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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
Elizabeth A. Cerceo, MD, FACP, FHM
- Free-to-Member
- Perioperative and Consultative Medicine
- 2.00 ABIM MOC Self Evaluation Points
- 2.00 AMA PRA Category 1 Credit™
$95.00
As a consultant, hospitalists commonly risk stratify and offer risk reduction strategies for patients undergoing surgery. Effective perioperative pulmonary risk consultation requires hospitalists to identify patient- and procedure-related predictors for developing postoperative pulmonary complications and to propose strategies to reduce the risk. The following module will examine these topics and provide evidence-based risk reduction strategies. In addition, the role of routine preoperative spirometry and chest radiograph will be discussed.
- Free-to-Member
- Perioperative and Consultative Medicine
- 2.00 ABIM MOC Self Evaluation Points
- 2.00 AMA PRA Category 1 Credit™
$95.00
Anemia is frequently seen in patients undergoing surgery, and patients with preoperative anemia are more likely to receive perioperative allogeneic blood transfusions than patients with normal hemoglobin levels. Allogeneic blood transfusions are associated with an increase in the rate of postoperative complications.
Evaluation of anemia should be performed in the preoperative period and begins with taking a detailed history and physical examination. All efforts must be used to correct anemia or reduce blood loss during surgery to avoid allogeneic blood transfusion. In this module, we will discuss many scenarios commonly faced in perioperative practice.
- Free-to-Member
- Perioperative and Consultative Medicine
- 2.00 ABIM MOC Self Evaluation Points
- 2.00 AMA PRA Category 1 Credit™
$95.00
Alana E. Sigmund, MD and Jason F. Shiffermiller, MD, MPH
- Free-to-Member
- Perioperative and Consultative Medicine
- 2.00 ABIM MOC Self Evaluation Points
- 2.00 AMA PRA Category 1 Credit™
$95.00
Hospitalized patients with diabetes require specific medical management in order to minimize the risk of hyperglycemia. This requires hospitalists to have an understanding of methods for glycemic control in both the critically ill and noncritically ill patient. This module, which focuses on the critically ill hospitalized patient, is part of a 2-part series that will evaluate the current scientific evidence regarding glycemic control and discuss how to formulate preoperative and postoperative intensive care unit plans. In addition, a thorough review of the evidence for intraoperative glycemic control and a discussion of how to transition patients off of an insulin drip are provided.
- Free-to-Member
- Perioperative and Consultative Medicine
- 2.00 ABIM MOC Self Evaluation Points
- 2.00 AMA PRA Category 1 Credit™
$95.00
Hospitalized patients with diabetes require specific medical management in order to minimize the risk of hyperglycemia. This requires hospitalists to have an understanding of methods for glycemic control in both the critically ill and noncritically ill patient. This module, which focuses on the noncritically ill patient, is part of a 2-part series that will evaluate the current scientific evidence regarding glycemic control and discuss which medications are best for controlling blood glucose levels in the hospital. A thorough discussion of how to determine the appropriate insulin dose and develop an insulin regimen for hospitalized patients is provided, as well as strategies for developing a discharge plan for patients on insulin.
- Free-to-Member
- Perioperative and Consultative Medicine
- 2.00 ABIM MOC Self Evaluation Points
- 2.00 AMA PRA Category 1 Credit™
$95.00
Although general internists and subspecialists are familiar with prescribing and managing medications in typical outpatient and inpatient venues, the perioperative period represents a challenging and often unfamiliar setting. This module will outline the principles, available evidence, and expert opinion to be considered when making perioperative management recommendations for some of the most commonly prescribed medications.
- Free-to-Member
- Perioperative and Consultative Medicine
- 2.00 ABIM MOC Self Evaluation Points
- 2.00 AMA PRA Category 1 Credit™
$95.00
Anticoagulant medications are commonly prescribed to patients in the United States for a number of medical problems. Interruptions in anticoagulation can result in severe adverse outcomes, including permanent disability and death, from arterial and venous thromboembolism. These medications can also be associated with serious perioperative bleeding events. In fact, both bleeding and thromboembolic risks are amplified in the periprocedural period. Many patients undergo routine and emergent procedures, thus it is critical for hospitalists, who are routinely asked to manage medically complex surgical patients, to understand the periprocedural management of anticoagulation. There are many nuances to consider: not all patients are at the same risk of thromboembolism, not all procedures are associated with the same risk of bleeding, and the indications for “reversal agents” are complex. This module will guide the participant on the perioperative timing of anticoagulant interruption, the potential need for perioperative bridging anticoagulation, and address these nuances to better equip hospitalists for managing perioperative reversal.
- Free-to-Member
- Perioperative and Consultative Medicine
- 2.00 ABIM MOC Self Evaluation Points
- 2.00 AMA PRA Category 1 Credit™
$95.00
Preoperative testing can provide valuable information to identify patients who are at high risk for perioperative complications and reduce perioperative morbidity and mortality; however, there is little benefit from routinely testing patients who are known to be at low risk. The objectives of preoperative testing are to identify patients who are at high risk for perioperative complications, assess the severity or stability of existing medical problems, and evaluate abnormal symptoms or signs detected during the preoperative assessment. This module discusses the common challenges and pitfalls of preoperative testing, describes how pretest probability influences the decision to order preoperative tests, and identifies appropriate indications for laboratory, radiologic, and other forms of preoperative test screening. The selection of appropriate screening tools to identify patients at high risk for specific perioperative complications and the use of post-test probability to select and interpret preoperative diagnostic testing is also examined.
- Free-to-Member
- Perioperative and Consultative Medicine
- 2.00 ABIM MOC Self Evaluation Points
- 2.00 AMA PRA Category 1 Credit™
$95.00
Patients with cirrhosis who undergo surgery are at increased risk for complications. Perioperative morbidity and mortality vary depending on the severity of cirrhosis, type of surgery, and whether it is elective or emergent. Identification of cirrhosis and accurate assessment of severity can be challenging but is necessary for case selection, informed consent, and anticipation of potential complications. Inaccurate risk assessment can sometimes lead to inappropriate exclusion of patients with cirrhosis from receiving useful surgery, as well. For instance, reliance on the Child-Pugh score alone likely significantly over-estimates perioperative mortality in patients with cirrhosis undergoing most procedures. This module identifies updated tools for perioperative risk prediction, outlines the most important elements of preoperative evaluation and optimization, and assists in formulation of pre- and postoperative care plans for patients with cirrhosis. Though our main focus is on cirrhosis, we will also touch on some important topics related to other acute and chronic liver disease.