TopMedTalk

Recording from TopMedTalk at EBPOM in Dingle, Ireland, Kate Leslie and Imogen Fecher-Jones interview Oliver Pratt, Consultant Anaesthetist at Salford Royal Hospital, Chair of the Primary FRCA Structured Oral Examinations for the Royal College of Anaesthetists, and a Medical Officer for the Kinder Mountain Rescue Team and Joe Cosgrove, a Consultant in Anaesthesia and Intensive Care Medicine at the Newcastle upon Tyne Hospitals NHS Foundation Trust, a Primary FRCA Examiner for the Royal College of Anaesthetists, and the Critical Care Outreach Lead specializing in advance care planning. He is also Events Medicine Doctor for Durham County Cricket Club and Newcastle United FC plus adviser to the England and Wales Cricket Board on medical contingency and major incident planning for international cricket matches. The discussion is about contributing to pre-hospital care in mountain rescue and event healthcare. Oliver describes joining Kinder Mountain Rescue as a volunteer; emphasising that organisational, teaching, and communication skills are often more useful than advanced procedures. He also notes increasing call-outs for poorly prepared walkers alongside serious cases such as major haemorrhage from a femoral artery laceration. Joe discusses stadium medicine at Newcastle United, where cardiac arrests occur about once per season, including a 19-year-old with Wolff-Parkinson White (WPW) syndrome and cocaine who survived after prolonged CPR amid derby-day security. Both outline structured debriefing practices, and Cosgrove mentions new mandatory event healthcare requirements and forthcoming government guidance, while Pratt directs listeners to Mountain Rescue England and Wales for involvement or donations. More on that here: https://www.mountain.rescue.org.uk/support-us/

This month's Perioperative Profile features Duminda Wijeysundera, Professor in the Department of Anesthesiology and Pain Medicine and IHPME at the University of Toronto, and a Staff Physician at St. Michael's Hospital, who holds the Endowed Chair in Translational Anesthesiology Research, serves as Head of Science at SPHERE, acts as a Senior Adjunct Scientist at ICES, and is a Trustee for the International Anesthesia Research Society (IARS). He describes growing up across Sri Lanka, the US, Singapore, and Canada, and how adaptability and cultural sensitivity shaped him; he entered medicine for scientific interest and stability, switched from internal medicine to anesthesiology, and pursued research training using Ontario administrative data, including work on epidural outcomes. He explains the METS study comparing clinicians' judgment, CPET, the Duke Activity Status Index, and NT-proBNP, and discusses follow-on FAST WALK and FIT After Surgery findings on postoperative disability, frailty, and the impact of poor social supports.

Recorded at the Evidence Based Perioperative Medicine (EPBOM) World Congress in London, this TopMedTalk episode, presented by Andy Cumpstey, features Guy Ludbrook, Professor of Anaesthesia and Head of Acute Care Medicine at the University of Adelaide and resident Georgia Cadzow, discussing the Perioperative Quality Initiative (POQI) POQI is a not-for-profit that uses a formal Delphi process to distill evidence and expert consensus into publishable clinical recommendations on topics such as perioperative hypotension, acute kidney injury, delirium, health economics, and fluid therapy. Georgia describes the iterative POQI meeting format, including pre-reading, small-group drafting, plenary workshopping, and final voting requiring 85% agreement. The conversation focuses on recent POQI work on Enhanced Postoperative Care (EPOC) units—protocolized, short-stay (24–48 hour) care for medium-risk postoperative patients—covering benefits and harms, economic impacts, and quality indicators, alongside plans for shared core datasets, the EPOC Network, and a 2027 second EPOC World Congress.

Today's TopMedTalk AI podcast was recorded at the Association of Anaesthetists of Great Britain and Ireland in London. It features Andy Cumpstey and Desiree Chappell and their guests, John Whittle, honorary associate professor of Perioperative medicine at University College London and  Duncan McPherson, Head of the clinical team at QMD Services and Anesthesiologist and Honorary Professor at University College London. We discuss how early AI research shares core requirements with other research—especially data safety and governance—while medical device regulation applies the same legal principles to AI as to other devices: safety and performance, alongside separate data protection laws. Patient concerns focus on data use, trust, and whether AI use in care should require consent. The panel addresses "black box" models, evolving software, bias and generalisability. The conversation contrasts regulated medical devices with unregulated scientific publishing, noting risks from AI-generated fraudulent papers and limits of relying on peer-reviewed literature, while emphasizing critical appraisal and appropriate clinical implementation.

At the 58th Society for Obstetric Anesthesia and Perinatology (SOAP) meeting in Montreal, TopMedTalk hosts Mike Grocott and Desiree Chappell interview Heather Nixon, SOAP immediate past president and Section Chief for Obstetric Anesthesiology; Section Chief for Simulation, Education, and Training Department of Anesthesiology University of Illinois, about SOAP's educational mission, governance, outreach, and special interest groups. Nixon describes her focus on intraoperative pain during caesarean delivery after a sentinel event and how listening to patient narratives, including The Retrievals (Season 2), highlighted issues such as dismissal of pain, communication failures, and cultural bias. She outlines SOAP's toolkit response and UIC system changes: intraoperative pain scoring every 15 minutes in Epic, empowerment to speak up, workflow education, and quicker conversion to general anesthesia to prevent prolonged severe pain, and notes SOAP's patient-facing Painless Push website. Link to the The Retrievals: https://podcasts.apple.com/gb/podcast/the-retrievals/id1691599042