Join us for the ultimate tour of the ultimate ecological wonder, the Galapagos Islands! Enjoy a stunning array of native wildlife and cultural tours on this perfect combination of land and sea excursions. Get to know Ecuador and stand in two global hemispheres at once. All this and more awaits when you join NWAS!


  Day Date City / Port
  Sun Feb 17 Quito
  Mon Feb 18 Quito / Colonial City Tour & Middle of the World
  Tue Feb 19 Quito
  Wed Feb 20 Quito / Otavalo / Quito
  Thu Feb 21 Quito / Baltra / Galapagos Islands Cruise
  • Mosquera Islet
  Fri Feb 22 Galapagos Islands Cruise
  • Egas Port (Santiago Island)
  • Rabida Island
  Sat Feb 23 Galapagos Islands Cruise
  • Urbina Bay (Isabela Island) 
  • Tagus Cove (Isabela Island) 
  Sun Feb 24 Galapagos Islands Cruise
  • Espinosa Point (Fernandina Island)
  • Vicente Roca Point (Isabela Island)
  Mon Feb 25 Galapagos Islands Cruise
  • Highlands Tortoise Reserve (Santa Cruz Island) 
  • Baltra Airport / Quito 
  Tue Feb 26 Puerto Ayora, Santa Cruz Island, Galapagos
  Wed Feb 27 Puerto Ayora, Santa Cruz Island, Galapagos
  Thu Feb 28 Santa Cruz Island, Galapagos / Departure

Hotels & Accommodations

Swissotel Quito swissotel

In traditional Ecuadorian languages, Quito means “the center of the earth.” When you stay at Swissotel Quito, you will find your center with the peace and tranquility of a comfortable stay.

Pull back the curtains and take in inspiring views overlooking one of the highest capital cities in elevation on earth. The captivating city infuses ancient, colonial, and modern influences which are reflected in Swissotel’s authentically furnished rooms. Features include en-suite bathrooms, 300 thread Egyptian cotton linen, and an ergonomically designed workspace with complimentary Wi-Fi.

With four restaurants, a delicatessen and coffee shop, and one of Quito’s most relaxing bars, guests at Swissotel will find a variety of food and drink for any occasion. If you’re looking to relax, have a dip in the hotel pool or enjoy one of eighty spa treatments available at Amrita. You will also have access to a fully-equipped gym to help you maintain your fitness.

The Galapagos Legendgalapagoslegend

Welcome aboard the Galapgas Legend, a charming vessel able to accommodate 100 seaworthy travellers on this unforgettable Galapagos tour. The craft is perfectly sized for an intimate experience while leaving plenty of room for a comfortable stay. Open decks make admiring the islands’ flora and fauna easy and enjoyable.

Each cabin includes a hair dryer, comfortable bedding, and updated furniture. Internet is accessible when anchoring in main islands. The M/V Galapagos Legend has 52 ocean view, air-conditioned cabins plus 3 interior cabins. To better enjoy the scenery privately, balcony suites have private balconies and panoramic windows. Junior suites have three meters of panoramic windows.

RED Mangrove Eco Luxury Hotelredmangrove

Situated on the oceanfront in Puerto Ayora, the Red Mangrove blends in naturally with a surrounding mangrove forest while offering the most pleasant views of Academy Bay available on Santa Cruz. Accommodations offer something for everyone due to its unique location between the water’s edge and the mangrove forest. The hotel’s very own private deck and restaurant area have incredible panoramic scenes of the Galapagos Islands.

Watch the Galapagos sun rise and fall on the recently renovated deck and restaurant of Almar by Isla Grill. Guests are now able to enjoy new tables, chairs, loungers and an inviting outdoor lounge concept. Beyond this area we reserved the term "official sea lion resting area" as a result of the constant presence of sea lions looking for a place to relax with their marine iguana friends.

Sunday, Feb 17, 2019 – Arrive in Quito

Arrive in Quito, the capital city of Ecuador

Arrive at the airport and transfer to the hotel.

Monday, Feb 18, 2019 – Quito / Colonial City Tour & Middle of the World (Breakfast, Lunch)

This morning's tour offers the best of Quito, with its rich cultural legacy, ornate façades and dazzling gilded altars. Visit Independence Square, the Archbishop’s Palace, the Metropolitan Cathedral as well as other sites of colonial art and architecture. In the afternoon, visit the famous Equatorial Monument, marked by geographers as latitude 000’00”. You will have the opportunity to straddle the two hemispheres at the same time.

Tuesday, Feb 19, 2019 – Quito (Breakfast & Lunch)

Wednesday, Feb 20, 2019 – Quito / Otavalo / Quito (Breakfast & Lunch)

Visit the well-known indigenous market in Otavalo for an arts and crafts shopping adventure. Visit Peguche (known for its weavers), a wind instruments workshop, Cotacachi (known for the manufacture of leather goods), and Cuicocha crater lake before returning to Quito.

Thursday, Feb 21, 2019 – Quito / Baltra / Galapagos Islands Cruise (Breakfast, Lunch, Dinner)

Depart Quito and fly to Baltra (2½-hour flight)

Arrive in the Galapagos, welcomed at the airport by tour naturalists and taken to a 10 minute bus drive to the pier to board the M/V Galapagos Legend.

Afternoon – Mosquera Islet – Wet Landing
Mosquera Islet is located between North Seymour and Baltra Island. This flat, sandy island has a large colony of sea lions. It is also an excellent site to observe shorebirds such as herons and lava gulls. There is no trail on the islet, but visitors can enjoy the open area. Most of the islet is covered with sand and barren lava rock. Very few sesuviumportulacastrum plants grow on the sand.

Difficulty Level: Easy
Type of Terrain: Sandy
Duration: 1½-hour walk / snorkeling.

Friday, Feb 22, 2019 – Galapagos Islands Cruise (Breakfast, Lunch, Dinner)

Morning – Egas Port (Santiago Island) – Wet Landing
Egas Port is a black volcanic sand beach visited by Darwin in 1835. The first section of the trail is formed of volcanic ash (eroded tuff) and the other half is an uneven terrain of volcanic basaltic rock. The unique, truly striking, layered terrain of Santiago shore is home to a variety of animals including the bizarre yellow-crowned night heron and marine wildlife including lobster, starfish and marine iguanas grazing on algae beds alongside Sally light-foot crabs. It is easy to see colonies of endemic fur seals swimming in cool water volcanic rock pools.

Difficulty Level: Intermediate
Type of Terrain: Flat & semi-rocky
Duration: 1½-hour walk / 1-hour snorkeling

Afternoon – Rabida Island – Wet Landing
Dark red sands cover the unique beaches of this island, home to sea lion colonies. Rabida is considered the epicenter of the Galapagos Islands due to the diversity of its volcanic geology. Nesting brown pelicans are found from July through September plus nine species of the famous Darwin’s finches. Here, a dinghy ride along marine cliffs is done to observe nesting seabirds. Snorkel off the coast where marine life is particularly active.

Difficulty Level: Easy
Type of Terrain: Sandy
Duration: 1 ½-hour walk / 1-hour snorkeling / 1-hour dinghy ride

Saturday, Feb 23, 2019 – Galapagos Islands Cruise (Breakfast, Lunch, Dinner)

Morning – Urbina Bay (Isabela Island) – Wet Landing
(tides permitting)

Volcanic black beach, depending on the season, it is possible to find giant tortoises, land iguanas, and the unusual flightless cormorant. After a short walk inland it’s snorkeling time, a chance to swim with sea turtles, sea lions, and countless tropical fish.

Urbina Bay features a wide variety of plants, including a range of colorful flowers, attracting different insects, birds, and reptiles. One of the highlights of the island is the uplifted coral reef that resulted from the 1954 seismic activity; here the views of Alcedo Volcano are remarkable.

Difficulty Level: Intermediate
Type of Terrain: Flat & rocky
Duration: 1½-hour walk / 1-hour snorkeling

Afternoon – Tagus Cove (Isabela Island) – Dry Landing
Arrive on Galapagos’ largest island. Here, you’ll learn about the eruption of the five volcanoes that form the island. The trail leads to Darwin’s salt-water crater lake, excellent views of lava fields, and fantastic volcanic formations.

Return by dinghy ride along a shoreline full of marine wildlife, where you can admire a variety of seabirds, such as Blue-footed Booby, Brown Noddy, terns, Flightless Cormorant and depending on the season, a large number of Galapagos Penguins which are just over 1 foot tall and the only penguin species in the world to live in the tropics.

The population of penguins on the islands is about 2,000, most of which live on the western portion of Isabela. There will be an opportunity to snorkel in deep water. Graffiti believed to have been left by 19th-century pirates is a curious reminder of an intriguing past.

Difficulty Level: Intermediate / Difficult
Type of Terrain: Steep / Steep
Duration: 2-hour walk / 40-minute dinghy ride / 1-hour snorkeling

Sunday, Feb 24, 2019 – Galapagos Islands Cruise (Breakfast, Lunch, Dinner)

Morning – Espinosa Point (Fernandina Island) – Dry Landing
From Espinosa Point, it’s possible to admire a wide view of Isabela Island across the Bolivar Channel, an area that boasts some of the highest diversity of endemic sea fauna in the Galapagos. The largest, most primitive-looking marine iguanas are found here mingling with sea lions and crabs.

Fernandina displays a wonderful opportunity to encounter flightless cormorants at their nesting sites, more Galapagos penguins, and the “King” of predators on the islands, the Galapagos hawk. Pa-hoe-hoe and AA lava formations cover the majority of Fernandina terrain. Vegetation is scarce inland, with few brachycereus cacti.

Difficulty Level: Intermediate
Type of Terrain: Flat / Semi rocky
Duration: 1½-hour walk / 1-hour snorkeling

Afternoon – Vicente Roca Point (Isabela Island)
Enjoy great deep-water snorkeling at one of the richest marine havens on Earth, the Bolivar Channel. Accessible by water, take a dinghy ride along the coast to observe a great diversity of sea and coastal birds. The upwelling of cold water currents in this part of the Galapagos gives rise to an abundance of marine life, a perfect place for deep snorkeling.

Difficulty Level: Moderate / High
Type of Terrain: Water
Duration: 1-hour snorkeling / 1-hour dinghy ride

Monday, Feb 25, 2019 – Galapagos Island Cruise – Puerto Ayora, Santa Cruz Island (Breakfast, Lunch)

Morning Highlands Tortoise Reserve (Santa Cruz Island) – Dry Landing
In the mountains of Galapagos, keep your eyes open for tree and ground finches, vermilion flycatchers, paint-billed crakes, yellow warblers, and cattle egrets (usually standing on the tortoises’ shell).

Watch the landscapes and ecosystems change as you travel the road from the coast through the agricultural zone and up into the dense humid forests. Often, Galapagos Giant Tortoises are seen on the way, wandering through pastures in the paddocks. This spot is a birdwatchers’ haven, since almost every land bird present on the island lives or migrates here.

Difficulty Level: Easy
Type of Terrain: Flat and muddy (depending on season)
Duration: 45-minute drive / 1½-hour walk

Transfer to hotel: RED Mangrove Eco Luxury Hotel – Puerto Ayora

Tuesday, February 26 – Puerto Ayora, Santa Cruz Island

Optional 2 Tank Dives or Land Tour

Wednesday, February 27 – Puerto Ayora, Santa Cruz Island

Thursday, February 28 – Puerto Ayora, Santa Cruz Island / Quito / Departure

Passengers will be transferred to Baltra Airport for their return flight to Quito. Upon arrival in Quito, connect with your flight home.

Email us at info@nwas.com or call us (800) 222-6927 • (509) 547-7065


This course is designed for physicians, certified registered nurse anesthetists, physician assistants, nurse practitioners, registered nurses and other medical care providers who must maintain state-of-the-art knowledge of the specialty or are impacted by it.


Presentations are designed to facilitate the physician, nurse specialist, and other providers maintaining skills of the same kind to review and update knowledge and abilities in one or more of these areas vital to the practicing professional:

Possess the scientific background for clinical practice

Maintain state-of-the-art knowledge of not only the specialty, but also of all additional related disciplines which may impact it

Maintain an up-to-the-minute armamentarium of knowledge and skills for the selection and use of complex equipment, pharmacological agents, and procedures necessary for the provision of quality patient care

Manage self and colleagues to function toward common goals in the clinical setting, the clinical and educational institutions, and the community in which the practice resides

Serve as an expert in matters involving health care delivery; serve as an informed manager of clinical and educational services provided, including the acquisition and distribution of resources necessary in meeting professional goals

Provide assistance with and support of other service providers, departments, institutions, and organizations dependent upon the professional expertise of the practitioner


At the conclusion of this activity, the participant will be able to:

Apply the pertinent physical and behavioral sciences - to include but not be limited to advanced anatomy and physiology, pathophysiology, chemistry, physics, psychology, and social sciences - as they impact and are affected by the planning, delivery, and monitoring of anesthesia and related services inherent in the anesthesia professions.

Explain the selection, dosing considerations with methods of administration, safe use, and contraindications and precautions of presented pharmacological agents through the understanding of their physico-chemical properties, pharmacokinetics and pharmacodynamics, updated uses, and more recently developed additional, related, and similar drugs.

Outline comprehensive management plans for the group of patients discussed, whether related in age, physical status, cultural background, invasive procedure, anesthetic or analgesic requirements, clinical setting, adverse reactions, and/or goals of care.

Apply the principles of safety and asepsis in the performance of anesthetic procedures and administrations, equipment use, and other applications encountered during the provision of anesthesia and analgesia whether in the surgical unit, the labor and delivery suite, the pain management clinic, or other more remote location of anesthetizing services.

Incorporate the appropriate recommendations and/or requirements of pertinent external organizations, institutions, and professional groups - recognized as serving as the authority for and/or holding the responsibility to compile and approve such tenets - in the provision of anesthesia and related services, whether medical, legal, philosophical, ethical, or health care management standards.

Apply the new techniques in the clinical setting of the participant.

Clinical Concerns in Anesthesia
12-Day Ecuador & Galapagos Islands Land & Sea Tour
February 17-28, 2019

Sunday, February 17 - Arrive in Quito, Ecuador

Arrive at the airport and transfer to Swissotel

Monday, February 18 - Quito, Ecuador

Colonial City & Middle of the World Tour

Tuesday, February 19 - Quito, Ecuador

  0645 Breakfast
  0725 Registration - Mandatory Sign In
  0730 From Symptoms to Biomarkers: Should We Change the Paradigms? J.Kryc  
  0830 Cleared for Surgery J.Kryc  
  0930 Break
  0945 Hard Lessons Learned From Unexpected Bad Outcomes: Part I J.Drummond  
  1045 Hard Lessons Learned From Unexpected Bad Outcomes: Part II J.Drummond  
  1145 Introduction to Nanotechnology: Honey I Shrunk the Kids J.Kryc  
  1245 Lunch Break
  1345 Nanomedicine: The Cyborg Era Begins J.Kryc  
  1445 Promoting Caution about Depth of Anesthesia Sells Gadgets, but Does It Alter Patient Outcomes? J.Drummond  
  1545 Depth of Anesthesia Monitors:- Keeping the Expectations Reasonable J.Drummond  
  1645 Adjourn

Wednesday, February 20 - Quito, Ecuador - Otavalo, Ecuador

  0645 Breakfast
  0725 Registration - Mandatory Sign In
  0730 Obstetric Issues Impacting Anesthesia Practice J.Kryc  
  0830 Preeclampsia: What the Non-Obstetric Anesthetist Needs to Know J.Kryc  
  0930 Adjourn
  0945 Depart for Otavalo for an arts and crafts shopping adventure. Visit Peguche known for its weavers and Cotacachi known for the manufacture of leather goods. View Cuicocha crater lake before returning to Quito.

Thursday, February 21 - Quito, Ecuador - Baltra, Ecuador - Galapagos Islands Cruise

  0645 Breakfast
  0745 Depart for airport and flight to Baltra. Board the cruise ship Galapagos Legend.
Afternoon - Mosquera Islet

Friday, February 22 - Galapagos Islands Cruise

Morning - Egas Port (Santiago Island)
Afternoon - Rabida Island
  1545 Registration - Mandatory Sign In
  1600 Obstetric Problems Blame the Epidural J.Kryc  
  1700 Enigmas of a Mothers Heart: Peripartum Cardiomyopathy and Acute Myocardial Infarction During Pregnancy J.Kryc  
  1800 Adjourn - Dinner

Saturday, February 23 - Galapagos Islands Cruise

Morning - Urbina Bay (Isabela Island)
Afternoon - Tagus Cove (Isabela Island)

Sunday, February 24 - Galapagos Islands Cruise

Morning - Espinosa Point (Fernandina Island)
Afternoon - Vicente Roca Point (Isabela Island)
  1545 Registration - Mandatory Sign In
  1600 Should Our Patients (Some? All? None?) Take Statins Perioperatively? J.Drummond  
  1700 Should Anyone Else in the OR Be Taking Statins Too? J.Drummond  
  1800 Adjourn - Dinner

Monday, February 25 - Galapagos Islands Cruise - Baltra, Ecuador - Puerto Ayora, Santa Cruise Island

Morning - Highlands Tortoise Reserve (Santa Cruz Island)
Transfer to hotel: RED Mangrove Eco Luxury Hotel - Puerto Ayora
  1200 Lunch
  1245 Registration
  1300 Are You Confused About Delirium (and its Causation, Prevention and Treatment)? J.Drummond  
  1400 Common Misunderstandings and Misadventures in Neuroanesthesia J.Drummond  
  1500 Adjourn

Tuesday, February 26 - Puerto Ayora, Santa Cruz Island, Galapagos

  0645 Breakfast
Optional 2 tank dive or Land Tour

Wednesday, February 27 - Puerto Ayora, Santa Cruz Island, Galapagos

  0630 Breakfast
  0930 Registration - Mandatory Sign In
  0945 Anesthetic Neurotoxicity in the Very Young: A Somewhat Contrarian View J.Drummond  
  1045 Where Does Dexmedetomidine Fit in OR Practice? J.Drummond  
  1145 Amniotic Fluid Embolism: Can We Affect the Outcomes? J.Kryc  
  1245 Substance Abuse During Pregnancy J.Kryc  
  2100 Adjourn    

20 CME I

20 CEC

Pharmacology Hours TBD†


Thursday, February 28 - Santa Cruz Island, Galapagos

  0645 Breakfast
Transfer to Baltra Airport - flight to Quito connect to home


John C. Drummond, MD, FRCPC
Professor, Department of Anesthesiology
University of California, San Diego
Staff Anesthesiologist, VA Medical Center
San Diego, California

Joseph J. Kryc, MD, MBA
Adjunct Clinical Associate Professor of Anesthesiology
Banner University Hospital
Tucson, Arizona


This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint providership of The A. Webb Roberts Center for Continuing Medical Education of Baylor Scott & White Health and Northwest Anesthesia Seminars. The A. Webb Roberts Center for Continuing Medical Education of Baylor Scott & White Health is accredited by the ACCME to provide continuing medical education for physicians.

The A. Webb Roberts Center for Continuing Medical Education of Baylor Scott & White Health designates this live activity for a maximum of 20 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

American Board of Anesthesiology: CME credit will be sent directly to The American Board of Anesthesiology to fulfill the Part 2 requirement for the Maintenance of Certification in Anesthesiology Program (MOCA®).

Canadian Physicians: This activity is eligible for Section 1 credits in the Royal College’s Maintenance of Certification (MOC) Program. Participants must log into MAINPORT to claim this activity.

Certified Registered Nurse Anesthetists: This program is designed to meet requirements for Class A CE credit. Once approved by AANA, this will be indicated.

Nurse Practitioners: The American Academy of Nurse Practitioners Certification Program (AANPCP) and the American Nurses Credentialing Center (ANCC) accept CME from organizations accredited by the ACCME.

Osteopathic Physicians: This program is eligible for Category 2 credit with the American Osteopathic Association (AOA).

Physician Assistants: The American Academy of Physician Assistants (AAPA) accepts certificates of participation for educational activities certified for AMA PRA Category 1 Credit™ from organizations accredited by ACCME or a recognized state medical society. Physician assistants may receive a maximum of 20 hours of Category I credit for completing this program.

Registered Nurses: NWAS is an approved provider for the following state nursing boards: Arkansas State Board of Nursing (Provider Number 50-7480), California Board of Registered Nursing (Provider Number 4833), District of Columbia Board of Nursing (Provider Number 50-7480), Florida Board of Nursing (Provider Number 50-7480), Georgia Board of Nursing (Provider Number 50-7480), and the South Carolina Board of Nursing (Provider Number 50-7480). This program offers 20 contact hours.

†Pharmacology hours subject to change.


Mark T. Murphy, MD, MSN Education, Austin, Texas, and Medical Director, Northwest Anesthesia Seminars, Pasco, Washington


Factors beyond our control sometimes necessitate changes in the schedule and faculty. If time permits, we will inform all registrants of any changes prior to the program. Changes on site due to local conditions will be announced in class.


We reserve the right to cancel a course for any reason. In such case, a minimum of 30 days notice will be given to those registered and 100% of tuition paid will be refunded. NWAS and NWWT will not be responsible for any non-refundable airfare, hotel, or other liabilities you may incur. We highly recommend purchase of travel insurance. Travel at your own risk.


$100 ______________ to _____________. No refund after _____________________; however, 50% of tuition paid may be applied toward tuition for another NWAS program within the next 12 months. Cancellation must be made in writing.


No penalty prior to _______________. $1,000 per person from ______________ to _____________. 100% non-refundable after ___________.

FAP (Frequent Attendee Points)

FAP lets you accumulate points based on dollars spent with NWAS including net hotel and tuition booked through NWAS (but not air). Once you have enough points to cover a full tuition they can be redeemed for tuition (no cash value). A great program to reward you for supporting NWAS! Click here for more information.

Lecture notes will be provided via download in PDF format.

You must sign-in every day you attend to receive credit.

While we strive for accuracy at all times with our published information, we cannot be responsible for typographical and other errors.

Please note that children and non-registered guests are not allowed to attend the lectures. The concierge can provide you with childcare information.

Travel at your own risk.

Airfare available through Universal Travel. Be sure to mention Northwest Anesthesia Seminars when booking (booking fees may apply.) Contact Kellee Kilmer: Phone number: (858) 456-7887 - Email: kellee@universaltravel1.com


We recommend that you register early to assure your spot. We reserve the right to close registrations to a course at any time without notice. We may not be able to accommodate onsite registrations.

Click here for course and hotel registration (Coming Soon)