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Impact of the Choice of Risk Model for Identifying Low-risk Patients Using the 2014 ACC/AHA Perioperative Guidelines
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A 77-year-old man is admitted to the hospital after sustaining a hip fracture. He has a medical history of chronic obstructive pulmonary disease, hypertension, hyperlipidemia, chronic back pain, and hearing loss. Before surgery, he receives midazolam for agitation and morphine for pain control. He undergoes a general anesthetic for his fracture repair, requiring high doses of fentanyl for pain control. Postoperatively, he has poor pulmonary mechanics and is taken to the intensive care unit (ICU) intubated and mechanically ventilated. On postoperative day 1, his sedation is weaned and he is put on a spontaneous breathing trial. While he appears intermittently awake, he will not follow commands and only intermittently makes eye contact. The patient is left intubated due to his altered mental status.
CME Credit: 1.00 AMA PRA Category 1 Credit™
Required Hardware / Software:Adobe Acrobat Reader, Internet connection. Web browser version must have been released within the last three years.
Activity Release Date:11/15/2016
Activity Expiration Date:11/14/2019
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Learning Objectives:After successfully completing this activity, the learner will be able to do the following:
Faculty & Credentials:
Editor-in-Chief: Evan D. Kharasch, M.D., Ph.D., has reported receiving consulting fees from TEN Healthcare and The Medicines Co., and honoraria from Astra-Zeneca.
CME Editors: Leslie C. Jameson, M.D. has reported no relevant financial relationships with commercial interests. Dan J. Kopacz, M.D., has an equity position in SoloDex, LLC.
Authors: Christina J. Hayhurst, M.D., and Christopher G. Hughes, M.D., report no relevant financial relationships with commercial interests. Pratik P. Pandharipande, M.D., reports receiving grant funding from Hospira, Inc.
ASA Staff: Kari L. Lee, Editorial Manager, has reported no relevant financial relationships with commercial interests. Ginger Clark, Senior Editor, has an equity position in Merck & Co.
Disclosure StatementThe American Society of Anesthesiologists remains strongly committed to providing the best available evidence-based clinical information to participants of this educational activity and requires an open disclosure of any potential conflict of interest identified by our faculty members. It is not the intent of the American Society of Anesthesiologists to eliminate all situations of potential conflict of interest, but rather to enable those who are working with the American Society of Anesthesiologists to recognize situations that may be subject to question by others. All disclosed conflicts of interest are reviewed by the educational activity course director/chair to ensure that such situations are properly evaluated and, if necessary, resolved. The American Society of Anesthesiologists educational standards pertaining to conflict of interest are intended to maintain the professional autonomy of the clinical experts inherent in promoting a balanced presentation of science. Through our review process, all American Society of Anesthesiologists CME activities are ensured of independent, objective, scientifically balanced presentations of information. Disclosure of any or no relationships will be made available for all educational activities.
The information provided at this CME activity is for continuing education purposes only and is not meant to substitute for the independent medical judgment of a healthcare provider relative to diagnostic and treatment options of a specific patient’s medical condition.
Core Competencies:Medical knowledge
Target Audience:ANESTHESIOLOGY Journal CME is intended for anesthesiologists. Researchers and other health care professionals with an interest in anesthesiology may also participate.
CME Credit: 1.00 AMA PRA Category 1 Credit™
The American Society of Anesthesiologists is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.
The American Society of Anesthesiologists designates this journal-based CME activity for a maximum of 1.00 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
1.00 Non-physician Credit Non-physicians may receive a Certificate of Completion stating that this activity was designated for 1.00 AMA PRA Category 1 Credit(s)™.
Activity Release Date: 11/17/2015 (All day) Activity Expiration Date: 11/16/2018 (All day)
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