Wednesday, March 1, 2017
9:00 AM – 11:30 AM	COMMITTEE: SPA Executive Committee Location: 310 (Level 3)
11:30 AM – 5:00 PM	COMMITTEE: SPA Board of Directors Location: 310 (Level 3)

Thursday, March 2, 2017
6:30 AM – 5:00 PM	Registration Location: Lone Star Foyer (Level 3)
3:00 PM – 7:00 PM	WORKSHOP: Perioperative Pediatric Advanced Life Support Simulation Coordinator: Scott C. Watkins, MD Rhonda A. Alexis, MD, FAAP; Stephanie Black, MD, EdM; Newton Buchanan; Eileen M. Griffin, CRNA; Harshad G. Gurnaney, MBBS, MPH; Roberta L Hales, MHA, RRT-NPS, RN; Anita Honkanen, MD, FAAP; Alexander K. Hughes, MD; Jill E. Kilkelly, MD; Lauren Lobaugh, MD; Elaine K. Ng, MD, FRCPC, MSHPE; Elaine K. Ng, MD, FRCPC, MSHPE; Devika Singh, MD; Eric T. Stickles, MD; David A. Young, MD, MEd, MBA; John Zhong, MD Objectives: An additional 4-8 hours of online course work prior to the workshop will be required for certification. Upon completion of this workshop, the participant will be able to: * Discuss the current AHA PALS update; * Discuss important considerations for PALS in the perioperative setting; * Describe the proper management of several high stakes perioperative events with differences from standard PALS; * Demonstrate team-based management of several simulated pediatric perioperative emergency scenarios; * Discuss the role of emergency manuals in this setting and practice using the SPA crisis manual in simulation. Location: 201-202 (Level 2)
4:30 PM – 6:30 PM	WORKSHOP: Integrating Acupuncture in Pediatric Perioperative Care and Pain Medicine Coordinator: Yuan-Chi Lin, MD, MPH Brenda Golianu, MD; Rosalie Tassone, MD, MPH; Cynthia Tung, MD; Shu-Ming Wang, MD Objectives: Upon completion of this workshop, participants will be able to * Review the history and theory of acupuncture. * Recognize scientific evidence of acupuncture practice. * Exam acupuncture meridian systems and micro-system paradigms. * Incorporate acupuncture in pediatric peri-operative practice and pain medicine. * Participate hands-on demonstration of acupuncture and related techniques. Location: Lonestar F (Level 3)
4:30 PM – 7:30 PM	WORKSHOP: Advanced Ultrasound Guided Regional Anesthesia Coordinator: Amod Sawardekar, MD, MBA Tarun Bhalla, MD, MBA, FASA, FAAP; Alan Bielsky, MD; Adrian T. Bosenberg, MB, ChB, FFA; Candice M. Burrier, MD; Arjunan Ganesh, MBBS; Chris D. Glover, MD, MBA; David Krodel, MD; Per-Arne Lonnqvist, MD; Nihar V. Patel, MD Objectives: Upon completion of this low faculty-to-attendee ratio workshop, the participant will have an understanding of: * Basic functions of the Ultrasound and probes. * Differentiation machine settings for various age groups. * Anatomy using Ultrasound guidance of all peripheral nerve blocks including upper and lower extremity, truncal, and central neuraxial blocks. * Scanning and performing the most common peripheral nerve and central neuraxial blocks utilized in pediatric anesthesia practice. Location: 212 (Level 2)
6:00 PM – 7:00 PM	COMMITTEE: PRAN Steering Committee Location: 301-302 (Level 3)
7:00 PM – 8:00 PM	COMMITTEE: PRAN Investigators/All Centers Location: 301-302 (Level 3)
7:00 PM – 9:30 PM	COMMITTEE: AAP SOA Executive Committee Location: 310 (Level 3)

Friday, March 3, 2017
6:00 AM – 5:30 PM	Registration Location: Lone Star Foyer (Level 3)
6:30 AM – 7:30 AM	COMMITTEE: SPA Communications Committee Location: 309 (Level 3)
PBLDs 1-16
6:30 AM – 7:40 AM	PBLD 1: Complete Tracheal Transection in a 3-year-old following Blunt Neck Trauma Gijo Alex, MD; Fernando Zayas-Bazan, MD Objectives: GOALS: * Discuss the mechanisms of laryngo-tracheal injuries secondary to blunt neck trauma. * Describe the presenting symptoms of patients with tracheal injuries. * Discuss the airway management in pediatric patients with tracheal injuries. * Describe important anesthetic and surgical considerations during tracheal repair Location: 201
6:30 AM – 7:40 AM	PBLD 2: Zebras or horses: Severe childhood obesity presenting like acute epiglottitis Olubukola O. Nafiu, MD, FRCA, MS; Kamie K. Yang, MD Objectives: GOALS: * Review the epidemiology of childhood obesity with particular emphasis on clinically severe obesity. * Review differential diagnoses of acute upper airway obstruction. * Discuss the unique problems associated with severe obesity and acute upper airway obstruction. * Recognize the peri-operative problems of childhood obesity. * Examine the systemic disorders associated with severe childhood obesity. Location: 201
6:30 AM – 7:40 AM	PBLD 3: Single ventricle, scoliosis surgery, sans transfusion: Management of major surgery in a complex Jehovah’s Witness teenager Lisa M. Einhorn, MD; Nathaniel Greene, MD, MBA, MHS, FAAP Objectives: GOALS: * Describe the anesthetic challenges presenting for major non-cardiac surgery in adolescents with single ventricle physiology. * Discuss risks factors for bleeding in scoliosis surgery and intraoperative factors associated with transfusion. * Review the indications for hemodilution and intraoperative blood salvage including risks and benefits. * Evaluate ethical dilemmas associated with providing care for children of Jehovah's Witnesses. * Identify system-level issues that arise in planning for a procedure for a patient with single ventricle physiology for elective surgery, including time, anesthesia coverage and involvement of anesthesia learners. Location: 201
6:30 AM – 7:40 AM	PBLD 4: Caught by the Perioperative Clinic: Complementary and alternative medicine before spinal surgery Calvin Kuan, MD; Tammy N. Wang, MD Objectives: GOALS: * Discuss how a perioperative surgical home can improve care for pediatric patients. * Review potential side effects of various herbal medications. * Identify potential child abuse and review the differential diagnosis of physical exam findings. * Discuss perioperative blood management and the potential benefits of a preoperative anemia clinic. * Review treatment options for excessive bleeding secondary to herbal medications. Location: 202
6:30 AM – 7:40 AM	PBLD 5: The Tension is Real: Perioperative management of a life-threatening congenital lung malformation in a neonate Andrew Matisoff, MD; Bhupen Mehta, MD Objectives: GOALS: * Review the anesthetic management for coarctation of the aorta repair with a focus on the non-cardiac complications that can occur during the surgery. * Discuss common congenital lung malformations, including congenital cystic adenomatoid malformation (CCAM), bronchogenic cycts, and congenital lobar emphysema, complications which can result from them, and their surgical and anesthetic management. * Discuss the selective ventilation techniques that can be applied to a neonate. We will focus on their role in the management a significant one sided air leak due to bronchopleural fistula. Location: 202
6:30 AM – 7:40 AM	PBLD 6: Did You Hear About the Four Month Old with a Tension Pneumo in Recovery? Kristin L. Richards, MD; Michelle L. Schlunt, MD Objectives: GOALS: * Discuss the current guidelines for outpatient anesthesia in preterm infants. * Review complications associated with laryngoscopy & bronchoscopy. * Review the diagnosis and management of tension pneumothorax in an infant. * Review lung divisions and bronchial anatomy to illustrate areas prone to tracheobronchial injury. * Review the management and ventilation strategies in an infant with a tracheobronchial injury. Location: 202
6:30 AM – 7:40 AM	PBLD 7: The Highs and Lows of Pulmonary Hypertension Amy M. Babb, MD; Sally A. Vender, MD Objectives: GOALS: * Understand the categories of chronic pulmonary hypertension pharmacologic treatments and their perioperative implications. * Identify the anesthetic management goals and formulate a plan for induction and maintenance of anesthesia in patients with severe pulmonary hypertension and right ventricular (RV) dysfunction. * Develop a strategy for diagnosing and treating intraoperative pulmonary hypertensive crisis and RV failure. * Understand how pulmonary hypertension and RV failure are diagnosed using transthoracic and transesophageal echocardiography (TEE). * How to integrate inhaled nitric oxide (iNO) into the anesthesia machine. Location: 203
6:30 AM – 7:40 AM	PBLD 8: Pediatric Liver Transplant for Unresectable Hepatic Pheochromocytoma. Prepare for the King of Roller Coaster Rides! Roger Fons, MD; Susan R. Staudt, MD Objectives: GOALS: * The participants will review the etiology and incidence of pheochromocytoma in the pediatric population compared to the adult population. * The discussants will better understand the potential roles of the anesthesiologist within the Perioperative Surgical Home model when preparing a patient with a pheochromocytoma for surgical intervention. * The participants will discuss which monitors, lines, and infusions may provide the most benefit for a case involving a large adrenergic secreting tumor and a liver transplant. * The participants will debate the management of extremes in hemodynamics during the pre-anhepatic phase /pre-pheochromocytoma tumor removal and how best to monitor and prepare for the postop labile blood pressure course. * The participants will discuss the causes and management options of resistant hypotension related to removal of a pheochromocytoma tumor and reperfusion hypotension from liver transplant. Also the pharmacokinetics of phentolamine and how same can benefit the neohepatic circulation in the setting of a very high catecholamine environment. Location: 203
6:30 AM – 7:40 AM	PBLD 9: When You Don't Know Everything, How Much Do You Need To Know? - A PICU Child for Broviac Catheter Placement Cassandra Armstead-Williams, MD; Madhankumar Sathyamoorthy, MBBS, MS, MBA Objectives: GOALS: * Identify pitfalls and challenges in preoperative assessment and transfer of care for a patient with complicated medical history from the ICU. * Understand the differential diagnosis and implications of unanticipated difficult ventilation in a previously intubated patient from the ICU. * Understand the problems in diagnosing and managing congenital lobar emphysema. * Identify common biases and cognitive errors in medical decision making in critical/emergency situations. * Understand strategies for the identification of evolving conflict conditions and efficient resolution. Location: 203
6:30 AM – 7:40 AM	PBLD 10: Unknown benefits of botox and intrathecal baclofen in a child with severe cerebral palsy presenting for lower extremity orthopedic surgery Lisa A. Gramlich, MD; Katharine E. Miles, MD Objectives: Upon completion of this PBLD, participants should be able to: - Describe methods of airway assessment in an uncooperative patient. - Delineate the challenges unique to starting a difficult pediatric case, choosing options for premedication, PIV placement, and airway management in order to safely and effectively care for a patient. - Discuss the use of surgeon-administered botulinum toxin as an adjunct to alleviate postoperative pain in lower limb orthopedic surgery. - Consider the ethics of off-label use of a drug in a pediatric population. - Encourage a multimodal approach to pain control after lower extremity orthopedic surgery that may involve opiates, alpha-2 agonists, baclofen, neuraxial techniques, and surgeon-administered injection of botulinum toxin, partnering with the surgeon in an effort to broaden the methods used to treat pain, anxiety, and spasticity after surgery. Location: 204
6:30 AM – 7:40 AM	PBLD 11: "Wait...what are all these bruises?" Suspected abuse in an autistic child! What next? Kim Strupp, MD; Matthew S. Wilder, MD Objectives: At the end of this problem based learning discussion, learners will be able to: * Describe the anesthetic implications of pervasive developmental disorders, including autism. * Recognize predictors of difficult intubation in children with mandibular fractures. * Interpret and apply the American Society of Anesthesiology difficult airway algorithm in a pediatric facial trauma patient. Discuss strategies to minimize bleeding during naso-tracheal intubation. Formulate a plan for reporting suspected child abuse and non-accidental trauma in children. Location: 204
6:30 AM – 7:40 AM	PBLD 12: Placement of a gastrostomy tube in a patient with Severe Charcot-Marie-Tooth Disease: to block or not to block Fay Jou, MD; Chandra N. Reynolds, MD Objectives: GOALS: * Describe the features of Charcot-Marie-Tooth disease and the challenges associated with anesthetizing patients presenting with symptoms. * Discuss the place for regional anesthesia, neuraxial anesthesia, and general anesthesia in the surgical care of the patient with significant respiratory compromise. * Discuss the role of the anesthesiologist as a consultant in the medically complex patient. * Explore the methods by which the anesthesiologist may communicate frank and difficult discussions with minor patients and their families. Location: 204
6:30 AM – 7:40 AM	PBLD 13: Regional Variations: Anesthesia for the Head-Injured Patient with Long Bone Fractures Cornelius A. Sullivan, MD; Tricia M. Vecchione, MD, MPH Objectives: GOALS: * Develop an anesthetic management plan for the pediatric trauma patient. Identify the relative risks and benefits of general anesthesia, epidural, and peripheral nerve catheters in this setting. * Discuss the signs and symptoms of compartment syndrome in pediatric patients and the potential impact of regional anesthesia on early diagnosis. * Appreciate the potential advantages of regional analgesia postoperatively after repair of tibial fracture and potential concerns of conventional opioid based analgesia in a trauma patient. Location: 207
6:30 AM – 7:40 AM	PBLD 14: An anxious, morbidly obese teenager needs sedation - "Oh, we think he's got a PE and can't lay flat." Amy Henry, MD; Lindsey Loveland, MD Objectives: GOALS: * Describe techniques for securing an airway in a pediatric patient with anxiety and morbid obesity. * Differentiate between sickle cell disease and sickle cell trait, and understand the implications of both disease processes. * Review tissue plasminogen activator (tPA) indications, and discuss the appropriateness of administering prior to obtaining imaging to confirm a thrombus. * Understand the potential physiologic and pathophysiologic disturbances and complications in a patient with a severe coagulopathy, requiring massive transfusion. Learners will expand their ability to anesthetize and safely secure the airway of morbidly obese, anxious pediatric patients. They will also appreciate the management of massive transfusions in caring for severely coagulopathic patients. Location: 207
6:30 AM – 7:40 AM	PBLD 15: Anesthetic Management Options in the Anticipated Pediatric Difficult Airway Anjali Adur, MD; Sara B. Robertson, MD Objectives: GOALS: * Recognize different management options for the anticipated pediatric difficult airway. * Describe evidence-based airway management techniques specific to the pediatric difficult airway. Become familiar with the newer devices used in the management of the pediatric difficult airway. This PBLD will hopefully change the way pediatric anesthesia practitioners approach and think about their anesthetic plan for the anticipated pediatric difficult airway from premedication through recovery. Location: 208
6:30 AM – 7:40 AM	PBLD 16: Full Head, Full Heart: A Neonate with a Vein of Galen Malformation Zoel Quinonez, MD, MPH; David F. Vener, MD Objectives: GOALS: * Participants will discuss the physiologic challenges of managing patients with Vein of Galen malformations, particularly those associated with a large and persistent left-to-right shunt. * Participants will review the criteria for intervention in children with Vein of Galen malformations, including the relevant work up, and the timing for intervention, if warranted. * Participants will discuss the difficulties in caring for neonates undergoing catheter-based procedures, either in the radiologic or catheterization suite. * Participants will develop strategies to care for neonates with transitional circulation undergoing urgent or emergent procedures. Location: 208
6:45 AM – 7:45 AM	Breakfast with Exhibitors Location: Griffin Hall (Level 2)
6:45 AM – 7:45 AM	Coffee with Posters Location: Lone Star Foyer/301-308 (Level 3)
7:45 AM – 8:00 AM	Welcome and Outline of Educational Program Rita Agarwal, MD, FAAP; John Fiadjoe, MD, MBA; Randall P. Flick, MD, MPH, FAAP Location: Lone Star A-E (Level 3)
Session I: Neonates - Fine-tuning your Anesthetic: from bench to OR Moderator: Mary Ellen McCann, MD MPH John Fiadjoe, MD, MBA
8:00 AM – 8:25 AM	Cerebral Autoregulation and Blood Pressure in the Neonate: How low can you go? Kenneth M. Brady, MD Objectives: Upon completion of this session, the participant will be able to: * Characterize differences in visceral and cerebral vascular bed responses to shock states. * Critically appraise published metrics of cerebrovascular autoregulation for neonates. * Apply working knowledge of critical closing pressure and pressure autoregulation to delineate the challenge of finding safe blood pressure in a preterm neonate. Location: Lone Star A-E (Level 3)
8:25 AM – 9:00 AM	Neonatal Ventilation: Fine-tuning the ventilator for better outcomes Walid Habre, MD, PhD Objectives: Upon completion of this session, the participant will be able to: * Understand the physiological characteristics of the neonatal respiratory system that dictate the ventilator settings * Explain how to adjust controlled ventilation to decrease the deleterious effects on hemodynamics, cardiac output and cerebral perfusion * Discuss the current available evidence for the choice of a ventilation mode that can improve clinical outcome Location: Lone Star A-E (Level 3)
9:00 AM – 9:35 AM	Neurotoxicity Round Table: European excellence or U.S. paranoia...what's going on? Moderator: John Fiadjoe, MD, MBA Randall P. Flick, MD, MPH, FAAP; Caleb Ing, MD; Per-Arne Lonnqvist, MD; Mary Ellen McCann, MD MPH Objectives: Upon completion of this session, the participant will be able to: * Discuss the evidence for and against a relationship between anesthetic exposure and subsequent learning difficulties. * Understand the differences in study methods between Europe and the United States that may account for differences in outcome. Location: Lone Star A-E (Level 3)
9:35 AM – 9:45 AM	Discussion Location: Lone Star A-E (Level 3)
9:45 AM – 10:15 AM	Coffee Break with Exhibitors Location: Griffin Hall (Level 2)
9:45 AM – 10:15 AM	Coffee Break with Posters Location: 301-308 (Level 3)
Session II: Enhanced Recovery After Surgery - Not just another acronym! Moderator: Mohammed Iqbal Ahmed, MBBS
10:15 AM – 10:35 AM	Enhanced Recovery After Surgery - Putting It Into Practice: Spine fusions and pectus excavatum repair Wallis T. Muhly, MD Objectives: Upon completion of this session, the participant will be able to: * Understand the theory and evidence supporting enhanced recovery pathways * Understand the challenges involved in the implementation of an enhanced recovery program * Learn how these pathways can be instituted and monitored for program effectiveness Location: Lone Star A-E (Level 3)
10:35 AM – 10:55 AM	Enhanced Recovery After Surgery - Putting It Into Practice: Urology Megan Brockel, MD Objectives: Upon completion of this session, the participant will be able to: * Describe how principles from evidence-based enhanced recovery guidelines in the adult literature can be safely applied to pediatric patients with the aim of improving post-operative outcomes and reducing hospital length-of-stay. * Discuss strategies for implementation of change in established perioperative care pathways for complex patients. * Identify future directions for enhanced recovery protocols in children in terms of clinical care and research. Location: Lone Star A-E (Level 3)
10:55 AM – 11:30 AM	Enhanced Recovery After Surgery: The surgical perspective Sanjay Krishnaswami, MD, FACS, FAAP Objectives: Upon completion of this session, the participant will be able to: * Understand the current state of care standardization (ERAS) in the pediatric surgical literature. * Recognize the applicability of standardized care pathways across disciplines and phases of surgical care. * Understand how the development, execution and examination of standardized care pathways can help bridge the gap between quality efforts and trainee education. Location: Lone Star A-E (Level 3)
11:30 AM – 11:45 AM	Discussion Location: Lone Star A-E (Level 3)
11:00 AM – 1:00 PM	COMMITTEE: CCAS Board of Directors Location: 310-311 (Level 3)
11:45 AM – 1:15 PM	LUNCH with Exhibitors Location: Griffin Hall (Level 2)
11:45 AM – 1:15 PM	LUNCH with Posters Location: 301-308 (Level 3)
Session III: AAP Session Moderator: Courtney A. Hardy, MD, MBA, FAAP
1:15 PM – 1:30 PM	AAP Robert M. Smith Award Presentation: Peter J. Davis, MD, FAAP Peter J. Davis, MD Location: Lone Star A-E (Level 3)
1:30 PM – 2:30 PM	AAP Advocacy Lecture: Intensive care decisions for fragile neonates Annie Janvier, BSc, PhD, MD Objectives: Upon completion of this session, the participant will be able to: * Recognize variations of practice for fragile neonates in the grey-zone. * Examine decision-making and parental perspectives for fragile neonates. Location: Lone Star A-E (Level 3)
Session IV: Achieving Excellence One Step at a Time Moderator: R. Blaine Easley, MD
2:30 PM – 2:50 PM	Drug Errors: Challenges and opportunities in anesthesia Karen C. Nanji, MD, MPH Objectives: Upon completion of this session, the participant will be able to: * Recognize the differences between medication error(s) and adverse drug event(s). * Identify types of potential adverse drug events in the operating room that may or may not involve medication errors. * Discuss methods of obtaining perioperative medication error data. Identify solutions that may have the potential to prevent perioperative medication errors and/or adverse drug events. Location: Lone Star A-E (Level 3)
2:50 PM – 3:10 PM	Can You Design Your Workspace to Reduce Errors? Eliot B. Grigg, MD Objectives: Upon completion of this session, the participant will be able to: * Review design principles and how they have (or have not) been applied to health care. * Understand how design can be used to improve patient safety through examples. * Apply design principles to improve safety at other institutions. Location: Lone Star A-E (Level 3)
3:10 PM – 3:30 PM	Improving Practice Through QI: Pursuing perfection - attaining excellence Anna M. Varughese, MD, MPH Objectives: Upon completion of this session, the participant will be able to: * Provide frameworks for improving practice through Quality Improvement such as the Model for Improvement and Lean techniques. * Underscore the importance of improving processes and increasing efficiencies, reducing waste and enhancing the patient/family experience in this era of evolving health care and cost constraints. * Provide examples for improving our practice through Quality Improvement. Location: Lone Star A-E (Level 3)
3:30 PM – 3:45 PM	Discussion Location: Lone Star A-E (Level 3)
3:30 PM – 6:00 PM	COMMITTEE: Pediatric Anesthesia Leadership Council (PALC) Location: Lone Star FG (Level 3)
3:30 PM – 4:00 PM	COMMITTEE: Q & S Checklists Subcommittee Location: Lone Star H (Level 3)
3:45 PM – 5:15 PM	COMMITTEE: CCAS-STS Database Committee Location: 309 (Level 3)
3:45 PM – 5:15 PM	COMMITTEE: SIG Simulation Location: 408-409 (Level 4)
3:45 PM – 4:00 PM	Coffee Break Location: Lone Star Foyer
WORKSHOPS
3:45 PM – 6:45 PM	WORKSHOP: Research Workshop Coordinator: Jerome Parness, MD, PhD, FAAP R. Blaine Easley, MD; Richard J. Levy, MD, FAAP; Olutoyin Olutoye, MD, M.Sc, FAAP Objectives: Upon completion of this workshop, the participant will be able to: * Choose a mentor. * Choose a research topic - basic science vs. clinical research. * Negotiating with funding agencies. * Describe strategies for starting and maintaining a research career. Session topics: Basic Science in Anesthesiology - Jerome Parness MD, PhD Clinical Research in Anesthesiology - R. Blaine Easley MD Mentoring - Olutoyin A. Olutoye MB ChB Negotiating Granting Agencies - Richard Levy MD Location: 207 (Level 2)
3:45 PM – 6:45 PM	WORKSHOP: Advanced Techniques for Peripheral Vascular Access Coordinator: Gregory J. Schears, MD Kara A. Alvarez, MD; Franklin B. Chiao, MD; Andrea Dutoit, MD; Paul J. Fronapfel, MD; Julia A. Galvez Delgado, MD, MBI, FASA; Jessica Lorenz, MD; Scott D. Markowitz, MD, MSOL, FAAP; Marc Mecoli, MD; Shannon Peters, MD; Raquel Schears, MD; Kim Strupp, MD; Premal Trivedi, MD; Robert T. Wilder, MD, PhD; Luis M. Zabala, MD Objectives: Upon completion of this workshop, participants will be able to *Optimize the use of ultrasound to obtain peripheral venous and arterial access. * Describe indications for and use intraosseous catheters to obtain vascular access. * Identify advantages of NIR technology for peripheral venous access and demonstrate on a phantom. *Improve their understanding of techniques for a successful central venous cannulation * Deploy various access adjuncts to successfully obtain vascular access Location: 203-204 (Level 2)
3:45 PM – 6:45 PM	WORKSHOP: Advanced Ultrasound Guided Regional Anesthesia Coordinator: Amod Sawardekar, MD, MBA Tarun Bhalla, MD, MBA, FASA, FAAP; Adrian T. Bosenberg, MB, ChB, FFA; Candice M. Burrier, MD; Arjunan Ganesh, MBBS; Chris D. Glover, MD, MBA; Katherine G. Keech, MD; David Krodel, MD; Per-Arne Lonnqvist, MD; Kesavan Sadacharam, MD Objectives: Upon completion of this low faculty-to-attendee ratio workshop, the participant will have an understanding of: *Basic functions of the Ultrasound and probes. * Differentiation machine settings for various age groups. * Anatomy using Ultrasound guidance of all peripheral nerve blocks including upper and lower extremity, truncal, and central neuraxial blocks. * Scanning and performing the most common peripheral nerve and central neuraxial blocks utilized in pediatric anesthesia practice. Location: 212 (Level 2)
3:45 PM – 6:45 PM	WORKSHOP: Transesohageal Echo (TEE) Coordinator: Denise Joffe, MD Matthew Jolley, MD; Gary A. Monteiro, MD; Faith J. Ross, MD Objectives: Upon completion of this workshop, the participant will: * Understand the mechanics of conducting a basic TEE exam. * Understand how intraoperative TEE can help in the diagnosis of hemodynamic abnormalities. *Review the principles necessary to conduct a comprehensive exam in patients with congenital heart disease. Location: 208 (Level 2)
3:45 PM – 6:45 PM	WORKSHOP: Difficult Pediatric Airway Coordinator: Raymond Park, MD; Bridget L. Muldowney, MD Guelay Bilen-Rosas, MD; Melissa L. Brooks Peterson, MD; Ellen Choi, MD; Edward Cooper, MD; Oleg Drozhinin, MD; Cheryl K. Gooden, MD, FAAP; Narasimhan Jagannathan, MD, MBA; Todd J. Kilbaugh, MD; Pete G. Kovatsis, MD; Maria Matuszczak, MD; Patrick N. Olomu, MD, FRCA; Vikram P. Patel, MD, MBBS; Jamie M. Peyton, MD; Madhankumar Sathyamoorthy, MBBS, MS, MBA; Lisa Sohn, MD; Paul A. Stricker, MD; Cornelius A. Sullivan, MD; Judit M. Szolnoki, MD; Bistra Vlassakova, MD; Lana Volz, MD; Christopher G. Ward, MD; Jennifer Zieg, MD Objectives: Upon completion of this workshop, the participant will gain: * Recognition of situations and pediatric syndromes in which alternative methods for securing the airway may be necessary. * An understanding of the development of a systematic anatomic and physiologic approach to the assessment of the difficult airway and to planning airway management. * An understanding of the availability of new devices and technologies for securing the airway and what their indications and limitations are. * Hands-on experience with devices and technologies useful for securing the airway. Location: 201-202 (Level 2)
4:00 PM – 5:30 PM	COMMITTEE: SPA Committee on International Education & Service Location: 310-311 (Level 3)
4:00 PM – 5:30 PM	COMMITTEE: Quality & Safety Committee Location: Lone Star H (Level 3)
Session V: Shaking up the Status Quo Moderator: Justin L. Lockman, MD, MSEd, FAAP
4:00 PM – 4:40 PM	Challenging Inhaled Anesthesia: TIVA in pediatric anesthesia J. Mark Ansermino, MD Objectives: Upon completion of this session, the participant will be able to: * Review the advantages and disadvantages of total intravenous anesthesia in children. * Learn the practical differences between the use of total intravenous anesthesia and inhaled anesthesia . * Discuss adjuvant drugs for the optimal use of intravenous anesthesia in children. Location: Lone Star A-E (Level 3)
4:40 PM – 5:20 PM	Gunfight at the OK Corral: NPO guidelines pro-con debate Ann G. Bailey, MD; Joseph P. Cravero, MD, FAAP Objectives: Upon completion of this session, the participant will be able to: * Describe early animal experiments that defined aspiration injury. * Review the large demographic studies that relate to aspiration and NPO time in children and adults. * Describe what might be considered irrational aspects of adherence to NPO guidelines from the ASA. * Review the physiology of gastric emptying * Describe the plethora of studies leading to the original ASA NPO guidelines * Discuss outcomes following adherence to the ASA guidelines in children Location: Lone Star A-E (Level 3)
5:20 PM – 5:30 PM	Discussion Location: Lone Star A-E (Level 3)
5:00 PM – 6:00 PM	COMMITTEE: CCAS SIG-Hemostasis Location: 407 (Level 4)
5:15 PM – 6:45 PM	COMMITTEE: SIG Pediatric Liver & Small Bowel Transplantation Location: 408-409 (Level 4)
5:30 PM – 6:30 PM	COMMITTEE: GAS Location: 309 (Level 3)
5:30 PM – 6:30 PM	COMMITTEE: SPPM Education & Communications Committees Location: 310- 311 (Level 3)
5:30 PM – 6:30 PM	COMMITTEE: SIG Pediatric Critical Care Medicine Location: Lone Star H (Level 3)
5:30 PM – 7:30 PM	Reception with Exhibitors Location: Griffin Hall (Level 2)

Saturday, March 4, 2017
6:00 AM – 8:00 AM	COMMITTEE: SPA Education Committee Location: Brazos (Level 2)
6:30 AM – 5:00 PM	Registration Location: Lone Star Foyer (Level 3)
PBLDs 17-24
6:50 AM – 8:00 AM	PBLD 17: When Pain and Drug Abuse Intersect: Perioperative Pain Management for the Sickle Cell Patient Angela D. McElrath, MD; Evelyn C. Monico, MD Objectives: GOALS: * Discuss the current understanding of pain pathophysiology in sickle cell disease as well as the epidemiology of vaso-occlusive pain. * Acquire anticipatory intraoperative and postoperative pain management strategies for a patient with Sickle Cell Disease. * Discuss the use of Buprenorphine/Naloxone (Suboxone) as an emerging therapy in sickle cell patients and its effect on the intra-operative course. * Develop a course of action when parental desires conflict with the desires of the pediatric patient. * Recognize hyperalgesia, opioid tolerance, dependence, addiction, and pseudoaddiction in the context of the sickle cell patient throughout the perioperative period. Location: 201
6:50 AM – 8:00 AM	PBLD 18: Post-Operative Vision Loss after Posterior Spinal Fusion Surgery Amy B. Beethe, MD; Jane A. Kugler, MD Objectives: GOALS * Discuss the factors associated with ischemic optic neuropathy after spinal fusion surgery. * Discuss the optimal time to disclose the risk of blindness with high risk surgical cases. * Discuss disclosure of adverse events. * Discuss the effects of "second victim" on both physicians and other healthcare members. Location: 201
6:50 AM – 8:00 AM	PBLD 19: Managing complications, errors, and ethics in a teenager refusing blood products ahead of a major orthopedic procedure Kasia P. Rubin, MD; Paul A. Tripi, MD Objectives: GOALS: * Assess the ethical challenges associated with issues of procedural assent, consent, refusal of treatment and the teenager. * Know the guidelines for professional conduct and avoid the risks associated with treating friends/family members. * Understand appropriate blood conservation techniques that can be performed both pre and intra-op to minimize the need for allogeneic blood transfusion. * Develop a management plan following an accidental dural puncture during attempted epidural placement for postoperative pain relief, with focus on the Jehovah Witness. Location: 202
6:50 AM – 8:00 AM	PBLD 20: 3 year old discharged to preschool after being declared an organ donor Marisa A. Sharkey, DO; Rochelle Skitt, MD Objectives: GOALS: * Formulate a plan for post-op opioid management and disposal of excess opioids in light of the opioid epidemic that the nation is facing. * Discuss a post-op pain management plan for young patients undergoing T&A and develop a protocol in place at your institution. * Define what a GCS of 5 means in terms of prognosis for a patient and determine what the best approach is to discuss an anesthetic plan with a patient’s family with a poor prognosis and unknown neurologic status. * Recognize opioid induced cerebellitis and be able to discuss the prognosis and understand the potential complications that accompany it. Location: 202
6:50 AM – 8:00 AM	PBLD 21: I can't breathe - Airway surgery in a newborn with Upper Airway Obstruction, Double Outlet Right Ventricle and Subpulmonic Stenosis Robert B. Bryskin, MD; Katrin Post-Martens, MD, MHS Objectives: GOALS: * Describe Double Outlet Right Ventricle (DORV) anatomy, its variants and its sequelae. * Discuss the anesthetic implications of a functional subpulmonic stenosis in a patient with DORV in the context of upper airway obstruction. * Analyze difficult airway management strategies in an infant with a dynamic cyanotic heart disease. * Describe circulatory/oxygenation support options available in a neonate. Location: 203
6:50 AM – 8:00 AM	PBLD 22: The Perils of Redo Laparoscopic Surgery in Pediatric Patients Napoleon Burt, MD; Eric J. Darrow, MD, PhD Objectives: GOALS: * Understand the physiologic and anatomic challenges of laparoscopy in small pediatric patients. * Identify the incidence, indicators, and treatment process of venous air embolism. * Work through the differential diagnosis and an OR applicable PALS algorithm for PEA. * Discuss massive blood transfusion policies and protocols. * Encourage effective, honest, professional communication with families during and after critical intraoperative events. Location: 203
6:50 AM – 8:00 AM	PBLD 23: Stridor in a former premature 2 year old 4 weeks after laryngeotracheal reconstruction Aman Kalra, MD, MBA; Henna Tirmizi, MD Objectives: GOALS: * Identify the particular airway and pulmonary concerns that exist when caring for formerly premature infants with subglottic stenosis status post laryngeotracheal reconstruction. * Formulate a well thought out anesthetic plan in which the surgeon requires near immobility concurrent with spontaneous respiration. * Prioritize patient safety while complementing the diagnostic and therapeutic needs of the surgeon. * Predict the patient’s postoperative needs, including risk of airway edema and recovery destination. Location: 204
6:50 AM – 8:00 AM	PBLD 24: Ethical Challenges in Delivering Care to a Pediatric Patient with a Difficult Airway in an Austere Environment Grace Hsu, MD; Princy Thottathil, MD Objectives: GOALS: * Identify approaches to difficult airway management in austere environments. * Describe approaches to ethical preparation preceding, during, and after short-term medical mission trips. * Discuss five common ways that clinicians experience ethical dilemmas in humanitarian aid. * Value the importance of ethics case studies and sharing ethics problems to engage in discussion and dialogue to make thoughtful and appropriate decisions in medical humanitarian service. Location: 204
7:00 AM – 8:00 AM	Case Study Poster Session (no CME) Moderators: James R. Eiszner, MD; Nathaniel Greene, MD, MBA, MHS, FAAP; Susan C. Nicolson, MD Location: 301-308 (Level 3)
7:00 AM – 8:00 AM	COMMITTEE: SPA Improvement Network (SPAIN) Location: 310-311 (Level 3)
7:00 AM – 8:00 AM	Breakfast with Exhibitors Location: Griffin Hall (Level 2)
7:00 AM – 8:00 AM	Coffee with Posters Location: 301-308 (Level 3)
Session I: Philip, Amy, and the musician formerly known as Prince...Opioids; Time for a change Moderator: Jeffrey L. Galinkin, MD, FAAP
8:00 AM – 8:20 AM	The Opioid Problem: How clinical research leads to discovery Myron Yaster, MD Objectives: Upon completion of this session, the participant will be able to: * Describe the epidemic of non-medical use of prescription opioids (NMUPO). * Discuss how we got here and how it was recognized as a model of clinical research. * Define the anesthesiologist's role in preventing NMUPO. Location: Lone Star A-E (Level 3)
8:20 AM – 8:45 AM	Challenging the opioid paradigm Tracy P. Jackson, MD Objectives: Upon completion of this session, the participant will be able to: * Explore the evolution of chronic pain from childhood onward. * Identify epidemiological risk factors for chronic pain common to both children and adults. * Describe patterns of prescription and ramifications of opioid use in children and adults. * Review evidence-based data for non-opioid management strategies for chronic pain applying to both children and adults. * Propose a unified path forward for prevention and treatment Location: Lone Star A-E (Level 3)
8:45 AM – 9:00 AM	Discussion Location: Lone Star A-E (Level 3)
Session II: Transforming our practice (and ourselves) through mindfulness Moderator: John Fiadjoe, MD, MBA
9:00 AM – 9:35 AM	Mindfulness in Practice: Enhancing patient care while taking care of yourself Michael J. Baime, MD Objectives: Upon completion of this session, the participant will be able to: * Review how mindfulness can be applied to manage stress and reactivity. * Describe the effect of mindfulness training on attention. * Reflect upon the ways that mindfulness can decrease burnout and enhance communication in health care. Location: Lone Star A-E (Level 3)
9:35 AM – 9:45 AM	Discussion Location: Lone Star A-E (Level 3)
9:45 AM – 10:15 AM	Coffee Break with Exhibitors Location: Griffin Hall (Level 2)
9:45 AM – 10:15 AM	Coffee Break with Posters Location: 301-308 (Level 3)
Session III: Poster Presentations and Awards
10:15 AM – 11:00 AM	Oral Presentations and Abstract Awards Moderators: Rita Agarwal, MD, FAAP; John Fiadjoe, MD, MBA Location: Lone Star A-E (Level 3)
11:00 AM – 12:30 PM	Walk Around Poster/Discussion Sessions Moderators: Carlos Javier Campos Lopez, MD, FAAP; Priti G. Dalal, MBBS, MD, FRCA; Narasimhan Jagannathan, MD, MBA; Nathalia Jimenez, MD; Richard J. Levy, MD, FAAP; Wanda C. Miller-Hance, MD; Olubukola O. Nafiu, MD, FRCA, MS; Vidya T. Raman, MD, MBA, FASA, FAAP; Senthilkumar Sadhasivam, MD, MPH, MBA, FASA; Mehernoor F. Watcha, MD; Myron Yaster, MD Olutoyin Olutoye, MD, M.Sc, FAAP Location: 301-308 (Level 3)
12:30 PM – 2:30 PM	COMMITTEE: SPPM Board of Directors Location: Brazos (Level 2)
12:30 PM – 1:45 PM	Lunch - On Own
Session IV: AAP Ask the Experts Panel Moderator: Courtney A. Hardy, MD, MBA, FAAP
1:45 PM – 2:10 PM	Blood Management in the Patient Undergoing Craniofacial Reconstruction Susan M. Goobie, MD Objectives: Upon completion of this session, the participant will be able to: * Review the indications and hazards of a pediatric blood transfusion. * Gain an understanding of evidence-based blood conservation methods for the bleeding pediatric patient. * Focus on recent research in Antifibrinolytics. Location: Lone Star A-E (Level 3)
2:10 PM – 2:35 PM	Challenging Craniofacial Syndromes Franklyn P. Cladis, MD Objectives: Upon completion of this session, the participant will be able to: * Organize and classify different craniofacial syndromes. * Discuss medical, surgical, and anesthetic challenges related to common craniofacial syndromes. * Evaluate anesthesia techniques to address the perioperative challenges of common craniofacial syndromes. Location: Lone Star A-E (Level 3)
2:35 PM – 2:45 PM	Discussion Location: Lone Star A-E (Level 3)
2:45 PM – 3:00 PM	Coffee Break Location: Lone Star Foyer (Level 3)
3:00 PM – 6:00 PM	COMMITTEE: PALC Advanced Professionalism Session (By invitation only) Location: 401 (Level 4)
3:00 PM – 4:30 PM	COMMITTEE: SIG-Biomedical Informatics & Technology Location: 205 (Level 2)
3:00 PM – 4:00 PM	COMMITTEE: SIG - Pediatric Anesthesia Trainee Group Location: 402 (Level 4)
WORKSHOPS (separate registration required)
3:00 PM – 5:00 PM	WORKSHOP: A Practical Approach to Creating a Pediatric Perioperative Surgical Home Coordinator: Vidya T. Raman, MD, MBA, FASA, FAAP Rahul Baijal, MD; Candice M. Burrier, MD; Gregory S. Cambier, MD; Rebecca E. Claure, MD; Lynne R. Ferrari, MD, FAAP; Wallis T. Muhly, MD; Kasia P. Rubin, MD; Karen M. Thomson, MD; Arlyne K. Thung, MD; Joshua C. Uffman, MD; Samuel Wald, MD, MBA Objectives: Upon completion of this workshop, participants will be able to: * Discuss the practical reasons to set up a Pediatric Perioperative Surgical Home (PSH) model. * Review the key point analysis that focuses on simplifying and prioritizing important factors in patient flow process and in implementation of a PSH model; Review some of the ASA PSH metrics and financial modeling systems pending. * Discuss the practical clinical pathways and guidelines to reduce variations in practice and the role of institutional support; * Understand how having a Pediatric Perioperative Surgical Home satisfies the Triple Aim (better patient care/outcomes, lower cost, and better patient/family satisfaction) goal; * Identify barriers to implement such programs. Location: 303-304 (Level 3)
3:00 PM – 5:00 PM	WORKSHOP: The Medical Malpractice Moment: Defending the Doctor at Deposition Coordinator: Robert S. Greenberg, MD Eric V. Jackson, MD, MBA; Brian Wilhelmi, MD Objectives: Upon completion of the workshop, the participant will be able to: * Describe the integral concepts and legal strategies inherent to medical malpractice cases. * Understand the benefits of disclosure and avoidance of malpractice claims. * Describe those qualities that make an ideal witness in a medical malpractice case. * Discuss preparation techniques for a deposition or trial testimony. Location: 306 (Level 3)
3:00 PM – 5:00 PM	WORKSHOP: Lesson from the Trenches: Reflections on achieving work-life balance Coordinator: Jim Fehr, MD; Guelay Bilen-Rosas, MD; Katherine G. Keech, MD Shobha Malviya, MD, FAAP; Celia C. Maneri, DO; Lynne Gerson Maxwell, MD, FAAP; Myron Yaster, MD Objectives: Upon completion of this workshop, participants will be able to: * Understand Maslach's inventory and symptoms of burnout. * Articulate how work impacts family life. * Gain insight into the importance of assessing your family and work situation on a regular basis. * Begin a discussion about work life balance that will continue beyond. Location: 211 (Level 2)
WORKSHOPS (separate registration required)
3:00 PM – 6:00 PM	WORKSHOP: Point of Care Ultrasound Coordinator: Wanda C. Miller-Hance, MD Adam C. Adler, MD; Lisa Caplan, MD; James A. DiNardo, MD; Andrew Matisoff, MD Objectives: Upon completion of this workshop, participants will be able to: * Discuss the clinical applications on point-of-care ultrasound, in particular, it's use in the perioperative setting and relevance to anesthesia practice. * Provide an overview of selected focused transthoracic echocardiography protocols. * Review the role of focused transthoracic ultrasound in cardiac assessment lung/pleura evaluation, and fluid status determination. * Acquire hands-on training on transthoracic echocardiography with an emphasis on imaging views used in the perioperative evaluation of cardiopulmonary function (for this purpose the workshop will use models and echocardiography simulator). Location: 301-302 (Level 3)
3:00 PM – 6:00 PM	WORKSHOP: Professionalism Workshop (see Learning Objectives for eligbility) Coordinator: Susan R. Staudt, MD Carolyn F. Bannister, MD, FAAP; Anita Honkanen, MD, FAAP; Thomas J. Long, MD, FAAP; Joyce F. Phillips, MD, FAAP; Echo Rowe, MD; Judit M. Szolnoki, MD; Samuel D. Yanofsky, MD, MSEd Objectives: This workshop is intended for Pediatric Anesthesia Leadership Council Members, Pediatric Anesthesia Program Directors Association Members, and/or faculty leaders interested in the principles of professionalism and the development of a professionalism development curriculum for faculty and trainees. (If you attended the Professionalism Course in Dallas in 2015, you will receive an invitation to the Advanced Professionalism workshop.) Through interactive sessions on Communication and Physician Wellness, this workshop will both teach the principles of professionalism and provide the initial tools necessary to build a local professionalism curriculum. Following the completion of this learning activity, the attendee will: Communication * Learn common sources of conflict and explore strategies for resolution. * Participate in interactive sessions on difficult conversations and delivering feedback. * Learn common causes of stress and burnout and explore strategies for building resilience and limiting stress. Physician Wellness * Develop a deeper understanding of identifying and working with the impaired physician. * Explore the concepts of the second and third victims. Location: 212 (Level 2)
3:00 PM – 6:00 PM	WORKSHOP: A Practical Approach to Quality Improvement and Performance Management Coordinator: Anna M. Varughese, MD, MPH Robert M. Brustowicz, MD, FAAP, FACMQ; David W. Buck, MD; Suanne M. Daves, MD; Trung Du, MD; Laura Schleelein, MD; Imelda Tjia, MD Objectives: Upon completion of this workshop, participants will be able to: * Provide the foundational knowledge required for quality improvement work appropriate for members with wide ranging background knowledge and experience, using the IHI "Model for Improvement" framework. * Provide the tools and analytical framework required for improvement work, with applied learning table exercises to enhance the applicability of these tools. * Provide examples of QI projects that have demonstrated successful planning, implementation and results on multi-disciplinary projects. * Discuss the psychology of change and the process of team building needed for fostering a culture of improvement and a QI discipline. Location: 307 (Level 3)
Session V: Ultrasound Review Richard J. Levy, MD, FAAP
3:00 PM – 3:25 PM	Vascular Access: New technology and best practices Luis M. Zabala, MD Objectives: Upon completion of this session, the participant will be able to: * Describe new technology available to obtain vascular access in a pediatric patient. * Identify the current literature supporting the use of ultrasound guided vascular cannulation and other technologies in pediatric patients. * Understand basic cognitive skills recommended for ultrasound vascular cannulation: Physical principals of ultrasound, operation of ultrasound equipment, infection control standards, surface anatomy, knowledge of flow spectral Doppler flow patterns to identify arterial and venous flow characteristics. * Describe the technique of dynamic ultrasound guided vascular access in a central venous vessel, peripheral venous vessel and peripheral arterial vessel. Location: Lone Star A-E (Level 3)
3:25 PM – 3:50 PM	Advanced Ultrasound Application in the Operating Room Marc Mecoli, MD Objectives: Upon completion of this session, the participant will be able to: * Explore the emerging applications of point of care ultrasound in the operating room. * Understand the use of ultrasound for preoperative assessment of gastric contents. * Recognize the utility of ultrasound for airway evaluation and endotracheal tube placement confirmation in children. * Review the role of lung ultrasound for the diagnosis of pneumothorax. Location: Lone Star A-E (Level 3)
4:15 PM – 4:30 PM	Discussion Location: Lone Star A-E (Level 3)
3:30 PM – 4:30 PM	COMMITTEE: Opioid Workgroup (Closed Group) Location: 204 (Level 2)
4:00 PM – 5:00 PM	COMMITTEE: CRNA/Allied Health SIG Location: 402 (Level 4)
4:30 PM – 6:00 PM	COMMITTEE: PeDI Registry (SIG Airway) Location: 205 (Level 2)
4:30 PM – 6:00 PM	COMMITTEE: Pediatric Craniofacial Collaborative Group (PCCG) Location: 204 (Level 2)
PBLDs 25-32
4:30 PM – 5:40 PM	PBLD 25: Just breathe! Morbid obesity and severe OSA for T & A with G6PD deficiency, no tylenol or NSAIDs allowed Michelle S. Kars, MD, FAAP; Frank H Kern, MD, FCCM Objectives: GOALS: * Discuss the preoperative evaluation and understand the diagnostic criteria for OSA in the pediatric patient. * Develop a plan for managing the airway for the morbidly obese patient. * Discuss the controversies of acetaminophen use in children with G6PD deficiency, and the use of NSAIDs in post-tonsillectomy patients. * Discuss pain management strategies for patients with severe OSA with limited use of opioids and restricted use of non-opioids. * Discuss the postoperative plan for ventilation support with severe OSA and persistent asthma. Location: 308
4:30 PM – 5:40 PM	PBLD 26: Let's Not Forget About the Second Victim Ellen Basile, DO; Cassandra R. Duncan-Azadi, MD Objectives: GOALS: * Understand who the second victim is. * Recognize the signs and symptoms of a second victim. * Identify the six stages of the second victim phenomenon. * Have more confidence to intervene appropriately if they or a colleague are a second victim. * Identify resources available to second victims and be encouraged to help start support systems at their own institutions if they do not exist. Location: 308
4:30 PM – 5:40 PM	PBLD 27: Comprehensive management of infant with malignant brain tumor Joann B. Hunsberger, MD; Sabine Kost-Byerly, MD Objectives: GOALS: * Develop a differential for patient with hypotonia and truncal ataxia. * Understand intraoperative management of patient with increased intracranial pressure. * Discuss importance of pediatric palliative care management. * Develop a plan for postoperative pain management for this patient. Location: 308
4:30 PM – 5:40 PM	PBLD 28: The 'Floppy Infant', an Anesthesiologists Dilemma: mitochondrial defect or congenital myopathy. Vincent Hsieh, MD; Rani A. Sunder, MD Objectives: GOALS: * An overview of differentials for hypotonia presenting in infancy. * Recognize and interpret labs and tests ordered as a comprehensive workup for undiagnosed myopathy. * Discuss anesthetic implications and perioperative considerations for mitochondrial disorders. * Discuss preoperative evaluation and risk assessment for a hypotonic infant. * Recognize situations in which ‘non-triggering, non-propofol based anesthetics’ may be preferred. Location: 309
4:30 PM – 5:40 PM	PBLD 29: It's Getting Hot in Here! 90% TBSA Burns in a 10-Year Old Aditee Ambardekar, MD, MSEd; Bettina Barr, MD Objectives: GOALS: * List the necessary evaluation and management of an acutely injured burn patient. * List the strategies for airway and pulmonary management in a critically injured, burned child. * Discuss considerations unique to adult facilities caring for pediatric patients. * Discuss strategies for anesthetic management for tangential excision and grafting. * List goals hemodynamic management in the intraoperative period. Location: 309
4:30 PM – 5:40 PM	PBLD 30: Perioperative management of a child with Noonan syndrome and hypertrophic cardiomyopathy presenting for outpatient MRI Martina Gomez Downard, MD, FASA; Ann Lawrence, MD Objectives: GOALS: * Discuss the incidence of hypertrophic cardiomyopathy and associated syndromes. * Review the clinical presentations and diagnosis of hypertrophic cardiomyopathy. * Discuss approaches to anesthetic management of hypertrophic cardiomyopathy. * Discuss implications of medical and surgical planning. Location: 310
4:30 PM – 5:40 PM	PBLD 31: Anesthetic challenges in patients with osteogenesis imperfecta Carol Carrillo, MD; Daniel P. Corsino, MD, FAAP Objectives: GOALS: * Understand the pathophysiology and anesthetic implications for patients with osteogenesis imperfecta. * Perform an appropriate pre-anesthetic evaluation for patients with osteogenesis imperfecta, from infancy to adulthood. * Formulate and execute an anesthetic plan for these patients including appropriate intraoperative and postoperative care. Location: 310
4:30 PM – 5:40 PM	PBLD 32: How to get an "A" for a Nuss Procedure: Management of Arrhythmias, Arrests, Allergies and Analgesia! Lauren Lobaugh, MD; Jonathan M. Tan, MD, MPH, MBI, FASA Objectives: GOALS: * Describe the preoperative workup and potential for allergic reactions to various Nuss bar metals. * Identify cardiac arrhythmias that can occur during a Nuss Procedure and approaches to their management. * Understand the implications of delivery of an electrical current through a metal implant during defibrillation or electrical cardioversion. * Discuss the literature and evidence for various methods of post-operative analgesia after a Nuss procedure, including the risks, benefits and alternatives - thoracic epidurals, thoracic paravertebral blocks and multimodal IV/PO medical management. Location: 310
5:00 PM – 6:00 PM	COMMITTEE: SIG - Pediatric Perioperative Surgical Home Location: 303-304 (Level 3)
5:00 PM – 6:00 PM	COMMITTEE: SPA Finance & Membership Committees Location: 402 (Level 4)

Sunday, March 5, 2017
6:30 AM – 8:00 AM	COMMITTEE: PAPDA (Program Directors) Location: 201-202 (Level 2)
7:00 AM – 8:00 AM	COMMITTEE: SPA Research Committee Location: 211-212 (Level 2)
7:00 AM – 11:00 AM	Registration Location: Lone Star Foyer (Level 3)
CRNA/Allied Health PBLDs
7:00 AM – 8:00 AM	PBLD #1: Risky Business: Managing post-tonsillectomy hemorrhage in an uncooperative autistic patient Nathan Jones, CRNA; Kenneth L. Wayman, MD Objectives: Learning Objectives: * Discuss the anesthetic management of a post-tonsillectomy hemorrhage. * Compare and contrast anesthetic induction approaches in the uncooperative patient presenting for emergency surgery. * Describe the pathophysiology and treatment of von Willenbrand's disease. Location: 205 (Level 2)
7:00 AM – 8:00 AM	PBLD #2: It's raining MEN! Thymectomy in an Adolescent with Multiple Endocrine Neoplasia and Myasthenia Gravis Sarah Ayoroa, MD; Julie Soelberg, CRNA Objectives: Learning Objectives: * Compare the common presentation and clinical features of the Multiple Endocrine Neoplasia (MEN) syndromes. * Describe the pathophysiology and medical treatment of myasthenia gravis, including myasthenia and cholinergic crisis. * Summarize the perioperative anesthetic considerations for a patient with myasthenia gravis. * Recognize the common surgical approaches and complications associated with thymectomy. Location: 205 (Level 2)
7:00 AM – 8:00 AM	PBLD #3: When the Routine is Anything But: Bleeding tonsil at the Children's Hospital of Philadelphia Jennifer Raynor, DNP, CRNA; Robert Simon, CRNA Objectives: Learning Objectives: * Discuss anesthetic management of a bleeding tonsil. * Identify and discuss the management of a difficult airway utilizing the difficult airway algorithm. Location: 205 (Level 2)
PBLDs 33-42
7:00 AM – 8:10 AM	PBLD 33: Can an old friend help? - The use of HFJV for neonatal thoracoscopic surgeries Farzana Afroze, MD; Helena Oechsner, MD Objectives: GOALS: * Discuss the differential diagnosis of neonatal congenital pulmonary anomalies. Discuss the challenges of anesthesia management for neonates with compromised pulmonary function during the perioperative period. * Discuss the indications and risks of invasive monitor placement in neonates. * Debate the pros and cons of thoracoscopic repairs in neonates/infants, including lung isolation techniques. * Review/discuss the utilization of intraoperative HFJV. Location: 307
7:00 AM – 8:10 AM	PBLD 34: An ALL patient with thrombocytopenia needing vascular access. Oops! That wasn't supposed to happen. What do I tell her parents? Greta Duncan Wiebe, MD; Michelle LeRiger, MD Objectives: GOALS: Discuss the preoperative evaluation, preparation and anesthetic implications for a child with ALL. * Understand the risks and potential complications associated with CVL placement. Review the management of unanticipated acute massive blood loss in a surgical pediatric patient. * Describe the process for disclosure of an adverse event to the family of a pediatric patient. * Discuss the impact of an unanticipated adverse event on the anesthesiologist. Location: 307
7:00 AM – 8:10 AM	PBLD 35: Airway foreign bodies: Is there a RIGHT way to get things out of the WRONG places? Megan Brockel, MD; Michelle Cederburg, MD Objectives: GOALS: * Discuss the considerations for assessment of the child with a suspected airway foreign body including history, symptoms, physical examination, and radiographic findings. * Review the evidence for removing airway foreign bodies emergently upon presentation of the child versus waiting until the following day during daytime hours. * Describe your preferred anesthetic management for airway foreign body removal and compare it to that of your peers. Analyze the literature regarding controlled ventilation versus spontaneous respiration for this common and high-risk procedure. * Explain the various surgical techniques that may be used to remove airway foreign bodies including rigid bronchoscopy and flexible bronchoscopy combined with either forceps or balloon catheters. Location: 308
7:00 AM – 8:10 AM	PBLD 36: Passed Out At Band Practice: Anesthetic Implications In A Patient With Spontaneous Subarachnoid Hemorrhage Christina M. Brown, MD; Russell Groener, MB, ChB, FCA Objectives: GOALS: * Diagnose a patient presenting with subarachnoid hemorrhage. * Describe the types of cerebral aneurysm and implications of each. * Formulate an anesthetic plan for a patient presenting for emergent cerebral aneurysm repair. * Manage common complications associated with cerebral aneurysm repair * Discuss controversies in the anesthetic management of cerebral aneurysm repair. Location: 308
7:00 AM – 8:10 AM	PBLD 37: Pediatric Anesthesia in an Ambulatory Setting David E. Liston, MD, MPH; Shilpa Verma, MD Objectives: GOALS: * Discern which pediatric surgeries are safe to perform and are suitable for a stand-alone ambulatory surgery center setting. * Apply evidenced-based criteria (where they exist) for common preoperative dilemmas faced by the anesthesiologist in assessing which patients are safe to proceed in a stand-alone pediatric outpatient surgery setting. * Understand the perioperative risks and complications behind commonly encountered pediatric morbidities such as: obstructive sleep apnea, prematurity, congenital heart disease, cystic fibrosis, cerebral palsy and asthma. Location: 308
7:00 AM – 8:10 AM	PBLD 38: The nuts and bolts of implementing a pediatric surgical home to facilitate enhanced recovery after surgery Andrew David Franklin, MD; Elisabeth M. Hughes, MD Objectives: GOALS: * Following the discussion, the learners should be able to describe the proposed benefits of an enhanced recovery after surgery program in the pediatric setting. * Following the discussion, learners should be able to recognize the key components necessary across several disciplines to institute a successful perioperative surgical home for enhanced recovery after surgery in the pediatric setting. * Following the discussion, the learners should be able to identify the potential challenges encountered when instituting a pediatric perioperative surgical home. Location: 309
7:00 AM – 8:10 AM	PBLD 39: What is Wrong With This "Kid" and Should He be Here In Our Cath Lab? Michael Nayshtut, DO; Karen M. Thomson, MD Objectives: GOALS: * Describe management considerations for a patient with acute myocardial ischemia and anesthetic goals of a patient with potential coronary ischemia. * Identify challenges in caring for patients with acute coronary ischemia at a pediatric hospital, and the pediatric anesthesiologist’s role in staying current in anesthetic management * Discuss challenges in providing care for young adults at pediatric institutions and of transitioning adolescent patients to adult heath systems * Identify barriers in communication between two institutions about best care for a patient, and the anesthesiologist’s role as an advocate in perioperative care. Location: 309
7:00 AM – 8:10 AM	PBLD 40: Don't resuscitate my baby, but please place a Ventriculoperitoneal Shunt Rhashedah Ekeoduru, MD; Sarah Tariq, MD Objectives: GOALS: * Discuss preoperative evaluation and preparation for premature infants. * Discuss the implications of a DNR order in the perioperative period. * Review the components of a pediatric DNR discussion. * Describe the anesthetic considerations for raised intracranial pressure. * Formulate an appropriate anesthetic plan for an infant with difficult iv access, risk of aspiration and risk of increased intracranial pressue, Location: 310
7:00 AM – 8:10 AM	PBLD 41: Opioid-sparing therapies in the patient with acute on chronic pain R. Scott Dingeman, MD, MEd, FAAP, FASA; Anastasia Grivoyannis, MD Objectives: GOALS: * Evaluate the benefits and potential complications of regional anesthesia for acute peri-operative pain management in the patient with chronic pain desiring opioid-sparing therapies. * Develop tools to manage the patient whose pain prolongs hospital stay. * Identify new therapies that may be appropriate for this patient population, such as abuse-deterrent long-acting opioids, prolonged-release local anesthetics, and new local anesthetics, and evaluate their benefits and risks. * Debate the goals of pediatric pain management and the role of the clinician when caring for a child experiencing pain who is no longer receiving disease-related therapy or approaching the end of her/his life. Location: 310
7:00 AM – 8:10 AM	PBLD 42: Under pressure: perioperative management for surgical resection of high-risk mediastinal mass with ECMO standby-Where? When? How ? Who with? Komal Kamra, MBBS; Manchula Navaratnam, MD Objectives: GOALS: * Pre-operative risk stratification for pediatric mediastinal masses including information from patient symptoms and signs and interpretation of important imaging modalities: CT scan and Transthoracic echo. * How to advocate for and lead effective preoperative multidisciplinary discussion and planning for high risk pediatric surgical cases. * Formulate a perioperative plan for surgical resection of large anterior mediastinal mass in a child with the potential for life-threatening cardiorespiratory compromise including options for anesthesia induction and intubation and the indications and options for ECMO back up. * Review management and recent clinical guidelines for massive blood transfusion in the operating room. Location: 310
7:15 AM – 8:15 AM	Breakfast Location: Lone Star Foyer (Level 3)
CRNA/Allied Heath Symposium
8:15 AM – 8:45 AM	Practical Data Mining: Turning data into knowledge B. Randall Brenn, MD Objectives: Upon completion of this session, the participant will be able to: * Recognize the merits of data driven healthcare * Discuss the use of data to improve anesthesia quality and safety Location: 203-204 (Level 2)
8:45 AM – 9:15 AM	Anesthetic Management of Patients Undergoing Selective Internal Radiation Therapy (SIRT) for Treatment of Pediatric Live Tumors Judy Audas, CRNA, DNAP Objectives: Upon completion of this session, the participant will be able to: * Identify the principles of Selective Internal Radiation Therapy (SIRT) as it relates to cancer treatment. * Restate pediatric-specific liver cancers and stages that currently benefit from SIRT (as compared to other treatment options). * Analyze the inherent risks for the pediatric patient undergoing SIRT. * Analyze the inherent risks for the providers involved in SIRT and identify protective measures. Incorporate the known concerns related to SIRT into the pediatric anesthesia care plan Location: 203-204 (Level 2)
9:15 AM – 9:45 AM	Examining DNAR Status in the Pediatric Palliative Surgical Population Margaret H Hartig, CRNA Objectives: Upon completion of this session, the participant will be able to: * Define the origins of palliative care and surgical palliative care and comprehend the benefits for our pediatric population. * Identify the differences between palliative surgery and non-curative surgery, and how understanding these nuances of care will lead to the need for DNAR status discussions in the pre-surgical evaluation period. * Understand why DNAR status communication is a necessary skill for pediatric anesthesia providers. Location: 203-204 (Level 2)
9:45 AM – 10:15 AM	Oh No- Not the Cardiac Cath Lab Again! Rhonda Martone, CRNA Objectives: Upon completion of this session, the participant will be able to: * List common procedures routinely performed in the cardiac Cath lab. Interpret physiologic and angiographic data obtained during the Cath by the interventional cardiologist. * Determine the appropriate anesthetic technique and monitoring necessary to facilitate hemodynamics, diagnostic and interventional catheterizations. * Understand the challenges and potential problems that are inherent to the Cath lab environment that the anesthesia provider must be prepared for and anticipate occurring. Location: 203-204 (Level 2)
10:15 AM – 10:45 AM	Value Based Healthcare and the Impact of Dedicated Team Planning for Idiopathic Spine Fusion at The Children's Hospital of Philadelphia Barbara DeZayas, CRNA Objectives: Upon completion of this session, the participant will be able to: * Explain the multidisciplinary QI approach to streamlining intraoperative care for pediatric spinal fusion patients. * Describe the benefits of a quality-improvement approach in facilitating a process change for pediatric spinal fusion surgery. * Discuss the challenges to the team-based approach currently in use at CHOP. * Explain how development of a real-time data tracking tool assists the team with monitoring sustained change among the pediatric spinal fusion team. Location: 203-204 (Level 2)
10:45 AM – 11:15 AM	The Use of Ultrasound in Pediatric Regional Anesthesia and Vascular Access Doyle Lim, MD Objectives: Upon completion of this session, the participant will be able to: * Describe basic tenets of ultrasound use in regional anesthesia and vascular access. * Identify risks and benefits in using ultrasound in regional anesthesia. * Recognize clinical situations where ultrasound use can improve efficiency and safety. Location: 203-204 (Level 2)
11:15 AM – 11:45 AM	Panel Discussion Location: 203-204 (Level 2)
Session I: Emotional Intelligence Moderator: Peggy P. McNaull, MD
8:15 AM – 8:50 AM	Emotional Intelligence: The secret sauce for success in patient care, research and education Echo Rowe, MD Objectives: Upon completion of this session, the participant will be able to: * Understand Emotional Intelligence. * Recognize how Emotional Intelligence helps build better teams. Location: Lone Star A-E (Level 3)
8:50 AM – 9:00 AM	Discussion Location: Lone Star A-E (Level 3)
Session II: Best Pediatric Anesthesia Research Moderator: Olutoyin Olutoye, MD, M.Sc, FAAP
9:00 AM – 9:45 AM	Updates from SPA Young Investigator Research Award Recipients Moderator: Charles B. Berde, MD, PhD Location: Lone Star A-E (Level 3)
9:45 AM – 10:45 AM	Best Pediatric Anesthesia Research Papers Location: Lone Star A-E (Level 3)
Session III: Who Wants to be a Millionaire?
10:45 AM – 11:45 AM	Who wants to be a Millionaire? Jim Fehr, MD; Stuart R. Hall, MD; Samuel Wald, MD, MBA Objectives: Upon completion of this session, the participant will be able to: * Review current controversies and practice pathways in a variety of practice settings. Location: Lone Star A-E (Level 3)
MOCA Simulation @ SPA (separate registration required)
11:30 AM – 7:00 PM	MOCA Simulation @ SPA Dolores B. Njoku, MD; Shivani K. Patel, MD; Devika Singh, MD; Stephanie Black, MD, EdM; Robert Blum; Newton Buchanan; Marco Corridore, MD; James R. Eiszner, MD; Jim Fehr, MD; Harshad G. Gurnaney, MBBS, MPH; Roberta L Hales, MHA, RRT-NPS, RN; Deepa Kattail, MD; Doyle Lim, MD; Shannon Polling; Joanne E. Shay, MD; M-Irfan Suleman, MD, FAAP, FASA; Pravin A. Taneja, MD Objectives: This course offers the participant: * Offer a contextual learning opportunity to assess and improve their practice in areas such as crisis management in a simulation setting at an ASA-endorsed activity. * Realistically recreate challenging clinical cases to allow participants to problem?solve in a manner that is similar to actual clinical experience. * Offer an opportunity for physicians to improve their skills in Practice-Based Learning and Improvement. Location: 208 (Level 2)
Educational Summary John Fiadjoe, MD, MBA
11:45 AM – 12:00 PM	Educational Summary John Fiadjoe, MD, MBA Location: Lone Star A-E (Level 3)
12:00 PM – 2:00 PM	COMMITTEE: Wake Up Safe Business Meeting Location: 211-212 (Level 2)
2:00 PM – 5:00 PM	COMMITTEE: Wake Up Safe Workshop Location: 211-212 (Level 2)

Monday, March 6, 2017
8:00 AM – 11:00 AM	COMMITTEE: Wake Up Safe Workshop Location: 211-212 (Level 2)