Perioperative Medicine

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Presentation transcript:

Perioperative Medicine Rob Stephens MD FRCA FFICM Consultant in Anaesthesia Thanks to Mark Edwards UCLHospitals NHS Foundation Trust NHS

Perioperative Medicine General What is it? Do we need it? Future directions? How do I do it? Perioperative Medicine

Perioperative Medicine General Enjoy Who’s happy? Lots in 2 years Do CV and chat Perioperative Medicine

Perioperative Medicine What is it? Limited focus of conventional anaesthesia vs more interesting and complex perioperative overview. PRE PRE INTRA INTRA INTRA POST Perioperative Medicine

Perioperative Medicine What is it? POST PRE INTRA Risk assessment Optimization Care stratification Consent Quality intraoperative care Evidence-based interventions Critical care / ward Pain Fluid Comorbidities Enhanced recovery Perioperative Medicine

What is it? Research Other specialities Process & quality improvement Has nice overlaps with other areas. Feel much more an integral, multidisciplinary part of the hospital (like ITU) than sitting in theatre pushing propofol. Perioperative Medicine

Perioperative Medicine Do we need it? “We do this stuff already…” But… “Epidemic” of higher risk surgery Limited resources Who is best placed to care for patients perioperatively? Perioperative Medicine

Perioperative Medicine Future Direction? Threats: Other specialities Are our skills under-utilised? Opportunities: Improved patient outcomes Profile of the profession Education More varied working life Perioperative Medicine

Perioperative Medicine Future Direction? Uncertainties: Practicalites Boundries Funding and Time Skills and knowledge Pathways Perioperative Medicine

Perioperative Medicine Future Direction? The buzz around periop medicine – drop in about the RCoA workgroup, official statement from President in college bulletin recently Perioperative Medicine

Perioperative Medicine Future Direction? “If we duck this challenge, others will not, and anaesthetists risk being sidelined from the activities we trained for so many years to perform.” Grocott & Pearse, BJA 2012 Perioperative Medicine

Perioperative Medicine How I did It Luck, chatting, randomness, niche interests Being part of a group Clinical: preassessment & interest in CPET major adult surgery lots of surgical critical care Time out for research & MD Relevant conferences & societies Happy & forward thinking workplace/colleagues Perioperative Medicine

Perioperative Medicine How to do it? Still a bit “DIY”, practical barriers Part of a group Preassessment and CPEx experience Get involved; quality improvement / research projects make it tangible Perioperative Medicine

Perioperative Medicine How to do it? Perioperative Medicine

Perioperative Medicine How to do it? Still a bit “DIY”, practical barriers Part of a group Preassessment and CPEx experience Get involved; quality improvement / research projects make it tangible Find out local outcomes, Surgeons, physicians, nurses, others Formal qualification? UCL Cert / Dip / MSc Perioperative Medicine Sept 2014 Brighton, others Perioperative Medicine

Perioperative Medicine Summary Exciting, evolving area A logical development of what we already do Up to you to form your own career path More formal qualifications coming Thank you robcmstephens@googlemail.com Perioperative Medicine