Neurosurgery for the Hospitalist

Successful neurosurgery co-management requires hospitalists to be familiar with the presentations, disease processes, management, and complications of neurosurgical inpatients. The first section of this activity summarizes common inpatient neurosurgical conditions. The second section prepares the reader to recognize and act on neurosurgical emergencies. The remaining four sections of the activity cover blood pressure management in patients with subarachnoid hemorrhage, sodium abnormalities in patients with brain tumors, the use of mannitol vs. dexamethasone, and the perioperative management of anticoagulants, in addition to other topics.

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Availability

On-Demand

Expires on Jan 30, 2028

Cost

Member: $0.00

Non-Member: $95.00

Credit Offered

2 CME Credits

2 ABIM-MOC Points

2 Participation Credits

Overview
Faculty
Accreditation
Recommended

Learning Objectives
After completing this activity, learners should be able to:

Summarize the epidemiology, clinical course, and prognosis of patients with subarachnoid hemorrhage.
Manage blood pressure and antithrombotic agents in patients with subarachnoid hemorrhage.
Describe basic shunt structure and diagnose common shunt complications.
Differentiate cerebral salt wasting syndrome from the syndrome of inappropriate antidiuretic hormone.
Detail the indications for and side effects of dexamethasone in neurosurgical patients.
Recommend venous thromboembolism prophylaxis for patients undergoing neurosurgery.

If you are a Program Director and would like to grant access to your trainees, please reach out to education@hospitalmedicine.org for an academic access code.

Faculty

Jason F. Shiffermiller, MD, MPH
Kurt Pfeifer, MD, FACP, SFHM, DFPM
Leonard Feldman, MD, FACP, FAAP, MHM

Faculty Disclosures
The faculty and planners of these activities have no relevant relationships to disclose. All relevant relationships were mitigated prior to the start of this activity.

Conflict of Interest Disclosure Policy
In accordance with the ACCME Standards for Commercial Support, SHM requires that individuals in a position to control the content of an educational activity disclose all relevant financial relationships with any commercial interest. SHM mitigates all conflicts of interest to ensure independence, objectivity, balance, and scientific rigor in all its educational programs. All relevant financial relationships shall be disclosed to participants prior to the start of the activity.

Furthermore, SHM seeks to verify that all scientific research referred to, reported, or used in a continuing medical education (CME) activity conforms to the generally accepted standards of experimental design, data collection, and analysis. SHM is committed to providing its learners with high-quality CME activities that promote improvements in healthcare and not those of a commercial interest.

Accreditation Statement
The Society of Hospital Medicine is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

CME Credit Statement
The Society of Hospital Medicine designates this online activity for a maximum of 2.00 AMA PRA Category 1 Credit^TM. Physicians should claim only credit commensurate with the extent of their participation in the activity.

MOC Credit Statement
Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to 2.00 MOC points in the American Board of Internal Medicine's (ABIM) Maintenance of Certification (MOC) program. Participants will earn MOC points equivalent to the amount of CME credits claimed for the activity. It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credit.

Perioperative Infections and Fever

Perioperative fever has multiple possible etiologies, including infections such as pneumonia, fungal infections, central-line associated infections, and urinary infections. By understanding the typical time frame and common risk factors for each etiology, hospitalists and other perioperative consultants can develop a differential diagnosis for perioperative fever. The following activity will provide a general approach for determining the differential diagnosis in patients with a perioperative fever, as well as an outline of the diagnostic and treatment modalities.

Multiple Credits

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Newly Diagnosed Postoperative Atrial Fibrillation after Non-cardiothoracic Surgery

Atrial fibrillation is the most common arrhythmia in the postoperative period. It is important that hospitalists understand the current management of postoperative atrial fibrillation (AF) because it is a frequent reason for consultation. Postoperative AF after noncardiac surgery has been associated with risk of thromboembolism, myocardial infarction, and mortality. The following activity addresses the incidence, natural history, risk factors, prevention, clinical significance, evaluation, and management of newly diagnosed postoperative AF after non-cardiothoracic surgery.

Multiple Credits

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The Hospitalist's Role in Ensuring Optimal Nutrition for Hospitalized Patients

Ensuring optimal nutrition for the hospitalized patient is a complex issue fraught with several pitfalls for clinicians as they asses the patient’s nutritional status and determine the caloric needs and appropriate delivery method. Many factors need to be considered when creating this patient-specific plan. The following activity discusses these issues and outlines the various dietary formulations (ie, oral, enteral nutrition, and parenteral nutrition). Step-by-step guidance for how to implement a nutritional plan for the different types of hospitalized patients that hospitalists encounter also is provided.

Multiple Credits

$0.00 - $95.00

Management Of Patients With Hip Fractures

Hip fractures are a frequent cause of hospitalization in the elderly population. As the population continues to age, the incidence is expected to increase. Since many patients with hip fracture suffer from multiple medical comorbidities, hospitalists play a critical role in their care. Management of these patients requires knowledge of multiple consultative medicine topics including preoperative cardiac and pulmonary risk stratification and reduction strategies, venous thromboembolism prevention, and diagnosis and management of common postoperative complications. Open lines of communication between the hospitalist, surgeon, and anesthesiologist are essential to optimize patient care.

Multiple Credits

$0.00 - $95.00

Perioperative Management of Sleep Apnea and Noninvasive Respiratory Management for the Hospitalist

Obstructive sleep apnea (OSA) has an increased incidence in the surgical population compared to the general patient population. The link between OSA and cardiac disease has been well established, although sleep apnea has also been associated with several other postoperative complications, the most feared being respiratory arrest. The following activity discusses these aspects of OSA and the different screening tools available to clinicians. A discussion of the logistical barriers to managing OSA and the options for treatment is included to help hospitalists successfully identify and manage these patients during the perioperative period.

Multiple Credits

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Rapid Clinical Updates: Updates in Acute Stroke Management

This session is presented by Madison Paul, MD and Emiliya Melkumova, MD. Our moderators are Ebrahim Barkoudah, MD, FACP, MPH, SFHM and Lily Ackermann, MD, ScM, FHM. This talk will discuss high-yield evidence-based answers to questions commonly encountered when taking care of acute stroke patients. This session will be helpful for academic and non-academic hospitalists physicians, physician assistants, nurse practitioners, or anyone else who practices adult hospital medicine. Attendees will learn the appropriate acute treatment of minor stroke and TIA, as well as how to manage anticoagulation in patients with a. fib and breakthrough stroke.

Multiple Credits

$0.00 - $95.00

The Hospitalist’s Role in the Perioperative Management of Hyponatremia

Hyponatremia is the most common electrolyte abnormality that occurs in hospitalized patients, and it is recognized as a serious in-hospital complication. It is a complex electrolyte disorder that results mainly from water imbalances and dysregulation of arginine vasopressin. Hyponatremia is associated with increased morbidity and mortality among geriatric patients and patients with heart, liver, or neurologic diseases. The following educational activity discusses the pathophysiology of hyponatremia, outlines methods for differentiating the cause, and provides examples of how to manage hyponatremia in various situations commonly faced by hospitalists.

Multiple Credits

$0.00 - $95.00

Perioperative Care of the Patient with Cancer

Therapeutic advances in cancer therapy have led to an increase in the number of patients undergoing surgery as part of their cancer treatment. These patients present several unique challenges, including weighing risks against adverse effects of delaying time-sensitive treatment and taking the patient’s cancer and its treatment into account when determining postoperative management. The following activity discusses these topics, with an emphasis on cardiovascular and pulmonary toxicities of radiation and chemotherapeutic agents as well as common hematologic problems encountered in patients with cancer or a history of cancer treatment.

Multiple Credits

$0.00 - $95.00