White Sulphur Springs, West Virginia

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Escape to the Southeast where an intimate, small town awaits. Set amid the Allegheny Mountains, Greenbrier County is an area rich in history and natural beauty, and also known far and wide as the most attractive area in West Virginia. Beautiful mountain views, specialty shops, Revolutionary and Civil War battle sites, art galleries, great restaurants and quiet country roads await you.

White Sulphur Springs, population 2,800, is home to the world-famous resort, The Greenbrier. The town boasts the presence of the oldest organized golf club in America, as well as the Federal Fish Hatchery and the Monongahela National Forest Information Center. This town has also received the prestigious "Main Street USA" designation. The nearby town of Alderson, population 1,100, recently gave new meaning to the old phrase "there's no such thing as bad publicity" when Martha Stewart was sentenced to the women's prison there.

The Greenbrier Resort

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The story of The Greenbrier begins at the spring of sulphur water that remains at the center of the resort property. It issues forth below the green dome of the white-columned Springhouse that has been the symbol of The Greenbrier for generations. Since 1778, people have come to "take the waters" to restore their health. In its first 125 years the resort was known by the name White Sulphur Springs.

The resort originally consisted of rows of cottages, many of which still stand today, including Paradise Row, Alabama Row and Baltimore Row. The cottages of Baltimore Row were designed by John H.B. Latrobe, a Baltimore lawyer and son of famed architect Benjamin Latrobe. His style extended later to the Tansas, South Carolina and Florida Rows and became the basis for the design of the new Copeland Hill cottages.

By the eve of the Civil War, White Sulphur Springs' reputation as the most fashionable social resort in the Southern states was well-established. This led to the 1858 addition of the first large hotel on the property, officially named the Grand Central Hotel, but known to long-time patrons as The Old White Hotel. The hotel boasted three stories of porches to catch summer breezes and ample space to promenade displaying one's fashionable attire. The resort was closed during the Civil War. Over the course of the conflict, both sides occupied the grounds, using the hotel either as a military headquarters or hospital. Shortly after the war's end, the resort reopened.

During World War II, The Greenbrier was put to two quite different uses by the U.S. government. The State Department leased the hotel for seven months after U.S. entry into the war and used it to intern German, Japanese and Italian diplomatic personnel, along with their families, until they could be exchanged for American diplomats stranded overseas. In September 1942, the U.S. Army purchased The Greenbrier, converted it into a two thousand-bed hospital and renamed it Ashford General Hospital. For four years the resort served as a surgical and rehabilitation center, and 24,148 soldiers were admitted and treated at the facility. The Greenbrier reopened to the public in 1948.

In the late 1950s the US government once again required the services of this resort. It wished to construct an Emergency Relocation Center (i.e. a bunker) for use by the U.S. Congress in the event of nuclear war. Between 1959 and 1962, the classified underground facility was built in conjunction with an above ground addition to the hotel, the West Virginia Wing. For 30 years, the owners of The Greenbrier and the federal government agreed that, in the case of an international crisis, the entire resort property would be conveyed to government use, specifically as the emergency location for the legislative branch of Congress. Above ground, life proceeded normally as The Greenbrier upgraded its property to stay competitive in the resort market. The convention center, which was used by the Greenbrier guests for business meetings, was actually a disguised workstation area for members of Congress complete with hidden blast doors. The underground bunker was finally closed in 1995. The complex is still maintained today by the Greenbrier and the facility remains much like it was in 1992 when the secret was revealed. While almost all of the furnishings were removed following the decommissioning of the bunker, furnishings close to what would have been in it at the time have been placed back in to approximate what the bunker looked like while it was still in operation. Two of the original bunks in the dormitories remain, however. Tours of this bunker are available through the hotel; don't miss out on this opportunity.

Ideally located on 6,500 acres in an upland valley of the Allegheny Mountains of West Virginia, The Greenbrier has been awarded the AAA Five Diamond status since inception of the award and is one of only three properties to have earned this distinction for 30 consecutive years. As a National Historic landmark, The Greenbrier's classic architecture, exquisite interior design, carefully sculpted landscape, impeccable service, and outstanding amenities have hosted distinguished guests from around the world since 1778. Over two centuries of famous guests, including 26 presidents, royalty, business leaders, politicians, and celebrities have stayed here. The Greenbrier's archives are maintained and displayed in the Presidents' Cottage Museum. Getting to The Greenbrier is now easier than ever with commercial and charter flights arriving daily just 15 minutes from the resort at the Greenbrier Valley Airport (LWB). Other convenient airports are located in Beckley (BKW) and Charleston (CRW), West Virginia, and Roanoke (ROA), Virginia with service provided by major carriers.


Main Lobby Known as The Greenbrier's living room, the stunning Main Lobby is a series of lobbies and sitting rooms with the designing touch of Dorothy Draper. Decorated with antiques and historic paintings, bright colors and floral designs, the soaring ceilings and cozy fireplace make the Main Lobby the ideal place to enjoy an afternoon tea and concert. Carleton Varney, president of the Dorothy Draper Company, oversees all interior design of The Greenbrier.

Dining The Greenbrier's excellence is perhaps most clearly defined by the fine dining. Regardless of venue or menu, every meal at The Greenbrier is a truly exquisite experience. Breakfast and dinner are served daily in the elegant Main Dining Room and are comprised of a delectable combination of classical, continental and American cuisine prepared by a team of chefs, many of whom were trained in The Greenbrier Culinary Apprenticeship Program. Draper's, named for the famed designer Dorothy Draper, serves lunch and offers dessert and fountain soda specialties. Evenings offer the pleasure of cabaret-style live entertainment in the Old White Lounge, the fun-filled sports bar Slammin' Sammy's and the conveniently located Lobby Bar. The Greenbrier cuisine is a delight like no other.

Guest Rooms All Greenbrier guests enjoy lavish accommodations decorated by Carleton Varney, president of Dorothy Draper and Company, Inc., New York. The Greenbrier offers 802 guest bedrooms all with full access to guest services.

Golf Since 1910, golf has been an important part of life at The Greenbrier. With three championship courses and the Golf Digest Academy, The Greenbrier is unmatched in its dedication to golfers. The Greenbrier does keep one course open for play year-round, weather permitting.

Recreation For guests who prefer other forms of recreation, The Greenbrier offers a variety of activities. The Greenbrier's Culinary Arts Center offers hands-on classes for children and adults. Guests may also enjoy the Off-Road Driving School, indoor swimming pool, falconry, bowling, hiking and jogging trails, horseback riding, and carriage rides.

Casino The Casino Club at The Greenbrier is an elegant venue that revels in the warmth and comfort of southern hospitality and mixes world-class gaming, live entertainment, international cuisines, and designer boutiques to create the grandest casino experience in the world. Take a spin on 320 state-of-the-art slot machines; try your luck at 37 table games including blackjack, craps, roulette, baccarat, and three-card poker; or test your skill at the Texas Hold ‘Em poker tables. The Tavern Casino is an exclusive, private gaming venue with a comfortable, yet refined, atmosphere. Discreetly located below Prime 44 West, the facility features a variety of table games, including blackjack, roulette, and three-card poker as well as slots. Unlike other gaming facilities, the Casinos are only open to overnight resort guests, members of The Greenbrier Sporting Club, and The Greenbrier Golf & Tennis Club.

Spa For 230 years, guests have been attracted to The Greenbrier's sulphur springs and the natural benefits of the minerals remain at the heart of The Greenbrier Spa experience. The Greenbrier Spa's treatments complement today's lifestyle, with greater attention to the healing powers of natural essences and minerals that have been trusted for centuries. Treatments include The Greenbrier Signature Treatment, Detox Kur, Ayurvedic Head Massage, Olive Oil Body Scrub and Mineral Body Mask. Other services include facials, hydrotherapy treatments, body fusions, manicures, pedicures, and waxing services.

Shopping With over 30 stores, shopping at The Greenbrier is a delight all its own. Most of the shops are located in the hotel's lower level, including The Greenbrier Shoppe and Newsstand, Carleton Varney Gift Gallery, Polo Ralph Lauren, The Greenbrier Gourmet Shop, and many others. The Art Colony on Alabama Row features a collection of shops with unique handcrafted items and exceptional pieces of original art. Finally, The Christmas Shop at the Depot is located across from the main entrance and is open year round with gifts and decorations to make every Christmas special.

*The Greenbrier Dress Code is an important complement to the standards that guests expect and which distinguish this resort.The Resort hopes that you will find that observance of these requirements adds to the pleasure and comfort of your visit. Country Club casual attire, including collared sport shirts, sweaters, jackets, dress slacks, and walking shorts are advised for day. Evening attire is business casual, jacket suggested for gentlemen; dresses or evening suits for ladies. Jeans are only allowed for outdoor activities. Please note: Tee shirts, tank tops, cut-offs, short shorts, sweatpants, men's hats, and baseball caps are not permitted at any of the venues. Attire for children ages 10 and older should be similar in dress to adult attire. Robes and swimwear may not be worn outside of guest rooms, except in the swimming pools and spa.

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.

Topics in Anesthesia
White Sulphur Springs, West Virginia
(The Greenbrier Resort)
December 7-10, 2017

Thursday, December 7

  0700 Registration - Mandatory Sign In - Continental Breakfast
  0725 Welcome NWAS Staff  
  0730 Cleared for Surgery J.Kryc  
  0830 Preoperative Evaluation of the Ambulatory Patient J.Kryc  
  0930 Break
  0945 Modern Fasting Guidelines R.Lenhardt  
  1045 Airway Evaluation R.Lenhardt  
  1145 Risk of Aspiration and GERD: Supraglottic Devices or Endotracheal Intubation? E.Lobato  
  1245 Adjourn 0.7 Pharmacology  

Friday, December 8

  0700 Registration - Mandatory Sign In - Continental Breakfast
  0730 Perioperative Evaluation and Management of Patients With Coronary Stents E.Lobato  
  0830 Intraoperative Myocardial Ischemia: Diagnosis and Management E.Lobato  
  0930 Break
  0945 Introduction to Nanotechnology: Honey I Shrunk the Kids J.Kryc  
  1045 Nanomedicine: The Cyborg Era Begins J.Kryc  
  1145 Anesthesia for Abdominal Robotic Surgery R.Lenhardt  
  1245 Adjourn 1.8 Pharmacology  

Saturday, December 9

  0700 Registration - Mandatory Sign In - Continental Breakfast
  0730 Anesthesia for the Morbidly Obese Patient R.Lenhardt  
  0830 Perioperative Management of Obesity Hypoventilation Syndrome R.Lenhardt  
  0930 Break
  0945 The Patient With Heart Failure Undergoing Noncardiac Surgery: Does the Ejection Fraction Matter? E.Lobato  
  1045 Anesthetic Management of the Patient With Valvular Heart Disease During Noncardiac Surgery: Who Is High Risk? E.Lobato  
  1145 Complications From MAC: Is It Our Fault? E.Lobato  
  1245 Adjourn 1 Pharmacology  

Sunday, December 10

  0700 Registration - Mandatory Sign In - Continental Breakfast
  0730 From Symptoms to Biomarkers: Should We Change the Paradigms? J.Kryc  
  0830 Statins and Noncardiac Surgery: Can We Reduce Perioperative Risk? J.Kryc  
  0930 Break
  0945 Cardiac Disease in Pregnancy J.Kryc  
  1045 Hemorrhagic Shock and Trauma R.Lenhardt  
  1145 Prevention and Treatment of Perioperative Hypothermia R.Lenhardt  
  1245 Adjourn 1.3 Pharmacology  

20 CME I

20 CEC

4.8 Pharmacology Hours†


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

Rainer Lenhardt, MD, MBA
Professor and Vice‑Chair for Clinical Affairs
Department of Anesthesiology and Preoperative Medicine
University of Louisville
Louisville, Kentucky

Emilio B. Lobato, MD
Anesthesiology Services
North Florida/South Georgia VAMC
Gainesville, Florida


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 #1033949; Expiration Date 12/10/2017.

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: 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 October 8, 2017 to November 7, 2017. No refund after November 7, 2017; 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: 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.