Perioperative Medicine

Deborah C. Richman, MBChB, FFA(SA) trained at the University of Cape Town, South Africa. Subsequently she was on the faculty of the Technion in Haifa, Israel - at Ha'Emek hospital in Afula. She started one of the first pre-operative clinics in Israel. Currently, as associate professor of clinical anesthesiology at Renaissance School of Medicine, Stony Brook, her roles include: medical director of Pre-Operative Services since 2006, member of the Institutional Ethics Committee and ACLS instructor.Deborah is past president of SPAQI (Society for Perioperative Assessment and Quality Improvement); and serves on their board of governors. Debra Pulley, MD is Professor of Anesthesiology at Washington University School of Medicine in St. Louis, MO. She first became intrigue with medicine while working as an environmental engineer managing disposal of hazardous waste and learning the effect industrial toxics can have on the human body. After medical school, she chose to specialize in anesthesiology.Several years into providing anesthetic care to patients, Debra recognized the need for multidisciplinary involvement in optimizing perioperative care of patients. She has served as president of the Society of Perioperative Assessment and Quality Improvement (SPAQI) and is currently on the Board of Governors.Adriana D. Oprea, MD is Associate Professor of Anesthesiology at Yale School of Medicine After completing a residency program in Internal Medicine, she worked as a hospitalist at Yale New Haven Hospital and retrained in Anesthesiology. She is dual board certified in internal medicine and anesthesiology and her area of academic and clinical interest is preoperative optimization, especially for patients with endocrine and hematologic disorders.She serves on multiple national committees on Perioperative Medicine and is part of the executive and guidelines committees for the Society for Perioperative Assessment and Quality Improvement (SPAQI).

• PART I PREOPERATIVE ASSESSMENT 1: Maureen Keshock and Kenneth Cummings: Preoperative Process: Phone Triage, Preoperative Clinic, or Virtual Patient Visits 2: Eileen Campbell and Janine Limoncelli: Perioperative Surgical Home Care Model: Utopia or Bureaucracy? 3: Jay S. Kersh and BobbieJean Sweitzer: Choosing Wisely: How to Advise the Patient on Preoperative Testing 4: Barbara Rogers and Wiebke Ackermann: My 79-Year-Old Patient for Right Inguinal Hernia Repair Has No Labs on File 5: Julio Montejano and Angela Selzer: Medication Management: Drug-Eluting Stent 2 Months Ago 6: Thomas Hickey and Shafik Boyaji: Perioperative Management of Medications for Substance Use Disorders 7: Deborah C. Richman: Indications for Preoperative C-Spine Imaging for Elective Procedures 8: Olivia Belloni, Rashwan Gogue, Luigi Beretta, and Enrico Maria Minnella: Prehabilitation Before Total Hip Replacement 9: Paris Dove, Emily Traer, Hilmy Ismail, and Bernhard Riedel: Cardiopulmonary Exercise Testing PART II AGE 10: Joseph P. Resti and Bettina Smallman: Ex-Premie for Interval Hernia Repair at 11 Weeks 11: Kaitlin Willham and Heather E. Nye: Geriatric Assessment: "The Get Up and Go, Got Up and Left" PART III ORGAN SYSTEMS 12: Samuel Papke, Michael Benson, and Joshua Zimmerman: AHA Guidelines Application 13: Jing Tao and Adriana D. Oprea: Perioperative Atrial Fibrillation and Anticoagulation Management 14: Elvera L. Baron and Menachem M. Weiner: Severe Aortic Stenosis: Candidate for a Surgicenter? 15: Michael Curtis, Nathaen Weitzel, and Miklos D. Kertai: Does Your Cataract Surgeon Know You Were Admitted for Heart Failure Last Week? 16: Debra D. Pulley and Anand Lakshminarasimhachar: Echo Shows Elevated Pulmonary Artery Pressure 17: Caroline R. Gross and Zdravka Zafirova: Shoulder Replacement in Patient Who Had a Heart and Lung Transplant 18: Wesley Rajaleelan and Jean Wong: COPD: Still Smoking, Still Wheezing 19: Sean Love, Chelsey Santino, and Tina Tran: Severe OSA in the Ambulatory Setting 20: Robert Fong: COVID-19 21: Sofia S. Jakab and Adriana D. Oprea: Cirrhosis and Truly Elective Major Surgery 22: Ramanjot S. Kang, Ashley Mathew, and Shirley Avraham: Patient Has Seizures and Needs "Clearance" 23: Samuel N. Blacker: Clinical Application of Perioperative Brain Health 24: Shilpa Rao: Restrictive Lung Disease from Parkinson's Disease Rigidity: Is It Real? 25: Debra D. Pulley: A 56-Year-Old with a Recent CVA for Elective Surgery: How Soon Is Too Soon? 291 26: Emily Y. Xue, David Moore, and Alexander F. Arriaga: Avoiding Exacerbation of Chronic Kidney Disease 27: Kenneth Cummings: Preoperative Anemia Management: Evaluation and Treatment 28: Nicole Verdecchia and Khoa Nguyen: Prolonged PTT in a Healthy Patient 29: Lindsay E. Carafone, Colin E. Bauer, Joshua D. Miller, and Steven D. Wittlin: Elevated Glucose on Admission Fingerstick: How High Can We Go? 30: Zyad J. Carr, Andrea Farela, and Adriana D. Oprea: Pheochromocytoma and MEN Syndromes PART IV WOMEN'S HEALTH 31: Nayema K. Salimi and Kristen L. Fardelmann: Pregnant Patient for Non-Obstetric Surgery 32: Evan Jin, Sangeeta Kumaraswami, and Garret Weber: Older Primigravida with Twin Pregnancy for Elective Cesarean Delivery PART V SURGICAL CONSIDERATIONS 33: Lesley Bennici, Morgane Factor, Sunitha Singh, and Ana Costa: Minimally Invasive Surgery and Other Elements of Enhanced Recovery Protocols 34: Seth Perelman and Christian Mabry: Blood Conservation PART VI ETHICS AND SHARED DECISION-MAKING 35: Joseph F. Kras: When DNR Stands in the OR: Who Benefits? Who Decides? 36: Stephen Harden and Nicholas Sadovnikoff: Informed Consent: Do We Really Do This Correctly? 37: Jeanna D. Blitz: Can I Refuse to Anesthetize This Patient? 38: Laura J. Ostapenko and Katherine A. Hill: Difficult Conversations PART VII MISCELLANEOUS 39: Debra D. Pulley: This Patient Has 17 Allergies: Including "General Anesthesia" 40: Jonathan Bacon and Ralph Epstein: Nonverbal Autistic 30-Year-Old for Full Mouth Dental Rehabilitation with Malignant Hyperthermia 41: Meredith Whitacre and Loreta Grecu: Patient with AAA with Implanted Spinal Cord (Neuro) Stimulator 42: Paula Trigo Blanco and Adriana D. Oprea: Patient with Pacemaker-Dependent ICD for Renal Cryoablation 43: Adam Adler and Arvind Chandrakantan: My Friend's Son Requests Surgery for Gynecomastia Caused by the Drugs He Uses for Bodybuilding 44: Cory W. Helder and Alessia Pedoto: Perioperative Care of the Cancer Patient PART VIII PACU 45: Jonathan L. Wong and Mana Saraghi: Discharge Criteria in Developmentally Disabled Patient with OSA 46: Ramon E. Abola: My Patient Is Twitching Like a Fish Out of Water: Avoiding the Risks of Residual Paralysis 47: Joy Steadman: My Patient in the PACU Is Not Making Any Sense 48: Avi Dobrusin and Muthuraj Kanakaraj: The HR Monitor Is Alarming in the PACU: Postoperative Arrhythmias