From the Leader in

NOW I N ITS 30th YEARPerioperative Medicine

A COURSE DESIGNED FOR PRACTITIONERS TO

LIMIT RISK AND IMPROVE PATIENT OUTCOMES BY PROPER

PREOPERATIVE EVALUATION, INTRAOPERATIVE MANAGEMENT AND POSTOPERATIVE CARE

PERI

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RATI

VE M

ANAG

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Sunday – WednesdayMarch 9 – 12, 2014

MARCO ISLAND MARRIOTTMarco Island, Florida

Up-to-date Topics and Clinical VignettesIndividual Consultations with Faculty Experts

Knowledge to empower your practice and organization to improve patient care

C o n t i n u i n g M e d i C a l e d u C a t i o n

DESCRIPTIONThirty million patients undergo surgical procedures in the U.S. each year, and the age and medical complexity of this patient population is increasing. All these patients require preoperative assessment, intraoperative management, and postoperative care. Every year the body of peer-reviewed literature on this topic increases and new guidelines on clinical management are formulated. Because the breadth of knowledge in perioperative medicine, which includes the diverse disciplines of cardiology, pulmonology, hematology, endocrinology, infectious diseases and geriatrics, is vast, many practitioners may not have up-to-date information that is critical to clinical practice.The curriculum for this course was specifically created to address the needs of clinicians who provide care for patients before, during, and after surgery based on current literature, feedback from course participants, and the opinion of experts from multiple institutions. As the established leader in perioperative medicine, this course aims to provide practitioners with the most up-to-date knowledge necessary to deliver effective, evidence-based care by affecting health care practices at the level of the individual and the larger health system.

WHO SHOULD ATTENDThis activity is intended for anesthesiologists, internal medicine specialists, hospitalists, surgeons, family practitioners, nurse anesthetists, nurse practitioners and physician assistants.

OBJECTIVESAfter attending this activity, the participant will demonstrate the ability to:• Describe current guidelines for preoperative

cardiac and pulmonary risk assessment and list several ways to predict and prevent cardiac and pulmonary complications using preoperative testing, and intraoperative and postoperative interventions.

• Describe the perioperative risks associated with diabetes, obesity, renal insufficiency, and cognitive dysfunction/delirium and list medical and/or surgical management strategies to minimize complications in patients with these medical conditions.

• Describe bleeding and thrombotic risks in surgical patients and list several strategies to reduce complications through evidence-based use of blood conservation methods, transfusion, anti-fibrinolytic agents and management of antithrombotic drug therapies.

• Recognize how to prevent, diagnose, and treat common healthcare associated infections that complicate surgical procedures.

• Recognize the impact of health care provider stress and institutional health care culture on the safety and quality of health care delivery in the perioperative period.

ACCREDITATION STATEMENTThe Johns Hopkins University School of Medicine is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

CREDIT DESIGNATION STATEMENTThe Johns Hopkins University School of Medicine designates this live activity for a maximum of 23.75 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

OTHER CREDITAmerican Nurses Credentialing Center American Nurses Credentialing Center accepts AMA PRA Category 1 CreditTM from organizations accredited by the ACCME. American Academy of Family Physicians This Live activity, Perioperative Management-In Its 30th Year, with a beginning date of 03/09/14, has been reviewed and is acceptable for up to 20.75 Prescribed credits by the American Academy of Family Physicians. Physicians should claim only the credit commensurate with the extent of their participation in the activity.American Association of Nurse Anesthetists This program has been prior approved by the American Association of Nurse Anesthetists for 23 CE credits; Code Number 1028597; Expiration Date 03/12/14.American Association of Nurse Practitioners American Association of Nurse Practitioners accepts AMA PRA Category 1 CreditTM from organizations accredited by the ACCME. American Academy of Physician AssistantsAmerican Academy of Physician Assistants accepts certificates of participation for educational activities certified for AMA PRA Category 1 Credit™ from organizations accredited by ACCME or a recognized state medical society. Physician assistants may receive a maximum of 23.75 AAPA Category 1 CME credits for completing this program.Contact Hours for Non-PhysiciansThe Johns Hopkins University has approved this activity for 23.75 contact hours for non-physicians.

POLICY ON SPEAKER AND PROVIDER DISCLOSUREIt is the policy of the Johns Hopkins University School of Medicine that the speaker and provider disclose real or apparent conflicts of interest relating to the topics of this educational activity, and also disclose discussions of unlabeled/unapproved uses of drugs or devices during their presentation(s). The Johns Hopkins University School of Medicine OCME has established policies in place that will identify and resolve all conflicts of interest prior to this educational activity. Detailed disclosure will be made in the activity handout materials.

GENERAL INFORMATIONREGISTRATIONSaturday, March 8 • 5:00 – 7:00 • Capri FoyerOnce registered, please join us for a reception at the Sunset Terrace South on Saturday from 5:00 -7:00 pm.

FEESREGISTRATION CUT-OFF DATE: March 3, 2014Methods of Payment: Payment by check or credit card must accompany the registration form prior to the activity. On-site payments by credit card only. Foreign payments must be by credit card or with a U.S. Dollar World Money Order. The registration fee includes instructional materials, continental breakfast, and refreshment breaks.Physicians . . . . . . . . . . . . . . . . . . . . . . . . . . .$729Nurse Anesthetists/Physician Assistants/Nurse Practitioners/Other Health Professionals . . .$635Residents/Fellows/Nurse Trainees* . . . . . . . .$350*with verification of status

You will receive a confirmation by e-mail if you have provided your e-mail address. Otherwise confirmation will be sent by mail. If you have not received it by March 3, 2014 call (410) 502-9636 to confirm that you are registered. A certificate of attendance will be sent by April 30, 2014 to the e-mail address you provide on the registration form. The Johns Hopkins University reserves the right to cancel or postpone any activity due to unforeseen circumstances. In this event, the University will refund the registration fee but is not responsible for travel expenses. Additionally, we reserve the right to change the venue to a comparable venue. Under such circumstances registrants will be notified as soon as possible.

LATE FEE AND REFUND POLICYA $50 late fee applies to registrations received after 5:00 p.m. EST on March 3, 2014. A handling fee of $50 will be deducted for cancellation. An additional fee may apply for cancellation of other events, including workshops and social activities. Refund requests must be received by fax or mail by March 3, 2014. No refunds will be made thereafter. Transfer of registration to another Johns Hopkins conference in lieu of cancellation is not possible.

SOCIAL EVENTA complimentary reception for registrants and faculty will be held on Saturday, March 8th, from 5:00 – 7:00 p.m. on the Sunset Terrace South. Light snacks will be served. Pre-registration will also be available during that time. Please indicate your attendance on the registration form. NOTE: The commercial support received is solely for the educational component of this activity and will not be used to support this social event.

EVALUATIONA form will be available to attendees to evaluate each session and each speaker’s presentation, as well as to identify future educational needs.

SYLLABUSThere are three options available for obtaining the syllabus:Flashdrive: All registrants will receive a flashdrive with the slides and paper for note taking. This is included in the cost of your registration. Hard Copy with Binder: A hard copy of the syllabus should be ordered ahead of time and is available for an additional charge. (See Registration Page)Online Version available for download: A link to the syllabus will be provided via email shortly before the activity, if you prefer to print the syllabus ahead of time. (There is a business center at the hotel, however, computers/printers are limited and the Marriott levies a charge for this service.)

HOTEL AND TRAVEL INFORMATION Marco Island Marriott Resort Golf Club and Spa (800) 438-4373400 South Collier Boulevard (239) 394-2511Marco Island, Florida 34145 Fax: (239) 642-2672The award winning Marco Island Marriott is scenically located directly on the Gulf of Mexico along 3 1/2 miles of white sand beach at the southwestern tip of Florida. The resort is easily accessible by car and enjoys breathtaking sunset views over the Gulf of Mexico. Nearby Naples offers incredible shopping and dining opportunities. With March temperatures averaging 80 degrees, the Marco Island Marriott is truly the perfect winter getaway meeting location!Our special group room rate is $399, single or double, plus state and local taxes. The cut-off date for hotel reservations is Thursday, February 13, 2014. If you intend to stay at the Marriott, please book early. The hotel is usually SOLD OUT by January 15- before the cut-off date. Check in time is 4:00 p.m. and check out time is 11:00 a.m. All reservation requests require a credit card guarantee of one night’s deposit. Deposits will be refunded for rooms cancelled more than seven days prior to arrival.HOTEL RESERVATION CUT-OFF DATE: FEBRUARY 13, 2014Avis Rent-A-Car: For car rental discounts, call Avis at (800) 331-1600 and mention AWD number A101999

EMERGENCY CALLSOn March 9-12, 2014 direct emergency calls to (239) 394-2511 and ask that a message be sent to the Johns Hopkins registration desk. Messages will be posted for participants.

OUTCOMES SURVEYA survey will be sent to all physician attendees within three months post activity to assist us in determining what impact this activity had on the attendee’s practice.

SPEAKERSCOURSE DIRECTORSNauder Faraday, MD, MPHProfessor of Anesthesiology/Critical Care Medicine and SurgeryDirector, Perioperative Hemostasis and Thrombosis Research LaboratoryDirector, Perioperative Genomic Research

Sean Berenholtz, MD, MHS, FCCMAssociate Professor of Anesthesiology/Critical Care Medicine and SurgeryDirector, ICU Performance Improvement Committee Co-Director, Johns Hopkins Quality and Safety Research Group

JOHNS HOPKINS FACULTYLauren Berkow, MDAssociate Professor of Anesthesiology/Critical Care Medicine and Otolaryngology and Head and Neck SurgeryDirector, Airway Services

Todd Dorman, MD, FCCMProfessor of Anesthesiology/Critical Care Medicine, Surgery, and NursingAssociate Dean and Director of Continuing Medical EducationVice Chair, Dept. of Anesthesiology/Critical Care Medicine

Leonard Feldman, MDAssistant Professor of MedicineDivision of General Internal MedicineDirector of Education, Johns Hopkins Hospitalist Service

Derek Fine, MDAssociate Professor of MedicineDivision of Nephrology

Anne Lidor, MDAssociate Professor of SurgeryDivision of Gastrointestinal Surgery

Pamela Lipsett, MD, FACS, FCCMProfessor of Surgery and Anesthesiology/Critical Care MedicineDirector, General Surgery and Surgical Critical Care Training ProgramsCo-Director, Surgical Intensive Care

Mark Romig, MDAssistant Professor of Anesthesiology

Frederick Sieber, MDProfessor of Anesthesiology/Critical Care MedicineClinical Director, Johns Hopkins Bayview Campus

Jerry Stonemetz, MDStaff Anesthesiologist, Dept of AnesthesiologyNational Medical Director for Anesthesia Services, Hospital Corporation of America

Ilan Wittstein, MDAssistant Professor of MedicineDivision of Cardiology

GUEST FACULTYElizabeth Martinez, MD, MHSStaff Anesthesiologist, Massachusetts General HospitalAssociate Professor of Anesthesiology, Harvard Medical SchoolBoston, Massachusetts

Peter Rock, MD, MBA, FCCM, FCCPProfessor of Medicine, Surgery, and AnesthesiologyChair, Dept. of Anesthesiology, University of Maryland School of MedicineBaltimore, Maryland

J. Bryan Sexton, PhDAssociate Professor of Psychiatry, Duke University School of MedicineDirector of Patient Safety, Training and ResearchDurham, North Carolina

Marc Shnider, MDStaff Anesthesiologist, Beth Israel Deaconess HospitalClinical Instructor in Anesthesia, Harvard Medical SchoolBoston, Massachusetts

Brett Simon, MD, PhDAnesthesiologist-in-Chief, Beth Israel Deaconess HospitalProfessor of Anesthesiology, Harvard Medical SchoolBoston, Massachusetts

TO REGISTER or FOR FURTHER INFORMATIONRegister Online www.HopkinsCME.edu (credit card and eCheck)Register by Phone (410) 502-9636(credit card only)Register by Fax (866) 510-7088Confirmation/Certificates (410) 502-9636General Information (410) 955-2959E-mail the Office of CME cmenet@jhmi.eduFollow us on Twitter: http://twitter.com/HopkinsCMEFacebook: http://www.facebook.com/HopkinsCMEFor general information, the direct link for this CME activity web page is: http://www.hopkinscme.edu/CourseDetail.aspx/80031669

AMERICANS WITH DISABILITIES ACTThe Johns Hopkins University School of Medicine fully complies with the legal requirements of the ADA and the rules and regulations thereof. Please notify us if you have any special needs.

ACKNOWLEDGEMENTApplications for commercial support from health care related industries are pending. A complete list of contributors will be provided in the syllabus.PlEAsE NOTE: The Physician Payments Sunshine Act was enacted by Congress to increase public awareness of financial relationships between drug and medical device manufacturers and physicians. In compliance with the requirements of this Act, the commercial supporter/s of this activity may require the Johns Hopkins University School of Medicine to report certain professional information (such as name, address, National Provider Identifier, and State License #) of physician attendees who receive complimentary food and beverage in conjunction with a CME activity. The commercial supporter is required to submit the collected data to the Centers for Medicare and Medicaid Services which will then publish the data on its website.

PROGRAMSunday, March 9, 2014 7:00 - 7:45 Registration/Continental Breakfast 7:45 - 8:00 Introduction 8:00 - 8:30 The Perioperative Stress Response

Todd Dorman, MD, FCCM 8:30 - 9:00 Preoperative Evaluation:

Optimized, Not Cleared Leonard Feldman, MD

9:00 - 9:30 Preoperative Cardiac Risk Assessment and Testing Ilan Wittstein, MD

9:30 - 10:00 Perioperative Myocardial Ischemia: Mechanisms and Management Strategies Nauder Faraday, MD, MPH

10:00 - 10:15 Questions and Answers 10:15 - 10:30 Case Discussion with Faculty/

Refreshment Break 10:30 - 11:00 Perioperative Management of

Patients on Chronic Anti-Platelet Therapy Nauder Faraday, MD, MPH

11:00 - 11:30 Surgical Site Infections Pamela Lipsett, MD, FACS, FCCM

11:30 - 12:30 Controversial Clinical Vignettes Evidence-Based Preoperative

Testing Sean Berenholtz, MD, MHS

The Preoperative Patient with a Pacemaker or ICD Ilan Wittstein, MD

Perioperative Management of the Hypertensive Patient Todd Dorman, MD, FCCM

Perioperative Management of Patients on Chronic Anti-Coagulant Therapy Nauder Faraday, MD, MPH

12:30 - 1:00 Health Care Provider Stress I: Recognition and Impact on Provider and Patient Outcomes J. Bryan Sexton, PhD

1:00 - 1:15 Questions and Answers

Monday, March 10, 2014 7:00 - 7:30 Continental Breakfast and Case

Discussion with Faculty 7:30 - 7:45 Questions and Answers 7:45 - 8:15 Preoperative Pulmonary Risk

Assessment and Testing Peter Rock, MD, MBA, FCCM, FCCP

8:15 - 8:45 Perioperative Management of Diabetes and Hyperglycemia Leonard Feldman, MD

8:45 - 9:15 Perioperative Management of Patients with Cardiomyopathy Todd Dorman, MD, FCCM

9:15 - 9:45 Health Care Provider Stress II: Fatigue Management J Bryan Sexton, PhD

9:45 - 10:00 Questions and Answers 10:00 - 10:15 Case Discussion with Faculty/

Refreshment Break 10:15 - 10:45 Perioperative Respiratory

Insufficiency: Mechanisms and Management Peter Rock, MD, MBA, FCCM, FCCP

10:45 - 12:00 Controversial Clinical Vignettes: Perioperative Glucose

Management in the Brittle Diabetic Leonard Feldman, MD

Preoperative Evaluation and Management of the Patient with Heart Failure Ilan Wittstein, MD

Intra- and Post-operative Challenges in Patients with Heart Failure Elizabeth Martinez, MD, MHS

Allergy and Anaphylaxis Todd Dorman, MD, FCCM

Managing the Difficult Airway Outside the OR Lauren Berkow, MD

12:00 - 12:30 Perioperative Risks and Management of Pulmonary Hypertension Brett Simon, MD, PhD

12:30 - 1:00 Health Care Provider Stress III: Dealing with Difficult Colleagues J Bryan Sexton, PhD

1:00 - 1:15 Questions and Answers

Tuesday, March 11, 2014 7:00 - 7:30 Continental Breakfast and Case

Discussion with Faculty 7:30 - 7:45 Questions and Answers 7:45 - 8:15 Preventing, Identifying, and

Managing Common Healthcare Associated Infections Pamela Lipsett, MD, FACS, FCCM

8:15 - 8:45 Perioperative Renal Dysfunction Derek Fine, MD

8:45 - 9:15 Perioperative Management of the Patient with Hepatic Disease Brett Simon, MD, PhD

PROGRAM 9:15 - 9:45 Management of Perioperative

Bleeding and Transfusion Nauder Faraday, MD, MPH

9:45 - 10:00 Questions and Answers 10:00 - 10:15 Case Discussion with Faculty/

Refreshment Break 10:15 - 10:45 Perioperative Management of the

Patient with Obstructive Sleep Apnea Peter Rock, MD, MBA, FCCM, FCCP

10:45 - 11:15 Acute Pain Management: Opioids, Non-Narcotics, and Nerve Blocks Marc Shnider, MD

11:15 - 12:45 Controversial Clinical Vignettes: Perioperative Fluid Management

Pamela Lipsett, MD, FACS, FCCM Managing Bleeding in Patients

Anticoagulated with Novel IIa/Xa Inhibitors Nauder Faraday, MD, MPH

Perioperative Management of Steroids and Adrenal Insufficiency Derek Fine, MD

Perioperative Management of the Patient on Chronic Immunosuppressive Therapy Mark Romig, MD

Pain Management in the Opioid-Tolerant Patient: A Case-Based Discussion Marc Shnider, MD

Perioperative Nutrition Support Anne Lidor, MD

12:45 - 1:15 Surgical Management of Obesity Anne Lidor, MD

1:15 - 1:30 Questions and Answers

Wednesday, March 12, 2014 7:00 - 7:30 Continental Breakfast and Case

Discussion with Faculty 7:30 - 7:45 Questions and Answers 7:45 - 8:15 Perioperative DVT and

Pulmonary Embolism Nauder Faraday, MD, MPH

8:15 - 8:45 Post-Operative Delirium and Cognitive Dysfunction Frederick Sieber, MD

8:45 - 9:15 Managing End of Life Issues in Surgical Patients Pamela Lipsett, MD, FACS, FCCM

9:15 - 9:45 Improving Perioperative Quality and Safety through System and Culture Change Sean Berenholtz, MD, MHS, FCCM

9:45 - 10:00 Questions and Answers 10:00 - 10:15 Case Discussion with Faculty/

Refreshment Break 10:15 - 10:45 Healthcare Reform: Implications

of New Payment Models and Compliance for Your Practice Jerry Stonemetz, MD

10:45 - 12:15 Controversial Clinical Vignettes: Perioperative Management of the

Patient with Dementia Frederick Seiber, MD

A Practical Approach to Measuring and Improving Safety and Teamwork Culture Sean Berenholtz, MD, MHS, FCCM

Improving the Quality of Sepsis Care Sean Berenholtz, MD, MHS, FCCM

Using Technology to Improve Perioperative Outcomes Mark Romig, MD

Anesthesia in the MRI and Endoscopy Suites Lauren Berkow, MD

Medico-Legal Liability in Perioperative Medicine: Common Pitfalls and How to Avoid Them Jerry Stonemetz, MD

12:15 - 12:30 Questions and Answers 12:30 Summary Adjourn

Please complete and return the Evaluation and Credit Report Forms. The Registration Desk will remain open during conference hours.

HISTORICALLY, THE HOTEL SELLS OUT QUICKLY. PLEASE MAKE YOUR

RESERVATIONS EARLY.Marco Island Marriott • (800) 438-4373

Reservation Cut-Off Date:Thursday, February 13, 2014

MARK YOUR CALENDARFuture date for Perioperative

Management at the Marco Island Marriott

March 15-18, 2015

The Johns Hopkins University school of Medicine takes responsibility for the content, quality and scientific integrity

of this CME activity.

This schedule is subject to change.

Perioperative Management - In Its 30th YearMarch 9-12, 2014

To Register: Online (credit card and eCheck): www.HopkinsCME.edu By fax: (866) 510-7088 By phone (credit card only): (410) 502-9636

Or mail this form to the Johns Hopkins University, Office of Continuing Medical Education, P.O. Box 64128, Baltimore, Maryland 21264-4128. Include check payable to HOPKINS/80031669 or include credit card information below.

PAYMENT MUST ACCOMPANY FORM TO CONFIRM YOUR REGISTRATION.M I am a Johns Hopkins speaker for this activity.

Please type or print clearly:last name first name m.i.

highest degree primary specialty Hopkins faculty/staff only JHED ID

For Physicians only: NPI – 10 digits State License # State of License

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You will receive a confirmation notice and your attendance certificate by e-mail if you provide your e-mail address.M Check here if you wish to receive e-mail notices about upcoming CME activities.M I will attend the complimentary pre-conference reception on Saturday evening.

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____________________________________________________________________________________ Please notify us if you have any special needs.

____________________________________________________________________________________ Registration Fees: The registration fee includes instructional materials, continental breakfasts and refreshment breaks. M Physicians . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $729M Nurse Anesthetists/Physician Assistants/Nurse Practitioners/Other Health Professionals . . . . . . $635M Residents*/Fellows*/Nurse Trainees . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $350

*with verification of statusM Hard Copy of Syllabus . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 50 Hard copies ordered in advance can be picked up at the time of registration. Limited quantities of syllabi will be made

available for purchase on-site for $60. Total amount enclosed $ _________________ Payment Type:

For registrations received after 5:00 p.m. EsT on March 3, 2014 include a $50 late fee. On-site registrations are payable only by credit card.

M Check (See instructions on top of form.)M Credit Card: M VISA M MASTERCARD M DISCOVER M AMEX

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REGISTRATION FORM Course Number 80031669

JHU Faculty/Staff Only: If you are using your Tuition Remission Benefit or an ION budget, please complete this registration form and return with appropriate payment processing form to OCME, Turner 20.Forms can be found on-line at http://www.hopkinscme.edu/Resources/resources.aspx.