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Anesthesiology CME Program  |   February 2006
Instructions for Obtaining Journal CME Credit
Article Information
Anesthesiology CME Program
Anesthesiology CME Program   |   February 2006
Instructions for Obtaining Journal CME Credit
Anesthesiology 2 2006, Vol.104, 395-396. doi:
Anesthesiology 2 2006, Vol.104, 395-396. doi:
Anesthesiology's journal-based CME program is open to all readers. Members of the American Society of Anesthesiologists participate at a preferred rate, but you need not be an ASA member or a journal subscriber to take part in this CME activity. Please complete the following steps:
  1. Read the article by Bhananker et al.  entitled “Injury and liability associated with monitored anesthesia care: A closed claims analysis” on page 228 and the accompanying editorial by Hug entitled “MAC should stand for maximum anesthesia caution, not minimal anesthesiology care” on page 221 of this issue.

  2. Review the questions and other required information for CME program completion (published in both the print and online journal).

  3. When ready, go to the CME Web site: . Submit your answers, form of payment, and other required information by December 31 of the year following the year of publication.

The American Society of Anesthesiologists is approved by the Accreditation Council for Continuing Medical Education (ACCME) to sponsor continuing medical education for physicians.
The American Society of Anesthesiologists designates this continuing medical education program for a maximum of 1 hour of Category 1 credit toward the AMA's Physician Recognition Award. Each physician should claim only those hours of credit actually spent in the activity.
Purpose:  The focus of the journal-based CME program, and the articles chosen for the program, is to educate readers on current developments in the science and clinical practice of the specialty of Anesthesiology.
Target Audience:  Physicians and other medical professionals whose medical specialty is the practice of anesthesia.
Learning Objectives:  After reading the articles, participants should have a better understanding of the risks and clinical challenges associated with monitored anesthesia care and sedation.
Disclosure Information:
Authors  –Carl C. Hug, Jr., M.D., Ph.D.
Grants or research support:  None
Consultantships or honoraria:  None
The author has no conflicts of interests. Dr. Hug was a member and chairman of the Claims/Risk Management Committee for The Emory Clinic, 1990–2000.
Authors  –Sanjay M. Bhananker, M.D., F.R.C.A., Karen L. Posner, Ph.D., Frederick W. Cheney, M.D., Robert A. Caplan, M.D., Lorri A. Lee, M.D., and Karen B. Domino, M.D., M.P.H.
Grants or research support:  Supported by the American Society of Anesthesiologists, Park Ridge, Illinois.
Consultantships or honoraria:  None
Question Writer  –Peter L. Bailey, M.D.
Dr. Bailey has no grants, research support, or consultant positions, nor does he receive any honoraria from outside sources, which may create conflicts of interest concerning this CME program.
Article Questions
Based on the article by Bhananker et al.  entitled “Injury and liability associated with monitored anesthesia care: A closed claims analysis”and its accompanying editorial by Hug entitled “MAC should stand for maximum anesthesia caution, not minimal anesthesiology care”in the February issue of Anesthesiology, choose the one correct answer for each question:
1. Which one of the following statements concerning the severity of injury in closed claims involving monitored anesthesia care (MAC) is most  likely true?
A. Injury related to permanent brain damage occurs in a smaller proportion of MAC claims compared to general anesthesia claims.
B. Injury related to permanent brain damage occurs in a similar proportion of MAC claims compared to general anesthesia claims.
C. Injury related to permanent brain damage occurs in a smaller proportion of MAC claims compared to regional anesthesia claims.
D. Injury related to permanent brain damage occurs in a similar proportion of MAC claims compared to regional anesthesia claims.
2. Which one of the following statements concerning the role of respiratory causes of injury in closed claims involving MAC is most  likely true?
A. Respiratory depression led to an adverse outcome in a greater proportion of MAC claims compared to general anesthesia claims.
B. Respiratory depression led to an adverse outcome in a lesser proportion of MAC claims compared to general anesthesia claims.
C. Inadequate oxygenation/ventilation was an uncommon (<10%) specific damaging event in MAC claims.
D. Inadequate oxygenation/ventilation was the most common specific respiratory damaging event in MAC claims.
3. Which one of the following statements concerning the role of patient movement as the primary damaging event in closed claims analyses is most  likely true?
A. Patient movement was determined to be the primary damaging event in a greater proportion of MAC claims compared to either regional or general anesthesia claims.
B. Patient movement was determined to be the primary damaging event in a greater proportion of general anesthesia claims compared to MAC claims.
C. Patient movement was determined to be the primary damaging event in a greater proportion of regional anesthesia claims compared to MAC claims.
D. Patient movement was determined to be the primary damaging event in a greater proportion of regional anesthesia claims compared to general anesthesia claims.
4. Which one of the following statements concerning the anesthesia care in MAC closed claims cases is most  likely true?
A. The use of propofol was not associated with excessive sedation in MAC claims cases.
B. Care in MAC claims cases, where injury was related to excessive sedation and respiratory depression, was determined to usually be substandard.
C. Capnography was used in most MAC claims cases.
D. An opioid was administered in all closed claims cases where it was determined that there was excessive sedation and respiratory depression.
5. Which of the following statements concerning burn injuries following fires in MAC closed claims is most  likely true?
A. Electrocautery is almost always the source of ignition.
B. Burns are not an important or relevant type of injury.
C. Alcohol prep solutions always play a role.
D. Modern surgical drapes do not burn
6. Which statement concerning the American Society of Anesthesiologists' Standards for Basic Anesthetic Monitoring is most  likely true?
A. Capnography is not mandated in intubated patients during general anesthesia.
B. Capnography is not mandated in patients with a laryngeal mask airway during general anesthesia.
C. Capnography is not mandated in all patients during general anesthesia.
D. Capnography is mandated in patients undergoing MAC