PERIOPERATIVE MANAGEMENT A COURSE DESIGNED FOR PRACTITIONERS TO LIMIT RISK AND IMPROVE PATIENT OUTCOMES BY PROPER PREOPERATIVE EVALUATION, INTRAOPERATIVE MANAGEMENT AND POSTOPERATIVE CARE F r o m the Lea d e r i n Pe r i o p erative M e d i c ine NOW TS 29t h Y E AR IN I Up-to-date Topics and Clinical Vignettes Individual Consultations with Faculty Experts Knowledge to empower your practice and organization to improve patient care Sunday – Wednesday March 10 – 13, 2013 MARCO ISLAND MARRIOTT Marco Island, Florida
DESCRIPTION ACCREDITATION STATEMENTThirty million patients undergo surgical procedures The Johns Hopkins University School of Medicinein the US each year, and the age and medical is accredited by the Accreditation Councilcomplexity of this patient population is increasing. for Continuing Medical Education to provideAll of these patients require preoperative continuing medical education for physicians.assessment, intraoperative management, and CREDIT DESIGNATION STATEMENTpostoperative care. Every year the body of peer- The Johns Hopkins University School of Medicinereviewed literature on this topic increases and designates this live activity for a maximum ofnew guidelines on clinical management are 23.50 AMA PRA Category 1 CreditsTM. Physiciansformulated. Because the breadth of knowledge in should claim only the credit commensurate withperioperative medicine, which includes the diverse the extent of their participation in the activity.disciplines of cardiology, pulmonology, hematology,endocrinology, infectious diseases and geriatrics, is OTHER CREDITvast, many practitioners may not have up-to-date American Nurses Credentialing Centerinformation that is critical to clinical practice. American Nurses Credentialing Center (ANCC)The curriculum for this course was specifically accepts AMA PRA Category 1 Credit TM fromcreated to address the needs of clinicians who organizations accredited by the ACCME.provide care for patients before, during, and after American Academy of Family Physicianssurgery based on current literature, feedback from This live activity, Perioperative Management -course participants and the opinion of experts from In Its 29th Year, with a beginning date of Marchmultiple institutions. As the established leader in 10, 2013, has been reviewed and is acceptable forperioperative medicine, this course aims to provide up to 20.75 Prescribed credits by the Americanpractitioners with the most up-to-date knowledge Academy of Family Physicians. Physicians shouldnecessary to deliver effective, evidence-based care claim only the credit commensurate with theby affecting health care practices at the level of the extent of their participation in the activity.individual and the larger health system. American Association of Nurse Anesthetists This program has been approved by the AmericanWHO SHOULD ATTEND Association of Nurse Anesthetists for 23 CEThis activity is intended for anesthesiologists, credits; Code Number 1027143; Expiration Dateinternal medicine specialists, hospitalists, surgeons, 03/13/13.family practitioners, nurse anesthetists, nurse American Academy of Nurse Practitionerspractitioners and physician assistants. American Academy of Nurse PractitionersOBJECTIVES (AANP) accepts AMA PRA Category 1 Credit TM from organizations accredited by the ACCME.After attending this activity, the participant willdemonstrate the ability to: American Academy of Physician Assistants• escribe current guidelines for preoperative D American Academy of Physician Assistants cardiac and pulmonary risk assessment and list (AAPA) accepts certificates of participation for several ways to predict and prevent cardiac and educational activities certified for AMA PRA pulmonary complications using preoperative Category 1 Credit TM from organizations accredited testing, and intraoperative and postoperative by the ACCME. Physician assistants may receive interventions. a maximum of 23.50 hours of Category 1 credit for completing this program.• escribe the perioperative risks associated D with diabetes, obesity, renal insufficiency, and Contact Hours for Non-Physicians cognitive decline and list medical and/or surgical The Johns Hopkins University has approved this management strategies to minimize complications activity for 23.50 contact hours for non-physicians. in patients with these medical conditions. POLICY ON SPEAKER AND PROVIDER• escribe bleeding and thrombotic risks in D DISCLOSURE surgical patients and list several strategies to It is the policy of the Johns Hopkins University reduce complications through evidence-based School of Medicine that the speaker and provider use of blood conservation methods, transfusion, disclose real or apparent conflicts of interest anti-fibrinolytic agents and management of relating to the topics of this educational activity, anti-thrombotic drug therapies. and also disclose discussions of unlabeled/• ecognize how to prevent, diagnose, and treat R unapproved uses of drugs or devices during their common healthcare associated infections that presentation(s). The Johns Hopkins University complicate surgical procedures. School of Medicine OCME has established• ecognize the impact of health care provider R policies in place that will identify and resolve stress and institutional healthcare culture on all conflicts of interest prior to this educational the safety and quality of healthcare delivery in activity. Detailed disclosure will be made in the the perioperative period. activity handout materials.
GENERAL INFORMATION additional fee may apply for cancellation of other events, including workshops and social activities.REGISTRATION Refund requests must be received by fax or mail bySaturday, March 9 • 5:00 - 7:00 p.m. • Capri Foyer March 4, 2013. No refunds will be made thereafter.Once registered, please join us for a reception Transfer of registration to another Johns Hopkinsat the Sunset Terrace South on Saturday from conference in lieu of cancellation is not possible.5:00 - 7:00 p.m. SOCIAL EVENTFEES A complimentary reception for registrants andREGISTRATION CUT-OFF DATE: faculty will be held on Saturday, March 9th, fromMarch 4, 2013 5:00 - 7:00 p.m. on the Sunset Terrace South.Methods of Payment: Payment by check or credit Light snacks will be served. Pre-registration willcard must accompany the registration form prior also be available during that time. Please indicateto the activity. On-site payments by credit card your attendance on the registration form.only. Foreign payments must be by credit card HOTEL AND TRAVEL INFORMATIONor with a U.S. Dollar World Money Order. The Marco Island Marriott Resortregistration fee includes instructional materials, Golf Club and Spa (800) 438-4373continental breakfasts and refreshment breaks. 400 South Collier Boulevard (239) 394-2511Physicians........................................................ $715 Marco Island, Florida 34145 Fax: (239) 642-2672Nurse Anesthetists/Physician Assistants/ The award winning Marco Island Marriott isNurse Practitioners/Other Health Professionals... $619 scenically located directly on the Gulf of MexicoResidents/Fellows/Nurse Trainees*................ $350 along 3 1/2 miles of white sand beach at the*with verification of status southwestern tip of Florida. The resort is easilyYou will receive a confirmation by e-mail if you accessible by car and enjoys breathtaking sunsethave provided your e-mail address. Otherwise views over the Gulf of Mexico. Nearby Naples offersconfirmation will be sent by mail. If you have not incredible shopping and dining opportunities. Withreceived it by March 4, 2013, call (410) 502-9636 March temperatures averaging 80 degrees, the Marcoto confirm that you are registered. A certificate of Island Marriott is truly the perfect winter getawayattendance will be sent by April 30, 2013 to the meeting location!e-mail address you provide on the registration form. Our special group room rate is $389, single or double,The Johns Hopkins University reserves the right to plus state and local taxes. The cut-off date for hotelcancel or postpone any activity due to unforeseen reservations is Thursday, February 7, 2013. If youcircumstances. In this event, the University will intend to stay at the Marriott, please book early.refund the registration fee but is not responsible for The hotel is usually SOLD OUT by January 15travel expenses. Additionally, we reserve the right – before the cut-off date. Check in time is 4:00to change the venue to a comparable venue. Under p.m. and check out time is 11:00 a.m. All reservationsuch circumstances registrants will be notified as requests require a credit card guarantee of onesoon as possible. night’s deposit. Deposits will be refunded for roomsSYLLABUS cancelled more than seven days prior to arrival.There are three options available for obtaining the HOTEL RESERVATION CUT-OFF DATE:syllabus: FEBRUARY 7, 2013Flashdrive: All registrants will receive a flashdrive Avis Rent-A-Car: For car rental discounts, call Avis atwith the slides and paper for note taking. This is (800) 331-1600 and mention AWD number A101999included in the cost of your registration.Hard Copy with Binder: A hard copy of the EVALUATIONsyllabus may be ordered ahead of time and A form will be available to attendees to evaluateis available for an additional charge. (See each session and each speaker’s presentation, asRegistration Form) well as to identify future educational needs.Online Version available for download: A link OUTCOMES SURVEYto the syllabus will be provided via email shortly A survey will be sent to all physician attendeesbefore the activity, if you prefer to print the within three months post activity to assist us insyllabus ahead of time. determining what impact this activity had on the(There is a business center at the hotel; however, attendee’s practice.computers/printers are limited and the Marriottlevies a charge for this service.) EMERGENCY CALLS On March 10-13, 2013 direct emergency calls toLATE FEE AND REFUND POLICY (239) 394-2511 and ask that a message be sent toA $50 late fee applies to registrations received the Johns Hopkins registration desk. Messagesafter 5:00 p.m. EST on March 4, 2013. A handling will be posted for participants.fee of $50 will be deducted for cancellation. An
SPEAKERSACTIVITY DIRECTORS Frederick Sieber, MD Associate Professor of Anesthesiology/Critical CareNauder Faraday, MD, MPH MedicineAssociate Professor of Anesthesiology/Critical Care Clinical Director, Johns Hopkins Bayview CampusMedicine and SurgeryDirector, Perioperative Hemostasis and Thrombosis Jerry Stonemetz, MDResearch Laboratory Staff Anesthesiologist, Department of AnesthesiologyDirector, Perioperative Genomic Research National Medical Director for Anesthesia Services, Hospital Corporation of AmericaSean Berenholtz, MD, MHS, FCCMAssociate Professor of Anesthesiology/Critical Care Ilan Wittstein, MDMedicine and Surgery Assistant Professor of MedicineDirector, ICU Performance Improvement Committee Division of CardiologyCo-Director, Johns Hopkins Quality and SafetyResearch Group GUEST SPEAKERS Elizabeth Martinez, MD, MHSJOHNS HOPKINS FACULTY Staff Anesthesiologist, Massachusetts General HospitalLauren Berkow, MD Associate Professor of Anesthesiology,Associate Professor of Anesthesiology/Critical Care Harvard Medical SchoolMedicine and Otolaryngology and Head and Neck Surgery Boston, MassachusettsDirector, Airway Services Peter Rock, MD, MBA, FCCM, FCCPTodd Dorman, MD, FCCM Professor of Medicine, Surgery, and AnesthesiologySenior Associate Dean for Education Coordination Chair, Department of AnesthesiologyAssociate Dean and Director, Office of CME University of Maryland School of MedicineProfessor and Vice Chair for Critical Care Baltimore, MarylandDepartment of Anesthesiology and Critical Care Medicine J. Bryan Sexton, PhDJoint Appointments in Medicine, Surgery and the Associate Professor of PsychiatrySchool of Nursing Duke University School of MedicineLeonard Feldman, MD Director of Patient Safety, Training and ResearchAssistant Professor of Medicine Durham, North CarolinaDivision of General Internal Medicine Marc Shnider, MDDirector of Education, Johns Hopkins Hospitalist Service Staff Anesthesiologist, Beth Israel Deaconess HospitalDerek Fine, MD Clinical Instructor in Anesthesia, Harvard Medical SchoolAssociate Professor of Medicine Boston, MassachusettsDivision of Nephrology Brett Simon, MD, PhDAnne Lidor, MD Anesthesiologist-in-Chief, Beth Israel Deaconess HospitalAssociate Professor of Surgery Professor of Anesthesiology, Harvard Medical SchoolDivision of Gastrointestinal Surgery Boston, MassachusettsPamela Lipsett, MD, FACS, FCCMProfessor of Surgery and Anesthesiology/Critical Care HISTORICALLY, THE HOTEL SELLSMedicine OUT QUICKLY. PLEASE MAKE YOURDirector, General Surgery and Surgical Critical Care RESERVATIONS EARLY.Training Programs Marco Island Marriott • (800) 438-4373Co-Director, Surgical Intensive Care Reservation Cut-Off Date: Wednesday, February 7, 2013 TO REGISTER or FOR FURTHER INFORMATION Register Online www.HopkinsCME.edu (credit card and eCheck) Register by Phone (410) 502-9636 (credit card only) Register by Fax (866) 510-7088AMERICANS WITH DISABILITIES ACT Confirmation/Certificates (410) 502-9636The Johns Hopkins University School of Medicine General Information (410) 955-2959fully complies with the legal requirements of the E-mail the Office of CME email@example.comADA and the rules and regulations thereof. Please Follow us on Twitter:notify us if you have any special needs. http://twitter.com/HopkinsCMEACKNOWLEDGEMENT Facebook: http://www.facebook.com/HopkinsCMEApplications for commercial support from health For general information, the direct link for thiscare related industries are pending. A complete list CME activity web page is: http://www.hopkinscme.of contributors will be provided in the syllabus. edu/CourseDetail.aspx/80030032
PROGRAMSunday, March 18, 2013 8:15 - 8:45 Perioperative Management of 7:00 - 7:45 Registration/Continental Breakfast Diabetes and Hyperglycemia Leonard Feldman, MD 7:45 - 8:00 ntroduction and Conference Goals I Nauder Faraday, MD, MPH 8:45 - 9:15 erioperative Management of P Patients with Cardiomyopathy 8:00 - 8:30 The Perioperative Stress Response Todd Dorman, MD, FCCM Todd Dorman, MD, FCCM 9:15 - 9:45 anagement of Perioperative M 8:30 - 9:00 Preoperative Evaluation: Bleeding and Transfusion Optimized, Not Cleared Nauder Faraday, MD, MPH Leonard Feldman, MD 9:45 - 10:00 Questions and Answers 9:00 - 9:30 reoperative Cardiac Risk P Assessment and Testing 1 0:00 - 10:15 Case Discussion with Faculty/ Ilan Wittstein, MD Refreshment Break 9:30 - 10:00 Perioperative Myocardial 10:15 - 10:45 The Preoperative Patient with Ischemia: Mechanisms and Obstructive Sleep Apnea Management Strategies Peter Rock, MD, MBA, FCCM, FCCP Nauder Faraday, MD, MPH 10:45 - 12:00 Controversial Clinical Vignettes: 10:00 - 10:15 Questions and Answers Perioperative Glucose Management in the Brittle 0:15 - 10:30 1 Case Discussion with Faculty/ Diabetic Refreshment Break Leonard Feldman, MD 10:30 - 11:00 erioperative Management of P Preoperative Evaluation and Patients on Chronic Anti-Platelet Management of the Patient with Therapy Heart Failure Nauder Faraday, MD, MPH Ilan Wittstein, MD 11:00 - 11:30 Surgical Site Infections ntra- and Post-operative I Pamela Lipsett, MD, FACS, FCCM Challenges in Patients with 11:30 - 12:30 Controversial Clinical Vignettes Heart Failure Evidence-Based Preoperative Elizabeth Martinez, MD, MPH Testing anaging Bleeding in Patients M Sean Berenholtz, MD, MHS, FCCM Anticoagulated with Novel he Preoperative Patient with a T IIa/Xa Inhibitors Pacemaker or AICD Nauder Faraday, MD, MHS Ilan Wittstein, MD anaging the Difficult Airway M erioperative Management of the P Outside the OR Hypertensive Patient Lauren Berkow, MD Todd Dorman, MD, FCCM 12:00 - 12:30 Preoperative Pulmonary Risk Perioperative Management Assessment and Testing of Patients on Chronic Anti- Peter Rock, MD, MBA, FCCM, FCCP Coagulant Therapy 12:30 - 1:00 Surgical Management of Obesity Nauder Faraday, MD, MPH Anne Lidor, MD 12:30 - 1:00 Perioperative Risks and 1:00 - 1:15 Questions and Answers Management of Pulmonary Hypertension Tuesday, March 12, 2013 Brett Simon, MD, PhD 7:00 - 7:30 Continental Breakfast and Case 1:00 - 1:15 Questions and Answers Discussion with FacultyMonday, March 11, 2013 7:30 - 7:45 Questions and Answers 7:00 - 7:30 Continental Breakfast and Case 7:45 - 8:15 Perioperative Respiratory Discussion with Faculty Insufficiency: Mechanisms and Management 7:30 - 7:45 Questions and Answers Peter Rock, MD, MBA, FCCM, FCCP 7:45 - 8:15 Preventing, Identifying, and 8:15 - 8:45 Perioperative Renal Dysfunction Managing Common Healthcare Derek Fine, MD Associated Infections Pamela Lipsett, MD, FACS, FCCM
8:45 - 9:15 erioperative Management of the P 9:15 - 9:45 mproving Perioperative Quality I Patient with Hepatic Disease and Safety through System and Brett Simon, MD, PhD Culture Change 9:15 - 9:45 ealth Care Provider Stress I: H Sean Berenholtz, MD, MHS, FCCM Recognition and Impact on 9:45 - 10:00 Questions and Answers Provider and Patient Outcomes 1 0:00 - 10:15 Case Discussion with Faculty/ J. Bryan Sexton, PhD Refreshment Break 9:45 - 10:00 Questions and Answers 10:15 - 10:45 uality Reporting and Financial Q1 0:00 - 10:15 Case Discussion with Faculty/ Incentives: Implications for Your Refreshment Break Practice and Institution 10:15 - 10:45 ealth Care Provider Stress II: H Jerry Stonemetz, MD Fatigue Management 10:45 - 11:15 Managing Transfers of Patient J. Bryan Sexton, PhD Care Safely and Effectively 10:45 - 11:15 cute Pain Management: A Elizabeth Martinez, MD, MPH Opioids, Non-Narcotics, and 11:15 - 12:15 Controversial Clinical Vignettes: Nerve Blocks Perioperative Management of the Marc Shnider, MD Patient with Dementia 11:15 - 12:30 Controversial Clinical Vignettes: Frederick Seiber, MD Perioperative Fluid Management mproving the Quality of I Pamela Lipsett, MD, FACS, FCCM Sepsis Care erioperative Management of P Sean Berenholtz, MD, MHS, FCCM Steroids and Adrenal Insufficiency nesthesia in the MRI and A Derek Fine, MD Endoscopy Suites Pain Management in the Opioid- Lauren Berkow, MD Tolerant Patient: A Case-Based Medico-Legal Liability in Discussion Perioperative Medicine: Common Marc Shnider, MD Pitfalls and How to Avoid Them Allergy and Anaphylaxis Jerry Stonemetz, MD Todd Dorman, MD, FCCM 12:15 - 12:30 Questions and Answers aparoscopic vs. Open Surgery: L 12:30 Summary Making the Right Choice Adjourn Anne Lidor, MD Please complete and return the 12:30 - 1:00 Health Care Provider Stress III: Evaluation and Credit Report Dealing with Difficult Colleagues Forms. The Registration Desk will J. Bryan Sexton, PhD remain open during conference hours. 1:00 - 1:15 Questions and Answers The Johns Hopkins University School of Medicine takesWednesday, March 13, 2013 responsibility for the content, quality and scientific 7:00 - 7:30 Continental Breakfast and Case integrity of this CME activity. Discussion with Faculty This schedule is subject to change. 7:30 - 7:45 Questions and Answers 7:45 - 8:15 Perioperative DVT and Pulmonary Embolism Nauder Faraday, MD, MPH 8:15 - 8:45 ost-Operative Delirium and P Cognitive Decline MARK YOUR CALENDAR Frederick Sieber, MD Future date for 8:45 - 9:15 anaging End of Life Issues in M Perioperative Management Surgical Patients Pamela Lipsett, MD, FACS, FCCM at the Marriott Marco Island March 9-12, 2014
REGISTRATION FORM Course Number 80030032 Perioperative Management - In Its 29th Year March 10-13, 2013 To Register: Online: www.HopkinsCME.edu By fax: (866) 510-7088 By phone (credit card only): (410) 502-9636Or mail this form to the Johns Hopkins University, Office of Continuing Medical Education, P.O. Box64128, Baltimore, Maryland 21264-4128. Include check payable to HOPKINS/80030032, or includecredit card information below.M I am a Johns Hopkins speaker for this activity. PAYMENT MUST ACCOMPANY FORM TO CONFIRM YOUR REGISTRATION. Please type or print clearly: last name first name m.i. highest degree primary specialty Hopkins Faculty/Staff Only – JHED ID: mailing address city state ZIP + 4 code country daytime telephone fax number e-mail / / / / / / / / / / / / / / / / / / / / / / / / / / / / /You will receive a confirmation notice and your attendance certificate by e-mail if you provide your e-mail address.M Check here if you wish to receive e-mail notices about upcoming CME activities.M I will attend the complimentary pre-conference reception on Saturday evening.What do you hope to learn by attending this activity?____________________________________________________________________________________ Please notify us if you have any special needs.____________________________________________________________________________________ Registration Fees:M Physicians........................................................................................................................................... $715M Nurse Anesthetists/Physician Assistants/Nurse Practitioners/Other Health Professionals............ $619M Residents/Fellows/Nurse Trainees*................................................................................................... $350 *with verification of statusM Hard Copy of Syllabus....................................................................................................................... $ 40 copies ordered in advance can be picked up at the time of registration. Limited quantities of syllabi will be made Hard available for purchase on-site for $50.For registrations received after 5:00 p.m. EST on March 4, 2013 include a $50 late fee. On-site registrationsare payable only by credit card. Total amount enclosed $__________________ Payment Type: JHU Faculty/Staff Only: If you are using your Tuition Remission Benefit or an ION budget, please complete this registration form and return with appropriate payment processing form to OCME, Turner 20. Forms can be found on-line at http://www.hopkinscme.edu/Resources/resources.aspx.M Check (See instructions on top of form.)M Credit Card: M VISA M MASTERCARD M DISCOVER M AMEXCard # - - - Exp. Date_________________Name on Card Signature Date