71st PostGraduate Assembly in Anesthesiology

Please Note: This session takes place on Thursday, December 7th from 7:00 am - 5:00 pm and

Friday, December 8th from 8:00 am to 11:00 '

Click here for more information.

After completion of this session, the participant will be able to:

• Identify the perioperative factors that contribute to lung injury in thoracic patients and strategies to avoid this complication;

• Understand recent developments in the physiology of one-lung ventilation and use this information to minimize hypoxemia during one-lung anesthesia;

• Develop a plan to improve the perioperative outcomes of patients having esophagectomy surgery;

• Manage anesthetic care for patients having airway surgery including invasive pulmonology, tracheal resection and tracheal injuries;

• Perform paravertebral analgesia and lung ultrasound;

• Improve their ability to provide safe and reliable lung isolation with double-lumen tubes and bronchial blockers;

• Understand the intraoperative implications of large mediastinal masses and develop an anesthetic plan to manage these patients;

• Develop a plan to manage post-thoracotomy pain for patients with contraindications to thoracic epidural analgesia;

• Discuss recent advances in anesthesia for lung transplantation and patients with pulmonary hypertension.

TS-01 & T-02 - Is There is Place for Nitric Oxide

TS-01 & TS-02 Protective Lung Ventilation During

SPECIALTY: Cancer

The PGA visitors may choose to tour the Josie Robertson Surgery Center during their visit to Memorial Sloan Kettering. The Josie Robertson Surgery Center opened in January 2016 and set a new standard for outpatient cancer surgery. JRSC is the first-of-its-kind freestanding facility on Manhattan’s Upper East Side, accommodating same-day outpatient and short stay surgical cases from the Breast, Gynecology, Head & Neck, Plastics & Reconstructive, and Urology services. The short stay procedures include unilateral and bilateral mastectomy with reconstruction, laparoscopic and robotic hysterectomy, thyroidectomy, nephrectomy, and laparoscopic and robotic prostatectomy, with clinical pathways designed for patients to go home the same day or with one overnight stay.

SPECIALTY:

Liver Transplant/Cardio Thoracic/Computerized Recording/Anesthesia Simulator

After completion of this session, the participant will be able to:

• Demonstrate basic pediatric life-support skills;

• Recognize the signs of impending respiratory failure and shock;

• Initiate treatment of impending and overt respiratory failure and shock;

• Identify and appropriately treat rhythm disturbances.

This activity contributes to the Part IV: Improvement in Medical Practice requirement of the American Board of Anesthesiology’s (ABA) redesigned Maintenance of Certification in Anesthesiology Program® (MOCA®), known as MOCA 2.0®. Please consult the ABA website, www.theABA.org, for a list of all MOCA 2.0 Part IV requirements and their associated point values.

After completion of this session, the participant will be able to:
•  Discuss the management of accidental dural puncture in obstetrics;
•  Develop an evidence-based decision regarding the use of intrathecal catheters in the prevention and management of  PDPH;
•  Review the treatment of spinal headache, including therapeutic and prophylactic blood patch.

After completion of this session, the participant will be able to: 
• Define three styles of leadership; 
• Identify their best fit style of leadership;
• Identify the style of leadership of the hospital administration and or surgery department.

After completion of this session, the participant will be able to:

• Apply the use of nerve stimulator techniques for upper and lower extremity blocks;

• Treat reflex sympathetic dystrophy with either intravenous anesthesia (Bier block) or nerve block;

• Utilize ultrasound technology for upper and lower extremity blocks.

This activity contributes to the Part IV: Improvement in Medical Practice requirement of the American Board of Anesthesiology’s (ABA) redesigned Maintenance of Certification in Anesthesiology Program® (MOCA®), known as MOCA 2.0®. Please consult the ABA website, www.theABA.org, for a list of all MOCA 2.0 Part IV requirements and their associated point values.

Panel Moderator:  Douglas B. Coursin, M.D.

Presentations:

Sepsis Could Kill Your Patient, You or Yours - Mark E. Nunnally, M.D. 

The 2nd Victim-Saving Ourselves and our Colleagues - Oliver P.F. Panzer, M.D.

Crisis Resource Management:  Resources to Save Our Patients and Ourselves - Vivek K. Moitra, M.D., FCCM

A Survival Guide for Physicians - Dealing With Burnout, Aging, and Preventable Health Issues - Douglas B. Coursin, M.D.

After completion of this session, the participant will be able to:

• Interpret the recommendations of the recently revised and published guidelines for the Surviving Sepsis Campaign (2016) as they apply to our patients and us;

• Illustrate elements of physicians as the 2nd victim and overall practitioner mental health and well-being after an “event";

• Identify the utility and application of a Crisis Resource Management approach in aiding our patients and us; 

• Emphasize the need for Physician self-awareness and care.

This activity contributes to the patient safety CME requirement for Part II: Lifelong Learning and Self-Assessment of the American Board of Anesthesiology’s (ABA) redesigned Maintenance of Certification in Anesthesiology Program® (MOCA®), known as MOCA 2.0®. Please consult the ABA website, www.theABA.org, for a list of all MOCA 2.0 requirements.

Panel Moderator: Steven N. Konstadt, M.D., M.B.A., FACC

Presentations:

Should My TAVR Patient Have GA or MAC? Evolution of a Team: Based Approach - Peter J. Neuburger, M.D. 

Who should be doing TEE for Interventional Procedures? The Anesthesiologist or Cardiologist? - G. Burkhard Mackensen, M.D, Ph.D., FASE

Mechanical Circulatory Support: When Should We Turn to It?- Jack S. Shanewise, M.D.  

Performance Outcomes Measures in Cardiac Anesthesia: How Will we Know How We Are Doing? - Laurent G. Glance, M.D.

After completion of this session, the participant will be able to:

• Describe considerations important to developing an anesthetic plan for a patient for TAVR;

• Prescribe an anesthetic and imaging plan for management of the high risk patient undergoing intervention or surgery;

• Describe situations in which mechanical circulatory support may improve patient outcomes;

• Choose between the different methods of mechanical circulatory support; 

• Incorporate cardiac anesthesia performance outcomes measures into her/his practice.

After completion of this session, the participant will be able to:

• Enumerate the indications for intrathecal pumps and spinal cord stimulators;

• Delineate the relative and absolute contraindications for spinal interventions;

• Enumerate at least three complications which can arise from interventional approaches.

After completion of this session, the participant will be able to:

• Enumerate the possible complications that can arise from endovascular approaches;

• Delineate anesthetic risk factors for the vascular patient;

• Enumerate the possibilities for postoperative analgesia in this population of patients.

After completion of this session, the participant will be able to:

• Discuss the epidemiology and scope of the occurrence of postoperative atrial fibrillation;

• Review proven measures of prophylaxis for postoperative atrial fibrillation;

• Employ acute therapy measures for postoperative atrial fibrillation;

• Employ methods to prevent stroke associated with postoperative atrial fibrillation.

Case Outline

After completion of this session, the participant will be able to:

• Identify the signs and symptoms of Local Anesthetic Systemic Toxicity;

• Formulate a plan to treat Local Anesthetic Systemic Toxicity.

Case Outline

After completion of this session, the participant will be able to:

• Identify risk factors for the cardiac arrest in the pediatric population;

• Develop an emergency response plan for cardiac arrest in this ambulatory procedure.

Full Title:  Fractured Humerus in a Patient on One of the Many Oral Anticoagulants (Clopidogrel, Rivaroxaban, Apixiban, Dabigatran):  ASRA Guidelines? 

After completion of this session, the participant will be able to:

• Review current ASRA guidelines regarding anticoagulation and antiplatelet therapy;

• Select the appropriate anesthetic management plan in the anticoagulated patient.

Case Outline

After completion of this session, the participant will be able to:

• Understand the principles of ultrasound applied to the assessment of the spine;

• Recognize the normal sonoanatomy of the spine;

• Perform a systematic ultrasound assessment of the spine in the sagittal and transverse plane;

• Identify a desired interspace;

• Identify the optimal needle insertion point;

• Determine the distance from the skin to the epidural or intrathecal spaces.

This activity contributes to the Part IV: Improvement in Medical Practice requirement of the American Board of Anesthesiology’s (ABA) redesigned Maintenance of Certification in Anesthesiology Program® (MOCA®), known as MOCA 2.0®. Please consult the ABA website, www.theABA.org, for a list of all MOCA 2.0 Part IV requirements and their associated point values.

Panel Moderator: Michael F. O'Connor, M.D., FCCM

Presentations:

Reversal of Anticoagulation - Daryl J. Kor, M.D., M.Sc.

Hepatic Encephalopathy and Liver Failure - Zdravka Zafirova, M.D.

Update on Tight Glycemic Control - Andrew B. Leibowitz, M.D.

The Patient with Chronic Lung Disease - Michael F. O'Connor, M.D., FCCM

After completion of this session, the participant will be able to:

• Describe the most effective way to reverse the most commonly used anticoagulants;

• Discuss the evaluation and management of encephalopathy in patients with chronic liver disease;

• Explain the current recommendations about how to manage glucose control in the perioperative setting and in the ICU;

• Describe the course of postoperative respiratory failure and effective interventions to mitigate and manage it.

Full Title: The 21st Century Stethoscope:  Point-of-Care Ultrasound (PoCUS) - A Powerful Perioperative Tool for the Anesthesiologist 

Panel Moderator: Mark P. Hamlin, M.D., M.S.

Presentations:

Assessing the Dyspneic Patient Basic Lung Ultrasound- Stephen C. Haskins, M.D.

Optimizing Volume Assessment with Surface UltrasoundOliver P.F. Panzer, M.D.

Focused Cardiac Ultrasound in ACLS The FEEL Protocol - Nibras Bughrara, M.D.

FORESIGHT- A Comprehensive PoCUS Examination - Davinder S. Ramsingh, M.D.

After completion of this session, the participant will be able to:

• Understand the Emerging Role of PoCUS for the anesthesiologist in the perioperative setting;

• Understand how to use Lung Ultrasound to assess and diagnose causes of respiratory distress;

• Understand how ultrasound can be utilized to assess volume status and fluid responsiveness in hypotensive patients;

• Understand the role for Focused Cardiac Ultrasound in Advance Cardiac Life Support to help with diagnosis and management of patients in a pulseless electrical activity (PEA) arrest;

• Learn how to use US to assess the Airway as well as Gastric Volume; 

• Learn how to successfully create and execute an educational program to teach a comprehensive PoCUS exam to anesthesiology trainees.

Focus Session Moderator: Donna A. Castello, D.O.

Presentations:

Update on Regulations Pertaining to Office-Based Procedures- Donna Castello, D.O.

Which Patients and What Procedures for Office-Base - Syed Shah, M.D.

After completion of this session, the participant will be able to: 
• Identify what procedures, and which patients, are suitable for office-based procedures and which should not be done in this venue;
•   Discuss the ASA guidelines as they apply to office-based anesthesia.

Focus Session Moderator: Keith A. Jones, M.D.

Presentations:

Theory vs. Reality: The Triple Aim of Improving Health Improving Delivery of Care and Reducing Cost - Alan E. Curle, M.D.

The Challenges of Demonstrating Value with the Perioperative Surgical Home - Jonathan S. Gal, M.D.

After completion of this session, the participant will be able to:

• Identify the Perioperative Surgical Home's triple aim of improving health, improving delivery of healthcare, and reducing the cost of care;

• Distinguish the benefits of the added value of anesthesiologists over other healthcare providers in coordinating care from the minute the decision is made to operate, until 30 days after surgery;

• Describe and breakdown the data, improved outcomes, evidence, and limitations from recent implementations of the Perioperative Surgical Home to be considered moving forward in continued and future efforts;

• Recognize the net effect from the proposed areas of cost savings, when the costs of implementing the Perioperative Surgical Home are also considered.

Focus Session Moderator: Dawn M. Sweeney, M.D. 

Presentations:

Adult with Repaired Congenital Heart Disease - Dawn M. Sweeney, M.D. 

Patient with Stent - Ketan Shevde, M.D.

After completion of this session, the participant will be able to:

• Discuss the clinical issues related to the two main types of coronary stents;

• Stratify the perioperative risks for patients with intracoronary stents;

• Develop management strategies for perioperative antiplatelet therapy for different types of coronary stents;

• Discuss the most common sequelae of repaired congenital heart disease;

• Develop management strategies for patients with repaired congenital heart disease with or without residual lesions;

• Develop management strategies for patients with Fontan physiology.

Focus Session Moderator: Marc E. Stone, M.D.

Practical Management of the Patient with a CIED
 

Presentations:

The Perioperative Assessment and Evaluation of the Patient with a CIED - Jennie Y. Ngai, M.D.

The Perioperative Management of the Patient with a CIED:  A Case Based Discussion - Marc E. Stone, M.D.

After completion of this session, the participant will be able to:

• Describe the different types of devices, their functions, and current indications for pacemakers and ICD’s;

• Perform an appropriate perioperative evaluation of the patient with a pacemaker or ICD;

• Formulate a plan for perioperative management of patients with implantable devices;

• Identify procedures that may interfere with these devices.

Full Title: “What is Buprenorphine???” Strategies for Perioperative Analgesic Management in Major Surgery

After completion of this session, the participant will be able to:

• Evaluate the patient with a history of opioid addiction who is managed with buprenorphine;

• Discuss multi-modal analgesic techniques, regional anesthetic considerations in relation to  addiction issues;

• Implement a treatment plan for  patients in addiction treatment;

• Identify perioperative concerns that have an evolving treatment paradigm. 

Case Outline

After completion of this session, the participant will be able to:

• Identify the clinical presentation and epidemiology of children with foreign body aspiration;

• Evaluate a patient presenting for removal of a tracheobronchial foreign body;

• Formulate an anesthetic plan for patients undergoing rigid bronchoscopy for removal of an airway foreign body;

• Explain the advantages and disadvantages of various strategies for ventilation and maintenance of anesthesia;

• Identify the perioperative complications associated with rigid bronchoscopy.

Case Outline

After completion of this session, the participant will be able to:

• Identify patients who would benefit from ERAS protocols;

• Construct an ERAS protocol for a specific patient population at their institution.

Case Outline

After completion of this session, the participant will be able to:

• Demonstrate basic skills in ultrasound technology;

• Apply ultrasound technology to perform peripheral and neuraxial blocks;

• Relate cadaver anatomy of peripheral nerve structures to live-model sonoanatomy;

• Discuss advantages and pitfalls of ultrasound guidance for paravertebral blocks;

• Utilize ultrasound techniques to perform truncal field blocks (TAP block, Ilioinguinal-Iliohypogastric blocks).

This activity contributes to the Part IV: Improvement in Medical Practice requirement of the American Board of Anesthesiology’s (ABA) redesigned Maintenance of Certification in Anesthesiology Program® (MOCA®), known as MOCA 2.0®. Please consult the ABA website, www.theABA.org, for a list of all MOCA 2.0 Part IV requirements and their associated point values.

After completion of this session, the participant will be able to:

• Identify the three components needed for a fire to start;

• Prioritize how to put out a fire;

• Understand the different fire extinguisher types.

MW-09

After completion of this session, the participant will be able to:

• Delineate the indications for cardiac pacemakers and implantable cardiac defibrillators (ICD);

• Delineate the ASA guidelines for the intra-operative management of pacemakers and ICDs;

• Delineate the anesthetic implications of transcatheter aortic valve implantation;

• Delineate the anesthetic considerations of transseptal puncture for cardiac ablation.

MW-11

After completion of this session, the participant will be able to:

Utilize ultrasound technology to perform:

• Paravertebral Nerve blocks;

• Spinal and Epidural anesthesia;

• Fascia Iliaca, Lateral Femoral Cutaneous, Iliohypogastric and Ilioinguinal Nerve Blocks.

This activity contributes to the Part IV: Improvement in Medical Practice requirement of the American Board of Anesthesiology’s (ABA) redesigned Maintenance of Certification in Anesthesiology Program® (MOCA®), known as MOCA 2.0®. Please consult the ABA website, www.theABA.org, for a list of all MOCA 2.0 Part IV requirements and their associated point values.

After completion of this session, the participant will be able to:

• Perform appropriate airway evaluation;

• Utilize numerous commercially available airway devices;

• Apply the ASA Difficult Airway Practice Parameters in clinical scenarios.

This activity contributes to the Part IV: Improvement in Medical Practice requirement of the American Board of Anesthesiology’s (ABA) redesigned Maintenance of Certification in Anesthesiology Program® (MOCA®), known as MOCA 2.0®. Please consult the ABA website, www.theABA.org, for a list of all MOCA 2.0 Part IV requirements and their associated point values.

After completion of this session, the participant will be able to:
•   Apply the current guidelines and treatment protocols for Advanced Cardiac Life Support; 
•   Demonstrate Basic Life Support skills. 

This activity contributes to the Part IV: Improvement in Medical Practice requirement of the American Board of Anesthesiology’s (ABA) redesigned Maintenance of Certification in Anesthesiology Program® (MOCA®), known as MOCA 2.0®. Please consult the ABA website, www.theABA.org, for a list of all MOCA 2.0 Part IV requirements and their associated point values.

Panel Moderator: Scott B. Groudine, M.D.

Presentations:

Anesthesia Practice Needs More Guidelines: Pro - Robert S. Lagasse, M.D.

Anesthesia Practice Needs More Guidelines: CON - Robert E. Johnstone, M.D.

Video Laryngoscopy Should Replace Direct Laryngoscopy as the Standard of Care for Intubation:  Pro - Richard Cooper, B.SC., M.D., FRCPC

 Video Laryngoscopy Should Replace Direct Laryngoscopy as the Standard of Care for Intubation – CON - Adam I. Levine, M.D.

After completion of this session, the participant will be able to:

• Describe the use of practice guidelines in anesthesia practice and the effect on improving patient safety and outcomes;

• Discuss the current evidence and controversies on whether or not anesthesia practice needs more guidelines to improve patient safety and outcomes;

• Discuss the evidence for and against the use of video laryngoscopy vs. direct laryngoscopy for intubation; 

• Debate whether video laryngoscopy should replace direct laryngoscopy as the standard of care for intubation.

After completion of this session, the participant will be able to:

• Identify the key anatomic views used in TTE;

• Identify the key anatomic structures visualized by TTE;

• Identify hypokinesis and akinesis of the myocardium.

MW Outline

After completion of this session, the participant will be able to:

• Delineate which pain syndromes are very difficult to effectively treat;

• Delineate the effect of the FDA mandated REMS program on opiate prescribing;

• Delineate which patients are most appropriate for a multi-disciplinary approach.

MW-15

After completion of this session, the participant will be able to:

• Manage increased intracranial pressure (ICP);

• Discuss controversies that may arise regarding hyperventilation, blood pressure management, osmotherapy, barbiturates and chemical paralysis;

• Employ emergency anesthetic management of airways, fluid resuscitation balance and effects of anesthetics/muscle relaxants on ICP in severe traumatic brain injury.

Case Outline

After completion of this session, the participant will be able to:

• Identify the pro and con data regarding perioperative beta-blockade and perioperative outcomes;

• Understand the physiology behind the beneficial and adverse effects of perioperative beta-blockade use;

• Formulate evidence-based guidelines for perioperative beta-blockers.

Case Outline

After completion of this session, the participant will be able to:

•  Recognize risk factors for delirium in the postoperative setting; 

•  Identify patients most likely to develop postoperative delirium; 

•  Formulate an anesthetic plan that minimizes the risk of postoperative delirium;  

•  Apply measures to treat delirium when it occurs.

Case Outline

After completion of this session, the participant will be able to:

• Recognize the complications of regional anesthesia for shoulder surgery;

• Formulate a plan to treat cardiac toxicity due to local anesthetic.

Case Outline

Panel Moderator: David L. Hepner, M.D.

Presentations:

Dollars & Sense The Value of the Preoperative Clinic - Bobbie-Jean Sweitzer, M.D.

The Advanced Practice Provider Training for High Quality Cost Effective Preoperative Practice - Jeanna D. Blitz, M.D.

Preoperative Evaluation and Optimization in an Era of Health Care Reform - David L. Hepner, M.D., M.P.H. 

Clinical Pearls in Perioperative Optimization - Zdravka Zafirova, M.D.

After completion of this session, the participant will be able to:

• Present a justification to administration for setting up a preoperative clinic;

�� Identify and address challenges in educating, training, and medically directing Advanced Practice Providers;

• Identify the true value added by testing/interventions and patient preparation in order to positively impact overall operating room cost effectiveness; 

• Highlight key issues in preoperative evaluation and optimization and highlight recent controversies.

This activity contributes to the patient safety CME requirement for Part II: Lifelong Learning and Self-Assessment of the American Board of Anesthesiology’s (ABA) redesigned Maintenance of Certification in Anesthesiology Program® (MOCA®), known as MOCA 2.0®. Please consult the ABA website, www.theABA.org, for a list of all MOCA 2.0 requirements.

Panel Moderator: Jerrold Lerman, M.D., FRCPC, FANZCA

Presentations:

Obstructive Sleep Apnea: New Concepts in Anesthesia Management - Linda J. Mason, M.D.

Palliated and Hybrid Congenital Heart Defects - Dawn M. Sweeney, M.D.

Why the FDA Thinks Anesthetics Harm Children - Dean B. Andropoulos, M.D.

Debunking Fears About the Pediatric Airway - Jerrold Lerman, M.D., FRCPC, FANZCA

Objectives

Focus Session Moderator: Ansgar M. Brambrink, M.D., Ph.D.

Presentations:

Pro - Gregory J. Crosby, M.D. 

Con - Alex Y. Bekker, M.D., Ph.D.

After completion of this session, the participant will be able to:

• Critically evaluate current literature on postoperative cognitive dysfunction (POCD);  

• Identify factors leading to POCD;

• Discuss the clinical significance of POCD.

Focus Session Moderator:  Michael B. Simon, M.D., M.B.A.

Presentations:

Academic - Charles J. Assini, Jr., Esq.

Private Practice - Ruchir Gupta, M.D.

After completion of this session, the participant will be able to:

• Review a contract for private practice and develop an appropriate plan for negotiation;

• Review an academic practice contract and develop a plan for negotiation.

Focus Session Moderators:  Janine M. Limoncelli, M.D. & Melinda A. Aquino, M.D. 

After completion of this session, the participant will be able to:

• Successfully negotiate a contract;

• Self-advocate in all professional scenarios;

• Acknowledge implicit bias and develop strategies for resolution;

• Individually navigate work/life balance challenges.

Dr. Vilma A. Joseph

Focus Session Moderator: James B. Eisenkraft, M.D.

Presentations:

Machine Safety - James B. Eisenkraft, M.D.

Intelligent Monitors - Patrick J. McCormick M.D., Meng

After completion of this session, the participant will be able to:

• Discuss advantages and disadvantages of the new anesthesia machines;

• Discuss the new development in monitoring;

• Discuss equipment safety issues in anesthesia practice;

• Develop a plan to safely integrate the new anesthesia machines and intelligent monitors into their practice;

• Describe the limitations of modern anesthesia machines and intelligent monitors, and apply this knowledge to their practice.

This activity contributes to the patient safety CME requirement for Part II: Lifelong Learning and Self-Assessment of the American Board of Anesthesiology’s (ABA) redesigned Maintenance of Certification in Anesthesiology Program® (MOCA®), known as MOCA 2.0®. Please consult the ABA website, www.theABA.org, for a list of all MOCA 2.0 requirements.

After completion of this session, the participant will be able to:

• Build a comprehensive understanding of the prevalence, mechanisms, risk factors and development of PPSP;

• Develop patient and surgery specific risk stratification strategies, within perioperative anesthesia and surgical practices, with the goal to reduce the incidence of PPSP;

• Analyze, summarize and apply currently available evidence in regional anesthesia and pain medicine to prevent and minimize PPSP, with emphasis on breast cancer and related surgeries.

Case Outline

After completion of this session, the participant will be able to:

• Identify criteria for difficult intubation in the pediatric age group;

• Describe technologies available for difficult intubation in the pediatric age group;

• Formulate management strategies for difficult intubation in the pediatric age group.

Case Outline

Full Title: Inadequate Spinal Anesthesia for C-Section (Now What Do I Do?!)  Mechanisms, Management and Prevention 

After completion of this session, the participant will be able to:

• Describe local-anesthetic maldistribution due to natural variations in CSF flow and anatomy;

• Develop an anesthetic plan to manage the patient with a “failed spinal” for C-Section.

Case Outline

After completion of this session, the participant will be able to:

• Identify risk factors for the cardiac arrest in the patient undergoing outpatient ENT procedures;

• Develop an emergency response plan for cardiac arrest in this ambulatory procedure.

Case Outline

After completion of this session, the participant will be able to:

• Identify areas of the world in which there are acute shortages of anesthesia providers;

• Enumerate two ways for anesthesiologists to become more involved in remedying these shortages;

• Delineate at least two NGOs that need anesthesiologist volunteers.

MW-17

After completion of this session, the participant will be able to:

• Evaluate the risk factors for perioperative thromboembolism;

• Recognize the need for prophylaxis for deep vein thrombosis;

• Delineate the new ASA practice guidelines for preventing POVL;

• List the tests to monitor anticoagulation activities;

• Assess the implications on the neuroaxial procedures;

• New agents for anticoagulation will be reviewed with respect to their role in the settings of atrial fibrillation and acute coronary syndromes and their impact on anesthetic management.

After completion of this session, the participant will be able to:

• Identify cardiac anatomy in the porcine heart;

• Identify porcine anatomical structures and learn the relationship to echocardiographic structures;

• Identify porcine anatomical structures and relate them to human surgical anatomic landmarks.

This activity contributes to the Part IV: Improvement in Medical Practice requirement of the American Board of Anesthesiology’s (ABA) redesigned Maintenance of Certification in Anesthesiology Program® (MOCA®), known as MOCA 2.0®. Please consult the ABA website, www.theABA.org, for a list of all MOCA 2.0 Part IV requirements and their associated point values.

Full Title: Hands-on Echocardiography Workshop: An Interactive and Case-Based Approach Using TEE and TTE in the Perioperative Setting

After completion of this session, the participant will be able to:

• Use echo to recognize common causes of hemodynamic instability in the GOR (expert case presentations, hands-on computer simulation);

• Understand how echo can help with the differential diagnosis in unstable patients (computer simulation, case presentations);

• Learn how to obtain a quick transthoracic exam in emergency situations (practice on live models);

• Acquire the knowledge to do a focused transthoracic echo exam (expert lecture, practice on live models);

• Learn how transesophageal echocardiography can be used as a monitoring tool in cases with expected hemodynamic compromise (hands on TEE simulator, expert lecture).

This activity contributes to the Part IV: Improvement in Medical Practice requirement of the American Board of Anesthesiology’s (ABA) redesigned Maintenance of Certification in Anesthesiology Program® (MOCA®), known as MOCA 2.0®. Please consult the ABA website, www.theABA.org, for a list of all MOCA 2.0 Part IV requirements and their associated point values.

Panel Moderator: Eugene R. Viscusi, M.D.

Presentations:

Acute Pain Management in the Patient with Known or Suspected Addiction - Eugene R. Viscusi, M.D.

Update on Multimodal Analgesia: New and Emerging Concepts - Danielle B. Ludwin, M.D.

Cannabinoids and Acute Pain Management - Yury Khelemsky, M.D.

The Expanding Role of Ketamine and the Acute Pain - Eric S. Schwenk, M.D.

After completion of this session, the participant will be able to:

• Manage acute pain in patients with known or suspected opioid addiction and in patients under treatment for substance abuse;

• Apply emerging multimodal analgesic techniques;

• Evaluate the current understanding of cannabinoids and perioperative pain management;

• Apply novel and emerging uses for ketamine in a safe and effective manner.

This activity contributes to the patient safety CME requirement for Part II: Lifelong Learning and Self-Assessment of the American Board of Anesthesiology’s (ABA) redesigned Maintenance of Certification in Anesthesiology Program® (MOCA®), known as MOCA 2.0®. Please consult the ABA website, www.theABA.org, for a list of all MOCA 2.0 requirements.

Panel Moderator: Robert E. Johnstone, M.D.

Presentations:

Your Daughter Asks You to Administer the Anesthetic for Her Planned Surgery: Is It Ethical To Do This?- Robert E. Johnstone, M.D. 

Surgeon plans to operate with residents in two ORs - Saundra E. Curry, M.D.

A colleague has written an interesting article - Richard D. Urman, M.D., M.B.A, 

The pharmacist informs you the hospital has run out of propofol, succinylcholine and epinephrine, and will not get new supplies until the next day. - Vinod Malhotra, M.D.

A Prison Warden asks You to Place a central Line for an Execution  - Lawrence J. Epstein, M.D.

A Patient with Dementia - Elizabeth A. M. Frost, M.D.

Objectives

After completion of this session, the participant will be able to:

• Apply the use of nerve stimulator techniques for upper and lower extremity blocks;

• Treat reflex sympathetic dystrophy with either intravenous anesthesia (Bier block) or nerve block;

• Utilize ultrasound technology for upper and lower extremity blocks.

This activity contributes to the Part IV: Improvement in Medical Practice requirement of the American Board of Anesthesiology’s (ABA) redesigned Maintenance of Certification in Anesthesiology Program® (MOCA®), known as MOCA 2.0®. Please consult the ABA website, www.theABA.org, for a list of all MOCA 2.0 Part IV requirements and their associated point values.

After completion of this session, the participant will be able to:

•   Identify features of the incubation phase of an active shooter incident through situational awareness;

•   Learn to ask for help early;

•   Understand how to evacuate in an emergency;

•   Know how to conduct a “lockdown”;

•   Learn how to fight in a self-defense situation;

•   Develop flexible thinking for an evolving active shooter situation.

After completion of this session, the participant will be able to:

• Delineate the requirements for monitoring outside the operating room with emphases on pediatrics;

• Develop a plan to get back-up;

• Delineate needs for safe anesthesia in extreme environments.

After completion of this session, the participant will be able to: 
• Enumerate the coagulation parameters that are acceptable to proceed with Regional Anesthesia; 

• Define the incidence of regional anesthesia related complications; 

• Elucidate the role of ultrasound in preventing regional anesthesia complications. 

MW-25

After completion of this session, the participant will be able to:

• Discuss the indications for rapid sequence intubation;

• Identify risk factors for respiratory instability during anesthetic induction in the morbidly obese;

• Delineate different strategies for anesthetic induction in the morbidly obese.

After completion of this session, the participant will be able to:

• Assess the airway of a patient with an airway mass;

• Identify anesthetic concerns of laser surgery;

• Describe the indications for and complications of jet ventilation;

• Formulate an anesthetic plan for utilizing jet ventilation.

Case Outline

Full Title: Postoperative Management of the Major Spinal Fusion Patient: Setting the Stage in the Preop Area?  

After completion of this session, the participant will be able to:

• Discuss strategies for preemptive analgesia;

• Identify adjunctive non-opioid medications useful throughout the perioperative period;

• Implement a pain management plan for spinal fusion patients that begins preoperatively and continues into the postoperative period.

Case Outline

After completion of this session, the participant will be able to:

• Identify causes of bronchospasm in the intraoperative period;

• Select an appropriate anesthetic plan for management of intraoperative bronchospasm;

• Formulate a plan utilizing updated ventilator modalities to manage a patient with perioperative bronchospasm.

Case Outline

Panel Moderator:  Meg A. Rosenblatt, M.D.

Presentations:Five Complications to Avoid with Regional Anesthesia- Joseph M. Neal, M.D.

Patient on Anticoagulant/Antiplatelet Therapy and Regional Anesthesia - Terese T. Horlocker, M.D.

Update on Anesthesia for Shoulder Surgery - Nabil M. Elkassabany, M.D, MSCE

​Ambulatory Lower Extremity Total Joint Replacements: The Good, The Bad and The Ugly - Meg A. Rosenblatt, M.D. 

After completion of this session, the participant will be able to:

• Describe techniques to avoid complications associated with regional anesthesia;

• Discuss the perioperative management of patients who are having regional anesthetics and are taking anticoagulant/antiplatelet medications;

• Describe the components of a successful shoulder arthroscopy enhanced recovery protocol (ShARP);

• Evaluate which patients are suitable and which anesthetics are appropriate for ambulatory lower extremity joint replacement procedures.

This activity contributes to the patient safety CME requirement for Part II: Lifelong Learning and Self-Assessment of the American Board of Anesthesiology’s (ABA) redesigned Maintenance of Certification in Anesthesiology Program® (MOCA®), known as MOCA 2.0®. Please consult the ABA website, www.theABA.org, for a list of all MOCA 2.0 requirements.

Panel Moderator:  Richard C. Prielipp, M.D., M.B.A.

Postoperative Infections: Can the Anesthesia Provider be at Fault?

Presentations:

Fecal Patina in the Anesthesia Work Area - L. Sylvia Munoz-Price, M.D., Ph.D.

Oral Flora Everywhere: Anesthesia and the Airway - David J. Birnbach, M.D., M.P.H.

Reusable vs. Disposable Laryngoscopes: Why Should You Care? - G. Burkhard Mackensen, M.D., Ph.D., FASE  

How do Routine Anesthesia Practices Impact Infectious Risks? - Daniel I. Sessler, M.D.

After completion of this session, the participant will be able to:

• Realize that Health Care Associated Infections (HCAI) affect 4 – 10% of hospitalized patients;

• Recognize that virulent and resistant bacteria are regularly identified in the OR anesthesia work space, and acknowledge that these bacteria are frequently transmitted to patients while in the OR;

• Understand how routine airway procedures (i.e., endotracheal intubation) may rapidly contaminate the anesthesia work space with oral flora;

• Acknowledge that anesthesia workspace contamination is associated with postoperative infections in surgical patients;

• Compare the functionality and cost-effectiveness of disposable vs. reusable laryngoscopes;

• Learn how other routine anesthesia practices (e.g., pre-warming patients, high inspired FiO2; laminar air flow in the OR; intraoperative hypothermia, FAW, etc.) may impact infectious risks.

Full Title:  The Making of a Successful Retirement with a Second Career After Retiring?  Exploring Career Options: For-Profit vs. Non-for-Profit

This session will address the barriers and challenges faced by the aging anesthesiologist. It will explore the many career options available in both the for-profit and the not-for-profit model. The presentation will address the advantages, responsibilities and commitments involved with each choice and will provide the learner with strategies and tools to make an informed decision. It will demonstrate the ability to impact healthcare in the community. Specific examples and links to resources will be provided.

Focus Session Moderator: Rhoda D. Levine, M.D. and Sandhya Malhotra, M.D.

Presentations:

Exploring the “For-Profit” Career Option - Michael S. Jakubowski, M.D.

Considering the “Not-for-Profit” Opportunities - Sandhya Malhotra, M.D. 

The Overseas Medical Mission - Cheryl K. Gooden, M.D., FAAP

Community Initiatives Impacting Healthcare Policy - David I. Weprin, J.D.

After completion of this session, the participant will be able to:
•   Recognize the challenges faced by the aging anesthesiologist;
•   Gain a better understanding of the options and opportunities available in order to pursue a second career;
•   Identify ways to impact healthcare in the community;
•   Improve the ability to make informed personalized decisions about to transitioning into retirement;
•   Decrease mental stress and improved focus on patient care by being better prepared with a long term plan.

Panel Moderator:  Scott B. Groudine, M.D.

Presentations:

Monitoring Neuromuscular Blockade (NMB) Clinically and/or by Using a Nerve Stimulator - Dominic J. Nardi, M.D.

What is Adequate Reversal and Should I Reverse or Antagonize to Get There? -  Kenneth I. Rosenfeld, M.D.

rNMB in the PACU and on the Ward How Often and How Significant?- Farzana Afroze, M.D.

After completion of this session, the participant will be able to:
• Evaluate the use of various neuromuscular monitoring techniques;

• Recognize the importance of monitoring neuromuscular blocking agents when they are used;

• Identify the parameters that indicate safe recovery from neuromuscular blocking agents;

• Identify postoperative residual block in the PACU​.

Full Title:  MACRA Simplified:  How We Got Here, How It's Been, Where We're Going, and How to Do Well

Focus Session Moderator:  David J. Wlody, M.D.

Presentations: 

A Recap of MACRA After Year 1, and Expectations Based on Recent CMS Rules - Jonathan S. Gal, M.D.

The Path to APM Success for Anesthesiologists - Alexander A. Hannenberg, M.D.

After completion of this session, the participant will be able to:

•    Review the evolution of MACRA replacing the Sustainable Growth Rate with the implementation of a new Quality Payment Program starting in 2017;
•    Discuss MIPS vs Advanced-APMs as the two reporting tracks, and how they are supposed to impact payments now and in the future;
•    Examine the recent regulatory changes proposed by CMS and their potential effect on anesthesiologists;
•    Evaluate the availability of procedure-focused APM opportunities, and how Perioperative Surgical Home can open the door to Advanced-APM QP status for anesthesiologists.

Full Title:  Disaster-Management:  The Active Shooter and Mass Casualties: Plan, Recognition and Physician Response

Focus Session Moderator: Kenneth B. Newman, M.D.

Presentations:

From the Mundane to The Horrific: How to Respond to Incidents in Your Community - Michael J. Dailey, M.D.

An Active Shooter Is in Your Hospital: Do You Know What To Do?" - Daniel F. Sisto, NYS Police -&- Michael C. Brooks, NYS Police

Recognizing a Threat and Profiling - Special Agent Barbara A. Daly, FBI

After completion of this session, the participant will be able to:

• Identify the stake holders to develop disaster planning in their institution including the response of the anesthesiology department;

• Develop a plan to deal with an internal or external disaster;

• Develop strategies to deal with mass casualties or an active shooter.

Focus Session Moderator:  Tong J. Gan, M.D., MHS, FRCA

Presentations:

How Do We Impact Outcome? - Anoushka M. Afonso, M.D.

Implementation and Long-Term Recovery - Timothy E. Miller, M.B., Ch.B., FRCA

After completion of this session, the participant will be able to:
•   Describe the principles of an ERAS program;

•   Describe the role of the anesthesiologist in an ERAS program;

•   Develop an ERAS program at their institutions.

•   Institute an ERAS program at their institutions.

Focus Session Moderator:  Richard A. Beers, M.D.

Presentations:

The Anesthesia Professional's Role in Limiting Infectious Risks - Richard A. Beers, M.D.

Keeping Your Patients Safe While Preparing and Administering Medications and Fluids- Elliott S. Greene, M.D.

How to Develop a Program to Reduce Surgical Site Infections - Amanda J. Rhee, M.D.

After completion of this session, the participant will be able to:

• Describe current infection prevention recommendations and safe injection practices as applicable to anesthesia practice;

• Implement infection prevention recommendations into practice.

This activity contributes to the patient safety CME requirement for Part II: Lifelong Learning and Self-Assessment of the American Board of Anesthesiology’s (ABA) redesigned Maintenance of Certification in Anesthesiology Program® (MOCA®), known as MOCA 2.0®. Please consult the ABA website, www.theABA.org, for a list of all MOCA 2.0 requirements.

After completion of this session, the participant will be able to:

• Define the professional terminology related to the anesthetic care of a transgender patient;

• Explain the implications of lack of understanding of transgender issues, among members of the OR team on patient safety;

• Predict major implications of completed transgender surgery for the perioperative care;

• Formulate a sensitive and informed communication approach to a transgender patient in the perioperative setting.

PBL-41 Case Outline

After completion of this session, the participant will be able to:

• Identify particular patient populations who may benefit from use of sugammadex;

• Discuss the mechanism of action of sugammadex;

• Develop a plan for the use of sugammadex taking into consideration the side effects, contraindications and cost.

Case Outline

After completion of this session, the participant will be able to:

• Discuss the evidence regarding various anesthetic and analgesic techniques for breast cancer surgery in patients with chronic pain including regional anesthesia, preoperative gabapentin, intravenous ketamine, and liposomal encapsulated bupivacaine for wound infiltration;

• Identify  the utility, risks and benefits of performing thoracic paravertebral nerve blocks and serratuanterior, pec 1, and pec 2 blocks for mastectomy;

• Develop a multimodal  plan for the management of acute and chronic post-mastectomy pain.

Case Outline

After completion of this session, the participant will be able to:

• Discuss the potential risks and advantages of the use of nitrous oxide;

• Identify which patients may be at increased risk from use of nitrous oxide;

• Establish an anesthetic plan which does not require the use of nitrous oxide in at-risk patients.

PBL-47 Case Outline

Full Title: Basic Point of Care Ultrasound (PoCUS) - Focused Surface Sonography for the Perioperative Anesthesiologist

After completion of this session, the participant will be able to acquire images, handle a portable ultrasound machine and interpret information from:

• A basic focused surface ultrasound exam of the heart, basic ultrasound exam of the lungs and perform an ultrasound survey for free fluid in the abdominal cavity (FAST exam).

Workshop participants will review relevant cases for anesthesiologists with the experts using:

• Point-of-care evaluation in patients with unexpected hypoxia, hypotension, oliguria and cardiac arrest.

Workshop participants will participate in the discussion during the moderator session with the experts and learn how to get started and continue (PoCUS) point-of-care ultrasound in your department.

This activity contributes to the Part IV: Improvement in Medical Practice requirement of the American Board of Anesthesiology’s (ABA) redesigned Maintenance of Certification in Anesthesiology Program® (MOCA®), known as MOCA 2.0®. Please consult the ABA website, www.theABA.org, for a list of all MOCA 2.0 Part IV requirements and their associated point values.

After completion of this session, the participant will be able to:

• Apply skills of dynamic decision-making, resource management, leadership and teamwork to a crisis scenario in the OR;

• Demonstrate communication and leadership skills in working with different personalities and behaviour during a crisis scenario.

This activity contributes to the Part IV: Improvement in Medical Practice requirement of the American Board of Anesthesiology’s (ABA) redesigned Maintenance of Certification in Anesthesiology Program® (MOCA®), known as MOCA 2.0®. Please consult the ABA website, www.theABA.org, for a list of all MOCA 2.0 Part IV requirements and their associated point values.

Panel Moderator: Richard Cooper, B.SC., M.SC., M.D., FRCPC

Presentations:

Personal Assessment of Airway Difficulty - William Rosenblatt, M.D.

Extubation of the Difficult Airway? - Richard Cooper, B.SC., M.SC., M.D., FRCPC

Airway Lessons from the Anesthesia Incident Reporting System and Anesthesia Quality Institute - Keith J. Ruskin, M.D.

After completion of this session, the participant will be able to:

• Apply his or her experience to airway evaluations and decision making;

• Understand risk stratification associated with extubation and strategies to mitigate patient harm; 

• Understand how to incorporate lessons learned from “near misses” into his or her airway management strategies.

This activity contributes to the patient safety CME requirement for Part II: Lifelong Learning and Self-Assessment of the American Board of Anesthesiology’s (ABA) redesigned Maintenance of Certification in Anesthesiology Program® (MOCA®), known as MOCA 2.0®. Please consult the ABA website, www.theABA.org, for a list of all MOCA 2.0 requirements.

After completion of this session, the participant will be able to: 

• Enumerate the latest changes in blood transfusion guidelines;

• Enumerate the latest changes in factor transfusion guidelines;

• Delineate the incidence and therapy of transfusion related complications.

MW-26

After completion of this session, the participant will be able to:
• Identify the key anatomic views used in TEE; 

• Identify the key anatomic structures visualized by TEE; 

• Identify hypokinesis and akinesis of the myocardium. 

After completion of this session, the participant will be able to:

• Describe the pathophysiology of hypertension;

• Describe the concept of tight control of blood pressure;

• Identify the different medications used to control blood pressure;

• Formulate an anesthetic plan for the patient with hypertension.

Case Outline

After completion of this session, the participant will be able to:

• Identify the major disease processes for which patients are scheduled for procedures in the EP suite;

• Understand occupational hazards and radiation exposure in the EP suite;

• Discuss the effects of anesthetic agents on cardiac electrophysiology;

• Formulate a plan to care for challenging cases in the EP suite and similar remote locations.

After completion of this session, the participant will be able to:

• Discuss anesthetic interactions between medications for Alzheimer’s disease and anesthetic agents;

• Formulate an anesthetic plan which takes into account these interactions and minimizes risk of delirium.

Case Outline

After completion of this session, the participant will be able to:

• Identify new concepts regarding the use of crystalloid and colloid volume replacement;

• Formulate a plan to maintain ideal volume status in the perioperative period.

Case Outline

Full Title: Advanced Point of Care Ultrasound (PoCUS) - Focused Surface Sonography for the Perioperative Anesthesiologist

Pre-requisite for workshop enrollment

• Somebody who completed a basic workshop (either our workshop last year or a basic workshop elsewhere);

• Has basic knowledge and skills in image acquisition;

• Has enrolled for the morning basic session and would like to further their skills at the advanced workshop.

After completion of this session, the participant will be able to acquire images and interpret information from:

• A standardized comprehensive cardiac exam of the heart. This will include assessment of global and segmental cardiac function, valvular structure and function, stroke volume measurement - cardiac output estimation and volume status assessment noninvasively by ultrasound;

• A systematic advanced lung exam and perform algorithm based lung findings interpretation.

• A systematic PoCUS airway examination. 
 

Workshop participants will review relevant cases for anesthesiologists with the experts using: 

• The PAUSE, FATE, RUSH, FAST and FEEL protocol in the hemodynamically unstable or hypoxic patient, through participation in workshop simulation cases and panel discussion.

Workshop participants will participate in the discussion during the moderator session with the experts and learn about the upcoming certification process ofr (PoCUS) point-of-care ultrasound.

This activity contributes to the Part IV: Improvement in Medical Practice requirement of the American Board of Anesthesiology’s (ABA) redesigned Maintenance of Certification in Anesthesiology Program® (MOCA®), known as MOCA 2.0®. Please consult the ABA website, www.theABA.org, for a list of all MOCA 2.0 Part IV requirements and their associated point values.

Panel Moderator:  David J. Wlody, M.D.

Presentations:

Ethical Issues in the Delivery Room - David J. Wlody, M.D.

Perioperative Management of the Anticoagulated Parturient - Terese T. Horlocker, M.D.

What is the Appropriate Blood Replacement Strategy for Maternal Hemorrhage? - Roulhac D. Toledano, M.D., Ph.D.

Should Ultrasound be Used Routinely for Obstetric Neuraxial Anesthesia? Jose C. A. Carvalho, M.D, Ph.D., FANZCA, FRCPC 

After completion of this session, the participant will be able to:

• Discuss ethical issues in caring for patients in the delivery room;

• Learn how to safely manage the anticoagulated parturient;

• Learn to optimize blood replacement therapy and pharmacologic management during maternal hemorrhage; 

• Discuss whether or not ultrasound should be used routinely for obstetrical neuraxial anesthesia.

This activity contributes to the patient safety CME requirement for Part II: Lifelong Learning and Self-Assessment of the American Board of Anesthesiology’s (ABA) redesigned Maintenance of Certification in Anesthesiology Program® (MOCA®), known as MOCA 2.0®. Please consult the ABA website, www.theABA.org, for a list of all MOCA 2.0 requirements.

Panel Moderator:  Linda J. Shore-Lesserson, M.D., FAHA, FASE

Presentations:

Transfusion in Cardiac Patients: When to Pull the Trigger? - Jonathan D. Leff, M.D., FASE

Pharmacologist Management of Bleeding: Are the New Factor Concentrates Safe? - Kenichi Tanaka, M.D., M.Sc.

Fluid Therapy in the Critically Ill What's the Goal - Andrew Shaw,M.B., B.S., FRCA, FFICM, FCCM 

Monitoring Hemostasis: What's the Benefit of POC Monitoring? - Linda J. Shore-Lesserson, M.D., FAHA, FASE

After completion of this session, the participant will be able to:

• Define the pillars of patient blood management and apply them to surgical patients;

• Describe coagulation tests that have been used to direct transfusion treatment in surgical bleeding patients;

• Define the risks of blood transfusion and the end-organ effects of transfusion;

• Identify alternate strategies for volume replacement to blood transfusion.

Focus Session Moderator:  Stephen A. Vitkun, M.D., M.B.A., Ph.D.

After completion of this session, the participant will be able to:

• Assess new research for validity;

• Develop programs in their institutions for residents to participate in research.

Focus Session Moderator: Anahita Dabo-Trubelja, M.D.

Presentations:

Can We Make a Difference? - Anahita Dabo-Trubelja, M.D.

Perioperative Care of the Pediatric Cancer Patient - Vittoria Arslan-Carlon, M.D.

After completion of this session, the participant will be able to:

•   Discuss the journey in evaluating anesthetic techniques to improve oncological outcomes; 

•   Discuss the need for safe surgery and anesthesia and develop an appropriate treatment plan;

•   Discuss the current trend in perioperative care of the pediatric cancer patient and develop a perioperative plan for the pediatric cancer patient. 

Focus Session Moderator: Zvi C. Jacob, M.D.

Presentations:

Occupational Hazards in the IR, MRI Suites and Radiation Safety - Zvi C. Jacob, M.D.
 Update on Novel Procedures in IR and MRI and Their Anesthetic Implication - Scott D. Lipson, M.D.

After completion of this session, the participant will be able to: 
•   Discuss the various hazards to personnel providing care in these out of OR settings;
•   Implement strategies and protocols to prevent adverse events; 
•   Recognize the many novel procedures being offered in IR and their anesthesia implications;
•   Determine best practices for providing anesthesia in these "remote" locations. 

This activity contributes to the patient safety CME requirement for Part II: Lifelong Learning and Self-Assessment of the American Board of Anesthesiology’s (ABA) redesigned Maintenance of Certification in Anesthesiology Program® (MOCA®), known as MOCA 2.0®. Please consult the ABA website, www.theABA.org, for a list of all MOCA 2.0 requirements.

Focus Session Moderator: Joseph M. Neal, M.D.

Presentations:

Regional Anesthesia in the Patient on Anticoagulation - Michael R. Anderson, M.D.

Use of Antifibrinolytics in Orthopedic Anesthesia - Yan Lai, M.D.

After completion of this session, the participant will be able to:

• Discuss the use of regional anesthesia in patients on anticoagulation or requiring anticoagulation;

• Develop a plan for use of regional anesthesia in patients on anticoagulation or requiring anticoagulation;

• Discuss the advantages and disadvantages of antifibrinolytics in orthopedics;

• Develop strategies for use of antifibrinolytics for orthopedic surgery.

After completion of this session, the participant will be able to:

• Review data regarding the impact of dexamethasone on postoperative analgesia;

• Recognize side effects of dexamethasone;

• Implement a plan utilizing dexamethasone in the appropriate patient.

Case Outline

After completion of this session, the participant will be able to:

• Discuss new oral anticoagulants;

• Review potential complications of epidural analgesia in the setting of anticoagulants and pharmacologic DVT prophylaxis;

• Develop a plan to manage oral anticoagulant medication in the patient receiving epidural analgesia.

Case Outline

After completion of this session, the participant will be able to:

• Build a comprehensive understanding of the prevalence, mechanisms, risk factors and development of PPSP;

• Develop patient and surgery specific risk stratification strategies, within perioperative anesthesia and surgical practices, with the goal to reduce the incidence of PPSP;

• Analyze, summarize and apply currently available evidence in regional anesthesia and pain medicine to prevent and minimize PPSP, with emphasis on breast cancer and related surgeries.

PGA71 PBL-61 Case Outline

After completion of this session, the participant will be able to:

• Review the challenges of providing anesthesia for procedures where the proceduralist has never met the patient;

• Implement mechanisms for risk stratification of patients for screening procedures.

Case Outline

Full Title: Beyond Nasal Cannula:  New Approaches to Nasal Oxygenation and Ventilation in Adult and Pediatric Patients

After completion of this session, the participant will be able to:

• Enumerate the advantages of newer forms of ventilation including Dual control modes, proportional assist ventilation, Bilevel airway pressure release ventilation and neurally adjusted ventilatory assist;

• Identify the clinical limitations of these new forms of ventilation;

• Identify which patients are most suitable for these modes of ventilation.

Full Title: Beyond Direct Laryngoscopy:  Fiberoptic and Other Techniques for Adult and Pediatric Airway Management

After completion of this session, the participant will be able to:

• Perform airway evaluation, patient preparation and techniques of fiberoptic intubation, video laryngoscopy and transtracheal jet ventilation for adult and pediatric patients.

This activity contributes to the Part IV: Improvement in Medical Practice requirement of the American Board of Anesthesiology’s (ABA) redesigned Maintenance of Certification in Anesthesiology Program® (MOCA®), known as MOCA 2.0®. Please consult the ABA website, www.theABA.org, for a list of all MOCA 2.0 Part IV requirements and their associated point values.

Panel Moderator:  Rebecca S. Twersky, M.D., M.P.H.

Presentations:

New Innovations for Outpatient Breast Cancer Surgery - Hanae K. Tokita, M.D. 

Fast Track Recovery: Making It Happen - Beverly K. Philip, M.D. 

Management of the OSA Patient- Ruchir Gupta, M.D.

Pros and Cons of Stocking Dantrolene and Succinylcholine - Meena S. Desai, M.D.

After completion of this session, the participant will be able to:

• Discuss the most up-to-date clinical anesthesia practices in ambulatory and office-based anesthesia;

• Develop strategies on implementing an ERAS program for outpatient breast surgery and understand the role of regional anesthesia;

• Understand the concept of “fast track” recovery for ambulatory surgery, and identify specific care processes, anesthetic agents and techniques that can promote or hinder it;

• Identify the risks associated with managing OSA patients outside the operating room and discuss safe anesthetic techniques for OSA and NORA; 

• Discuss current controversies associated with stocking dantrolene and succinylcholine in ASCs and office-based practices.

After completion of this session, the participant will be able to:

• Define the anatomic differences in the forms of postoperative vision loss;

• Delineate the factors that appear to be critical in contributing to the development of POVL;

• Employ recommended strategies to minimize risk of prone position-related postoperative visual loss.

After completion of this session, the participant will be able to:

•  Increase awareness of regional techniques for cardiac and cardiac related procedures; 

•  Review anatomy and technical skills to perform regional blocks for cardiac and cardiac related procedures; 

•  Discuss potential advantages of adding regional blocks as adjunct for pain management. 

MW-34

After completion of this session, the participant will be able to:

• Identify etiologies of pain from herniated disc;

• Describe various interventional techniques to address pain from herniated lumbar disc; 

• Formulate an interventional based plan for the management of a patient with herniated lumbar disc.

Case Outline

After completion of this session, the participant will be able to:

• Review challenges in providing care in the interventional radiology suite;

• Identify signs and symptoms of contrast reaction;

• Formulate a plan to manage hypotensive emergencies in NORA locations.

Case Outline

After completion of this session, the participant will be able to:

• Identify common causes of respiratory distress in the postoperative period;

• Incorporate a plan to stratify and triage the care of the PACU patient with respiratory distress.

Case Outline

After completion of this session, the participant will be able to:

• Identify new concepts regarding the use of crystalloid and colloid volume replacement;

• Formulate a plan to maintain ideal volume status in the perioperative period.

Case Outline

Panel Moderator:  Richard A. Beers, M.D.

Honorary Moderator:  George Silvay, M.D., Ph.D.

Presentations:

Surely Surgical - Carin A. Hagberg, M.D.

Positively Percutaneous! - Irene P. Osborn, M.D. 

Flat Out Fact! - Jose C. A. Carvalho, M.D, Ph.D., FANZCA, FRCPC

Fiction for Sure! - Richard M. Smiley, M.D., Ph.D.

Environmental and Population Health Considerations - Jodi D. Sherman, M.D.

After completion of this session, the participant will be able to:
• Compare and contrast the safety and efficacy of surgical and percutaneous cricothyrotomy in the "Cannot Intubate, Cannot Ventilate" scenario;
• Evaluate the clinical utility of the everyday availability of ultrasonographic equipment to facilitate routine procedures in obstetrical anesthesia;
• Identify recommendations and regulations intended to prevent medication errors and infectious transmission in dynamic perioperative care settings and discuss their impact upon the environment and population health.

Focus Session Moderator:  Linda J. Shore-Lesserson, M.D., FAHA, FASE

Presentations:

Blood Management: Patients for Whom Blood is Not an Option - Himani Bhatt, D.O., M.P.A.

Preparing for and Managing Intraoperative Hemorrhage - Kenichi Tanaka, M.D., M.Sc.

After completion of this session, the participant will be able to:

• Develop and implement a pre-operative strategy to optimize these patients prior to surgery in a multidisciplinary team approach

• Develop and implement a strategy to minimize blood loss and manage unanticipated hemorrhage according to the wishes of the patient.