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 individuals in control of content for this activity have no relevant relationships with ACCME-defined ineligible companies to disclose unless listed here. Any relevant relationships were mitigated prior to the start of this activity.

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 enduring material for a maximum of 2.00 AMA PRA Category 1 Credit(s)^TM. Physicians should claim only the 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.

SHM Consults: Perioperative and Consultative Medicine

As hospitalist roles surge, mastering consultative and perioperative care has become a career essential. Gain the proven frameworks and clinical confidence to navigate complex surgical co-management and specialist consultations, leading to safer patients and smoother workflows.

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SHM Consults Advanced Curriculum

Hospitalists are the fastest growing portion of the physician work force. Some estimate there will be 50,000 hospitalists needed in the next 10 years. As the number of hospitalists grows, so too will the clinical settings in which we practice. Consultative medicine is a service provided by many hospitalists, and a future in which almost all surgical patients are co-managed by hospitalists is already a reality for some. For many of us, our training in consultative medicine during residency was limited. We hope this curriculum will help you to feel more confident about your knowledge and skills and will lead to better patient outcomes. We welcome your comments and suggestions for future topics.

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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.

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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.

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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.

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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

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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.

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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

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