73rd PostGraduate Assembly in Anesthesiology

Please Note: This session takes place on Thursday 12/12 from 7am-6pm and Friday 12/13 from 8-11am. 

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

• Review the guidelines for ERAS in Thoracic Surgery
• Identify the perioperative factors that contribute to lung injury in thoracic surgery patients and plan 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, trachea resection and tracheal injuries;
• Perform paravertebral analgesia and lung ultrasound;
• Demonstrate their ability to provide safe and reliable lung isolation with double-lumen tubes and bronchial blockers;
• Recognize 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 in whom epidural analgesia is contraindicated;
• Discuss recent advances in anesthesia for lung transplantation and patients with pulmonary hypertension.

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:

Cardiac Anesthesia/Pediatrics/Neuro/Obstetrics

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; 
• Demonstrate effective communication skills during a crisis situation with team members. 

Requirements for Certificate:

To receive a PALS certificate, the participant will have to successfully complete the course and pass a written and practical examination which will be administered at the end of the course.

Due to the requirement to review literature in advance, this workshop is limited to preregistration.

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

• Describe the pathophysiology and factors associated with  postoperative vomiting;
• Enumerate the associated factors for PONV;
• Design an anesthetic plan to minimize nausea and vomiting in patients at risk;
• Measure reduced occurrences of PONV and their patient populations.

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

• Delineate the indications and contraindications to sedation for TAVR;
• Delineate the indications and contraindications to general anesthesia for TAVR;
• Create an algorithm that addresses the critical hemodynamic effects during TAVR and the treatments for these events.
• Perform an anesthesia assessment of TAVR patients that identifies whether GA or sedation is the preferred option.

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

• Define three styles of leadership and identify their best fit style;
• Execute new leadership qualities in their everyday anesthesiology practice;
• Identify the style of leadership of the hospital administration and or surgery department.

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

• Enumerate the indications and contra-indication to intrathecal pump therapy;
• Create and use the consensus algorithm for intrathecal drug therapy in their practice;
• Create an algorithm to treat overdose situations. 

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

• Plan a comprehensive system for the perioperative management of the medically complex patient scheduled for the Gastroenterology Suite;
• Develop a comprehensive anesthetic plan for the care of the patient undergoing an Electrophysiology Procedure which also mitigates the challenges of providing care in that environment.
• Construct systems to improve the safety of the clinicians providing care in the Interventional Radiology suite. 

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

• Describe the epidemiology, presentation, and physiologic implications of coexisting cardiac diseases in pregnant patients;
• Discuss the interaction of pregnancy with coexisting cardiac diseases;
• Devise an anesthetic management plan for the patient with valvular heart disease, pulmonary hypertension and cardiomyopathy of pregnancy.

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

• Discuss the impact that cancer has on the health of our communities;
• Formulate an anesthesia plan that takes into account cancer and anti-cancer therapeutics;
• Enumerate new modalities and new treatments for cancer; 
• Describe the genetic basis and metabolic impact of cancer in surgical patients. 

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. 

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

• Enumerate 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 planes;
• Identify a desired interspace;
• Identify the optimal needle insertion point;
• Determine the distance from the skin to the epidural or intrathecal spaces.

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

• Devise a plan for the pretesting of a cardiac patient for non-cardiac surgery;
• Apply appropriate frailty testing in the preoperative setting;
• Create algorithms for the perioperative management of antiplatelet therapy. 

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

• Identify procedure-related risks and potential complications in neurosurgical patients with different pathologies;
• Devise a multidisciplinary approach to expedite care and avoid complications in emergency traumatic brain injury, interventional neuroradiology, and elective spine surgery patients;
• Describe best practices for caring for patients requiring emergency neuro-interventional procedures using a multidisciplinary approach.

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

• Define the basic "anatomy and physiology" of data flow in an electronic health enterprise that supports clinical operations;
• Use the basic principles of informatics to improve the practice of anesthesiology;
• Explain the ways in which machine learning has been implemented in clinical decision support and relate that to their own practice. 

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

• Describe the principle and technique of new balloon occlusion techniques in trauma hemorrhage and discuss available outcome data;
• Apply new techniques to trauma patients based upon current military and civilian data;
• Create algorithms for the use of whole blood in trauma resuscitation;
• Define the coagulopathy of trauma and implement various treatments using transfusion protocols and pharmacology

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

• Justify to other clinicians and/or administrators the rationale to proceed or delay surgery for hyperglycemia and/or high HbA1c;
• Determine the ideal timing for dialysis preoperatively based upon the risks associated with hyperkalemia and other abnormal metabolics in chronic kidney disease patients;
• Describe the impact of liver dysfunction and anesthetic choice on the outcome of non-transplant surgery.

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

• Enumerate 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 planes;
• Identify a desired interspace;
• Identify the optimal needle insertion point;
• Determine the distance from the skin to the epidural or intrathecal spaces.
  

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

• Discuss the potential peri-procedural problems of patients following hepatic transplantation 
• Develop an anesthetic plan to safely manage these patients;
• Recognize signs of impending hepatic failure
• Manage patients developing acute perioperative hepatic failure.

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

• Stratify patients as to who would be a candidate for awake craniotomy vs. asleep craniotomies;
• Develop an anesthetic plan for patients undergoing awake craniotomy;
• Develop an anesthetic plan for patients not suitable for awake craniotomy. 

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

• Identify the challenges of diversity between practitioners and how to overcome them;
• Describe how through education and overcoming bias, effective communication between healthcare providers and patients can be achieved;
• Demonstrate the impact of implicit bias on physicians and  patient care and discuss the possible effect of implicit bias on access to quality healthcare;
• Discuss supporting data on health care disparities 

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

• Describe the value in spending money on a pre-operative process;
• Demonstrate to administration the advantages of a formal preoperative clinic; 
• List the various factors that contribute to OR efficiency.

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

• Discuss the anesthetic implications of implantable cardiac defibrillators, pacemakers, left ventricular assist devices and artificial hearts;
• Create a list of anesthetic challenges and management strategies;
• Design a management algorithm for the patient with a cardiac implantable device having non-cardiac surgery;
• Make recommendations to consultant physicians and surgeons regarding the best choice for on or off-pump cardiac surgery.

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

• Acutely recognize local anesthetic toxicity;
• Create an evidence-based treatment algorithm for Local Anesthetic Toxicity using intralipid therapy;
• Appropriately address the patient and family after the local anesthetic toxicity complication.

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

• Enumerate anesthesia risk factors and possible complications that can arise from endovascular approaches;
• Create an anesthetic plan for an endovascular surgery patient that minimizes potential risks;
• Utilize a number of different options for postoperative analgesia in this population of patients.

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

• Define which medications may affect the coagulation pathway and thus complicate regional anesthesia;
• Create a policy for their department for cessation of anticoagulant drugs in anticipation of the use of regional anesthesia;
• Implement the use of tests may help to guide intraoperative therapy.

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

• Identify common comorbidities in patient with kyphoscoliosis;
• Discuss concerns at caring for this patient in a NORA location;
• Formulate an anesthetic plan to care for the kypoplasty patient.

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

• Identify various anesthetic and non-obstetrical surgery considerations throughout pregnancy;
• Formulate an anesthetic plan that takes into consideration the fetal and maternal effects of non-obstetric surgery during pregnancy;
• Manage the issues surrounding laparoscopic surgery in the patient. 

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. 

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

• Identify risk factors for cardiac arrest in the pediatric population;
• Develop an emergency response plan for cardiac arrest in this ambulatory procedure. 

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

• Review the most recent guidelines regarding perioperative blood product transfusion;
• Identify barriers to the timely provision of adequate blood products in a case requiring massive transfusion;
• Implement a comprehensive transfusion protocol, including one addressing massive transfusions. 

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

• Discuss the mechanism of action by which ketamine exerts pain control;
• Identify the psychomimetic and physiologic effects of ketamine;
• Incorporate ketamine into a perioperative anesthetic and pain management plan. 

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

• Recognize signs and symptoms of postpartum hemorrhage;
• Identify indications for the use of tranexamic acid in maternal hemorrhage;
• Implement a program for the use of tranexamic acid in appropriate situations. 

The Impaired Physician - Issues of Professionalism: The Aging Practitioner and the Impaired Physician

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

• Identify issues related to aging in a practitioner and how to address the issue;
• Identify and assess the impaired physician; 
• Interpret the current recommendations of the Department of Health’s Committee for Physician Health;
• Develop a plan to manage the aging or impaired physician 

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

• Describe the risks and benefits of tight control 
• Manage glucose in the perioperative phase and;
• Provide to patients perioperative instructions for the newer diabetic medications.

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

• Identify issues related to aging in a practitioner and how to address the issue; 
• Identify and assess the impaired physician;
• Interpret the current recommendations of the Department of Health’s Committee for Physician Health; 
• Develop a plan to manage the aging or impaired physician in their institution/department.

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.  

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

• Evaluate the pregnant patient with a history of cardiomyopathy
• Collaborate with obstetrics, cardiology, electrophysiology and the patient to formulate an anesthetic plan for cesarean delivery.

"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 and 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. 

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

• Discuss the physiologic consequences of cirrhosis;
• Implement a treatment plan for the patient with cirrhosis being cared for in a non-OR area. 

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

• Describe the perioperative management of obesity and obstructive sleep apnea (OSA) in patients presenting for ambulatory surgery;
• Summarize the current literature examining pediatric obesity and OSA and how these comorbidities increase the risk for perioperative adverse events;
• Identify which factors may make certain patients inappropriate candidates for ambulatory surgery – as applies to the patient themselves as well as the particular capabilities of your ASC;
• Apply knowledge of the impact of pediatric obesity, prematurity and suspected or diagnosed OSA to everyday ambulatory anesthesia practice. 

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

• Identify patients at risk for malignant hyperthermia;
• Recognize the signs of malignant hyperthermia;
• Formulate and execute a plan for the management of a malignant hyperthermia reaction. 

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. 

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

• Identify the anesthetic concerns regarding the care of the obese patient in the ambulatory setting concerns;
• Establish an algorithm to determine which obese patients might be excluded from an ambulatory surgery center. 

Held in the state of the art anatomy lab located in the SUNY-Downstate Medical Center in Brooklyn, NY.  

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

• Demonstrate basic skills in the use of a standard ultrasound machine technology;
• Apply ultrasound technology skills 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).

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

• Describe the evidence based changes to vasopressor therapy;
• Incorporate new approaches for diagnosing and treating sepsis into their practice;
• Create and adopt clinical practice guidelines for transfusion therapy.

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

• Introduce into their practice, the use of checklists in trauma patients;
• Disseminate the latest guidelines for hemorrhagic shock and apply them to current practice;
• Identify the limitations of the ASA difficult airway in trauma patients.

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

• Delineate the indications for cardiac pacemakers and implantable cardiac defibrillators (ICD); 
• Establish a policy for the intra-operative management of pacemakers and ICDs based upon the ASA guidelines;
• Create a sedation protocol for anesthesiologists that describes the management of transcatheter aortic valve implantation;
• Delineate the anesthetic considerations and complications of transseptal puncture for cardiac ablation and create a list of tests to diagnose complications. 

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

• Delineate the challenges in creating a pre-anesthesia clinic;
• Create the protocols for preoperative drug management and testing used in the pre-anesthesia clinic;
• Discuss the objectives of the pre-anesthesia clinic;
• Create a flowchart that describes optimal staffing in the pre-anesthesia clinic.

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

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

• Describe the advantages of using ultrasound guidance to perform pain medicine procedures;
• Review indications and risks of ultrasound guided pain procedures;
• Describe sonoanatomy of anatomic structures pertinent to pain procedures;
• List relevant equipment and medications required for ultrasound guided pain medicine procedures;
• Perform ultrasonographic examination of relevant anatomy in human volunteers;
• Review needle technique relevant to each procedure, as well as other ergonomic considerations;
• Evaluate economic considerations of utilizing an ultrasound in pain practice.

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

• Utilize ultrasound technology to perform the following blocks: Paravertebral Nerve; Spinal and Epidural; Truncal including TAP (Transversus Abdominis Plane), Quadratus Lumborum, and Rectus Sheath; and Fascia Iliaca, Lateral Femoral Cutaneous, Iliohypogastric.

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

• Perform an appropriate airway evaluation;
• Utilize numerous commercially available airway devices; 
• Apply the ASA difficult airway practice parameters in clinical scenarios.

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

• Identify the value of neuromuscular blockade monitoring and the morbidity that results from incomplete resolution of a neuromuscular block;
• Utilize strategies that indicate that a patient is safe for extubation
• Describe the ethical concerns of Physician physician assisted suicide;
• Analyze the responsibility that proposed laws regarding physician assisted suicide would place on physicians.

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

• List the steps in evaluating the ex-premature infant;
• Develop a plan for the perioperative management of the ex-premature school age child; 
• Incorporate strategies that are proven successful when caring for special needs patients. 

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; 
• Institute an ERAS protocol for ambulatory surgeries. 

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

• Describe the features of and risk factors for Persistent Postoperative Surgical Pain;
• Formulate a multimodal multidisciplinary evidence-based treatment plan for the prevention of PPSP. 

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

• Outline the role of the anesthesiologist in donation after cardiac death 
• Manage the donor after cardiac death intraoperatively;
• Discuss and explain the process of organ allocation and procurement and the protocols to encourage organ donation;
• Incorporate the process of organ procurement into their practice. 

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

• Identify patients vulnerable to postoperative delirium (POD) and postoperative cognitive dysfunction (POCD) and alter management based upon this vulnerability;
• Recognize POCD as a complication of anesthesia and surgery;
• Explain the role of anesthetic choice in development of delirium POD and POCD and design an anesthetic management plan to improve outcomes;
• Describe the Perioperative Brain Initiative and help design an age-friendly hospital to maintain brain health in older patients.

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

• Describe the elements of an enhanced recovery after surgery (ERAS) program; 
• Elucidate components of successful ERAS protocols for patients undergoing cardiac, breast, and general surgical procedures;
• Integrate components of ERAS protocols into their institutional practices. 

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

• Describe key workforce trends, key drivers of supply and demand, and potential policy directions;
• Discuss the economic foundation of anesthesiology payment, trends that are affecting payment levels, and strategies deployed by ASA;
• Implement care models in their practice that include physician delivered, medically directed and supervised anesthesia care.
• Update billing modifiers based on current practice environment.

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

• Demonstrate how transthoracic echocardiography can be added to the care of patients in cardiac arrest;
• Perform synchronized pulse checks coordinated with CPR in order to limit no-flow intervals during CPR;
• Differentiate PEA and pseudo PEA with transthoracic imaging;
• Identify early return of spontaneous circulation;
• Identify the treatable causes of PEA and Pseudo PEA: pericardial tamponade, tension pneumothorax, hypovolemia, pulmonary embolism (or other cause of acute RV dysfunction), LV dysfunction (global or regional) to help guide therapy;
• Acquire high-quality subcostal images in a time efficient manner;
• Enumerate the limitations/risks of focused echo in cardiac arrest;
• Incorporate focused echo during cardiac arrest; 
• Improve on closed loop communication. 

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

• Discuss advantages and disadvantages of modern anesthesia machines
• Discuss the new development in monitoring;
• Discuss equipment safety issues in anesthesia practice; 
• Develop a plan to safely integrate modern anesthesia machines and intelligent monitors into their practice; 
• Describe the limitations of modern anesthesia machines and intelligent monitors 
• Integrate into their practice methods to overcome the limitations of modern anesthesia machines and intelligent monitors. 

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

• Describe the various new payment systems currently in practice;
• Adjust their practices to comply with four new payment systems. 

• Successfully navigate both academic and private practice and the challenges of work-life balance;
• Describe how to successfully develop research; 
• Discuss the issues of advocacy in anesthesiology and how to become actively involved
• Develop a pathway towards promotion and leadership in your career.

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;
• Communicate hypokinesis and akinesis of the myocardium to the surgeon and suggest treatment strategies.

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

• Identify the risk factors associated with surgery during pregnancy and the potential risk of miscarriage; 
• Design an anesthesia administration plan to minimize the risk of loss of the fetus;
• Delineate the critical time periods for organogenesis during pregnancy and create anesthesia strategies to minimize fetal organ damage.

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

• Identify which pain syndromes are very difficult to effectively treat;
• Manage the effect of the FDA mandated REMS program on opiate prescribing;
• Create a strategy for a multi-disciplinary approach to pain in appropriate patients.

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

• Enumerate factors that Anesthesiologists can impact in value based care;
• Create a business plan for anesthesiologists role in value based care and present it to administrators;
• Identify these issues and create a learning tool to present these concepts to insurers.

No Breathing, No Problem? Anesthetic Considerations for a Pediatric Patient with OSA and Multiple Comorbidities for Sequential Procedures 

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

• Discuss the pathophysiology of Obstructive Sleep Apnea (OSA) in pediatric patients;
• Make a presumptive diagnosis of OSA in undiagnosed patients;
• Evaluate the effects of anesthetics on patients with OSA;
• Formulate a postoperative pain control plan in OSA patients
• Establish the PACU monitoring and discharge criteria for OSA patients. 

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

• Describe frailty and its relation to co-morbidities;
• Incorporate qualitative and quantitate measures to assess frailty in the preoperative evaluation of the patient. 

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

• Identify the pro and con data regarding perioperative ACE/ARB administration and perioperative outcomes;
• Review the physiology behind the beneficial and adverse effects of perioperative ACE/ARB use;
• Formulate evidence-based guidelines for perioperative ACE/ARB continuation or discontinuation.

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

• Discuss the physiology of the common types of congenital heart disease pre and post repair;
• Identify the physiology impact of pregnancy and labor and delivery on the baseline physiology;
• Formulate an anesthetic plan to care for these patients during the peripartum period.

Medication Assisted Treatment and the Perioperative Patient: Opioids, Agonist/Antagonists and More ....Oh My!

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

• Identify the different characteristics of buprenorphine-naloxone sublingual film, buprenorphine tablet and buprenorphine patch;
• Develop an anesthetic plan incorporating the impact current use of these medications; 
• Develop a pre-procedure screening and medication management plan for patients taking buprenorphine. 

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

• Discuss ASA guidelines for the prevention of neuraxial infections;
• Recognize the clinical signs and symptoms of spinal epidural abscess (SEA);
• Review the treatment options (surgical decompression versus alternatives) for SEA. 

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

• Discuss the latest scientific knowledge regarding anesthetic neurotoxicity in pediatric patients.
• Formulate a discussion plan to address the questions of parents regarding anesthetic neurotoxicity

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

• List the top claims against anesthesiologists; 
• Describe key areas of risk in anesthesiology that can result in malpractice claims;
• Identify common issues that lead to patient injury in anesthesiology;
• Develop strategies to reduce liability exposure and potential claims. 

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

• Identify the features of frailty and screen patients preoperatively;
• Identify the risk factors for postoperative cognitive decline (POCD)
• Utilize appropriate screening tools to assess risk; 
• Develop strategies to minimize POCD and delirium in the elderly following surgery and anesthesia. 

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

• Build a comprehensive understanding (not acceptable word) 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. 

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

• Discuss risks and benefits of gas selections used for laparoscopic and gastroenterology insufflation;
• Identify critical intraabdominal pressures
• Develop a plan to respond to sudden cardiac and respiratory physiologic consequences of insufflation 

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. 

The Joint Commission Just Found Your Anesthesia Department Non-Compliant with Hand Hygiene in the OR! What Do You Do Now?

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

• Discuss how anesthesia provider hand hygiene contributes to surgical site infections;
• Review the rates of anesthesia provider hand hygiene compliance reported in the literature;
• Build a successful plan for improving anesthesia provider hand hygiene;
• Monitor compliance with a hand hygiene improvement program.  

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

• Identify predisposing factors implicated in development of subdural block;
• Employ a diagnostic paradigm to identify the rare complication of subdural block;
• Formulate an anesthetic plan to care for the patient with subdural block. 

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

• Discuss current AHA/ACC and ASA guidelines regarding aortic stenosis;
• Identify risk factors not captured in RCRI ad Gupta scores;
• Formulate an anesthetic plan for the patient with aortic stenosis.

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

• Identify the differential diagnosis of post induction, pre-incision cardiovascular collapse;
• Recognize the signs and symptoms of anaphylaxis under general anesthesia;
• Develop a treatment plan for anaphylaxis. 

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;
• Create a methodology for the establishment of areas in need and respondent anesthesiologist volunteers so that a matching system can help resolve the problem.

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

• Create an algorithm that addresses airway assessment and management in obese patients;
• Recognize intraoperative complications and expediently treat these complications;
• Enumerate at least three postoperative complications which may occur and suggest appropriate treatments.

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;
• Create a protocol for their practice that incorporates the  ASA practice guidelines for preventing POVL; 
• Suggest the appropriate  tests to monitor anticoagulation activities;
• Recommend certain anticoagulation testing prior to  neuroaxial procedures;
• Create protocols for management of anticoagulation and document increased efficiency and reduced cancellation rates as a result of their use.

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

• Identify the pathophysiologic changes and obstetric management of a patient with HELLP syndrome;
• Choose the ideal anesthetic management and monitoring techniques used in dealing with a patient with pregnancy induced hypertension;
• Create a list of indications and contraindications to epidural anesthesia.

This three-hour, highly engaging live activity is based on the FDA’s current Opioid Analgesic REMS Education Blueprint for Health Care Providers Involved in the Treatment and Monitoring of Patients with Pain. The dual goals of the education are maintaining patient access to appropriate pain medications while reducing the often devastating outcomes associated with inappropriate prescribing, misuse and abuse of opioid analgesics. Expert faculty will explain basics of acute and chronic pain, nonpharmacologic and pharmacologic strategies for pain management and safe use of opioid analgesics when appropriate. Strategies to monitor for signs of opioid misuse, abuse, and addiction will also be explored. Participants will engage in a combination of learning formats including case-based clinical practice questions, patient counseling demonstrations (using patient and caregiver actors) and action-plan development to create an effective learning experience while generating a high level of actionable insights.

Upon completion of this course, the participants should be able to:

• Summarize key concepts and practices in managing pain and preventing opioid misuse, abuse and addiction;
• Assess patients with pain to inform treatment planning, monitor treatment response, ensure safe use when opioid analgesics are appropriate and detect opioid abuse or addiction;
• Develop individualized pain treatment plans, including nonpharmacologic and/or pharmacologic (non-opioid and opioid analgesics) as appropriate;
• Identify strategies to safely and effectively initiate, modify, and discontinue use of opioid analgesics
• Manage patients with opioid use disorder, or identify patients requiring referral to an addiction specialist.

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

• Compose care plans for patients with left ventricular assist devices requiring non-cardiac procedures;
• Categorize the causes and impacts of respiratory failure in the perioperative setting;
• Appropriately manage patients with hepatic dysfunction to minimize adverse outcomes. 

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

• Discuss the Inpatient Prospective Payment System utilized for hospital billing and its driving force for major risk adjustment metrics within US News Rankings and bundles;
• Describe the basic types of health care risk-based payment models;
• Respond to recent legislative, regulatory, and publications that may (or appear to) affect payment for anesthesia services. 

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

• Identify the general principles of diagnosing perioperative anaphylaxis and describe the immediate and postoperative management;
• Distinguish between allergic and non-allergic acute perioperative hypersensitivity reactions and how they are diagnosed;
• Assess penicillin allergy labels, manage allergic patients, and de-label patients without true allergy. 

Active Shooter and Disaster Preparedness Workshop: "Was That a Gunshot!?" How to Keep Calm and Respond in the Middle of Chaos

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;
• Ask for help early;
• Execute an evacuation in an emergency;
• Conduct a "Lockdown";
• Fight in a self-defense situation;
• Develop flexible thinking for an evolving active shooter situation.

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:

• Distinguish airway and anatomic characteristics that would make TEE difficult;
• Recognize normal anatomy and pathology in standard TEE views and make recommendations for treatment;
• Apply skills and obtain the views described in the updated published standard TEE exam;
• Define the TEE views that help in the differential diagnosis of hemodynamically unstable patients;
• Use echocardiography to recognize common causes of hemodynamic instability in the operating room;
• Create a differential diagnosis for unstable patients using the ultrasound techniques TTE and TEE;
• Participate in decision making using echocardiography in the hemodynamically unstable patient;
• Perform a quick transthoracic exam (a basic focused TTE exam) in emergency situations;
• Use TEE as a monitoring tool in the operating room.

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

• Demonstrate basic skills in ultrasound technology;
• Utilize ultrasound technology for central venous and arterial access;
• Optimize billing for ultrasound guided vascular access.

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

• Interpret echocardiographic images obtained in patients undergoing extracorporeal circulatory support implantation;
• Utilize strategic decision making skills with the interventionalist to collaboratively treat the patient in circulatory shock;
• Prepare an educational program for cardiac anesthesiologists participating in the care of ECMO patients;
• List the new emerging technologies that is are being used outside the operating room;
• Create a cardiac anesthesiologist "leader" for "outside of OR" locations and ensure appropriate training;
• Organize a team approach to the management of structural heart disease;
• Recognize the importance of quality metrics and benchmarking;
• Create practices and policies that enhance measured outcomes in their practice. 

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

• Explain the relevance of POCUS in clinical practice;
• Describe the important emerging role of ultrasound in assessing gastric contents, gastric volume, and NPO status before induction;
• Introduce airway ultrasound into their practice to aid in endotracheal tube placement as well as to identify the cricothyroid membrane for patient where there is a concern for “cannot intubate, cannot ventilate";
• Educate their teams on the role of focused cardiac ultrasound in ACLS to help with diagnosis and management of patients in a pulseless electrical activity (PEA) arrest.

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

• Design an analgesic plan for patients with chronic opioid exposure and substance use disorder with consideration for treatment initiation;
• Apply current and emerging multimodal analgesic approaches within the context of enhanced recovery pathways;
• Counsel patients on the utility and risks of various cannabinoid products;
• Administer ketamine for novel uses in consultation with an acute pain service. 

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

• List the steps in creating a preoperative anemia clinic;
• Create a plan to minimize blood loss and need for transfusion;
• Identify alternatives to blood transfusion;
• Recognize the current risks of blood transfusion;
• Synthesize an algorithm using point-of-care testing.

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

• Describe the impact of frailty and of anesthetic choice on postoperative outcomes following lower extremity total joint replacement;
• Apply the components of a successful ERAS program for shoulder surgeries;
• Use fascial plane blocks to augment our armamentarium in postoperative analgesia. 

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

• Recognize unique PACU challenges, such as respiratory depression and mechanical ventilation, and develop practices to improve patient safety;
• Apply the current KDIGO criteria to diagnose Acute Kidney Injury (AKI), ) and subclinical AKI;
• Identify the role of oliguria in the perioperative period;
• Implement strategies to prevent AKI;
• Recognize risk factors for postoperative pulmonary complications and describe the evidence from the Protective Ventilation Network (PROVENet) Trials;
• Describe various techniques to reduce post cardiac surgery complications;
• Implement changes such as anesthetic choice, restrictive transfusion, and use of vasoactive drugs to prevent postoperative delirium. 

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

• Utilize ultrasound technology to perform the following blocks: Paravertebral Nerve; Spinal and Epidural; Truncal including TAP (Transversus Abdominis Plane), Quadratus Lumborum, and Rectus Sheath; and Fascia Iliaca, Lateral Femoral Cutaneous, Iliohypogastric.

Anesthesia and the Developing Brain: Do Anesthetics Really Harm Children? Animal vs. Human Evidence

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

• Discuss the animal data demonstrating negative effects of anesthetics on the developing brain;
• Discuss the current knowledge regarding the possible negative effect of anesthetics on the developing brain in humans;
• Discuss the areas of research to elucidate the effect of anesthetics on the developing brain of humans;
• Discuss the ethical issues of not providing anesthetic care to infants;
• Advise parents about their child’s impending surgery and anesthetic when asked about the effects of anesthetic agents on their child. 

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

• List the challenges of providing care in the field and in a warzone; 
• Describe the differences between trauma and civilian casualties and the operational differences in patient care;
• Incorporate current trauma management protocols in their institution. 

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

• Describe the challenges faced by the aging anesthesiologist;
• Identify the issues that will impact a physician's ability to practice;
• Identify options and opportunities available in order to pursue a second career and ways to impact healthcare in the community; 
• Formulate informed personalized decisions about transitioning into retirement;
• Develop a long term plan that allows the practitioner to be better prepared for the future, while decreasing current mental stress and improving focus on patient care.       

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

• Discuss the pharmacology of relevant drug interactions;
• Formulate an alternative anesthesia medication plan based on the patient's medications;
• Recognize the different side effects of these drugs and have a monitoring and management plan in place.

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;
• Simulate how to evacuate in an emergency;
• Know how to conduct a “lockdown”;
• Know 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:

• Properly position patients for spinal surgery;
• Properly assign the use of cell-saver, autologous blood donation and hemodilution to appropriate surgical procedures;
• Enumerate the risk factors for postoperative visual loss;
• Implement changes in practice to avoid postoperative visual loss.

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:

• Manage accidental dural puncture in obstetrics;
• Develop an evidence-based decision regarding the use of intrathecal catheters in the prevention and management of PDPH;
• Perform a therapeutic and prophylactic blood patch in the event of PDPH.

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

• Discuss new guidelines from the APS;
• Incorporate new pain management guidelines into their practice.

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. 

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

• Identify appropriate intravenous and inhaled medications for labor analgesia;
• Develop a plan to provide pain relief to the parturient who is not a candidate for neuraxial analgesia.

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. 

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

• Define addiction, tolerance and abuse;
• Recognize the clinical features associated with the use of alcohol and marijuana;
• Develop an anesthetic plan incorporating knowledge of the anesthetic consequences of alcohol and marijuana use in the pediatric patient. 

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

• Identify professional difficulties encountered by the burned out physician;
• Recognize the implications of burnout among medical professionals, with emphasis on anesthesiologists and critical care specialists;
• Explain how burnout affects clinical competency, patient care and interaction between members of anesthesia team;
• Deploy methods to recognize burnout and point out ways to help your colleague anesthesiologist to overcome it;
• Formulate a plan for burnout prevention/reduction in your department or practice. 

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

• Recognize patient characteristics which would allow safe TJR in the ASC setting;
• Discuss the steps necessary in a clinical pathway to establish a program to TJR in an ASC;
• Implement a pain management plan which would allow for ASC management of TJR.

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

Challenges in Obstetric Anesthesia: Troubleshooting Neuraxial Analgesia During Labor and Delivery

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

• Describe the advantages and disadvantages of different labor analgesic techniques;
• Advise a laboring patient on the best type of neuroaxial analgesia;
• Formulate a plan for troubleshooting an inadequate epidural.

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

• Define emergence delirium.
• List three risk factors associated with emergence delirium;
• List three techniques to decrease the risk of emergence delirium for your pediatric patients undergoing GA;
• List at least one treatment option for emergence delirium;
• Formulate discussion points to talk to families about the risk of emergence delirium;
• Formulate discussion points to talk to families about a pediatric patient that has demonstrated emergence delirium.

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

• Distinguish among various placental abnormalities and their implications for hemorrhage;
• Formulate a plan for the anesthetic management of the patient with placenta accreta. 

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

• Discuss the preoperative evaluation for a patient with a large facial tumor and how it would differ for a vascular and nonvascular tumor;
• Discuss the significance and implications of a multidisciplinary approach for complex airway/ craniofacial surgery;
• Review the ASA difficult airway algorithm, exploring the challenges and various methods of induction of anesthesia for an extreme difficult airway;
• Identify potential intraoperative difficulties including hemodynamic instability in resecting a large tumor;
• Explore options for intraoperative support including ECMO for challenging tumor resections. 

"What is Buprenorphine???": Strategies for Perioperative Analgesic Management in Major Surgery/Perioperative Management of an Opioid Dependent Patient Managed on Buprenorphine

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 and 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. 

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

• Discuss the indication for EBUS;
• Compare different anesthetic techniques for the management of the EBUS patient;
• Implement a safe anesthetic for the EBUS patient 

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

• Identify common bleeding risks associated with advanced liver disease;
• Formulate a preoperative plan to minimize the risk of hemorrhage;
• Implement an anesthetic plan that will minimize the neurologic sequelae associated with alcohol withdrawal. 

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

• Discuss the challenges of caring for individuals without capacity to consent or ability to provide useful medical history;
• Review the physical findings of valvular heart disease
• Interpret abbreviations in a medical record;
• Implement an anesthetic plan based upon imperfect information. 

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

• Place left and right-sided double lumen endobronchial tubes utilizing fiberoptic bronchoscopy;
• Place various types of endobronchial blockers to provide one lung ventilation;
• Apply techniques for successful lung separation in patients with a difficult airway;
• Manage hypoxia in a patient with one-lung ventilation;
• Manage postoperative analgesia in the post-lung resection patient.

Basic Point of Care Ultrasound (PoCUS): Focused Surface Ultrasound for the Perioperative Anesthesiologist 

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

• Acquire images from a basic focused ultrasound (PoCUS) exam; 
• Perform basic handling of a portable ultrasound machine in order to perform a PoCUS exam; 
• Perform a gastric content ultrasound evaluation; 
• Interpret ultrasound images from a PoCUS exam of the heart and lungs;
• Create a PoCus program at their institution. 

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

• Recognize controversial issues associated with anesthetic drug labeling and standardization of concentrations;
• Develop practical workflow changes that reduce the risk of medication administration errors;
• Manage the downstream effects of drug shortages and the selection of drug substitutes.

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;
• Demonstrate effective communication skills during a crisis situation with team members.

Requirements for Certificate:

To receive an ACLS Certificate, the participant will have to successfully complete the course and pass a written and practical examination, which will be administered at the end of the course.

This workshop is limited to pre-registration.

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

• Describe the scope of preventable harm;
• Implement elements of a care pathway to prevent postoperative delirium;
• Use a systems approach to address “wellness” in the anesthesiology workforce. 

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

• Properly assess pediatric patients for risk;
• Describe how obesity impacts OSA and incorporate efforts to minimize risk into your practice plan;
• Formulate a plan for the management of patients with congenital heart defects;
• Introduce new methods to manage postoperative complications of adenotonsillectomy;
• Design a perioperative care plan for the pediatric patient who has suffered a concussive injury.

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

• Design a plan for managing the patient with pulmonary hypertension and hypokinetic right heart;
• Explain the perioperative management of the patient with a coronary stent;
• Formulate a plan for the management of the patient with undiagnosed cardiac disease;
• Describe the key points in the management of the patient with an LVAD (left ventricular assist device).

This intermediate workshop is recommended for the practicing anesthesiologist who either:

• Enrolled in the morning basic workshop and would like to broaden their clinical skills or
• Already has some basic knowledge in surface ultrasound.

After completion of this session, participants will be able to:

• Acquire and interpret PoCUS images;
• Perform a standardized comprehensive cardiac exam of the heart that includes assessment of global left and right ventricular function, stroke volume measurement, valvular and volume status assessment;
• Perform an advanced lung exam and interpret findings;
• Perform a systematic PoCUS airway examination;
• Apply diagnostic principles of the FEEL protocol during cardiac arrest.

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.

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

• Discuss current methods of pain management in pediatric patients including both pharmacologic and regional methods;
• Describe the medications used for pain relief in children in terms of pharmacokinetics, pharmacodynamics, and adverse side effects;
• Discuss the risks and benefits of various types of regional anesthesia for pediatric patients;
• Formulate an anesthetic plan for pain management in pediatric patients undergoing various types of surgical procedures. 

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

• Recognize signs of vasoplegia;
• Develop treatment protocols for vasoplegia;
• Discuss the role of methylene blue in treatment of vasoplegia;
• Implement various treatment protocols based on their risks and benefits. 

After attending this panel, participants will be able to:

• Incorporate the essential elements of a quality management program that uses quality metrics for data driven performance improvement;
• Incorporate the essential elements of a patient safety culture that encourages continuous identification of vulnerabilities and demonstrates a willingness to transparently deal with them; 
• List the ACGME CPR for Safety and Quality and the necessary elements for satisfying these requirements.

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:

• Enumerate the coagulation parameters that are acceptable to proceed with regional anesthesia;
• Define the incidence of regional anesthesia related complications;
• Create guidelines for their department in drug cessation and testing anticoagulation that establish safe and evidence based practice.
• Use ultrasound to prevent regional anesthesia complications.

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

• Create blood transfusion algorithms that conform to the evidence based literature;
• Enumerate the latest changes in factor transfusion guidelines;
• Expediently recognize and treat a transfusion related complication.

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

• Identify which procedures are at increased risk for perioperative complications;
• Utilize additional monitoring in appropriate orthopedic procedures;
• Incorporate strategies to reduce blood loss into routine management.

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;
• Communicate hypokinesis and akinesis of the myocardium to the surgeon and suggest appropriate treatment.

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. 

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

• Evaluate fetal heart rate tracings and review the etiology of the different types of fetal heart rate patterns;
• Explain how opioids and anesthetics affect the fetus and interpretation of the fetal heart rate tracing;
• Formulate a labor analgesia plan for the patient with an ominous fetal heart rate tracing;
• Recognize the effects of spinal and general anesthesia on mother and baby;
• Formulate a management plan for an emergency cesarean delivery.

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. 

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

• Identify drug addiction vs. drug tolerance vs. physical dependence;
• Assess the analgesic options regarding postoperative pain management;
• Identify analgesic requirements for the perioperative period;
• Formulate a strategic analgesic plan. 

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. 

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

• Discuss comorbidities for patients undergoing EVAR ;
• Formulate an anesthetic plan for patients undergoing EVAR 

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

• Discuss the pathophysiology of Obstructive Sleep Apnea (OSA) in adults;
• Make a presumptive diagnosis of OSA in undiagnosed patients;
• Assess the eligibility of OSA patients for ambulatory surgery;
• Evaluate the effects of anesthetics on patients with OSA;
• Formulate postoperative pain control in OSA patients in an outpatient setting;
• Establish the outpatient PACU monitoring and discharge criteria for OSA patients. 

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

• Stratify what procedures and which patients are suitable for office-based procedures and which should not be done in this venue;
• Discuss the perioperative implications of OSA;
• Implement the use of the ASA guidelines as they apply to office based anesthesia. 

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

• Describe early postoperative pulmonary complications that may occur in the PACU and the different equipment available to treat these complications;
• Recognize early postoperative pulmonary complications in the PACU;
• Develop a protocol driven treatment plan;
• Discuss the monitoring and reversal of neuromuscular blockadeImplement a standardized process for patients treated with these agents.

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

• Prepare the anesthesia machine for MH susceptible patients;
• Recognize the signs of MH;
• Manage the patient who develops signs of MH during an anesthetic;

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

• Discuss the advantages and disadvantages of robotic assisted laparoscopic surgeries;
• Plan appropriately for robotic assisted laparoscopic surgeries; 
• Discuss the complications of robotic laparoscopic surgery;
• Recognize and manage the complications of robotic assisted laparoscopic surgery. 

Challenges in Acute Pain Management: The Patient with Cancer Undergoing Minimally Invasive Esophageal Surgery

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

• Identify the possible indications/contraindications of the available analgesia modalities as well as the role of different analgesics on cancer recurrence
• Perform an appropriate preoperative evaluation of a patient coming for a thoracic procedure and identify the appropriate analgesic options.
• Desctibe the role of adjuvants given in the preoperative, intraoperative and postoperative period and the advantages of multimodal analgesia.
• Implement an analgesic plan as part of enhanced recovery pathway after surgery (ERAS) and perioperative surgical home (PSH)

Perioperative Management of Patients with Left Ventricular Assist Devices Undergoing Non-Cardiac Surgery

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

• Discuss the hemodynamic management of patients with LVAD;
• Understand (change word) the similarities and differences between different LVAD systems;
• Recognize the alarms associated with LVADs and basic troubleshooting maneuvers;
• Describe the anesthetic and surgical implications associated with laparoscopic procedures in patients with LVADs;
• Implement a team-based approach to LVAD patients undergoing non-cardiac procedures. 

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;
• Recognize 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:

• Build a comprehensive understanding (what does this mean,not measurable, need another work) 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. 

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

• Review various modalities for non-invasive hemodynamic monitoring;
• Select patients and procedures in which non-invasive hemodynamic monitoring would be advantageous. 

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 fibrilla

Asymptomatic Viral Respiratory Infection in a Child with Severe Pulmonary Hypertension and Chronic Lung Disease Scheduled for Myringotomy and Adenoidectomy

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

• Discuss the anesthetic concerns in a child with pulmonary hypertension;
• Identify risk factors for patient who present with viral infection;
• Select an anesthetic plan for a patient with pulmonary risk factors for a necessary but brief procedure. 

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

• Delineate which pain syndromes are very difficult to effectively treat;
• Manage their patients despite the FDA mandated REMS program on opiate prescribing;
• Create a protocol for a multi-disciplinary approach in appropriate patients.

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

• Delineate which pain syndromes are very difficult to effectively treat;
• Manage their patients despite the FDA mandated REMS program on opiate prescribing;
• Create a protocol for a multi-disciplinary approach in appropriate patients.

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

• Enumerate the cure infection control deficiencies identified recently and revise their hospital policies accordingly;
• Bring three evidence based changes to their own practice which should improve Infection control;
• Identify two non-evidence based recommendations that are being advanced by JCAHO.

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

• Describe the challenges associated with anesthetics for patients undergoing bariatric surgery;
• Discuss the issues unique to delivering an anesthetic for a patient undergoing gender reassignment surgery;
• Formulate a plan to manage a patient undergoing organ donation after cardiac death.

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

• Describe the benefits and drawbacks of minimizing or eliminating opioid use during perioperative care;
• Implement strategies for minimizing or eliminating opioid use in the perioperative period;
• Identify evidence-based practices of anesthesia professionals that may reduce the incidence of surgical site infection;
• Review and compare past and present perioperative fluid management strategies;
• Discuss current concepts and recommendations for perioperative fluid management.

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 an airway evaluation;
• Prepare the patient for an awake intubation;
• Incorporate into their practice techniques of bronchoscopic intubation and video laryngoscopy for adult and pediatric patients and cricothyrotomy for adult patients.

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

• Create the optimal anesthetic plan for the older ambulatory patient.
• Implement preoperative screening for frailty and delirium;
• Formulate a plan to safely provide anesthesia for ambulatory and office-based cosmetic surgery;
• Adapt ERAS to ambulatory surgery
• Identify and measure meaningful clinical and quality outcomes.

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

• Describe the nuances and techniques for performing “awake intubation”;
• Review the current considerations for managing the airway in morbidly obese patients;
• Employ techniques than can be employed for extending apnea time;
• Make a rational decision to perform or abandon cricoid pressure based upon evidence. 

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

• Discuss the anesthetic management of patients who present with or develop unusual or unique medical issues that demand innovative anesthetic management strategies;
• Acquire insight into the thought processes of colleagues and mentors as they describe their management of complex problems in anesthesia care;
• Enhance their anesthetic management of patients who present with complex and rare problems. 

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

• Develop and implement a preoperative strategy prior to surgery in a multidisciplinary team approach to optimize patients who refuse blood products;
• Develop and implement a strategy to minimize blood loss and manage unanticipated hemorrhage according to the patient's wishes. 

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; (K)
• Implement strategies and protocols to prevent adverse events; 
• List the many novel procedures being offered in IR and recognize their anesthesia implications;
• Incorporate best practices and published protocols for providing anesthesia care in these locations. 

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

• Define the anatomic differences in the forms of postoperative vision loss;
• Remove or eliminate 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:

• Introduce the use of newer anesthetic agents in the neonatal period into their practice;
• Discuss the requirements for postoperative observation in very young neonates;
• Implement strategies to avoid complications encountered in neonatal anesthesia.

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

• Describe the pathway to patenting an idea;
• Avoid the fundamentals and pitfalls of designing a new product;
• Create a new idea, introduce it, and capitalize on it.

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

• Identify common coincident injuries in a patient with a traumatic brain or cervical spinal cord injury;
• Implement an anesthetic plan to maximize neurologic outcome in such a trauma patient. 

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. 

PBLD-58 Case - PGA73

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

• Diagnose the parturient with HELLP Syndrome;
• Identify the anesthetic implications of HELLP Syndrome;
• Manage the HELLP syndrome patient in the peripartum period. 

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

• Identify blood products and volume expanders that are prohibited and those that may be allowed by Jehovah's witnesses;
• Review the ethical considerations in caring for a Jehovah’s witness who is a minor;
• Formulate a plan to care for a Jehovah's witness patient who is a trauma victim. 

PBLD- 60 Case - PGA73

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. 

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

• Differentiate between VV and VA ECMO;
• Identify indications for placement of ECMO;
• Describe complications associated with ECMO;
• Formulate a plan to wean both VA and VV ECMO 

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

• Discuss the allergic potential of DEHP;
• Identify anesthetic equipment that contains DHEP;  
• Formulate an anesthetic plan considering the DHEP allergic patient;   Is there surgical equipment that you would suspect to have DEHP? The patient is planned for a MAC anesthetic. How would you prepare for her anesthetic?

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

• List the different types of CIED and describe the possible perioperative complications;
• Formulate a management plan for these patients when they present to the operating room or other procedural areas.

After completion of this session the participants will be able to: 

• Develop an anesthetic management plan for patients after cancer therapy;
• Develop a plan for management of patients with congenital heart disease for both simple and more complex surgical procedures.