Carolina Dreaming Newsletter by UNC Anesthesiology

DEPARTMENT OF ANESTHESIOLOGY

UNC ANESTHESIOLOGY NEWS VOLUME 1 • ISSUE 2 • FALL 2016

INSIDE THIS ISSUE Frank H. Moretz Anesthesiology Resident Education & Travel Fund CAPSEL Numbers at a Glance Chairman's Note CRNAs on a Mission Profile: Alvis Page Resident Update Basic Science & Clinical Research January – June 2016 Faculty Publications, Awards & Presentations

Carolina

DREAMING Alum’s Gift to University a Gracious Gesture to UNC Anesthesiology

n April 2015, UNC alumnus Dr. Frank Moretz — undergraduate (’71), medical school (’75) and Anesthesiology residency (’78) — established a $3 million planned gift to the University, to be distributed evenly between UNC’s Departments of Anesthesiology, Psychology and School of Medicine satellite Asheville campus. Dr. Moretz’s generosity demonstrates his enduring ties to UNC. Post-medical school, Dr. Moretz planned to serve as a US Air Force (USAF) Flight Surgeon. Prior to starting his internship, he approached then-Department Chair Dr. Ken Sugioka requesting permission to spend time in supplemental training in anesthesiology. Under Dr. Sugioka’s guidance, Dr. Moretz discovered his love

The Frank H. Moretz Anesthesiology Resident Education and Travel Fund earmarks $1 million to promote learning, leadership, professional development and advocacy experiences for our future physician anesthesiologists. “There are so many opportunities for these young doctors these days,” Moretz said. “The demands on a clinical department can be staggering. This gift will create learning opportunities that otherwise might go unrealized.”

“This gift will change our program. We can look for experiences to enhance the professional development of our residents and place them in a position to contribute for the rest of their professional lives. Dr. Moretz has given us an example with his career and now he has given us a means to have others follow in his footsteps.”

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– Dr. David Zvara, Chair of Anesthesiology

Dr. Moretz retired from clinical care in the past year. A long-time resident of Asheville, NC, he now heavily invests himself in the interests of the region and community. As a 2016 NC House of Representatives District 115 candidate, Moretz hopes to further serve his region’s constituency at the state level.

“I feel that my life has been one of service — I served my country in the military and my patients for 40 years, and now I want to serve the citizens of Buncombe County and North Carolina as an elected representative. The best way I can serve future generations of learners is through my endowment to the University,” Moretz said.

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for the profession, and he transitioned to UNC’s threeyear Anesthesiology residency program. The would-be Flight Surgeon instead began his 40-year career as a USAF anesthesiologist.

Residency alumnus (’78) and benefactor Dr. Frank Moretz caught up with Department Chair Dr. David Zvara when he visited the Department in July 2016.

“Anesthesiologists are frequently overlooked as the most-suited provider to coordinate continuity of care on a surgical patient’s treatment team,” Moretz said. “Fortunately, the field of anesthesiology has developed the perioperative surgical home as a patient-centric, team-based approach to care that relies upon multiple providers. The anesthesiologist should be the one to ensure delivery of quality care through all perioperative stages.”

Carolina Dreaming

Simulation in Medical Education

Patient Safety and Experiential Learning in Teaching High-Fidelity, OR Decision-making

n teaching hospitals, anesthesiology training and patient care intersect in a way that cannot always follow medicine’s learn-by-doing tradition. Conceptually, three specialty-intensive training years should allow future anesthesiologists to learn skills and judgment within clinical settings. In high-stakes patient care, however, residents need to acquire experience in practice environments first. Fortunately, high-fidelity simulation provides an efficient solution to teach residents quick, independent decision-making. At UNC, simulation has been integral to clinical teaching for several decades. In the early 1980s, the School of Medicine (SOM) employed task trainers and standardized patients (SPs) to assess learners’ clinical skills. By 1994, the Department of Anesthesiology installed the SOM’s first high-fidelity simulator in its Clinical Skills and Patient Simulation Center (CSPSC). After Assistant Professor Dr. Rob Isaak and Associate Professor Dr. Marjorie Stiegler joined faculty in 2011 and 2012, respectively, they reformalized the Department’s CSPSC procedural and team simulation training. In November 2013, both co-founded the Consortium of Anesthesiology Patient Safety and Experiential Learning (CAPSEL). To facilitate CAPSEL, Stiegler and Isaak are joined by 15 other teaching faculty, including: Drs. Lavinia Kolarczyk, Brian Barrick, Candra Bass, Hemanth Baboolal, Kate Cobb, Rob Kyle, Claude McFarlane, Monika Nanda, Kim Nichols, Matt McDaniel, Maryam Jowza, James Krakowski, Ben Redmon, Kim Blasius and Greg Balfanz. Jamie Land serves as CAPSEL’s administrative program support.

“In a high-stakes field of medicine, CAPSEL provides a controlled environment for safely training residents to be active treatment team participants who have seconds to diagnose and trouble-shoot clinical issues. Everyday procedures and routine cases can quickly become emergency situations, and no procedure is without potential harm to patients.” – Dr. Majorie Stiegler, CAPSEL’s Director and Patient Safety facilitator

As CAPSEL’s Assistant Director and the Department’s Residency Simulation Program Director, Isaak oversees Experiential Learning. He notes: “In the ACGME’s new accreditation era, assessment via simulated patient encounters over three years generates ‘milestone’ [observable behaviors] data about a resident’s progression along several competency continuums.” Stiegler and Isaak have published and presented regionally, nationally and internationally on simulation in resident education. Both have also acquired simulation instruction skills at Harvard Medical School’s Center for Medical Simulation. Looking ahead, Isaak noted: “By nature, simulation is intra-professional and multi-disciplinary. At UNC Hospitals, anesthesiologists work with clinical faculty from various divisions and departments. CAPSEL’s long-term aim is for hospital entities to cross-train residents together so that multiple disciplines can manage critical and non-critical events uniformly as participants on the same treatment teams.”

Clockwise: Dr. Majorie Stiegler (L) directs a simulation exercise with anesthesiology residents training on Objective Structured Clinical Exam (OSCE)-style patient encounters. Dr. Rob Isaak (R) observes an anesthesiology resident during an OSCE examination. Recent graduate Dr. Amy Penwarden (Bottom) learning trauma surgery resuscitation via simulated endotracheal intubation.

UNC ANESTHESIOLOGY NEWS | VOLUME 1 • ISSUE 2 • FALL 2016

NUMBERS

Chairman’s Note

AT A GLANCE

David A. Zvara, MD Professor and Chair

UNC Department of Anesthesiology

UNC Department of Anesthesiology Faculty

Undergraduate Institutions

Medical Schools

115

National Meeting Presentations

Publications

National Committee Seats

760

Combined Years of Clinical Experience

n 2010, I shared a document with members of the Department and the Dean outlining my vision for UNC Anesthesiology. The document highlighted 10 principles that I thought important as your Chairman. Here they are. As a Chairman, I should: • • • • • • • • • •

Lead by example Expect the best in others Communicate with clarity Recruit the best talent Seek consensus Expect judgment Constantly improve Measure it Seek profitable business Chair one department

One of these I identified as “my highest priority.” Can you guess which one? Recruit the best talent. I believed it then, and I believe it now. Quoting directly from my communication: “If we can find, hire and retain the best physicians, the best CRNAs, nurses and staff, all else will naturally fall into place.” I believe this more today than ever. Look around at the amazing accomplishments and stories seen and shared each day by our Department members. Our faculty, CRNAs and staff are among the most dedicated, professional and altruistic people I’ve ever encountered in a single workplace. This issue of Carolina Dreaming highlights some of these people and their stories. I wish that I could better communicate the energy and vibrancy I see amongst our team. As I walk the hallways and randomly stop to talk, I’m always energized by what I hear. For this, I am thankful. This year, we again welcome a new group of residents. We also welcome all department newcomers. Each brings something special, and from each, we expect the best. To our alumni, I’m thrilled to share that your legacy lives on in the actions, deeds and attitudes of those here today. We have an obligation to each of you who have passed through these doors. For those contributing to our ongoing financial missions, whether it be great or small, we are grateful for your contributions as your gifts move our clinical and academic mission forward. Please enjoy this second issue of Carolina Dreaming, and please share your thoughts and accomplishments with me. Let’s recruit the best. Let’s work hard to keep the best. Let us, together, be the best.

* As of July 2016

Carolina Dreaming

CRNAs on a Mission

hen a surgery team heads on a medical mission trip, a skilled anesthetist needs to come along. At UNC, 12 current CRNAs have traveled to five countries with UNC- and non-UNCaffiliated teams, including: Laura Niday, Lili Teleki, Bobby Silvers, Jennifer Buchanan, Bob Morris, Jamal Khrais, Marcia Guine, Shanna Davis, Dori Baboolal, David Dorito, Amy Hueske and Jaclyn Shipley. In 2013, Department CRNAs formed a non-profit — “CRNAs On a Mission — to support their own who participate in global medical mission trips. Comprised of UNC CRNAs, the organization’s Board of Directors (BOD) conducts fundraising to offset trip-related expenses. BOD member Laura Niday was two months shy of completing her training in 2010 when she was invited to join a group headed to the Dominican Republic (DR). She’d never given medical missions much thought but chose not to pass the opportunity up. Today, Niday has traveled to DR eight times, serves now as trip leader and has joined teams traveling to Rwanda and Palestine. In Niday’s words: “These trips have introduced me to the most grateful patients I’ve ever met. Lacking essential equipment attaches me more to a patient in a foreign country than stateside. Back home, I experience ‘sensory overload’ from all the numbers, information and alarms. I miss the simplicity of a precordial stethoscope and a hand on the bag.” A UNC CRNA of six years, Lili Teleki traveled to Nicaragua with a UNC Orthopaedics team in 2012 as one of two anesthesia providers. Two years later, she joined an International Organization for Women and Development urogynecologic team in Rwanda.

CRNAs Lili Teleki (L) in Nicaragua & Laura Niday (R) in Dominican Republic

On both trips, Teleki found herself in extremely under-resourced OR settings. In Nicaragua, laryngeal mask airway (LMA)s and endotracheal tube (ETT)s were re-used and needle sharps were discarded in cardboard boxes. In Rwanda, Teleki’s encountered a lack of essentials wholly unimaginable to stateside anesthesia providers. In her words: “…narcotics were split between patients…spinal blocks were done without any sedation…general anesthesia was reserved for ureteral re-implants or abdominal hysterectomies.” Of her trips, Teleki notes: “I became a stronger provider and learned to take care of patients with questionable monitors and limited supplies. I’m now much more cognizant of using as little as possible in my day-to-day practice.”

Alvis Page – Hardly Ready to Retire

55-Year University Employee Beloved to UNC Anesthesiology

till in his teens, long-time Department employee Alvis Page began working in 1961 in NC Memorial Hospital’s bakery. He learned to navigate the seven-floor clinical corridors of UNC’s only hospital, eventually transitioning to overseeing respiratory therapy equipment. As anesthesia care grew at UNC, Page shifted to working solely for the Department of Anesthesiology. In 1975, Page became a certified anesthesia technician (Cer.A.T.), though he had already acquired many skills from servicing equipment used in procedural/OR and post-anesthesia care unit (PACU) environments. At 30 years of University service, Page retired in 1991. That year, then-Department Chairman Dr. Phil Boysen tapped him to oversee start-up of a School of Medicine patient simulation laboratory to train anesthesia technicians and others. “Technology was changing so fast in anesthesia care in those days that I wanted to be a part of it,” Page notes. Until recent years, Page has maintained his Cer.A.T. status while still attending Grand Rounds and traveling to conferences. After celebrating 50 years of University service in 2011, he shifted to half-days, becoming the Department’s courier and go-to guy with an invaluable bank of knowledge. “I’ve led a fulfilling life beyond my job, but in 55 years with UNC, I’ve grown to identify strongly with the only workplace I’ve ever known. Within a big hospital, UNC Anesthesiology has given me leadership roles, security, friendship and a workplace family. It’s been a main reason I’ve stayed so long.” A Department staffer of almost 10 years, Chairman’s Executive Assistant Kathy Sutton notes: “Alvis always has a positive attitude, a smile on his face and a kind word to say to everyone he meets. He does so much for the Department, giving of himself whenever he is asked or sees a need.”

UNC ANESTHESIOLOGY NEWS | VOLUME 1 • ISSUE 2 • FALL 2016

Dual Residency Track Pairs Health Administration & Clinical Learning

RESIDENT UPDATE

Goodbye to Our Grads Dr. Vishal Dhandha

Dr. Jordan Hancock

arly in residency, Clinical Instructor Dr. Jordan Hancock realized that obtaining skills in operational efficiency and leadership, as well as an informed perspective on population health, would benefit him in his career. A year behind Hancock, 4th-year resident (CA-3) Dr. Vishal Dhandha recognized he needed foundational knowledge in healthcare economics and leadership skills to leverage his physician’s interest in administration. Thanks to an innovative new track launched by the Department’s residency program in 2015, both Hancock and Dhandha became the first two resident enrollees in the Executive Master’s Program in Health Administration offered by UNC’s top-ranked Gillings School of Public Health. In 2014, Residency Program Director Dr. Harendra Arora and Associate Director Dr. Susie Martinelli petitioned the Department to consider offering a dual track for interested CA-3 residents to pursue a Master of Public Health (MPH) or Health Administration (MHA) during training. With Chairman Dr. David Zvara’s approval, program leadership secured American Board of Anesthesiology and Accreditation Council for Graduate Medical Education approvals to offer a dual track to residents to fully fund one resident annually to enter this two-year track. As a selected rising CA-3, a resident enrolls in the dual degree track of choice, participating throughout his/her final residency year in twice-weekly e-learning sessions, as well as in limited on-campus sessions. Beyond residency, the enrollee spends an additional year as a Fellow Instructor, where sufficient non-clinical time is available to complete project work and obtain the degree. “Involvement in healthcare administration repeatedly comes up when interviewing residency applicants share their career interests with me,” noted Arora. “I first learned about these programs from another School of Medicine faculty member who had obtained his MPH from the UNC School of Public Health and talked about their robust curriculum. It made me think how incredible it would be for our residents to have a deeper understanding of healthcare delivery and to obtain the administrative skills at the outset as they prepare to launch their careers, whether within an academic setting or in private practice.”

Jennifer Allan, MD Sean Claar, MD Amine El-Amraoui, MD Jenny Eskilden, MD Jordan Hancock, MD Blair Herndon, MD Benjamin Judd, MD Drew Karenz, MD Hayden Kirby, MD Amy Penwarden, MD Joseph Piscitello, MD Kevin Powell, MD Chelsea Willie, MD

Regional Anesthesia Fellowship – UNC Mission Health System/Mission Hospital Asheville, NC Regional Anesthesia Fellowship – UNC Instructor – UNC Instructor – UNC Obstetric Anesthesia Fellowship – UNC American Anesthesiology – Greensboro, NC Alamance Regional Hospital – Burlington, NC Greater Houston Anesthesia – Houston, TX Obstetric Anesthesia Fellowship – UNC Alamance Regional Hospital – Burlington, NC Pediatric Anesthesia Fellowship – UNC Children’s Hospital of Philadelphia Pediatric Anesthesia Fellowship

Hello to Our New Folks PGY1 Patricia Doerr Candy Ezimora Brent Harkrider Christopher Huber Leslie Matthews Andres Rojas Elizabeth Snow Bryan Whitlow Stephanie Woodward

UVA School of Medicine University of Rochester School of Medicine & Dentistry University of Oklahoma College of Medicine University of KY College of Medicine WVU School of Medicine UVA School of Medicine New York Medical College Baylor College of Medicine University of Utah School of Medicine

CA1 (PGY1 training not in Department of Anesthesiology) Kathryn Fitzgerald Jeremy Gue Lindsey Gouker* Bryan Kidd Marley Lawrence**

PGY1-3 Pediatrics – Wake Forest University PGY1 Medicine – University of TX - San Antonio PGY1-3 Pediatrics – Albany Medical College PGY1 Transitional – Southern Illinois University PGY1 Pediatrics – UNC

* Also completed one year Pediatric HEM/ONC Fellowship ** Combined Anesthesiology/Pediatric residency

Carolina Dreaming

Basic Science & Clinical Research

Linnstaedt & Mauck Making Early Career Translational Strides Appointed in July 2015, Dr. Mauck, (MD, PhD) came to UNC after training as an anesthesiologist, physician-scientist, and pain medicine physician. In residency, he became interested in the fundamental question of why patients transition from acute to chronic pain in the aftermath of a stressful event such as trauma or surgery. In fellowship, Dr. Mauck studied chronic pain development in veterans requiring amputation. In the years ahead, he hopes his clinical and translational research efforts will support the development of biologically-based interventions to prevent and treat chronic pain. “The life-altering transition from acute to chronic pain remains a mystery. Although pre-clinical data suggest a potential role of neuro-inflammation and central sensitization, this has yet to be fully explored in humans. As a perioperative physician caring for patients throughout their continuum of care, I’ve seen the incredible pain they endure. As a clinical researcher, I’m compelled to continue my efforts toward the discovery of new treatments to prevent and treat chronic pain.” Dr. Mauck began working first at UNC with Vice Chair of Research Dr. Samuel McLean, a mentor with extensive experience in chronic pain research related to trauma recovery. In summer 2015, the two commenced a detailed analysis of McLean’s longitudinal, year-long pilot study exploring clinical predictors of persistent pain after burn injury.

MicroRNA Biologist & Asst. Professor Dr. Sarah Linnstaedt (L) in her lab • Asst. Professor & Clinical Pain Medicine Researcher Dr. Matt Mauck (R) presenting at a North American Pain School conference.

McLean believes the potential of both of these young researchers is tremendous. “Honestly, with both Sarah and Matt, the sky is the limit. Both are very bright, passionate, extremely hard-working, bring an intense, entrepreneurial spirit to their work, and have picked critically important research areas. UNC Anesthesiology should be proud to have such topnotch science going on within its walls.”

In their short time at UNC, Assistant Professors Drs. Sarah Linnstaedt and Matt Mauck have performed cutting-edge translational pain research as a basic scientist (Linnstaedt) and a clinical researcher (Mauck). Both have established ties with others in UNC’s cross-disciplinary research community and pursue a common goal of better understanding the pathogenesis of chronic pain and related disorders after trauma or surgery. In fall 2012, Dr. Linnstaedt joined the Department and brought her translational expertise in microRNA mechanisms to UNC. With departmental investment, she established a research laboratory to gain new insights into the cause of chronic pain and to identify novel molecular targets for therapeutics. In four years, Linnstaedt has collaborated with basic science and clinical researchers at UNC on translational biology studies that seek to identify mediators driving transition from acute to chronic pain. Dr. Linnstaedt’s lab has also generated molecular/cell culture and behavioral study findings that translate between animals and humans. At the 2016 American Pain Society meeting, she presented findings of a study showing that microRNA-19b differentially predicts chronic pain development in women versus men following trauma/stress exposure and that sex-specific differences in expression occur both in the blood and other pain-relevant tissues. As Dr. Linnstaedt explains: “Understanding molecular mediators of chronic pain development that cause increased pain vulnerability in women is incredibly important. This is because recent estimates suggest that 70% of all individuals with chronic pain are women. In order to more precisely treat every individual, it is important to understand mechanisms of pain biology in both sexes.”

Third-year UNC medical student Michael Gonzalez working in Linnstaedt laboratory

UNC ANESTHESIOLOGY NEWS | VOLUME 1 • ISSUE 2 • FALL 2016

Featured Publications, Awards & Presentations January to June 2016 ABSTRACTS Cobb K, Potisek M, Willie C, Hobbs G, Blasius K. From Pediatrics to Obstetrics: Conversion of an Interdisciplinary Clinician Based Simulation Program to Improve Peripartum Emergency Response Times. Society for Simulation in Healthcare. Annual International Meeting on Simulation in Healthcare (IMSH) Meeting, San Diego, CA, January 2016. Blasius K , Willie C, Hobbs G, McNaull P, Baboolal H, Joyner B. It Takes a Team to Make a Team: Building Blocks for Our Pediatric Operative Team. Annual International Meeting on Simulation in Healthcare (IMSH), San Diego, CA, January 2016. Isaak R, Hobbs G, Kolarczyk L, Balfanz G, Bass C, Stiegler M. Real Time vs. Delayed Assessment of ACGME Milestones Through Simulation Scenarios. Annual International Meeting for Simulation in Healthcare (IMSH), San Diego, CA, February 2016.

McHugh SM, Kolarczyk L, Lang RS, Wei LM, Jose M, Subramaniam K. A comparison of high-dose and lowdose tranexamic acid antifibrinolytic protocols for primary coronary artery bypass surgery. Indian J Anaesth. 2016 Feb;60(2):94-101. doi: 10.4103/0019-5049.176279. Qadri YJ, Kumar PA, Lateef B, Arora H. An Unusual Presentation of a Mediastinal Mass. Journal of Cardiothoracic and Vascular Anesthesia, Vol30, No 1. February 2016:pp. 269–272. Asgarian C, Martinelli S, Mark JB, Kumar PA. Partial Anomalous Hepatic Venous Return: A Systematic Intraoperative Exclusion of Other Serious Diagnoses. Anesth Analg. Feb 2016; 122(2): 349-353. Passannante AN. “Who needs a preoperative evaluation?” Preoperative and postoperative challenges. Audio-Digest Anesthesiology. Audiodigest Anesthesiology. Volume 58, Issue 20 May 28,2016 ISSN 0271-1265.

Berry B, Marino M, Martinelli S, Kumar PA. Intracardiac Thrombus Formation with Subsequent Left Ventricular Dysfunction in a Patient Undergoing Aortic Valve Replacement for Aortic Stenosis. Society of Cardiovascular Anesthesiologists (SCA), San Diego, CA, April 2016.

McKenzie CP, Carvalho B, Riley ET. The Wiley Spinal Catheter-Over-Needle System for Continuous Spinal Anesthesia: A Case Series of 5 Cesarean Deliveries Complicated by Paresthesias and Headaches. Reg Anesth Pain Med. May-June 2016;41(3):405-10.

Herndon B, Nichols K, Smith KA. An Early Success Story: Extracorporeal Membrane Oxygenation (ECMO) for Acute Respiratory Distress Syndrome (ARDS) during Pregnancy. Society of Obstetric Anesthesiology and Perinatology 48th Annual Meeting, Boston, MA, May 2016.

McKenzie CP, Cobb B, Riley ET, Carvalho B. Programmed intermittent epidural boluses for maintenance of labor analgesia: an impact study. Int J Obstet Anesth. 2016 May;26:32-8. doi: 10.1016/j.ijoa.2015.11.005.

Smith KA, Sitzmann D. Peripartum Management of Stenotic Mechanical Mitral Valve Requiring Warfarin Therapy. Society of Obstetric Anesthesiology and Perinatology 48th Annual Meeting, Boston, MA, May 2016. Vellanki S, Smith KA. Management of Acute Promyelocytic Leukemia during Pregnancy. Society of Obstetric Anesthesiology and Perinatology 48th Annual Meeting, Boston, MA, May 2016. Hodnett J, Smith KA. Management of a Parturient with Aplastic Anemia and Cerebral Arteriovenous Malformation. Society of Obstetric Anesthesiology and Perinatology 48th Annual Meeting. Boston, MA, May 2016.

Isaak R, Chen F, Hobbs G, Martinelli S, Stiegler M, Arora H. Standardized Mixed-Fidelity Simulation for ACGME Milestones Competency Assessment and Objective Structured Clinical Exam Preparation. Med Sci Educ. 2016:1–5 doi:10.1007/s40670-016-0277-0 BOOK CHAPTERS Smeltz A, Kumar PA. Angiotensin axis blocking drugs in the perioperative period: a review. Anesthesiology News Special Edition. February 2016. NEW FUNDING: GRANTS AND SALARY SUPPORT Bobby Wunnava, MD: 2016-2017 Medtronic Fellowship Grant notification. Amount $10,000. Dates 7/1/16 – 6/30/17.

Smeltz A, MD. 1) Acute rupture of anterior mediastinal teratoma causing tamponade; 2) BioGlue®-associated loss of aortic valve leaflet motility sonographically masked by newly replaced mechanical mitral valve. (Thoracic Symposium) Society of Cardiovascular Anesthesiologists (SCA), San Diego, CA, April 2016. Karenz A, MD. Management of a Patient with Kartagener's Disease for Bilateral Orthotropic Lung Transplantation. Society of Cardiovascular Anesthesiologists (SCA), San Diego, CA, April 2016. Rohman T, MD. Rescue TEE and Pharmacological Management of a Cardiac Arrest in a Patient with a Heart Transplant. Society of Cardiovascular Anesthesiologists (SCA), San Diego, CA, April 2016. Rosenkrans D, MD. Anesthetic Monitoring Directly Impacts Patient Outcome During Novel Suprasternal TAVR Approach. Society of Cardiovascular Anesthesiologists (SCA), San Diego, CA, April 2016. Straube L, MD. Regional Anesthesia for Non-Cardiac Surgery in a Patient with a Left Ventricular Assist Device. Society of Cardiovascular Anesthesiologists (SCA), San Diego, CA, April 2016. Claar S, MD. Severe, Unexplained Lactic Acidosis during Cardiopulmonary Bypass. Society of Cardiovascular Anesthesiologists (SCA), San Diego, CA, April 2016. Marino M, MD. Immobility Of Mechanical Mitral Valve Leaflet Due To Residual Subvalvular Apparatus Detected By Intraoperative TEE. Society of Cardiovascular Anesthesiologists (SCA), San Diego, CA, April 2016. Berry B, MD. Intracardiac Thrombus Formation with Subsequent Left Ventricular Dysfunction in a Patient Undergoing Aortic Valve Replacement for Aortic Stenosis. Society of Cardiovascular Anesthesiologists (SCA), San Diego, CA, April 2016. Second Author: Morgan Marino MD / Faculty: Martinelli, Kumar Macksey L, MSN, CRNA. EKG Interpretation. 2nd Annual UNC CRNA Anesthesia Meeting, Chapel Hill, NC, April 2016.

Hertz, CM. Characteristics of a Tertiary Care Center Ambulatory Surgery Patient Population, and Predictors of Unplanned Hospital Admission. Society for Ambulatory Anesthesia (SAMBA) 31st Annual Meeting, Orlando, FL, May 2016.

INVITED PRESENTATIONS

Hueske A, MSN, CRNA. The Business of Anesthesia. 2nd Annual UNC CRNA Anesthesia Meeting, Chapel Hill, NC, April 2016.

Blasius K. Interprofessional Education (IPE) and Simulation: What? So What? Now What? IMSH, Society for Simulation in Healthcare Annual Meeting, San Diego, CA, January 2016.

Niday L, MSN, CRNA: Enhanced Recovery After Surgery: Is it really enhancing recovery? 2nd Annual UNC CRNA Anesthesia Meeting, Chapel Hill, NC, April 2016.

Chen F, Arora H, Martinelli S, Mayer D, Passannante A, Smith K. The Predictive Value of Pre-Recruitment Academic Achievement on Resident Performance in Anesthesiology. Society for Education in Anesthesia Spring Meeting, Baltimore, MD, June, 2016.

Koenig M, Blasius K, Kopp V. “Audit of institutional practices of infant intubation.” Society for Pediatric Anesthesia/ American Academy of Pediatrics. Pediatric Anesthesiology 2016 meeting, Colorado Springs, CO, April 2016.

Silvers R, MSN, CRNA / Art Bryson, MSN, CRNA. Anesthesia in the Outer Lands. 2nd Annual UNC CRNA Anesthesia Meeting, Chapel Hill, NC, April 2016.

MANUSCRIPTS Barrick B, Smeltz A, Ganesh A, Arora H, Kumar PA. Aortic Valve Thrombus in a Patient with an Extracorporeal Left Ventricular Assist Device: The Dilemma of Management. JCVA. Jan. 2016;30:196-9. Kolarczyk LM, McNaull P, Hance L, Bednar P, Kim HJ, Isaak R. Implementation of an Enhanced Recovery After Surgery (ERAS) Clinical Pathway Using Lean Six Sigma Principles: A Framework for Ongoing Quality Improvement. SDRP Journal of Anesthesia & Surgery. 1.1 (2016): 1-7. Web 22 Feb 2016.

Stiegler M, Isaak R. Milestones and OSCEs: Start to Finish, a Multi-Institutional Approach. Annual International Meeting on Simulation in Healthcare (IMSH) Meeting, January 2016. Stiegler M, Isaak R. Expert Communication: The Power of Frames and Reframing for Difficult Debriefing and Real Life Situations. International Meeting for Simulation in Healthcare. January 2016 San Diego.

Bass C, Stander S. Ultrasound-Guided Infiltrative Truncal Block Workshop. American Society for Enhanced Recovery. Washington, DC, April 2016. Linnstaedt SD (moderator), McLean SA, Levine J. StressInduced Persistent Pain: Mechanistic Insights from Humans and Animals. Invited Symposium Presentation at the 2016 Annual Meeting of the American Pain Society, Austin TX, May 2016.

Kumar PA. Grand Rounds: Cardiac Stents and their implications for Anesthesia Care (Oral Presentation Invited) Visiting Professor - Wayne State University, Detroit, MI, February 2016.

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DEPARTMENT OF ANESTHESIOLOGY

UNC-CHAPEL HILL

N2198 UNC Hospitals CB# 7010 Chapel Hill, NC 27599-7010

Upcoming Events September 17

October 23

9th Annual UNC-Duke-Wake Forest Pediatrics Anesthesiology Conference William & Ida Friday Center (Chapel Hill, NC)

UNC Dept. of Anesthesiology Annual Alumni Reception – ASA 2016 Mid-Atlantic Club (Chicago, IL)

September 23-25

November 17-19

North Carolina Society of Anesthesiologists Annual Meeting Charleston Marriott (Charleston, SC)

15th Annual American Society of Regional Anesthesia & Pain Medicine Meeting Hilton San Diego Bayfront Hotel (San Diego, CA)

October 1

January 21-25, 2017

UNC Division of Pain Management: “Pain, Addiction and the Law” CME Course William & Ida Friday Center (Chapel Hill, NC)

October 21-26 American Society of Anesthesiologists Annual Meeting McCormick Convention Center (Chicago, IL)

Society of Critical Care Medicine’s 46th Critical Care Congress Hawaii Convention Center (Honolulu, HI)

March 18, 2017 3rd Annual UNC CRNA Anesthesia Spring Meeting Venue TBD (Chapel Hill, NC)

For more information regarding the events listed above, please visit www.med.unc.edu/anesthesiology.