Program

GOALS:
1. Describe the clinical assessment of a hypovolemic pediatric patient.
2. Formulate an anesthetic plan for the management of a post-tonsillectomy bleed.
3. Recognize the signs suggestive of substance abuse in the workplace.
4. Describe the challenges associated with recognition and intervention of substance abuse among physicians.
5. Summarize the plan for evaluation of an impaired physician.

GOALS:
1. Describe the physical and emotional concerns when caring for the adolescent patient.
2. Review the implications of pregnancy testing in the adolescent female.
3. Recognize trends in adolescent substance abuse and the potential consequences of substance use in the perioperative period.
4. Define consent and assent and decide how to proceed should an adolescent not assent to a surgery or procedure.
5. Identify patients predisposed to serotonin syndrome and list medications routinely administered by anesthesiologists that can trigger this potentially lethal reaction in the perioperative period.

GOALS:
1.Identify primary concerns of anesthesiologists and parents regarding the exposure of children under one year of age to general anesthesia
2. Understand the latest findings from brain MRI studies after birth asphyxia
3. Evaluate the importance of advancing, and the benefits to, medical research in balance with the risks of anesthesia in this patient population
4. Create an interdisciplinary team to evaluate institutional policy and practical implantation of research MRIs in your practice
5.Determine individual attitudes regarding the ethics of non-essential MRI scanning under general anesthesia and reconcile differing opinions in a practice group

GOALS:
1. Discuss preoperative evaluation, preparation, disease progression and anesthetic implications associated Epidermolysis Bullosa (EB).
2. Review pathophysiology of EB and Identify suitable sedative and anesthetic choices for a patient with EB presenting for non- invasive and invasive procedures
3. Devise a strategy for managing the challenges related to airway management in patients with EB.
4. Discuss the recognition and management of the difficult airway in off -site locations

GOALS:
1. Recognize the patient/caregiver, physician and situational factors that contribute to a challenging medical encounter.
2. Recognize the 4 types of difficult caregivers. Discuss the suggested strategies for managing the medical encounter and implement them in the perioperative setting.
3. Appreciate the risk and effect of such negative interactions on the anesthesia provider and how it could impact the provider�s care for the patient.

GOALS:
1. Recognize the bioethical issues raised when a pediatric patient refuses a healthcare intervention;
2. Discuss the four basic bioethical principles of autonomy, beneficence, nonmaleficence, and justice as they apply to care of the pediatric patient;
3. Define the concepts of surrogate decision-maker, the best-interest standard, and substituted judgment as applied in the care of a pediatric patient;
4. Identify the bioethical issues raised by disclosing sensitive medical information about a minor patient;
5. Debate bioethical issues involved in the establishment of a do-not-resuscitate status in a pediatric patient.

GOALS:
1. Evaluate the benefits and potential complications of proceeding with surgery in the intubated child with an upper respiratory tract infection.
2. Understand anesthetic implications of proceeding with surgery in a child with a viral respiratory illness including airway changes, ventilation and postoperative complications.
3. Develop management strategies for a patient with symptomatic tracheal obstruction.
4. Plan airway management when recurrent laryngeal nerve monitoring is required in an infant.
5. Identify anesthetic concerns and management strategies in a child with a potential mediastinal mass.

GOALS:
1. Risk stratify the patient with Fontan physiology presenting for non-cardiac surgery
2. Identify signs and symptoms associated with a failing Fontan circulation
3. Develop an anesthetic plan to manage such a patient, focusing specifically on the risks and benefits of different strategies for induction, monitoring, pain management, and extubation
4. Summarize factors to be considered when determining anesthetizing location and post-operative disposition of patients with Fontan physiology

GOALS:
1. Discuss anesthetic options for minimally stimulating and non-invasive procedures.
2. Understand the anesthetic implications and risks of pulmonary hypertension and discuss strategies to minimize perioperative complications.
3. Discuss a differential diagnosis for airway obstruction after anesthesia and options for evaluation and intervention.
4. Be able to discuss unanticipated anesthetic outcomes with families and providers in a professional and sensitive fashion.

GOALS:
1. Understand the perioperative management of patient�s with mitochonidral myopathies
2. Know the risks of pulmonary aspiration in the setting of the full stomach
3. Ascertain a pathway during a difficult, mandatory IV placement
4. Manage drug therapies for complex pediatric patients

GOALS:
* Identify "at risk" children when presenting for clinical care and evaluate for abuse
* Identify criteria which would determine the appropriateness for surgical care in children in whom follow up is unclear or not available
* Identify the risks of perioperative care in a child with an active URI
* Understand the pediatric anesthesiologist's role as a first reporter if abuse is suspected

GOALS:
* Discuss the incidence, pathophysiology, and treatment of anaphylactic reactions.
* Describe the additional risks of out of OR anesthesia, after hours' procedures, and be able to evaluate and improve safety precautions at your institution.
* Discuss different conflict styles observed in the care of our patients and potentially more effectively manage conflicts arising from competing interests.
* Evaluate the effectiveness of handoff procedures at your institution and discuss opportunities to improve them.

Upon completion of this session, the participant will be able to:
* Describe the components of the immune system.
* Differentiate between innate and adaptive immune response.
* Differentiate between humoral and cell mediated immunity.
* Discuss commonly used tests to pick up disorders in components of the immune system.
* Discuss several common primary immunodeficiency diseases.

Upon completion of this session, the participant will be able to:
* List the common agents responsible for anaphylactic reactions.
* Recognize the clinical presentation of anaphylactic reactions.
* Summarize the management of an anaphylactic reaction.
* Evaluate desensitization therapies to reduce the incidence of anaphylactic reactions.

Upon completion of this session, the participant will be able to:
* Discuss the changes in the immune response during the perioperative period.
* Evaluate the proposed effects of opioids on the immune system.
* Describe the modulatory actions of regional anesthesia on the immune system.
* Critically analyze the association between transfusion related immune suppression and poor clinical outcomes.

Upon completion of this session, the participant will be able to:
* Identify the food allergies that have the most significant impact on anesthetic management.
* Critically analyze recent research in food allergies and the impact newer findings will have on anesthetic practice.
* Describe how to incorporate food allergy concerns into the preoperative evaluation.
* Recognize when a food allergy interaction is taking place.
* Discuss possible medicolegal implications of food allergies in patient care.

Upon completion of this session, the participant will be able to:
* Describe the concept of the Perioperative Surgical Home (PSH).
* Explain how the PSH model fits with national health care goals.
* Discuss the role of the anesthesiologist in managing the PSH model.
* Compare quality metrics used for implementation of a pediatric PSH model to the adult population.

Upon completion of this session, the participant will be able to:
* Describe the steps in the implementation of a PSH model for scoliosis correction.
* Assess cost savings and improved outcomes following implementation of an enhanced recovery pathway for scoliosis repair.
* Summarize strategies to optimize patient preparation and reduce variability in the perioperative care of patient undergoing posterior spinal fusion.
* Identify barriers encountered during the implementation of a Perioperative Surgical Home for scoliosis repair.

Upon completion of this session, the participant will be able to:
* Describe the operational elements of the adenoidectomy project, a pediatric perioperative surgical home (PSH) model at Nationwide Children's Hospital.
* Identify barriers encountered during the implementation of a pediatric PSH model.
* Assess cost savings and improved parental satisfaction scores following implementation of a pediatric PSH model.
* Summarize strategies to improve the coordination of perioperative care of children undergoing adenoidectomy.

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

Upon completion of this session, the participant will be able to:
* Discuss the regulatory guidelines in place for oversight of a sedation service.
* Differentiate sedation medications that can be used by anesthesiologists vs. non-anesthesia providers.
* Evaluate the safety data for sedation services staffed by anesthesiologists vs. non-anesthesia providers.
* Analyze the return on investment associated with different staffing models.

Upon completion of this session, the participant will be able to:
* Discuss the physics of nuclear medicine scans.
* Describe administration of anesthesia in a nuclear medicine suite.
* Explain the safety concerns of a nuclear scan to both the patient and the anesthesia provider.
* Discuss the anesthetic management issues unique to nuclear medicine.

Upon completion of this session, the participant will be able to:
* Describe the unique environment of the cardiac catheterization lab.
* Evaluate the safety data on patients undergoing anesthesia in the cath lab.
* Interpret the anesthetic management implications of the cardiac catheterization consensus statement.

Upon completion of this session, the participant will be able to:
* Articulate the differences between the environment in the space station and on Earth.
* Explain the limitations and ramifications of the space station's resources as they relate to anesthesiology.
* Describe the physiologic implications of extreme acceleration, radiation exposure, and zero-gravity Interpret the anesthetic management implications of the cardiac catheterization consensus statement.
* Discuss the medical decision making process in the setting of the space station.
* Apply the concepts of anesthetic care in space to anesthetic practice in isolated and resource constrained sites on Earth.