Department of Anesthesiology UMass Memorial Medical Center University of Massachusetts Medical Center June 2012 Welcome New Members! Since our last newsletter, we have added new members to our team. Welcome to Denis Childs, CRNA and Terri Boelke, Executive Administrative Secretary to Dr. Stephen Heard. Staff News Dr. Spiro Spanakis was elected as MSA Vice President for the 2012-2013 year. Drs. Bronwyn Cooper, Elifce Cosar and Mathias Walz have been promoted to Clinical Associate Professors of Anesthesiology. Congratulations to Drs. Bob Canelli and Sean Collins. Dr. Heard recently announced that they will be the Chief Residents for the 2012-2013 academic year. The Department of Anesthesiology has had many recent retirees. Dr. Astrid Liland, Dr. Anil Vyas, Janice Adams and Marguerite Eckhouse have recently retired. Dr. Richard Breed will retire at the end June. We wish them all the best.

Dr. Lance Lichtor has left the department in March. Dr. Monica Ganatra, Dr. Nicholas Watson, Dr. Alex Zilber, Nancy Wurman, CRNA, and Chris Pereira, CRNA will be leaving the department in the near future. We wish them success and happiness in their new endeavors. Tony Craig, CRNA, was elected President of the Massachusetts Association of Nurse Anesthetists.

MSA Update on Sedation and Analgesia Drs. Kaur, Matheos, Mueller, Watson, Lee, Spanakis, Desai, Badr, Zanconato, Shaikh, Zayaruzny, Collins (Mass Eye & Ear), and Shapiro (Harvard Medical School), presented lectures and workshops at the Sixth Massachusetts Society of Anesthesiologists Update on Sedation and Analgesia held in Waltham on April 28, 2012. This day long symposium provided participants with a comprehensive review of issues related to sedation and analgesia. Topics of the lectures and workshops included patient evaluation and monitoring, pediatric considerations, pharmacological principles, medicolegal considerations, JCAHO standards, adult simulation, pediatric simulation and basic airway management. Drs. Kaur and Desai were the Program Chairs and Drs. Spanakis and Badr were Program Co-Chairs.

Junior Faculty Development Program Drs. Rana Badr and Spiro Spanakis graduated from the Junior Faculty Development Program on May 24, 2012. Dr. Badr’s project focused on the development of a cardiac anesthesia curriculum for anesthesia residents and Dr. Spanakis’ project concentrated on the development of a simulation curriculum.

Community Service For the past seven years, Dr. Peter Foley has represented the Department of Anesthesiology at the annual UMass Children’s Medical Center Teddy Bear Clinic. It was held at the Solomon Pond Mall on April 21, 2012. Dr. Foley along with Drs. Kate Metcalf and Jen Smith could be found at the “Sleepy Bear Booth”. Thank you to Joan Stairs who provided the equipment package for the clinic.

Milestones The following employees recently celebrated service anniversaries with UMass Medical School or UMass Memorial.

Years of

Service 5 Bronwyn Cooper MD 5 Carolyn Mc Laughlin CRNA 5 Issam Khayata MD 5 Jesse Bourque CRNA 5 Melinda Gauvin 5 Michael Amankwah 5 Shaheen Shaikh MD 10 Christian Mueller MD 10 Gilbert Fishbein MD 10 Gloria Maravilla 15 Anil Vyas MD 15 Lisa Nicholson 15 Sudershan Singla MD 20 John Pullerits MD 25 Karen Longtine, RN 25 Melissa O'Neill, RN 25 Shubjeet Kaur MD 30 Susan St. Martin

New Babies Congratulations to…….. Chris Barnes welcomed Everett Martin Barnes to his family. Everett, born on March 15 at 5:30 am, was 6 pounds 1 ounce and was 19 inches long.

Edwin welcomed Erin Asong Aroke on May 10. She was born at 5:35 am and weighed 7 pounds 10 ounces. Matt Stebulis’ son, Orin Stebulis, was born on May 20. He was 9 pounds 12.8 ounces at birth.

Congratulations to the Class of 2012! Last Saturday evening, the graduating residents of the class of 2012 were honored and received their graduation certificates, presented by Dr. Heard and Dr. Duduch, at the Residency Graduation Dinner at Pleasant Valley Country Club in Sutton, MA. The following certificates were also presented: Fiberoptic Intubation Certification, presented by Dr. Elifce Cosar, to

Dr. Joshua Camara; Dr. Gassan Chaiban; Dr. John ; Dr. Betty Medeiros-Beattie; Dr. Katherine Metcalf; Dr. Nathanael Slater and Dr. Jason Spiegler

Ultrasound-Guided Regional Anesthesia Certification, presented by Dr. Issam Khayata, to

Dr. Joshua Camara; Dr. Gassan Chaiban; Dr. John ; Dr. Betty Medeiros-Beattie; Dr. Katherine Metcalf; Dr. Nathanael Slater and Dr. Jason Spiegler

Recognition for the highest In-Training Exam Scores, presented by Dr. Manish Desai, to PGY1 – Brian Tevlin, MD PGY2 – Nicholas Petrinec, DO and Kyle Smith, MD (tie) PGY3 – Zachary Nightingale, MD PGY4 – John Hamilton, MD

Congratulations to Dr. Costin Negroiu who received the Teacher of the Year Award. Second and third runners up, Dr. Nicholas Watson and Dr. Elifce Cosar, were also presented certificates.

We wish the graduates much happiness and success as they begin their careers in Anesthesiology. Dr. Joshua Camara will begin a Pediatric Anesthesia Fellowship at Children’s National Medical Center, Washington, DC. Dr. Gassan Chaiban will begin a Pain Fellowship at the University of Toledo Medical Center, Toledo, OH Dr. John Hamilton will be an attending Anesthesiologist at Walter Reed National Military Medical Center, Bethesda, MD Dr. Betty Medeiros-Beattie will be an attending Anesthesiologist at Miriam Hospital, Providence, RI Dr. Katherine Metcalf will begin a Pediatric Anesthesia Fellowship at Seattle Children’s Hospital, Seattle, WA Dr. Nathanael Slater will be staying at UMass Memorial Medical Center as an attending Anesthesiologist and Critical Care Intensivist Dr. Jason Spiegler will be an attending Anesthesiologist with Riverdale Anesthesia Associates, Riverdale, GA

NEARC The New England Anesthesia Resident Conference was held on March 24, 2012 in Burlington, VT. The following residents and medical students along with their faculty mentor presented posters at the meeting. Jason Blue, MD, Rana Badr, MD Sunday, Bloody Sunday: Unanticipated Ascending Aortic Dissection and Grafting After Coming Off CPB for CABG Robert Canelli MD, John Weaver MD, Elifce Cosar MD Anesthetic Considerations for Cervical Fusion Surgery in Advanced Rheumatoid Arthritis and Severe Pulmonary Hypertension Adam Currier, MD, Issam Khayata, MD Ultrasound as a Modality for Detection and Treatment of an Ilioinguinal Neuroma Jose De León MD, Betty Medeiros-Beattie MD, Stephen O. Heard MD, Antonio Aponte-Feliciano MD Delayed Emergence from General Anesthesia Layla Fakhrzadeh MD, Elifce Cosar MD, Christian Mueller MD, Nicholas Watson MD Paraplegia Following Pneumonectomy and Descending Thoracic Aorta Mass Resection Lindsay Gittens MSIV, Katherine Metcalf MD, Nicholas C. Watson MD Thrombotic Thrombocytopenic Purpura or Disseminated Intravascular Coagulation? Diagnostic Dilemma in the ICU Spiro Khoury MD, Nicholas C. Watson MD Antibiotic-Induced Thrombocytopenia in the ICU: Case Report of a Diagnostic Challenge Nancy Lee BA, Stephen O. Heard MD Management of a Patient with an Encapsulated Parapneumonic Empyema Complicated by the Intraoperative Development of an Acute Bronchopleural Fistula and ARDS Nicholas Petrinec DO, Bree Huning MSIII, Nicholas C. Watson M.D. Point of Care Testing Error in the ICU Nathanael A. Slater DO, Nicholas C. Watson MD Transfusion-Related Acute Lung Injury during Liver Transplant: Case Report

Publications … Poster Presentations … Outside Presentations Dr. Shubjeet Kaur presented two posters at the 2012 ASA Practice Management Conference in Orlando, FL, January, 2012. The posters are titled “Patient Flow in Perioperative Services: Analysis of Factors that Impact OR Turn Over Time” and “Post-Anesthesia Evaluation: Systems Based Team Approach to Achieve Compliance with CMS Interpretive Guidelines”. Dr. Issam Khayata presented at the First Syrian American Medical Society (SAMS) Conference in Florida in February 2012. The title was “Mobile Anesthesia: Ready, Set, Pack and Go”. This was presented as part of the Humanitarian Medicine in Disasters and Crisis Situations. Special appreciation goes to Jesse Bourque, CRNA for providing valuable information on this topic. It was very well received. The article has been accepted for publication in the Avicenna Journal of Medicine. Drs. Matthias Walz and Stephen Heard presented a poster at the Society of Critical Care Medicine’s 41st Critical Care Conference in Houston, Texas, February 4-8, 2012. Walz J, Ellison R, Flaherty H, McIlwaine J, Mack D, Whyte K, Heard, S: Effect of a multidisciplinary team approach to eradicate central venous catheter (CVC) bloodstream infections (CRBSI). Crit Care Med 2011;39 (Suppl):161. Drs. Costin Negroiu and Bronwyn Cooper attended the Society of Education in Anesthesia (SEA) Teaching and Learning Workshop held in Raleigh, NC, on March 2, 2012. Dr. Kaur spoke at the 2012 American Association of Clinical Directors’ Perioperative Leadership Summit held in New Orleans, March 9-11, 2012. The title of her presentation was “Conflict Resolution/Negotiation and Meta-Leadership”. Drs. Manisha Desai and Antonio Aponte-Feliciano presented two abstracts at the Anesthesia History Association meeting, Kansas, MO, on May 3-5, 2012. Their titles are “History of Anesthesia Related Sites in Hartford, Connecticut” and “Alternate Methods to Teach the History of Anesthesia”. Drs. Manisha Desai and Rebecca Zanconato presented “Bringing It Home”, a workshop at the Society of Education in Anesthesia (SEA) in Milwaukee, WI, on June 1 - June 3, 2012. Issam Khayata, MD; Gustavo Angaramo, MD; Robert Lee, MD; Costin Negroiu, MD; Alexander Zilber, MD; Patty Amelin, NP: The Use of Ultrasound to Measure the Depth of Thoracic Epidural Space. This was a poster presentation at the American Society of Interventional Pain Physicians 2012 Annual Meeting; Washington, DC, June 9-13, 2012. Loftus RW, Brown JR, Koff MD, Reddy S, Heard SO, Patel HM, Fernandez PG, Beach ML, Corwin HL, Jensen JT, Kispert D, Huysman B, Dodds TM, Ruoff KL, Yeager MP: Multiple reservoirs contribute to intraoperative bacterial transmission. Anesth Analg 2012;114:1236-48. Zhao H, Heard SO, Mullen MT, Crawford S, Goldberg RJ, Frendl G, Lilly CM: An evaluation of the diagnostic accuracy of the 1991 American College of Chest Physicians/Society of Critical Care Medicine and the 2001 Society of Critical Care Medicine/European Society of Intensive Care Medicine/American College of Chest Physicians/American Thoracic Society/Surgical Infection Society sepsis definition. Crit Care Med 2012; 40:1700-6. Watson NC: Likert or not, we are biased. Anesthesiology. 2012;116:1160.