“I know nothing…” Hugh Montgomery – Ernest Henry Starling Plenary Lecture | EBPOM 2022

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

Guidance on prehabilitation for cancer | EBPOM London 2020

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

EBPOM London 2020 | Guidance on prehabilitation for cancer

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

TopMedTalk | CPET Cardio Pulmonary Exercise Testing

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.

COVID 19 | Oxygen economy, CPAP and ventilators

Our guest is an intensivist and specialist in dangerous transmissible diseases as well as being one of the scientists who took part in the Xtreme Everest expedition which investigated the effects of human tolerance of hypoxia. What about continuous positive airway pressure (CPAP)? Information suggests this may be more useful as we head into the pandemic stage “based on the experience the Italians are describing to us”. This piece looks at how the UK is preparing to tackle the global pandemic before asking some important questions about oxygen supplies. There’s a tendency for people to use more rather than less, should we look to reverse this? “We give people a range to put their oxygen saturation between and people naturally want to go for the higher end of that target,” in this time of crisis and potential shortages is it important to change that habit? “The whole National Health Service has changed its thinking…” the piece wraps with some thoughts about how enticing it is to see the UK’s Government and health service move to stop medics being bound by red tape and overly strict guidelines. Presented by Monty Mythen with his guest Dan Martin, OBE, Anaesthetist and Intensivist at the Royal Free Hospital and Reader at University College London (UCL). Link to the story about the Critical Care Nurse who attracted the nation’s sympathy in the press recently: https://www.standard.co.uk/news/uk/nurse-urges-public-stop-panic-buying-dawn-bilbrough-a4392596.html For more of our COVID 19 coverage go here: https://www.topmedtalk.com/covid-19/ Thank you to our sponsor Edwards Lifesciences. Edwards clinical education (ECE): https://www.edwards.com/clinicaleducation

ANES19 | Greg Fischer

The TopMedTalk team are live from Anesthesiology 2019 at the Orange County Convention Center in Orlando. With over 14,000 delegates, clinicians, thought leaders and professionals, it’s the largest gathering of Anesthesiologists and Anesthesia providers in the world. Check out the www.topmedtalk.com website now to hear live audio, while you are there remember to subscribe for updates so you can always be one step ahead of the crowd. Also, if you fancy watching the show as it happens go to our Twitter feed www.twitter.com/topmedtalk to see the team in action. This piece focuses upon cerebral oximetry. Can it help practitioners monitor cerebral oxygenation in situations in which pulse oximetry alone may not be fully indicative of the oxygen in the brain? How does it relate to hypoxia? This piece is a deep dive into the technology and its front line applications. Presented by Desiree Chappell and Monty Mythen with Mike Grocott, Professor of Anaesthesia and critical care at the University of Southampton and their guest, Greg Fischer, Chairman, Department of Anesthesiology & Critical Care Medicine at Memorial Sloan Kettering Cancer Center. — Like this, want more? Mike mentions the exciting research done during Xtreme Everest, hear his engaging lecture on that project here: https://www.topmedtalk.com/10-xtreme-everest-physiology-on-top-of-the-world/