Perioperative Medicine and the Geriatrician

Professor Warren Clements is an interventional radiologist and researcher at the Alfred hospital and Monash University. In this podcast, Warren discusses the seven habits that he regards as important in helping to become a highly effective clinician-scientist.

If you have just been told that you need an operation, you're now at the start of a surgical journey. It may be a short journey or it may be a long one, but either way this podcast series is here to help you.

A Just Culture in the workplace means that everyone should feel safe to speak up, and leads to open and honest communication, systems thinking, engagement, and participation, where everyone is involved in making improvements. Professor Janet Anderson and Garry Mann, our Human Factors team, talk to Yooralla’s Director of Just Culture Miranda Cornelissen, about the benefits of implementing a Just Culture in the workplace.

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.

Thuy Bui is the Lead Pharmacist of the Analgesic Stewardship and Perioperative Medicine Services at the Alfred. She discusses the very important role of the pharmacist in all stages of the Perioperative process.

Any patient undergoing a procedure or intervention should be provided with an explanation of the procedure and the risks involved, and be asked to give their consent. Often this is a process that is poorly done or misunderstood by both of the clinician and the patient. Dr Maryanne Balkin discusses the legal and ethical issues surrounding informed consent and the capacity to provide consent.

Increasing numbers of older people are undergoing surgery and adverse outcomes are common within this patient group. Dr Margot Lodge is a Geriatrician with a special interest in Perioperative Medicine. She discusses the role of the geriatrician in Perioperative Medicine and the use of implementation science in adopting new models of care for the older person undergoing surgery.

Dr Lana Vestarkis is an Anaesthetist at Sunshine Coast University Hospital. For her Master of Perioperative Medicine Capstone Project, Lana worked with her colleague Dr Anna Pietzsch to attempt to rationalise preoperative blood testing in the elective surgical setting. Their project is not only having a major impact in their health network but has gone on to win a national prize. Lana and Anna discuss their project, including the challenges faced and the lessons learned when trying to bring about change.

SARS-CoV-2 infection increases perioperative risks, both with the acute infection and its aftermath. Accruing data suggests that elective surgery should be deferred for 7 weeks for most types of surgery, although individualised risk assessment may reduce or increase this timeframe. Paul Myles talks with Dr Kariem El-Boghdadly from Guy's Hospital in London, the lead author of a recently published consensus statement arising in the UK.

Methadone creates many challenges for the perioperative physician. In this episode, Dr Olivia Leahy talks with Dr Harry Sivakumar - a fellow of both ANZCA and the faculty of pain medicine - regarding the use of methadone in opioid replacement therapy, chronic pain and acute pain management contexts.