaxis.2 Learn more about this treatment option along with current management guidelines, key clinical considerations, and a real-world case study with TJ Gan, MD, MBA, MHS, and Dru Riddle, PhD, DNP. Dr. Gan is the Head of the Division of Anesthesiology and Perioperative Medicine, Critical Care, and Pain Medicine at the University of Texas MD Anderson Cancer Center in Houston, and Dr. Riddle is a certified nurse anesthetist at Texas Christian University in Ft. Worth, TX.

This piece is part of our coverage of The International Anesthesia Research Society (IARS) annual meeting. What exactly is artificial intelligence (AI)? How could generative AI be used in perioperative medicine? How is AI currently used? Why is there a need for more “granular data”? Presented by Desiree Chappell, TopMedTalk co-editor in Chief and Monty Mythen, TopMedTalk's founder, with their guest Hannah Lonsdale, Assistant Professor in Pediatric Anesthesiology at Vanderbilt UMC.

"TopMedTalk Down Under" continues 'as live' coverage of the 2024 Australian and New Zealand College of Anaesthetists (ANZCA) and Faculty of Pain Medicine's Annual Scientific Meeting. This piece explores the challenges and rewards of working in global health and the importance of collaboration and education in improving healthcare systems. Presented by Andy Cumpstey, Clinical lecturer, University Hospital Southampton NHS Foundation Trust and the University of Southampton, England, and Kate Leslie, Professor, Specialist Anaesthetist and Head of Research at the Royal Melbourne Hospital and the University of Melbourne with their guests Amanda Baric, Order of the Polar Star, Deputy Director of the Department of Anaesthesia and Perioperative Medicine at Northern Health and Debra Devonshire, visiting medical officer at Monash Health, Cabrini and Peninsula private hospitals.

"TopMedTalk Down Under" continues 'as live' coverage of the 2024 Australian and New Zealand College of Anaesthetists (ANZCA) and Faculty of Pain Medicine's Annual Scientific Meeting. This piece is essential listening for anyone who has an interest in the future of both the meeting and the organisation. It was recorded the day before our guests took their titles; Incoming ANZCA President David Story, Professor and Foundation Chair of Anaesthesia at the University of Melbourne, Head of the University Department of Critical Care; and the Incoming Dean of the Faculty of Pain Medicine, Dilip Kapur, Specialist Pain Medicine Physician, Adelaide. It is presented by Presented by Andy Cumpstey, Clinical lecturer, University Hospital Southampton NHS Foundation Trust and the University of Southampton, England, and Kate Leslie, Professor, Specialist Anaesthetist and Head of Research at the Royal Melbourne Hospital and the University of Melbourne with their guests Amanda Baric, Order of the Polar Star, Deputy Director of the Department of Anaesthesia and Perioperative Medicine at Northern Health and Debra Devonshire, visiting medical officer at Monash Health, Cabrini and Peninsula private hospitals. Find out more about the ANZCA here: https://www.anzca.edu.au/

A panel discussion 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 featuring; Andrew Davies, Consultant in upper gastro-intestinal surgery at Guy's and St Thomas' NHS Hospital Trust, Heather Gill, a vascular surgeon at McGill University and Research Chair for the Canadian Society of vascular surgery, Gerry Danjoux, consultant in Anaesthesia and Sleep Medicine at South Tees Hospitals NHS Trust, Chelsia Gillis, Assistant Professor in the School of Human Nutrition in the Faculty of Agricultural and Environmental Sciences at McGill University and Liam Humphreys, Senior Research Fellow and lead of the Living Well with Chronic Disease research theme at the Advanced Wellbeing Research Centre. Liam's presentation is here: https://topmedtalk.libsyn.com/behavioural-change-vs-psychological-interventions-which-is-key-in-prehabilitation-prehabilitation-world-congress Chelsia's presentation is here: https://topmedtalk.libsyn.com/prehab-initiative-standardisation-of-screening-assessment-interventions-and-outcomes-prehabilitation-world-congress Andrew's presentation is here: https://topmedtalk.libsyn.com/should-we-delay-surgery-for-prehabilitation-prehabilitation-world-congress

One doctor debates whether to work for the nation's largest insurance company after it purchased the independent practice she worked for in Oregon. Guest:Gwen O'Keefe, MD, Assistant Professor of Medicine, Department of Anesthesiology & Perioperative Medicine, OHSULearn more and read a full transcript on our website.Subscribe to our weekly newsletter.Follow us on X, LinkedIn and Youtube. Email us at info@tradeoffs.org. Hosted on Acast. See acast.com/privacy for more information.

This is the second part of a question and answer session which was originally presented at The World Congress of Prehabilitation. Featuring Mike Grocott, TopMedTalk's co-editor in Chief and the Professor of Anaesthesia and Critical Care Medicine at the University of Southampton as well as an NIHR Senior Investigator, 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), Franco Carli, Professor of Anesthesia at McGill University and Associate Professor in the School of Dietetics and Human Nutrition at McGill University, Gerrit Slooter, Surgical Oncologist, Maxima Medical Centre, The Netherlands and Linda Denehy, Head of the Melbourne School of Health Sciences and Professor of Physiotherapy at The University of Melbourne, Australia. If you'd like to hear part one please go here: https://topmedtalk.libsyn.com/prehabilitation-where-are-we-now-part-1-the-world-congress-of-prehabilitation If you'd like to hear the excellent talk which prompted this discussion please go here:  https://topmedtalk.libsyn.com/what-is-prehabilitation-the-world-congress-of-prehabilitation TopMedTalk is the broadcasting arm of Evidence Based Perioperative Medicine (EBPOM), if you'd like to attend one of our forthcoming conferences go now to http://www.ebpom.org

This question and answer session was originally presented at The World Congress of Prehabilitation. It features Mike Grocott, TopMedTalk's co-editor in Chief and the Professor of Anaesthesia and Critical Care Medicine at the University of Southampton as well as an NIHR Senior Investigator, 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), Franco Carli, Professor of Anesthesia at McGill University and Associate Professor in the School of Dietetics and Human Nutrition at McGill University, Gerrit Slooter, Surgical Oncologist, Maxima Medical Centre, The Netherlands and Linda Denehy, Head of the Melbourne School of Health Sciences and Professor of Physiotherapy at The University of Melbourne, Australia. Although this piece works as a standalone listen, if you'd like to hear the excellent talk which prompted it please go here: https://topmedtalk.libsyn.com/what-is-prehabilitation-the-world-congress-of-prehabilitation Part two of this piece will follow soon, make sure you are subscribed to TopMedTalk to ensure you don't miss out. TopMedTalk is the broadcasting arm of Evidence Based Perioperative Medicine (EBPOM), if you'd like to attend one of our forthcoming conferences go now to http://www.ebpom.org

More from our exclusive coverage of the 18th World Congress of Anaesthesiologists (WCA 2024) as Desiree Chappell speaks with her guests 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 BobbieJean Sweitzer, Systems Director of Perioperative Practices at Inova Health, Falls Church, Virginia. How has the term malnutrition evolved? Should we consider frailty in our younger patients more than we do? What are the particular challenges when caring for high risk patients with multiple co-morbidities? Where does nutrition education begin and should it ever end? And finally, what are the small simple changes we can make which will provide a meaningful impact upon patient care?

The GLP-1 agonists have been generating much discussion and a degree of consternation in the Perioperative Medicine community. Our panel of experts discusses the mode of action, indications, and perioperative implications of this class of medications.

This piece reflects the fact we are currently getting ready for the 18th World Congress of Anaesthesiologists (WCA 2024) - we're going to be bringing you all the coverage of the meeting that we can, live from Singapore. The podcast primes you for the topics we're expecting to encounter and gives you a taste of where the discussions are at the moment. Featured in this piece are: Carolyn Johnston, consultant Anaesthetist in St Georges hospital in London and Improvement lead for the National Emergency Laparotomy Network: TopMedTalk: EBPOM Highlight 1.27 | Obstetric anaesthesia (libsyn.com) Dr Attila Kett, anaesthesiologist and Chairman at St Peter's University Hospital at New Jersey: TopMedTalk: Enhanced Recovery for obstetrics | Perioperative Coach (libsyn.com) Alexander J Butwick, Obstetric Anesthesiologist and Researcher in maternal hemorrhage, pain relief in labor, and obstetric epidemiology at Stanford University TopMedTalk: TopMedTalk | Why is maternal mortality so high in the USA? (libsyn.com) Adriane Chapman, Professor at University of Southampton, Head of Digital Health Research Group, Director for the Centre for Health Technologies TopMedTalk: The Potential of Artificial Intelligence in Perioperative Care Q&A | EBPOM World Congress (libsyn.com) Sandy (Alexander) Jackson, specialty trainee in anaesthetics and intensive care medicine and an NIHR Doctoral Fellow at the University of Southampton TopMedTalk: Artificial Intelligence in Perioperative Care - Part 2 | EBPOM 2023 (libsyn.com) Guy Ludbrook Professor of Anaesthesia at the University of Adelaide and Royal Adelaide Hospital TopMedTalk: The hidden pandemic of post operative complications | EBPOM London 2020 (libsyn.com) 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 TopMedTalk: Morpheus Plenary Lecture: Exercise is a Perioperative medicine | EBPOM World Congress 2022 (libsyn.com) 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 TopMedTalk: Diversity and gender balance in research | TopMedTalk (libsyn.com)

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

Adam J. Milam, MD, PhD is a Senior Associate Consultant in the Department of Anesthesiology and Perioperative Medicine at Mayo Clinic Arizona. Prior to starting this position, he completed his cardiothoracic anesthesiology fellowship at Cleveland Clinic and residency at Cedars-Sinai Medical Center. He graduated from Wayne State University School of Medicine. Prior to medical school, he attended Johns Hopkins University where he graduated with a Bachelor of Arts in Public Health. He also holds a Master of Health Science as well as a Doctor of Philosophy in Public Health from the Department of Mental Health at Johns Hopkins Bloomberg School of Public Health.Dr. Milam has been actively involved in several national and state societies including the American Society of Anesthesiologists, the Society of Cardiovascular Anesthesiologists, the National Medical Association, and the California Society of Anesthesiologists; he serves on committees for each of these organizations. He also is actively engaged in research; Dr. Milam's research is rooted in practices, policies, and interventions to address health disparities and health inequities. He has published over 80 peer-reviewed publications and has more than 75 national, international, and invited presentations. His research has been featured and disseminated in leading public health and medical journals as well as Men's Health, Rolling Stone, and US News & World Report. His work has been used to guide local and state legislation that promote health equity. Dr. Milam's research also explores barriers to and possible strategies to improve diversity in the medical workforce. He has received multiple national awards including the Herbert W. Nickens Scholarship from the Association of American Medical Colleges and the Excellence in Public Health Award from the U.S. Public Health Service Physician Professional Advisory Committee; Dr. Milam is also a member of the Delta Omega Public Health Honor Society. Dr. Milam's Twitter Dr. Milam's Website

"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

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.

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.

In this episode we discussed how Justin Harvey came to specialize with pain physicians and why he partnered with ASPN. He talked about the different factors when choosing a practice and what to look for in an employment contract. Justin discussed several ways for physicians to build wealth and take advantage of taxes.  Host, Patrick Buchanan, MD: Dr. Buchanan is double board certified in Physical Medicine and Rehabilitation and Pain Medicine. His goal is to help his patients get their life back by managing their pain and focus on things they love and enjoy. https://www.californiapaindoctors.com/patrick-buchanan-m-d/ https://www.instagram.com/patdbmd/?hl=en Special Guest Host, Dawood Sayed, MD: Dr. Dawood Sayed is a Professor in the Department of Anesthesiology, Pain and Perioperative Medicine at The University of Kansas Medical Center and a Board-certified Anesthesiologist at The University of Kansas Health System. https://www.kumc.edu/dsayed.html https://twitter.com/dsayed1  Guest, Justin Harvey, CFP: Justin Harvey is a financial advisor and founder of APM Wealth. He specializes in helping pain physicians make smart financial decisions. He also hosts a podcast called APMSucces. https://apm-wealth.com/ https://apmsuccess.com/ About ASPN: ASPN was created to bring the top minds in the fields of pain and neuroscience together. ASPN has a mission to improve education, highlight scientific curiosity, establish best practice, and elevate each other in a quest to improve the field of pain and neuroscience. All initiatives of ASPN are dedicated to improving patient outcomes, education, research, and innovation. ASPN's website and social links: https://aspnpain.com https://www.youtube.com/channel/UCixMNhEtOiRm1aQmDWtzxmg https://www.instagram.com/aspn_painneuro/ https://www.facebook.com/PainNeuro https://www.linkedin.com/in/aspn/ https://twitter.com/aspn_painneuro   Our sponsors: Mainstay Medical: The Only FDA Approved Restorative Therapy for Chronic Mechanical Low Back Pain caused by Multifidus Dysfunction. Restore Control, Restore Function, Restore Stability, ReActiv8 Life. https://mainstaymedical.com/ Vertos Medical: The company behind the mild Procedure. Move beyond palliative therapies and address a major root cause of LSS, without leaving any implants behind. https://www.vertosmed.com/ Spinal Simplicity: Minuteman is an outpatient, minimally invasive, spine fusion therapy that decreases recovery time, and can alleviate pain for patients with chronic back and leg pain. Minuteman stabilizes and fixates the spine, addressing the core etiology. Get back to life with Minuteman! https://spinalsimplicity.com/

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/

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/

In this episode we discussed the various stimulation therapy options for low back pain. Our guest, Dr Rob Heros, shared his treatment algorithm for low back pain. He discussed the current data on different stimulation studies treating low back pain. He shared his experience with consulting for various medical device companies and the opportunities to be a research investigator in these studies. Dr. Heroes' patient shared his experience with low back pain and his treatment with Reactiv8.  Takeaways from the episode: Dr. Heros shares his algorithm for low back pain and discusses the current data for stimulation to treat low back pain.  Dr. Heros and Dr. Sayed discuss how they balance consulting and research with patient care Dr. Heros' patient shares his experience with Reactiv8 therapy.   Host, Patrick Buchanan, MD: Dr. Buchanan is double board certified in Physical Medicine and Rehabilitation and Pain Medicine. His goal is to help his patients get their life back by managing their pain and focus on things they love and enjoy. https://www.californiapaindoctors.com/patrick-buchanan-m-d/ https://www.instagram.com/patdbmd/?hl=en Special Guest Host, Dawood Sayed, MD: Dr. Dawood Sayed is a Professor in the Department of Anesthesiology, Pain and Perioperative Medicine at The University of Kansas Medical Center and a Board-certified Anesthesiologist at The University of Kansas Health System. https://www.kumc.edu/dsayed.html https://twitter.com/dsayed1   Guest, Dr. Rob Heros, MD: Dr. Heros is an interventional pain physician at Spinal Diagnostics in Oregon. He is board certified in Physical Medicine and Rehabilitation and has been practicing Pain Medicine for over 16 years. He has been involved in several landmark clinical research studies for stimulation to treat low back pain.  https://spinaldx.com/ About ASPN: ASPN was created to bring the top minds in the fields of pain and neuroscience together. ASPN has a mission to improve education, highlight scientific curiosity, establish best practice, and elevate each other in a quest to improve the field of pain and neuroscience. All initiatives of ASPN are dedicated to improving patient outcomes, education, research, and innovation. ASPN's website and social links: https://aspnpain.com https://www.youtube.com/channel/UCixMNhEtOiRm1aQmDWtzxmg https://www.instagram.com/aspn_painneuro/ https://www.facebook.com/PainNeuro https://www.linkedin.com/in/aspn/ https://twitter.com/aspn_painneuro   Our sponsors: Mainstay Medical: The Only FDA Approved Restorative Therapy for Chronic Mechanical Low Back Pain caused by Multifidus Dysfunction. Restore Control, Restore Function, Restore Stability, ReActiv8 Life. https://mainstaymedical.com/  

“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.

We've Come a Long Way From Ether Learn how an anesthesiologist approaches perioperative medicine from how to choose the right type of anesthesia (general anesthesia vs regional anesthesia vs MAC), to preoperative risk assessment, and how to avoid anesthesia related complications. Our guest, anesthesiologist, Dr. Angela Selzer (Denver, CO) helps us explore high yield pearls regarding the practice of anesthesiology to empower the internal medicine clinician to deliver team-based, perioperative care. Claim Free CE credit for this episode through VCU Health CE at curbsiders.vcuhealth.org! Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME! Show Segments Intro, disclaimer, guest bio Guest one-liner Introduction to anesthesiology  Introduction to regional anesthesiology   Walk through what an anesthesiologist does in the operating room Ambulatory surgery center exclusions  Approach to preop assessments “Will it change management?” applied to anesthesiologists ASA Classes  Anesthesia complications Take Home Points; Outro; Bonus clip Credits Written and Produced by: Edison Jyang; Avital O'Glasser MD, FACP, SFHM Cover Art: Sarah Phoebe Roberts, MPH Infographic:  Avital O'Glasser MD, FACP, SFHM; Edison Jyang Show Notes: Avital O'Glasser MD, FACP, SFHM Hosts: Matthew Watto MD, FACP; Avital O'Glasser MD, FACP, SFHM Technical Production: Pod Paste  Reviewer: Sai S Achi, MD MBA Showrunner: Matthew Watto MD, FACP Technical Production: PodPaste Guest: Angela Selzer, MD Sponsor: Better Help Save 10% off your first month at BetterHelp.com/curb  Sponsor: Hello Fresh Go to HelloFresh.com/curb65 and use code curb65 for 65% off plus free shipping.  Sponsor: Indeed Visit Indeed.com/internalmedicine to start hiring now. Full transcript HERE