Jason F Shiffermiller, MD, MPH, Nicolle Peterson, DO, Chad W Vokoun, MD, Michael P Smith, MD, Daniel L Surdell, MD, Andrew P Gard, MD, and Rachel E Thompson, MD, MPH

Based on the original module Neurosurgery for the Hospitalist by Christina G Ryan, MD, James Maliszewski, MD, Andrew Moellering, MD, Urmila Mukherjee, MD, Andjela Drincic, MD, Andrew Gard, MD, and Rachel E Thompson, MD, MPH, SFHM

If you are a Program Director and would like to grant access to your trainees, please reach out to education@hospitalmedicine.org for an academic access code.

Summary

Successful neurosurgery co-management requires hospitalists to be familiar with the presentations, disease processes, management, and complications of neurosurgical inpatients. The first and longest section of this module summarizes common inpatient neurosurgical conditions. The second section prepares the reader to recognize and act on neurosurgical emergencies. The remaining four sections of the module provide more detail on the medical management of neurosurgical conditions. These sections cover blood pressure management in patients with subarachnoid hemorrhage, sodium abnormalities in patients with brain tumors, the use of mannitol vs. dexamethasone, and the perioperative management of anticoagulants, in addition to other topics.

Goal

To provide hospitalists with a foundation of clinical knowledge that informs the neurosurgery co-management aspect of their work.

Target Audience

This activity is designed for hospitalists. No prerequisites required.

Learning Objectives

After completing the module, the participant will demonstrate the ability to:

1. Summarize the epidemiology, clinical course, and prognosis of patients with subarachnoid hemorrhage.
2. Manage blood pressure and antithrombotic agents in patients with subarachnoid hemorrhage.
3. Describe basic shunt structure and diagnose common shunt complications.
4. Differentiate cerebral salt wasting syndrome from the syndrome of inappropriate antidiuretic hormone.
5. Detail the indications for and side effects of dexamethasone in neurosurgical patients.
6. Recommend venous thromboembolism prophylaxis for patients undergoing neurosurgery.

Accreditation Statement

The Society of Hospital Medicine is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

Credit Statement Designation

The Society of Hospital Medicine designates this activity for a maximum of 2.00 AMA PRA Category 1 Credits^TM. Physicians should only claim credit commensurate with the extent of their participation in the activity.

Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to 2.00 MOC points in the American Board of Internal Medicine's (ABIM) Maintenance of Certification (MOC) program. Participants will earn MOC points equivalent to the amount of CME credits claimed for the activity. It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credit.

Release Date: October 19, 2021                    Expiration Date: October 19, 2024

Estimated time to complete: 2 hours

Conflict of Interest Disclosure Policy

In accordance with the ACCME Standards for Commercial Support, SHM requires that individuals in a position to control the content of an educational activity disclose all relevant financial relationships with any commercial interest. SHM mitigates all conflicts of interest to ensure independence, objectivity, balance, and scientific rigor in all its educational programs. All relevant financial relationships shall be disclosed to participants prior to the start of the activity.

Furthermore, SHM seeks to verify that all scientific research referred to, reported, or used in a continuing medical education (CME) activity conforms to the generally accepted standards of experimental design, data collection, and analysis. SHM is committed to providing its learners with high-quality CME activities that promote improvements in healthcare and not those of a commercial interest.

Instructions

The following is an interactive educational module designed to help you gauge your basic knowledge of the topic and then direct you to areas you may need to focus on. It consists of several sections: a pre-test, a study program, a post-test, and a CME evaluation. All sections must be completed to receive CME credit.