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Lesson 280: PreAnesthetic Assessment of
the Patient With Neurotrauma |
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Course Authors:
Julie A. Gayle, MD, Assistant professor, Department of
Anesthesiology, Louisiana State University Health Sciences Center,
New Orleans, Louisiana
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Registration Fee: $15.00
2.0 AMA PRA Category 1 CreditsTM
available until June 30, 2010
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Amir Baluch, MD, Resident, Department of Anesthesiology,
University of Miami Leonard M. Miller School of Medicine, Miami,
Florida
Alan Kaye, MD, PhD, DABPM, Professor and chairman,
Department of Anesthesiology, Louisiana State University Health
Sciences Center, New Orleans, Louisiana
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Reviewed By:
James Riopelle, MD, Professor, Department
of Anesthesiology, Louisiana State University Health Sciences
Center, New Orleans, Louisiana
Review Date: December, 2008
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REGISTRATION INFORMATION:
Participants who do not possess a copy of Anesthesiology News
can download and print the course material in an easy to read
convenient format. Participants must 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).
Click on the link below to download and print the course material
and post-test exam.
Register for the exam to enter your responses to receive CME credit. 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.
The registration fee for this course is $15.00
Physicians are provided with two opportunities to successfully complete the
exam presented here.
Software Requirements: Adobe Acrobat Reader and any standard
Internet Browser.
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NEEDS STATEMENT
Patients who have a cervical spine injury (CSI) are challenging
cases for anesthesiologists. Proper management of the airway,
control of circulation, and immobilization of the cervical spine are
critical for achieving a favorable outcome. Systemic manifestations
of spinal cord injury and associated head injuries are but a few of
the issues that may present in cases involving cervical spine
trauma.
CASE HISTORY
A 17-year-old boy was admitted to the emergency department after
a motor vehicle accident. The paramedics reported that he was the
restrained driver of a small car that had sustained heavy damage on
the driver’s side. He had experienced no loss of consciousness;
however, he described pain in his neck and left upper quadrant. At
the scene of the accident, a rigid cervical collar had been placed;
in addition, 2 large-bore IV cannulae were inserted.
In the emergency department, the patient was tachycardic, with a
heart rate of 110 beats per minute. His systolic blood pressure
remained at approximately 100 mm Hg despite fluid challenges. On
plain radiographs of his neck, several areas were difficult to
visualize, and further evaluation with computed tomography was
required. An abdominal scan revealed a splenic laceration requiring
surgery.
LEARNING OBJECTIVES
At the end of this activity, the participant should be able to:
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Discuss the
epidemiology of CSI.
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Explain the
pathophysiology of CSI.
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Recognize the
characteristic injuries associated with abnormal movements of the
spinal column.
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Describe the
systemic manifestations of CSI.
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Outline the
diagnosis and treatment of the patient with a CSI.
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Summarize areas
of current research involving the treatment of CSI.
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Apply appropriate
preoperative testing and evaluation.
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Develop an
anesthetic plan for the patient with suspected or diagnosed CSI.
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Recognize and
manage the patient with a difficult airway and CSI.
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Explain the
effects of anesthetic agents on the spinal cord that are observed
during intraoperative monitoring.
TARGET AUDIENCE: Anesthesiologists
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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
Dr. Kaye has disclosed that he is a member of the speakers’
bureau of Baxter. The other authors, 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.
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
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