Full Day Sedation Symposium
The Fundamentals of Sedation: Reviewing the Basics - Bridging the Specialties
Cancun, Mexico 2015
Friday, September 18, 2015
The Fundamentals of Sedation: Bridging the Specialties
This full-day Introduction to Sedation Outside the OR symposium provides an overview of sedation and
is directed toward a multidisciplinary audience that includes physicians, dentists, nurses and trainees. The
morning session “sets the stage” for successful sedation and challenges the participants to consider their
goals for sedation and how best to achieve them. Morning presentations address pediatric-specific
anatomic and physiologic considerations, presedation assessment, appropriate monitoring and personnel
as well as the Pediatric Airway Workshop; all of which are directed toward both medical and dental
participants. The remainder of the session targets medical- or dental-specific groups to reflect particular
interests and practice. Case scenarios will be presented with the intent to foster vigorous discussion of
options for sedation and best practice models. The day will reach a conclusion as the medical and dental
groups reconvene for interactive Simulated Medical and Dental Sedation Demonstrations. These
interactive video simulations are designed to provide medical and dental participants the opportunity to
directly observe the application of sedation outside the OR and raise questions regarding best practice.
The simulations will emphasize the principles and skills presented during the symposium and allow
participants the opportunity to reinforce their knowledge and understanding of the day’s curriculum.
7:00-8:00 a.m.
Breakfast and Registration
8:00-8:30 a.m.
Welcome and Introduction
Keira Mason, MD and Mark Roback, MD
8:30-12:00
Sedation Outside the OR: Getting Started
Mark Roback, MD: Moderator
8:30-9:00 a.m.
Setting the Stage for Sedation Outside the OR
Mark Roback, MD
9:00-9:20 am
Airway Anatomy and Management
Peter Brooks, MD
9:20-9:45
Essentials of Pediatric Physiology and Anatomy
Tim Horeczko, MD
9:45-10:10
Physiologic Monitoring
Tim Horeczko, MD
10:10-10:35
Morning Break
10:35-11:05
From Start to Finish: Presedation Assessment & Post Sedation Readiness for
Discharge
Keira Mason
11:05-11:30
Management of Challenging Patients
Dimitris Emmanouil, DDS, MS, PhD
11:30-Noon
Beyond the Drugs: Techniques for Minimizing Depth of Sedation and Improving the
Patient Experience
Piet Leroy , MD
12:00-1:00 pm
Lunch on your own OR Optional Breakout
Optional Airway Workshop: Basic
Jen Dearden, MD
OR
Target Controlled Infusion Workshop: Working Lunch in Spanish
Pablo Sepulveda, MD
Medical Track
Moderator:
1:00-1:30
Pharmacology of Sedation: A Broad Review
Medical: Timothy Horeczko, MD
 A Pharmacologic Review of Commonly
Used Medications
Dental Track
Moderator: Ronald Kosinski, DDS
1:00-1:45
Safe Practices for Office Based Anesthesia
Eduardo Alcaino, BDS(Hons), MDSc FRACDS
MRACDS (Paed)
1:30-2:00
Pharmacology of Sedation :A Broad Review
Medical: Timothy Horeczko, MD
 Emergency Medications: Options and
Routes of Delivery
1:45-2:30
Dental Pharmacology and Adjunct Behavior
Management Techniques in Pediatric Dentistry
TBA
2:30-2:45
2:00-2:30
Rescue: Managing Sedation Adverse Events
Medical: Mark Roback, MD
 Risk factors and predictors
 Management and approach
 Special populations
2:30-2:45
Afternoon Break
2:45-3:30
Sedation Regimens for the Pediatric Patient
Minimal Moderate and Deep Sedation
Michael Webb, DDS
Afternoon Break
2:45-3:15
Neurocognitive Effects of Sedation:
Medical: Anthony Absalom, MD
 Identify potential risks
 Examine the data
 Discuss impact on practice
3:30-4:15
2015 The Use of Simulation training in Pediatric
Dentistry "Let's Practice Sedation Safely"
Ronald Kosinski, DMD
3:15-4:45 pm
Case Studies in Pediatric Sedation
Medical: Mark Roback , Keira Mason, Douglas
Carlson
 Cases presented from various sedation
venues and audience queried about best
practice strategies
 Extensive Q&A time allotted
4:15-4:45
Case Studies in Pediatric Dental Sedation
Dental:
Ronald Kosinski, DMD
Eduardo Alcaino, BDS(Hons), MDSc FRACDS
MRACDS (Paed)
Michael Webb, DDS
Cory Resnick, DMD, MD
4:45-5:45 p.m.
Simulated Sedation Interactive Videos (medical and dental)
Jonathon Chiles, MD, Kevin Barton, MD, Doug Carlson, MD, Ron Kosinski, DMD, and Mark Roback,
MD
Fundamentals of Sedation: Bridging the Specialties (Spanish Friday):
Workshop Coordinator: Pablo Sepulveda, MD
8:30 – 8:50
Conceptos farmacológicos para el uso clínico (Vida media de eliminación, Vida media
Contextual, Tiempo de decaimiento efectivo, Latencia, TTPE, Cp max, efecto máximo) (Pablo
Sepulveda, MD)
8:50 - 9:15
MD)
Técnicas de administración en sedación: Bolos, Perfusión, TCI, otras (Heberto Muñoz,
9:20 - 9:40
Impacto de covariables en la Farmacología Pediátrica (Pablo Sepulveda, MD)
9:45 – 10:05
Seguridad y Sedación en pediatría, Conceptos generales (Alberto Sánchez, MD)
CAFE
10:30 – 10:50 Adverse events in sedation: predictors and methods to reduce risk (Ricardo Quiñonez,
MD)
10:55 – 11:15 Escalas de Sedación, y su utilidad clínica (Alberto Sánchez , MD)
11:20 – 11:40 Normas Internacionales (visión Latinoamericana vs Norteamericana) (Heberto Muñoz,
MD)
11:45 – 12:05 Programas de Sedación para no-anestesiólogos: desarrollo e implementación(Ricardo
Quiñonez, MD)
12:10 – 12: 25 Reanimación Pediátrica, programas de entrenamiento (Al Casta, MD)
LUNCH
Simulation and TCI session
13:00 – 14:30
15:00 – 15:20 Los limites: pacientes extremos (Neonato, niño Obeso, Down síndrome, niño epiléptico)
(Nancy Rodríguez, MD)
15:25 – 15:45 Anestesia General o Sedación fuera de quirófano? ¿Quién puede y Quien No? (Nancy
Rodríguez, MD)
15:50 – 16:10 Que hay de Nuevo en las guías de sedación (Carlos Muñoz, MD)
16:15 – 16:35 Escenarios Clínicos: Cómo lo hago? (Dental, Endoscopia, Imagenología, Quimioterapia)
(Paola Ostermann, MD)
CAFE
17:00 – 17:20 Tópicos en debate: Premedicación?, Ayuno?, Propofol por No anestesista? N20? (Paola
Ostermann, MD)
17:25 – 17:40 Métodos para incorporar la simulación en entrenamiento de sedación (Andres Navedo,
MD)
17:45
Clausura
Saturday, September 19, 2015
Weekend Conference: Moving Sedation Forward
6:30-7:00 a.m.
Early Bird Registration
7:00- 8:15 a.m.
Registration/Breakfast OR
Optional Breakfast Breakout Panel (Pre-registration and fee required)
Difficult Airway Workshop: Basic Skills
Jennifer Dearden, MD (Leader)
Ketamine: Mark Roback, MD and Cyril Sahyoun, MD
Dexmedetomidine: Mohamed Mahmoud, MD
Moderator: Keira P. Mason, MD
Welcome Address
8:30-8:45 a.m.
Keira P. Mason, MD
8:45-10:00 a.m.
Keynote Address: Overcoming The Impossible To Get To What's Possible
Ray Zahab
10:00-10:30 a.m. Question and Answer Panel
10:30-11:00 a.m. Book Signing and Morning Break
Challenges & Innovations in Sedation & Analgesia Moderator: Piet Leroy, MD
11:00-11:30 a.m. The Most Common and Challenging Pediatric Syndromes and Behavior
Mohamed Mahmoud, MD
11:30-12:00 p.m. Creative, Innovative and New Techniques and Approaches to Pain Management
Jerrold Lerman, MD
12:00-12:30 p.m. Practical Aspects to Assessment, Management, and Drug Dosing of the Obese
Paul Samuels, MD
12:30-1:00 p.m.
Panel Discussion
Mohamed Mahmoud, MD, Jerrold Lerman, MD, Paul Samuels, MD
1:00-2:30 p.m.
Lunch On Your Own OR Optional Lunch Breakout Panel (Pre-registration and fee required)
Nitrous: Franz Babl, MD asked, Bo Kennedy, MD
Simulation Workshop: TBA
The Essentials of Sedation Outside the OR Moderators: Keira Mason, MD
2:30-3:00 p.m.
TBA
3:00-3:30 p.m.
3:30-4:00 p.m.
4:00-4:30 p.m.
4:30-5:00 p.m.
Adverse Events in Sedation: Establishing a New Culture of Safety
Keira Mason, MD
Exploring Old and New Alternative Techniques to Sedation: Nasal, Oral and Intravenous
Franz Babl, MD
Sedating the Emergent ASA III/IV Patient
Cyril Sahyoun, MD
The Best Articles in the High Impact Journals of 2014
Timothy Martin, MD
5:00-5:30 p.m.
Panel Discussion
5:30-8:00 p.m.
Complimentary Cocktail Reception (Faculty, Attendees and Sponsors)
Sunday, September 20, 2015
Weekend Conference: Moving Sedation Forward
7:00- 8:15 a.m.
Registration/Breakfast OR
Optional Breakfast Breakout Panel (Pre-registration and fee required)
Dexmedetomidine: Keira Mason, MD, Mohamed Mahmoud, MD
Ketamine: Mark Roback, MD, Franz Babl, MD
Propofol: Joss Thomas, MD, Doug Carlson, MD
Moderator: Keira P. Mason, MD
8:30-9:15 a.m.
Keynote Address: The Controversial Role of Sedation in Death by Legal Injection and Physician
Assisted Suicide
Gail van Norman, MD
9:15-9:35 a.m.
Propofol and the Michael Jackson Trial
Pablo Sepulveda, MD
9:35-9:50 a.m.
9:50-10:05 a.m.
10:05-10:20 a.m.
Question and Answer Panel
Morning Break
The International Sedation Project
Keira P. Mason, MD
The Cutting Edge of Sedation Moderator: Franz Babl, MD
10:20-10:45 a.m. What’s New in Sedation?
Jerrold Lerman, MD
10:45-11:30 p.m. Target-Controlled Infusions: Practical Aspects from A-Z and Computer Assisted Sedation
Anthony Absalom, MBChB, FRCA
11:30-12:00 p.m. Non Pharmacologic Techniques to Optimize Sedation Care
Piet Leroy, MD
12:00-12:30 p.m. Is There a Future to Computer Assisted Sedation?
TBA
12:30-1:00 p.m.
Panel Discussion
1:00-2:30 p.m.
Lunch On Your Own OR Optional Lunch Breakout Panel (Pre-registration and fee required)
Acupuncture Hands On Workshop: Yuan Chi-Lin, MD
Logistics, Challenges and Solutions to Developing and Running a
Sedation Program: Joss Thomas, MD, Doug Carlson, MD, Ricardo
Quinonez, MD
Concurrent Afternoon General Session Lectures: You may attend and combine any of the two concurrent sessions.
Pre-registration is not required and lectures are included in weekend registration.
Sessions will be held from: 2:30-5:00 p.m.
General Session A: Methods to Improve Safety and Patient Care
General Session B: Developing a Comprehensive Sedation Program: From A-Z
All sessions will be held from: 2:30-5:00 p.m.
General Session A: Methods to Improve Safety and Patient Care
Moderator: Jerrold Lerman, MD
2:30-2:50 p.m.
NPO Status: A Necessity or a Luxury? : Debunking the Truth Through Recent Literature
Mark Roback, MD
2:50-3:20 p.m.
Pro/Con: There is No Role for Nitrous in the 21st century
Franz Babl, MD and Bo Kennedy, MD
3:20-3:40 p.m.
Dexmedetomidine: Clinical Applications, Limitations and Future Use
Keira P. Mason, MD
3:40-4:00 p.m.
Lessons Learned: Developing and Running a Non Anesthesia Developed Sedation Program
Joss Thomas, MD
4:00-4:30 p.m.
Obstructive Sleep Apnea: A Pediatric Epidemic
Jerrold Lerman, MD
4:30-4:45 p.m.
Panel Discussion
4:50-5:00 p.m.
Debriefing
General Session B: Developing a Comprehensive Sedation Program: From A-Z
Moderator: Douglas Carlson, MD
2:30-3:00 p.m.
Meeting Every Patient's Sedation Needs: Finding the Gaps in Your System
Douglas Carlson, MD
3:00-3:30 p.m.
Training and Credentialing Sedation Providers
Dean Andropoulos, MD
3:30-4:00 p.m.
Insuring Safe Reliable Systems for Sedation: Quality Measurement and Process
Improvement
Ricardo Quinonez, MD
4:00-4:30 p.m.
Non-anesthesiologist Use of Propofol
Dean Andropoulos, MD
4:30-5:00 p.m.
Medications that you should add to your practice
Douglas Carlson, MD
Friday, September 18, 2015
Full-Day High Fidelity Pediatric Sedation Simulation Workshops
Optional and limited enrollment. Pre-registration is required. Participants will spend one hour in each of
the six scenarios.
6:30-7:30 a.m.
Registration and Breakfast
7:30-8:30 a.m.
8:30-9:30 a.m.
Introduction: Simulation in the 21st Century Integration into
Sedation Training
James Fehr, MD
Scenario 1, Scenario 2, Scenario 3
9:30-10:30 a.m.
Scenario 1, Scenario 2, Scenario 3
10:30-10:45 a.m. Break
10:45-11:45p.m.
Scenario 1, Scenario 2, Scenario 3
11:45-1:00p.m.
Lunch On Your Own or Optional Difficult Airway Workshop
Optional Lunch: Difficult Airway Workshop: Basic
Pre-Registration and Fee Required
Jennifer Dearden, MD (Leader)
1:00-2:00 p.m.
Scenario 4, Scenario 5, Scenario 6
2:00-3:00 p.m.
Scenario 4, Scenario 5, Scenario 6
3:00-4:00 p.m.
Scenario 4, Scenario 5, Scenario 6
4:00-4:30 p.m.
Closing Remarks and Debriefing/Interactive Feedback
Moderator and Leader of Simulation Workshops: James Fehr, MD
Anesthesia Directed Scenario:
Sharon Redd, MD*, Vanessa Young, BA, RN
Dental Medicine Directed Scenario:
Calvin Kuan, MD*, Jerry Chao, MD, Jen Wagner, MD, Echo Rowe, MD
Emergency Medicine Directed Scenario:
Robert Kennedy, MD*, Jon Chiles, MD
Hospital Medicine Directed Scenario:
Yasmeen Daud, MD*, Kim Hamlin, MD
Post Sedation Recovery Event Scenario:
John Zhong, MD*, Michele Trinka, RN, MSN, CCRN, PCCN, Dayna Downing, MBA
Procedural Sedation Scenario:
Anna Maria Onisei, MD, Saif Siddiqui, MD*
*Indicates Scenario/Workshop Leader
PEDIATRIC SEDATION OUTSIDE OF THE OPERATING ROOM
Saturday, September 19, 2015
Dental Sedation Simulation Workshops
Optional and limited enrollment. Pre-registration is required. Participants will spend one hour in each
of the four scenarios.
6:30-7:30 a.m.
Registration
Breakfast
7:30- 8:00 a.m.
Introduction: Simulation in the 21st Century
Integration into Sedation Training
James Fehr, MD
8:00-9:00 a.m.
Scenario 1, Scenario 2
9:00-10:00 a.m.
Scenario 1, Scenario 2
10:00-10:30 a.m.
Break
10:30-11:30 a.m.
Scenario 3, Scenario 4
11:30-12:30p.m.
Scenario 3, Scenario 4
12:30-1:15p.m.
Closing Remarks and Debriefing/Interactive
Feedback
Moderator and Leader of Simulation Workshops:
James Fehr, MD
Scenario 1: Dental Procedure Lidocaine Toxicity and Anaphylaxis
Michael Webb, DDS*, Eduardo Alcaino, BDS(Hons), MDSc FRACDS MRACDS (Paed)
Scenario 2: Dental Procedure Aspiration
Tim Martin, MD*, Ron Kosinski, DDS
Scenario 3: Dental Procedure Disruptive Parent, Distraction of Provider Leading to Cardiac
Arrest from Unrecognized Apnea
Luciane Costa, DDS and TBA
Scenario 4: Dental Procedure Over Sedation, Respiratory Depression
Saif Siddiqui, MD*, Corey Resnick, DMD, MD
*Indicates Scenario/Workshop Leader