San Juan, Puerto Rico

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With more than 500 years in the making, San Juan is the cultural, social, and historic heart of Puerto Rico. Become captivated by the enchantment of the island’s culture, its modern city amenities and entertainment, and the tropical beauty of a Caribbean destination. Discover the historic treasures of majestic Old San Juan, the charming walled city with its imposing fortresses and colorful colonial architecture.

A short taxi ride from the old city are world-class boutiques and the inviting beaches and resorts of Ocean Park and Isla Verde. Santurce neighborhood is a fashionable urban-cultural-art-district. Check out ‘Plaza del Mercado’ and ‘La Placita’, as it’s affectionately known, a thriving public market by day where vendors hawk their wares and some of the freshest produce from all over the island and a vivacious hot spot for nightlife when the sun goes down; a variety of restaurants, cafes, and bars line its side streets, adding unique flavors to the surrounding activity.

Explore the numerous Puerto Rican attractions including the Bacardi Rum distillery, El Morro, San Cristobal and El Yunque rainforest—the only tropical rain forest in the U.S. National Forest system! Puerto Rico is a Free Commonwealth of the United States, so no passport is required for US citizens. With daily flights offered from major cities in the United States, travel to San Juan is convenient and affordable. As you sleep, dine, and shop, you’ll receive warm and friendly hospitality for an enjoyable stay. Plus, the weather is perfect with an average temperature in the 80’s all year. It’s always summer in San Juan, Puerto Rico!

San Juan Marriott Resort & Stellaris Casino

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San Juan Marriott Resort & Stellaris Casino Soak up the sun in style at this full-service luxury resort along Condado Beach in San Juan, offering the perfect balance of adventure and relaxation. Lounge under a beachfront palm or make a splash in the resort-style pool, complete with a waterslide and hot tub. The resort offers fun daily activities to keep all ages entertained. The resort also features a casino and variety of restaurants and bars.

Spa treatments also are available in the wellness center. When it’s time to sleep, unwind in guest rooms that feature 1 King or 2 Double beds (based on hotel availability), balcony, LCD TV, coffee/tea maker, mini refrigerator, safe, iron/board, hair dryer, robes, and more. Pool view rooms are located in the Cabana Wing and are approximately 350 square feet. Ocean View rooms are located in the hotel’s choice of the Main Tower or Cabana wing and are approximately 250 sq feet. The San Juan Marriott Resort is located approximately 5 miles from the Luis Muñoz Marín International Airport (SJU).

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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.

Relevant Topics in Anesthesia
San Juan, Puerto Rico
January 14–18, 2019

Monday, January 14

  0700 Registration - Mandatory Sign In - Continental Breakfast
  0725 Welcome NWAS Staff  
  0730 Anatomy, Physiology and Pharmacology in the Pediatric Patient H.De Soto  
  0830 The Patient With Congenital Heart Disease for Noncardiac Surgery H.De Soto  
  0930 Break
  0945 Perioperative Management of the Patient With Stents or CIEDs M.Murphy  
  1045 Fire in the OR: Who Also Gets Burned? M.Murphy  
  1145 Sleep Endoscopy and Obstructive Sleep Apnea: Can We Have Some Peace and Quiet? S.Donnelly  
  1245 Adjourn
1.5 Pharmacology Hours

Tuesday, January 15

  0700 Registration - Mandatory Sign In - Continental Breakfast
  0730 Herbs, Supplements and Other Substances Your Patients Are Not Reporting: Part I M.Murphy  
  0830 Herbs, Supplements and Other Substances Your Patients Are Not Reporting: Part II M.Murphy  
  0930 Break
  0945 Neonatal Surgical Emergencies H.De Soto  
  1045 Ultrasound 101: Lights Out, Now It's a Snow Storm! H.Nagavelli  
  1145 Hot Blocks in Anesthesia: PEC 1 and 2, Paravertebrals, I-PACK, and Quadratus Lumborum Blocks H.Nagavelli  
  1245 Adjourn
2.2 Pharmacology Hours

Wednesday, January 16 - Open Day


Thursday, January 17

  0700 Registration - Mandatory Sign In - Continental Breakfast
  0730 Pediatric Dilemmas in the Outpatient H.De Soto  
  0830 Anesthesia in the Child Outside the Operating Room H.De Soto  
  0930 Break
  0945 Enhanced Recovery and Anesthesia: Sprinting to Recovery H.Nagavelli  
  1045 The Bright Side of Pain Management: Non-Opioid Analgesics H.Nagavelli  
  1145 Anesthesia for Grafts and Fistulas: Technique DOES Matter! S.Donnelly  
  1245 Adjourn
2.3 Pharmacology Hours

Friday, January 18

  0700 Registration - Mandatory Sign In - Continental Breakfast
  0730 Pediatric Potpourri: Current Controversies H.De Soto  
  0830 Recovery Room Issues in the Pediatric Patient H.De Soto  
  0930 Break
  0945 Case Discussions From the American Quality Institute: Lessons Learned M.Murphy  
  1045 Risk Management: The Minefields Where You Walk and Work M.Murphy  
  1145 Review of the Recent Literature M.Murphy  
  1245 Adjourn
0.9 Pharmacology Hours

20 CME

20 Class A CEC

6.9 Pharmacology Hours†

Refreshments served at the meeting are for registered attendees only.


Hernando De Soto, MD
Chief of Anesthesia, University of Florida Proton Institute
Chief of Pediatric Anesthesia and Airway Services
University of Florida Health Hospital
Jacksonville, Florida

Sarah Donnelly, CRNA
Deputy Chief Certified Registered Nurse Anesthetist
Veterans Affairs Medical Center
Washington, District of Columbia

Mark T. Murphy, MD
MSN Education, LLC
St. Petersburg, Florida
Medical Director
Northwest Anesthesia Seminars
Pasco, Washington

Harika R. Nagavelli, MD
Clinical Assistant Professor of Anesthesiology and Critical Care Medicine
George Washington University School of Medicine and Health Sciences
Regional Anesthesia and Acute Pain Service Coordinator
Washington DC Veterans Affairs Medical Center
Washington, District of Columbia


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 #1036258; Expiration Date 1/18/2019.

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, LLC, Treasure Island, Florida, 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 November 15, 2018 to December 15, 2018. No refund after December 15, 2018; 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) 456-7962 - 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.