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AMDA Long Term Care Medicine - 2012


C06 - When the Long Term Care Resident Goes to Surgery: A Guide for the Clinical Team


Mar 10, 2012 11:00am ‐ Mar 10, 2012 12:30pm

Standard: $24.00

Description

Accreditation
The American Medical Directors Association (AMDA) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

Designation Statement:
The American Medical Directors Association designates this educational activity for a maximum of 1.5 AMA PRA Category 1 Credit(s)™. Physicians should only claim credit commensurate with the extent of their participation in the activity.

AMDCP Credit Designation:
This session has been approved for a total of clinical 1.5 credit hours toward certification as a Certified Medical Director in Long Term Care (CMD).

Session Description:
This session will provide an overview of surgical care for long term care residents. The long term care clinical team must be adept at recognizing surgical emergencies, know when to arrange urgent transfer to acute care, and prepare robust seniors living in continuing care retirement communities for elective surgeries to improve quality and quantity of life. In addition, most skilled long term care facilities provide rehabilitation and aftercare for elderly surgical patients. Accordingly, this session will review the atypical and often protean presentation of surgical emergencies in the elderly, using a case-based approach. Attention will shift next to preparation of the long term care client for elective surgery, with an emphasis on reducing cardiopulmonary complications and prevention of delirium. The session will conclude with discussion of key pre- and post-operative pharmacotherapy issues. Attendees will be given an opportunity for questions and discussion.

Learning Objectives(s):

  • Recognize the presentation of surgical emergencies in long term care.
  • Provide strategies for reducing peri- and post-operative risks for long term care residents.
  • Optimize pain management, thromboembolism prevention, and other post-operative therapies.


Speakers(s):
Daniel Bluestein, MD, MS, CMD; Thomas Grant, MD; Thomas J. Lynch, PharmD

Disclosure(s):
Daniel Bluestein, MD, MS, CMD has no financial disclosures to report. Thomas Grant, MD has no financial disclosures to report. Thomas J. Lynch, PharmD has no financial disclosures to report.

References(s):
Dharmarajan TS, Sohagia A. Urgent Surgery in a Near Supercentenarian Nursing Home Resident: Possible With Favorable Outcome! JAMDA 2007; 8(8):543-4). Ghanta RK, Shekar PS, McGurk S, Rosborough DM, Aranki SF. Nonelective cardiac surgery in the elderly: is it justified? J Thorac Cardiovasc Surg. 2010 Jul;140(1):103-9, 109. Hamel MB, William G. Henderson WG, Khuri SF, Daley J. Surgical Outcomes for Patients Aged 80 and Older: Morbidity and Mortality from Major Noncardiac Surgery. J Am Geriatr Soc 2005; 53:424-9. Lee DH, Buth KJ, Martin BJ, Yip AM, Hirsch GM. Frail patients are at increased risk for mortality and prolonged institutional care after cardiac surgery. Circulation. 2010 Mar 2;121(8):973-8. Limmer S, Unger L, Czymek R, Kujath P, Hoffmann M. Emergency thoracic surgery in elderly patients. JRSM Short Rep. 2011 Feb 18;2(2):13. Litmathe J, Feindt P, Kurt M, Gams E, Boeken U. Aortic valve replacement in octogenarians: outcome and predictors of complications. Hellenic J Cardiol. 2011 May-Jun;52(3):211-5. Lyon C, Clark DC. Diagnosis of acute abdominal pain in older patients. Am Fam Physician. 2006;74(9):1537-44. Mirbagheri N. Dark JD, Watters DAK. How Do Patients Aged 85 and Older Fare with Abdominal Surgery?J Am Geriatr Soc 2010; 58:104-8. Orosz GM, MD, Hannan EL, Magaziner J, Koval K, Gilbert M, Aufses A, Straus E, Vespe E, Siu AL. Hip Fracture in the Older Patient: Reasons for Delay in Hospitalization and Timing of Surgical Repair. J Am Geriatr Soc 2002; 50:1336-40. Pofahl WE, Pories WJ. Current Status and Future Directions of Geriatric General Surgery. J Am Geriatr Soc 2003; 51:S351-S354.

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