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- Free-to-Member
- Perioperative and Consultative Medicine
- 2.00 ABIM MOC Self Evaluation Points
- 2.00 AMA PRA Category 1 Credit™
$95.00
Prophylaxis for deep vein thrombosis (DVT) and pulmonary embolism (PE), together referred to as venous thromboembolism (VTE), must be addressed for every patient going to the operating room. Multiple guidelines are available to assist choosing the correct prophylactic agent for each patient and type of surgery. The American College of Physicians (ACCP) guidelines have been one of the standards for hospitalist for decades but was last updated in 2012 (1) and recommendations and suggestions are based on the type of surgery. The American Society of Hematology (ASH), which put forth their first guideline in this field in 2019 (2), took a broader and slightly more universal approach to prevention strategies. The authors of this module bring forth a blended approach of these two guidelines with an emphasis on the newer guideline.
- Free-to-Member
- Perioperative and Consultative Medicine
- 2.00 ABIM MOC Self Evaluation Points
- 2.00 AMA PRA Category 1 Credit™
$95.00
Perioperative fever has multiple possible etiologies, including infections such as pneumonia, fungal infections, central-line associated infections, and urinary infections. By understanding the typical time frame and common risk factors for each etiology, hospitalists and other perioperative consultants can develop a differential diagnosis for perioperative fever. The following module will provide a general approach for determining the differential diagnosis in patients with a perioperative fever, as well as an outline of the diagnostic and treatment modalities.
- Free-to-Member
- Perioperative and Consultative Medicine
$95.00
Acute kidney injury (AKI) is an important complication following cardiac and noncardiac surgery. Up to 18% of hospitalized patients develop AKI, and those who are critically ill have an even higher risk. Comparatively, the incidence of AKI in the perioperative period is 18-47%(1). Patients with even modest increases in their serum creatinine have increases in their mortality, morbidity, length of stay, and hospital costs. Perioperative AKI is associated with an increased risk of sepsis, anemia, coagulopathy, and mechanical ventilation. Notably, mortality is higher in patients with perioperative AKI even after complete renal recovery(1). Perioperative AKI correlates with type of surgical procedure, patient characteristics, volume status, hemodynamics, and exposure to nephrotoxins. Presurgical risk stratification and early risk mitigation is extremely important to avoid injury and need for renal replacement therapy (RRT). The following module defines perioperative AKI, identifies specific risk factors and tools for risk stratification, provides an overview of the workup of perioperative AKI, and evaluates various renal protective strategies that can be implemented during this high-risk period.
- Free-to-Member
- Perioperative and Consultative Medicine
$95.00
Medical consultation is an important clinical responsibility for most hospitalists. Traditionally, consultants evaluated patients at the request of the referring physician (RP) and provided an assessment and recommendations. Today, hospitalists are also asked to provide both informal “curbside” advice and more comprehensive comanagement of medical problems. Hospitalists who are effective consultants communicate skillfully and act professionally. The following module describes the different roles that hospitalists can perform as medical consultants and provides strategies for improving communication and RP satisfaction.
- Free-to-Member
- Perioperative and Consultative Medicine
$95.00
Pain is probably the most common presenting or associated symptom in patients in the hospital, and patients are often more concerned about being in pain than they are about the primary reason for admission. Pain is a completely subjective experience that is the consequence of the filtering, modulating, and distorting of the afferent nerve activity (i.e., nociceptive input) through the affective (i.e., limbic system) and cognitive processes unique to each individual. The following educational module discusses why postoperative pain requires treatment, outlines methods for performing a proper assessment of pain, provides strategies for utilizing patient-controlled analgesia safely and effectively, and summarizes the use of opioid and non-opioid analgesics in the postoperative setting to help hospitalists improve patients’ quality of recovery and life.
- Free-to-Member
- Perioperative and Consultative Medicine
$95.00
Perioperative cardiac complications are the most widely feared medical issues for the anesthesiologist, surgeon, and medical consultant as they approach a patient with the option of surgery. To assess for the preoperative cardiac risk, hospitalists should follow a step-wise algorithm. The following module reviews the risk assessment process and enables the hospitalist to order appropriate preoperative testing.
- Free-to-Member
- Perioperative and Consultative Medicine
$95.00
Perioperative cardiac complications are the most widely feared medical issues for the anesthesiologist, surgeon, and medical consultant as they approach a patient in the perioperative period. Only recently have management strategies been addressed in high-quality studies. The following module explains the roles of medical and interventional treatments in lowering perioperative cardiac event rates. This module also discusses the typical presentation of coronary syndromes postoperatively and the management of antiplatelet and cardiac medications.
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