White Sulphur Springs, West Virginia

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

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. Spas of America, the largest spa and wellness travel website, recently named The Greenbrier Spa No. 4 on its list of the Top 100 Spas of 2021.

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.

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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 anesthesia specialty or are impacted by it.


The practitioner of anesthesiology must 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; and provide assistance with and support of other service providers, departments, institutions, and organizations dependent upon the professional expertise of the practitioner. Presentations are designed to facilitate the healthcare provider in reviewing, updating, and/or expanding knowledge and abilities in one or more of these areas vital to the practicing professional.


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
June 19-22, 2023

Monday, June 19

  0700 Registration - Mandatory Sign In - Continental Breakfast
  0725 Welcome NWAS Staff
  0730 Damage Control Resuscitation: Tactics for the Exsanguinating Patient S.Galvagno
  0830 Endpoints of Resuscitation in Trauma and Sepsis S.Galvagno
  0930 Break
  0945 Sepsis in Children R.Ing
  1045 Anesthetic Considerations in Blunt Thoracic Trauma in the Pediatric Patient R.Ing
  1145 Pharmacogenetics and Personalized Anesthesia Care P.Strube
  1245 Adjourn

Tuesday, June 20

  0700 Registration - Mandatory Sign In - Continental Breakfast
  0730 Opioid Free: Are We Crazy or Bold? P.Strube
  0830 Old Drugs for New Tricks, Maximizing Outcomes P.Strube
  0930 Break
  0945 Crush Syndrome Management S.Galvagno
  1045 Current Management of COVID-19 S.Galvagno
  1145 Intubation for the Sick Child With Severe Cardiac Disease R.Ing
  1245 Adjourn

Wednesday, June 21

  0700 Registration - Mandatory Sign In - Continental Breakfast
  0730 The Critically Ill Infant for Anesthesia R.Ing
  0830 Anesthesia for the Extremely Low Birth Weight Child R.Ing
  0930 Break
  0945 A Different View of Allergies and Sensitivity P.Strube
  1045 Illegal Drugs and the Impact on Anesthesia Care P.Strube
  1145 Anesthetic Considerations for Burn Patients S.Galvagno
  1245 Adjourn

Thursday, June 22

  0700 Registration - Mandatory Sign In - Continental Breakfast
  0730 The Challenges of Remote Anesthesia: Outside the Operating Room P.Strube
  0830 Recent Literature in Pediatric Anesthesia That Impacts Clinical Practice R.Ing
  0930 Break
  0945 Anesthetic Considerations in Pediatric Pulmonary Hypertension R.Ing
  1045 How to Prevent Your Patient from Crashing After Emergency Intubation: Perfusion-Protective Ventilation S.Galvagno
  1145 Evidence-Based Use of Vasopressors S.Galvagno
  1245 Adjourn  

20 CME

20 Class A CE

9 Pharmacology Hours†

Refreshments served at the meeting are for registered attendees only.
Rev. 1/27/23


Sam Galvagno, DO, PhD, MS, FCCM
Colonel, USAF, MC, SFS
Professor (Tenured)
Executive Vice Chair
Department of Anesthesiology
The University of Maryland School of Medicine
State Medical Director, Critical Care Coordination Center (C4)
Maryland Institute for Emergency Medical Services Systems (MIEMSS)
IMA to the Director
Reserve Medical Directorate
Headquarters, United States Air Force
Pentagon, Washington, District of Columbia

Richard J. Ing, MBBCh, FCA(SA)
Professor, Children's Hospital Colorado
University of Colorado Health Science Center
Department of Anesthesiology
Anschutz Medical Campus
Aurora, Colorado

Peter Strube, DNAP, CRNA, MBA, MSNA, APNP, APRN, LTC (Retired)
Assistant Professor, University of Tennessee, Chattanooga
CEO Trollway Anesthesia and Educational Services
Mount Horeb, Wisconsin


Northwest Anesthesia Seminars / Northwest Seminars is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

Northwest Anesthesia Seminars / Northwest Seminars 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: This activity contributes to the CME component of the American Board of Anesthesiology’s redesigned Maintenance of Certification in Anesthesiology™ (MOCA®) program, known as MOCA 2.0®. Please consult the ABA website, www.theABA.org, for a list of all MOCA 2.0® requirements.

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 American Association of Nurse Anesthesiology for 20 Class A CE credits; AANA approval number 1042106; Expiration Date 06/22/2023.

Nurse Practitioners: The American Academy of Nurse Practitioners Certification Board (AANPCB) 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/NWS is an approved provider for the following state nursing boards: Arkansas State Board of Nursing (Provider Number 50-7480), 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).

The AANA is an approved provider by the California Board of Registered Nursing, CEP #10862.

This program offers 20 contact hours.

†Pharmacology hours subject to change.


Mark T. Murphy, MD, MSN Education, LLC, Treasure Island, Florida, Medical Director, Northwest 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 days notice will be given to those registered and 100% of tuition paid will be refunded. NWAS/NWS 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 April 20, 2023 to May 20, 2023. No refund after May 20, 2023; however, 50% of tuition paid may be applied toward tuition for another NWS/NWAS program within the next 12 months. Cancellation must be made in writing. No tuition credit or refund will be issued for attendees that are no-shows for the program.

FAP (Frequent Attendee Points)

We value your patronage and have a simple program to reward you. Our Frequent Attendee Points (FAP) program gives you an added bonus for money spent on our seminars, as well as cruise cabins booked through our in-house travel agency, Northwest Worldwide Travel.

You are automatically enrolled in this program with your paid registration. Click here for more information.

*Effective January 1, 2023, net hotel stays for 2023 and beyond will no longer be included in FAP calculations.

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.


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.

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