Guacalito de la Isla, Nicaragua

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Discover the secrets of this uncharted paradise when you indulge in excursions to nearby beaches and villages, volcanoes, and islands. Shop for a variety of Nicaraguan handicrafts perfect for that souvenir. The surfing here tops the lists of many surf enthusiasts who enjoy Nicaragua’s great year-round conditions, consistent waves, and space to move around without the crowds seen in locations further south. 80 degree temps are normal for the area, and this weather lends itself to a variety of outdoor adventures.

Spend days exploring the abundance of beauty from the jungles to the sea. Jump aboard a water taxi and go on a snorkel trip. Surf heaven awaits at renowned Manzanillo Point, where novices can enjoy lessons and coaching sessions as well as guided half-day boat and all-terrain-vehicle tours along the coast. Advanced surfers will enjoy the best waves at secluded spots that only locals know about.

Enjoy golf at its absolute finest. Out of the lush rainforest and rugged ocean bluffs comes a David McLay Kidd signature oceanfront, 18-hole, world class golf course. A challenge to players of all skill levels, Guacalito Golf Course seamlessly melds natural terrain while preserving the breathtaking environment that makes Nicaragua’s Emerald Coast special. Biking, archery, and tennis are also popular pastimes here.

Mukul Beach, Golf & Spa, Auberge Resorts Collection

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Recipient of the Conde Nast Traveler’s Reader’s Choice Awards 2017: Best Resorts In Central America. The resort is located on 1,675 acres of Nicaragua’s blossoming southwest Pacific shore in an expansive coastal region known as the Emerald Coast. For the duration of your stay, consider Mukul, Auberge Resorts Collection home, Playa Manzanillo’s immaculate white sands as your personal playground, and the entire Emerald Coast of Nicaragua your kingdom. Discover the secrets of this uncharted paradise when you indulge in excursions to nearby beaches and villages, volcanoes, and islands.

Golfers will find challenges for players of all skill levels. The Guacalito Golf Course seamlessly melds natural terrain while preserving the breathtaking environment that makes Nicaragua’s Emerald Coast special. Beautiful hardwood bridges made with fallen timber grace many holes. On the 18th hole, an unconventional par-3, was designed specifically to save mature trees instead of removing them.
When it’s time to relax, Spa Mukul includes six experiences housed in six individual, private spa suites. Each suite harnesses a different ancient healing tradition, often using local Nicaraguan ingredients.

Satiate your hunger when you choose from over 5 dining venues featuring innovative creations made with local ingredients, many of these dishes showcasing Mexican, Italian, French, Mediterranean, and Asian flavors. The mission here is to use traditional Nicaraguan ingredients in new ways—known as “Cocina NiKul”—with dishes such as Cabbage-wrapped Braised Regional Lamb, Local Grass-Fed Beef Consomme and Duck Confit Tamal.

Everything about Mukul’s Bohios feel like something from a storybook. Perfectly placed 300 feet above the Playa Manzanillo, nestled like tree houses in the lush rainforest canopy. Built of sustainable native teak and pine, Bohios feature floor-to-ceiling glass perfectly framing views of the hotel’s choice of golf course, mountains and/or ocean. A sliding glass door leads onto a sweeping wooden deck with a private plunge pool and separate lounging veranda with custom daybed. The spacious bathroom is surfaced in Nicaraguan travertine marble and includes a wet room, double vanity, spacious walk-in closet, hairdyer, and double-headed shower. Bohios accommodate a max of 2 people, and feature a single King bed with custom linens, Molton Brown bath amenities, safe, hair dryer, ice machine and honor bar with mini-refrigerator, flat screen television with entertainment center, central air-conditioning, and Wi-Fi internet access.

3 and 4 Bedroom Residences feature ocean views, hotel’s choice of 3 or 4 bedrooms and 3 or 4 full bathrooms, plus service quarters with separate bathroom, expansive terrace connecting the main living area with the outdoors. Ground floor units feature a private plunge pool on the veranda. Second floor units feature a chic sun deck and stunning views. Exclusive access to a beautiful lounge and large pool for guests and residents of the Las Terrazas neighborhood only. Max occupancy of 6 people.

International flights to Nicaragua land at Augusto C. Sandino International Airport (MGA) in Managua, Nicaragua the nation’s capital. Many guests also choose to fly into one of Costa Rica’s two international airports: Daniel Oduber Quirós International Airport (LIR) in Liberia and San Jose (SJO). If flying via San Jose, guests will need to fly to the nearby Liberia airport before taking a 30-minute flight on Sansa Airlines which brings you to the Emerald Coast International Airport (ECI) in Nicaragua. Mukul, Auberge Resorts Collection’s VIP Concierge Service at both airports in Costa Rica ensure that your connection is seamless and comfortable. Guests can then be are then picked up and driven to the resort by private car (fee applies).

Ideally located, this unique coastal community is only 10 minutes away from the International Costa Esmeralda Airport, and just two hours away from Managua’s International Airport. Whether arriving in Nicaragua’s capital city of Managua or heading directly to San Jose or Liberia, Costa Rica, *Mukul, Auberge Resorts Collection’s concierges and private drivers will be there waiting with a smile and a fresh beverage, your perfect welcome to the warmth of Central America. Even better, each vehicle is equipped with Wi-Fi, so you can catch up with family and let them know you arrived safely while experiencing your first views of Nicaragua’s stunning topography.*Fees apply for transportation services.

Email us at 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.

Anesthesia Update
Guacalito de la Isla, Nicaragua
February 3–8, 2019

Sunday, February 3

  0800 Registration - Mandatory Sign In - Continental Breakfast
  0825 Welcome NWAS Staff  
  0830 Review ACC/AHA Guidelines for Cardiac Evaluation of Patients Undergoing Noncardiac Surgery K.Candiotti  
  0930 Clinical Applications of Pharmacogenomics K.Candiotti  
  1030 Break
  1045 Ketamine: Multiple Uses for an Old Friend G.Crosland  
  1145 Enhanced Recovery Protocols and Anesthesia S.Clendenen  
  1245 Adjourn 1.5 Pharmacology Hours

Monday, February 4

  0800 Registration - Mandatory Sign In - Continental Breakfast
  0830 Opioid Crisis in America: What Now? S.Clendenen  
  0930 Ultrasound 101: What's Different About Ultrasound for Regional Anesthesia? S.Clendenen  
  1030 Break
  1045 Surgical Site Infections: Is My Cloth Hat Really Killing People? K.Candiotti  
  1145 Dental Anesthesia for the Special Needs Patient G.Crosland  
  1245 Adjourn 0.9 Pharmacology Hours

Tuesday, February 5

  0800 Registration - Mandatory Sign In - Continental Breakfast
  0830 Evaluation of the Difficult Pediatric Airway G.Crosland  
  0930 Management of the Difficult Pediatric Airway G.Crosland  
  1030 Break
  1045 Epidural, Paravertebral, or Transversus Abdominis Plane Block: Is There an Ideal Block? S.Clendenen  
  1145 Infectious Risks for the Anesthesia Provider K.Candiotti  
  1245 Adjourn
0.5 Pharmacology Hours

Wednesday, February 6 - Day Open


Thursday, February 7

  0800 Registration - Mandatory Sign In - Continental Breakfast
  0830 Management of Patients Exposed to Chemical Weapons K.Candiotti  
  0930 Hypothermia K.Candiotti  
  1030 Break
  1045 Tonsillectomy: Myths and Current Controversies G.Crosland  
  1145 Regional Anesthesia and Analgesia for Orthopedic Surgery S.Clendenen  
  1245 Adjourn
1.2 Pharmacology Hours

Friday, February 8

  0800 Registration - Mandatory Sign In - Continental Breakfast
  0830 Peripheral Nerve Catheters and Home Management S.Clendenen  
  0930 Obstructive Sleep Apnea S.Clendenen  
  1030 Break
  1045 PONV Update K.Candiotti  
  1145 Houston, We Have a Problem: PBLD G.Crosland  
  1245 Adjourn
1.1 Pharmacology Hours

20 CME

20 CEC

5.2 Pharmacology Hours†

  Refreshments served at the meetings are for registered attendees only.  


Keith A. Candiotti, MD
Professor of Anesthesiology
Anesthesiology, Perioperative Medicine and Pain Management
University of Miami
Miami, Florida

Steven R. Clendenen, MD
Chair, Division of Regional Anesthesia
Vice-Chair Practice, Department of Anesthesiology
Associate Professor of Anesthesiology
Mayo Clinic
Jacksonville, Florida

J. Grady Crosland, MD
Associate Professor of Anesthesiology and Emergency Medicine
Assistant Professor of Pediatrics
Division of Pediatric Anesthesiology and Pain Medicine
Arkansas Children's Hospital
Little Rock, Arkansas


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 has been prior approved by the AANA for 20 Class A CEC; AANA Code #1036204; Expiration Date 2/8/2019.

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 December 5, 2018 to January 4, 2019. No refund after January 4, 2019; 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.

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:


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.