TopMedTalk

Recorded in Prato, Italy at the 8th Collaborative Clinical Trials in Anesthesiology meeting.
Desiree Chappell and guest co-host Mark Priestley interview Professor Karim El-Boghdadly, Consultant Anaesthetist and Clinical Lead for Theatres, Anaesthesia, and Peri-operative Medicine at Guy's and St Thomas' NHS Foundation Trust, as well as an Honorary Reader at King's College London about the perioperative implications of GLP-1 receptor agonists.
El-Boghdadly explains expanding GLP-1 use, delayed gastric emptying, and why early "hold for a week" guidance may be impractical. He describes a UK trainee research network observational study across ~130 hospitals collecting ~47,000 cases, including ~1,300 GLP-1 patients, and reports an unadjusted ~11-fold higher aspiration/regurgitation rate in GLP-1 users (about 1 in 70) versus non-users (about 1 in 800), with about half occurring on emergence/extubation. The discussion emphasizes risk assessment, extubation planning, low uptake of gastric ultrasound, and the need for future randomized trials.
The paper being discussed is here: https://associationofanaesthetists-publications.onlinelibrary.wiley.com/doi/10.1111/anae.70380
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This month's TopMedTalk Classic was originally aired in 2019 but remains very relevant today.
Presented by Dr Jugdeep Dhesi, Clinical Lead, POPS and Consultant Geriatrician, Guys and St Thomas' NHS Trust, and an expert on frailty. This talk explores how our understanding and discussion has improved regarding a condition that is still yet to have a clear, universally accepted, definition. How do we build a patient's physical reserve? What is the best way to conceptualise frailty? Are there any universal treatments available?
TopMedTalk's back catalogue contains over 2000 episodes covering all aspects of perioperative medicine. We'd love you to go back and listen to some of our other classic episodes.

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.