| NEEDS STATEMENT
Over the past few years, intraoperative awareness has been
sensationalized in the media as a major problem during anesthesia.
The true incidence and prevalence have been questioned. This
lesson is a review of the pertinent data. The topic has been
identified by committee as required learning by clinical
anesthesiologists.
| |
| CASE HISTORY A
25-year-old man with no underlying medical illness was
scheduled for open reduction and internal fixation of
malunion after a fracture of the distal right femur. The
operation was expected to last more than 3 hours, and the
use of a fracture table was planned. Four months earlier,
the patient had undergone emergency surgery after a motor
vehicle accident in which his pelvis and distal right
femur had been fractured. He reported having experienced
intraoperative awareness during anesthesia. He stated that
he had heard voices and the sound of metal and hammering
and had felt moderate pain and helplessness at the time.
He expressed his considerable fear of undergoing
anesthesia again and was apprehensive that such an episode
might recur. Since the surgery, he had experienced
nightmares and the signs and symptoms of post-traumatic
stress disorder. A review of the patient’s anesthetic
record showed that he had been in hypovolemic shock with
blood pressure values ranging from 50/30 to 85/40 mm Hg
and a heart rate of 130 beats/min. He was reported to have
been semiconscious before the induction of anesthesia, and
his American Society of Anesthesiologists (ASA) physical
status classification was IV-E.
|
|
| |
LEARNING OBJECTIVES
At the end of this activity, the participant should be able to:
-
Define intraoperative awareness.
-
Describe widely used diagnostic
instruments for recognizing awareness.
-
Identify risk factors for
awareness.
-
Describe the psychological
effect of awareness.
-
Outline a management plan for
the patient who has experienced intraoperative awareness.
-
List the preoperative
considerations for the patient who has experienced
intraoperative awareness.
-
Discuss the prevention of
intraoperative awareness.
-
Recognize the limitations of
brain function monitors.
-
State the incidence of
postoperative awareness.
-
List the types of surgery most
likely to result in awareness.
TARGET AUDIENCE: Anesthesiologists
INSTRUCTIONS FOR COMPLETING THIS COURSE
The estimated time to complete this activity is 2 hours. There
are two options for completing this CME activity.
Option 1: Exam Only. This option can only be
exercised by subscribers to Anesthesiology News who possess
a material copy of the course. Participants who select this
option must read the article in the journal, reflect on the information
presented, and then register to complete the exam and course evaluation
online before the availability date listed above. (CME credit is not valid past this
date.)
To register for the exam only, click on the Register For Exam link
located at the bottom of this page. DO NOT select this option if you
do not possess a material copy of the CME course material.
There are ten questions in the examination and you must achieve
a score of 80% or better to earn CME credit. Following successful
completion, your certificate will be immediately available online.
In addition, a historical record of completed CME courses is
maintained online in an individualized profile. This includes
copies of course certificates which can be printed at any time.
Option 2: Course Material and Exam. All participants
are eligible for this option.
You must first register for this course by clicking the "Register
for Course" link located at the bottom of this page. Course
material is presented in small digestible sections followed by exam
questions pertaining to the information in the segment covered.
As you read through the material on the course pages, you will occasionally
be prompted to answer exam questions.
There are several short pages of information and 10 multiple choice
questions presented in this course. You must achieve a minimum
grade of 80% (8 correct answers) to receive CME credit. The exam and
course evaluation must be completed before the availability date
listed above. (CME
credit is not valid past this date.)
The course software does not permit you to page back from the exam
questions. You must be sure that you understand the material
presented on each page before proceeding.
When you have answered the last exam question, the Course Results
page will display. This page will contain your final grade and allow
you to immediately view/print your Certificate if you have achieved
the minimum passing score of 80%.
Upon successful completion, your Certificate will be available
at all times from your Student Control Panel. In addition,
a historical record of completed CME courses is maintained online
in an individualized profile. This includes copies of course
certificates which can be printed at any time.
The course does not need to be completed in a single online session.
You can log off at any point and return to the course at your convenience.
If you wish to obtain more information regarding the features of this
site, you may visit the Orientation page.
Click here to view Orientation.
REGISTRATION
The registration fee for this course is $15.00
Physicians are provided with two opportunities to complete the
course presented here.
Accreditation Statement
Mount Sinai School of Medicine is accredited by the Accreditation
Council for Continuing Medical Education (ACCME) to provide continuing
medical education for physicians.
Credit Designation: The Mount Sinai School of Medicine designates
each educational activity for a maximum of 2 AMA PRA Category 1 CreditsTM.
Physicians should only claim credit commensurate with the extent of
their participation in the activity.
It is the policy of Mount Sinai School of Medicine to ensure objectivity,
balance, independence, and scientific rigor in all CME-sponsored educational
activities. All faculty participating in the planning or implementation
of a sponsored activity are expected to disclose to the audience any
relevant financial relationships and to assist in resolving any conflict
of interest that may arise from the relationship. Presenters must
also make a meaningful disclosure to the audience of their discussions
of unlabeled or unapproved drugs or devices.
Disclosures
The author, reviewer, and editor have no relationships with
pharmaceutical companies or manufacturers of products to disclose.
This educational activity may contain discussion of published
and/or investigational uses of agents for the treatment of
disease. Some uses of these agents have not been approved by the
FDA. Please refer to the official prescribing information for each
product for approved indications, contraindications, and warnings.
CONTACT INFORMATION
Questions regarding course content may be directed to Dr. Elizabeth
Frost: ElzFrost@aol.com.
If you require technical assistance with completing this
course, please contact Continuing Education Online Customer Service
at 718-648-8080 or send e-mail to
ceo.contact7@proceo.com.
All other requests for administrative assistance should be directed
to Josephine Greene in the CME office at the Mount Sinai School of
Medicine : 212-241-4441 or send email to
Josephine.Greene@msnyuhealth.org
CALL FOR WRITERS
If you would like to write a CME lesson in Anesthesiology News,
please send an e-mail to Elizabeth A.M. Frost, MD, at
ElzFrost@aol.com
|
|
This option is for the examination
ONLY. No course material is provided. This option
is available for subscribers of Anesthesiology News who
possess a material copy of the course material. DO NOT select
this option if you do not have the course material. |
|
|
This option is available for all participants. This option
includes a full online text version of the course material and
exam. |
|
