Supplemental Online Lesson

Lesson S12: PreAnesthetic Assessment of the Patient For Colonoscopy

Registration Fee: $15.00
2.0 AMA PRA Category 1 Credits^TM

Release Date: May 1st, 2010
 Termination Date: May 31st, 2011

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.

Colonoscopy is commonly used for routine cancer screening and therapeutic intervention of colorectal pathologies. Many anesthesiologists work in ambulatory surgical or office based settings and it has been estimated that up to 10% of anesthetics administered in the USA are for gastrointestinal examinations. Although these ambulatory procedures are not associated with significant morbidity or mortality, complications can arise. Patients are often elderly and may be taking multiple medications. Physicians should be knowledgeable of the required patient preparation and be able to assess the risks and benefits of sedation so that patients can be appropriately selected.

A 73 year old woman presented to the outpatient clinic for routine colonoscopy. She gave a history of hypertension and type 2 diabetes. Medications included furosemide, simvastatin, glyburide, aspirin and amlodipine. She stated that she was anxious about the procedure and admitted that she had noticed some bleeding recently after defecation. Family history included a father who died of colon cancer at the age of 63. Blood pressure was 175/105, pulse 62. Blood glucose level by finger stick was 225mg/dl.

LEARNING OBJECTIVES

At the end of this activity, the participant should be able to:

1. Describe the bowel preparation performed prior to colonoscopy.

2. Understand drug dosing and techniques for relief of discomfort and/or pain related to colonoscopy.

3. List complications of bowel preparation.

4. Recognize and treat complications of iatrogenic electrolyte imbalance in this population.

5. Describe the requirements of the endoscopist performing the procedure.

6. Identify patients who are not candidates for the test on an outpatient basis.

7. Define discharge criteria for patients who have undergone colonoscopy.

8. Recognize complications of colonoscopy.

9. Outline appropriate preoperative tests.

10. Formulate a perioperative plan.

TARGET AUDIENCE:  Anesthesiologists

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 Credits^TM. 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.

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