32 ND ANNUAL MEETING

Transcription

1 32 ND ANNUAL MEETING MAY 4-6, 2017 JW Marriott Camelback Inn Resort & Spa Scottsdale, AZ Jointly provided by Register online at

2 Program Schedule Wednesday, May 3 5:00 pm 6:30 pm Registration Open Thursday, May 4 7:00 am 5:00 pm Registration Open 7:00 am 8:00 am Continental Breakfast 8:00 am 10:00 am General Session 1: Ambulatory Anesthesia and Surgery and Healthcare Reform A Panel Discussion Moderator: Brian M. Parker, M.D. Regulatory Don Arnold, M.D. Government ASA DC Office, Manuel Bonilla, M.S. Outcome Measures Leopoldo Rodriguez, M.D., F.A.A.P. Perioperative Surgical Home Douglas Merrill, M.D., M.B.A. 10:00 am 10:15 am Break 10:15 am 12:00 pm General Session 2: Future Challenges in Ambulatory Anesthesia Moderator: Keira Mason, M.D. Population Health Management Optimized for Ambulatory Anesthesia: Improving the Triple Aim Arthur Boudreaux, M.D. Optimizing Recovery Tong J. Gan, M.D., M.H.S., F.R.C.A. Future Roles of New Anesthesia Delivery Systems and Agents Keira Mason, M.D. 1:00 pm 3:00 pm General Session 3: Practice Management Issues Moderator: Michael Walsh, M.D. Infection Control Issues in Ambulatory Douglas Merrill, M.D., M.B.A. Legal Vignettes: It's Not Just the Interoperative Course Christopher Burkle, M.D., J.D. Nuts and Bolts of Anesthesia Billing and Coding Sharron Merrick, M.S., C.C.S.-P. 3:00 pm 3:15 pm Break 3:15 pm 5:00 pm Lecture: Muscle Relaxant Use in Ambulatory Surgery Kai Schoenhage, M.D. General Session 4: Rapid Fire Pro-Con Debates Pre-op Screening Prior to Day of Surgery for OSA Improves Care Pro: Leopoldo Rodriguez, M.D., F.A.A.P. Con: Girish Joshi, M.B.B.S., M.D., F.F.A.R.C.S.I Carefully Selected Ambulatory Patients Can Be Discharged Without an Escort Pro: Christopher Burkle, M.D., J.D. Con: Keira Mason, M.D. 5:00 pm 7:00 pm Welcome Reception with Exhibitors Friday, May 5 7:00 am 5:00 pm Registration Open 7:00 am 8:00 am Breakfast Moderated Poster Session 7:00 am 3:15 pm Exhibit Hall Open 2 Register online at

3 Friday, May 5 (continued) 8:00 am 10:00 am General Session 5: Regional Anesthesia and Pain Topics Moderator: Roy Greengrass, M.D. Paravertebral Blocks for Ambulatory Surgery Roy Greengrass, M.D. Evidence-based Review of Multimodal Analgesia for Ambulatory Surgery Eugene Viscusi, M.D. Evidence-based Review of Motor Sparing Nerve Blocks for Ambulatory Surgery Ralf Gebhard, M.D. 10:00 am 11:00 am Break with Exhibitors Moderated Poster Session 11:00 am 12:00 pm American Society of Anesthesiologists Update Linda Mason, M.D. 1:00 pm 3:00 pm General Session 6: ERAS: Enhanced Recovery After Surgery ERAS for Ambulatory Breast Surgery Hanae Tokita, M.D. ERAS for Ortho/Total Joint Eugene Viscusi, M.D. ERAS for Robotic Hysterectomy and Prostatectomy -- Tong J. Gan, M.D ERAS for Ambulatory Bariatric Surgery Girish Joshi, M.D. 1:00 pm 3:00 pm Hands-on Workshop: Basic Regional Ultrasound Workshop 3:00 pm 3:30 pm Break with Exhibitors Roy Greengrass, M.D.; Alberto Ardon, M.D.; Katherine Dobie, M.D.; Ralf Gebhard, M.D.; Arun Prasad, M.B.B.S., FRCA, FRCPC 3:30 pm 5:30 pm Hands-On Workshop: Advanced Regional Ultrasound Techniques 3:30 pm 4:30 pm Consult the Experts Roy Greengrass, M.D.; Alberto Ardon, M.D.; Katherine Dobie, M.D.; Ralf Gebhard, M.D.; Arun Prasad, M.B.B.S. FRCA, FRCPC Quality and Safety Issues Douglas Merrill, M.D. Common Problems Encountered During Pediatric Ambulatory Care - Stress, Separation Anxiety, Emergence Agitation, Laryngospasm, Propofol pain, Other Issues -- Kumar Belani, MBBS, MS, FACA, FAAP 3:30 pm 4:30 pm Problem-Based Learning Discussion (PBLD) 4:35 pm 5:35 pm Consult the Experts Managing the Patient with Severe COPD Presenting for Shoulder Surgery Fatima Ahmad, M.D. Local Anesthetic Systemic Toxicity: An Atypical Presentation Irina Gasanova, M.D. Quality and Safety Issues Douglas Merrill, M.D. 4:35 pm 5:35 pm Problem-Based Learning Discussion (PBLD) Managing the Patient with Severe COPD Presenting for Shoulder Surgery Fatima Ahmad, M.D. Local Anesthetic Systemic Toxicity: An Atypical Presentation Irina Gasanova, M.D. Saturday, May 6 7:00 am 5:00 pm Registration Open Common Problems Encountered During Pediatric Ambulatory Care - Stress, Separation Anxiety, Emergence Agitation, Laryngospasm, Propofol pain, Other Issues -- Kumar Belani, MBBS, MS, FACA, FAAP 7:00 am 8:00 am Breakfast Moderated Poster Session 7:00 am 10:30 am Exhibit Hall Open 8:00 am 9:45 am General Session 7: Non-operating Room Anesthesia (NORA) Panel Moderator: Srini Pyati, M.D. Optimal Management of OSA Patient in the NORA Setting Ruchir Gupta, M.D. Quality and Outcomes for NORA: Process and Measurement Basem Abdelmalak, M.D. NPO Guidelines for NORA: What is New and How Does It Affect Anesthesia Providers Michael Presta, M.D. Register online at 3

4 Saturday, May 6 (continued) 10:00 am 10:30 am Break with Exhibitors Moderated Poster Session 10:30 am 12:00 pm General Session 8: Cases from the Real World Moderator: Barbara Gold, M.D. 12:00 pm 1:30 pm Business Meeting and Awards Luncheon White Mountain Awards Resident Travel Awards Excellence and Innovation Presentations and Awards 1:30 pm 5:30 pm Office Based Anesthesia Mini Symposium* Moderator: Michael Lam, M.D. OBA Patient Selection Pros and Cons, Richard Urman, M.D.; Rosalind Ritchie, M.D. OBA Emergencies, Thomas Wherry, M.D. Mobile Anesthesia Equipment/Practice, Stephen R. Smith, M.D. Billing and Coding in OBA/What Pays in OBA Accreditation and Safety, Michael Walsh, MD What is the Future of OBA? Thomas Wherry, M.D. 1:30 pm 5:30 pm Jeep Tour (Optional)** 1:30 pm 3:30 pm Residents-Only Hands-On Workshop: Regional Ultrasound Techniques* Roy Greengrass, M.D.; Alberto Ardon, M.D.; Katherine Dobie, M.D.; Ralf Gebhard, M.D.; Arun Prasad, M.B.B.S. FRCA, FRCPC 3:15 pm 3:30 pm Refreshment Break and Networking 3:30 pm 5:30 pm Resident Session 6:30 pm 9:30 pm SAMBA Social Event *Pre-registration required **Pre-registration and additional fees required 4 Register online at

5 Session Descriptions/Learning Objectives General Session 1: Ambulatory Anesthesia and Surgery and Healthcare Reform A Panel Discussion During this session the attendee will learn about the economic pressures being placed on providers to make healthcare more affordable while maintaining quality and safety, the impact that regulatory bodies have on daily practice and their importance and the use of true outcomes measures for both improving care and driving reimbursement. This session will also focus on the perioperative surgical home and how it can be adapted to the ambulatory environment. General Session 2: Future Challenges in Ambulatory Anesthesia During this session the attendee will learn about the Institute for Health Improvement s triple aim improving the patient healthcare experience, improving the health of populations and improving the cost per capita of healthcare and how anesthesiologists can impact it. This session will also cover enhanced recovery pathways and how these can impact patient satisfaction, through output and cost. New anesthetic agents delivery systems and the applicability to your practice will also be discussed. General Session 3: Practice Management Issues This session will focus on a number of practical issues in the management of ambulatory patients including infection control, legal pitfalls and billing and coding issues for ambulatory anesthesia. General Session 4: Rapid Fire Pro-Con Debates Controversial ambulatory anesthesia topics will be debated. Participants will have a chance to hear both sides on issues such as timing of preoperative evaluation for OSA, discharging patients without an escort and the necessity of stocking dantrolene. General Session 5: Regional Anesthesia and Pain Topics This session will examine the use of regional anesthesia in ambulatory surgery, including paravertebral blocks and motor sparing nerve blocks. The theoretical basis for multimodal analgesia and the existing scientific evidence supporting its benefit in improving pain control after surgery will also be explored. General Session 6: ERAS: Enhanced Recovery After Surgery This session examines enhanced recovery protocols and strategies for emerging outpatient procedures including: robotic surgery, major breast surgery, total joint replacement and bariatric procedures. General Session 7: Non-Operating Room Anesthesia (NORA) Panel During this session the attendee will learn how to best evaluate and care for patients with obstructive sleep apnea in the NORA setting, learn about the use of quality and outcomes data in the emerging field of NORA, how that data can be used to improve patient care and the application of NORA specific NPO guidelines in that setting. General Session 8: Cases From the Real World During this session, attendees will examine actual case scenarios and integrate various methods of care and strategies for preclinical problem solving for ambulatory surgical patients into their daily practice. Consult the Experts These small group sessions are specifically designed to provide an opportunity for open and detailed discussions of relevant ambulatory anesthesia and surgery topics. Expert speaker session formats may range from a relatively unstructured open house, where attendees can stop by and ask specific questions to prepared introductory topic remarks followed by open discussion by the small group. ASA Update Attendees will gain an understanding of the American Society of Anesthesiologists role in an educational, research and scientific association of physicians and delineate how practitioners can use its resources to enhance their patient care and professional activities. Problem Based Learning Discussions (PBLD) Attendees will discuss and critique the evaluation, management and implementation of patient care in specific ambulatory clinical scenarios. Excellence and Innovation Presentations Attendees will be able to describe focused ambulatory anesthesia knowledge gained through research as presented by scientific abstract awardees. Hands-On Regional Workshops Based on participant expertise, attendees will demonstrate both basic and advanced techniques for peripheral nerve blocks using single shot techniques as well as regional catheters for ambulatory anesthetic management. Attendees will also describe common or serious complications of regional techniques and how to both manage and avoid them. Register online at 5

6 Office Based Anesthesia (OBA) Mini Symposium Saturday, May 6 1:30 pm 5:30 pm For anesthesiologists opening an office-based practice, there are numerous considerations for best designing and operating the practice. This half-day symposium will address patient selection and clinical aspects of performing anesthesia in an office based surgery, as well as the practical issues involved in running an OBA practice. Session 1 Office Based Anesthesia: Patient Selection and the OBA Practice After this session, attendees will be able to: Identify appropriate patients for Office Based Anesthesia (OBA) and understand the pros and cons of doing certain patients and/or procedures in the office. Explain how to manage MH and other emergencies in office based surgery. List the unique aspects of performing anesthesia for emergency situations in an office based surgery. Identify practical keys to starting an OBA practice. Describe the unique aspects of a mobile anesthesia practice and mobile anesthesia equipment. Session 2 Practical Management and Future Challenges of Office Based Anesthesia After this session, attendees will be able to: Describe some issues surrounding billing and collections for OBA. Understand coding and insurance in OBA. List different accreditation requirements and options for office based anesthesia and surgery. Discuss patient safety standards, recommendations and algorithms when practicing anesthesia in an office based surgery. Formulate a marketing strategy for OBA Describe the future direction and challenges of OBA. 1:30 pm 2:00 pm OBA Patient Selection Pros and Cons Richard Urman, M.D,; Rosalind Ritchie, M.D. 2:00 pm 2:30 pm OBA Emergencies Thomas Wherry, M.D. 2:30 pm 3:00 pm Mobile Anesthesia Equipment/Practice Stephen R. Smith, M.D. 3:00 pm 3:15 pm Q&A 3:30 pm 4:00 pm Billing and Coding in OBA/What Pays in OBA TBD 4:00 pm 4:30 pm Accreditation and Safety TBD 4:30 pm 5:00 pm What is the Future of OBA? Thomas Wherry, M.D. 5:00 pm 5:15 pm Q&A Resident Focused Program Resident Hands-on Workshop 1:30 pm 3:30 pm Regional Ultrasound Techniques* Moderator: Roy A. Greengrass, M.D. Presenters: Roy Greengrass, M.D.; Alberto Ardon, M.D.; Katherine Dobie, M.D.; Ralf Gebhard, M.D.; Arun Prasad, M.B.B.S. FRCA, FRCPC *Registration required, maximum of 30 slots available Resident Session 3:30 pm 5:30 pm Moderator: Steven Butz, M.D. Adventures in Supervision: Common Pitfalls and Strategies (an interactive role-playing session) Niraja Rajan M.D. What to Look for in a Job Offer Ruchir Gupta, M.D. The Practice of Anesthesia: A Five Year Outlook TBA 6 Register online at

7 Jeep Tour Saturday, May 6 1:30 pm 5:30 pm $ per person Enjoy this unique opportunity to explore the Sonoran Desert via four-wheel drive vehicles. Each off road vehicle is driven by an Arizona cowboy guide who will entertain and educate your guests with interesting and entertaining facts about the desert and the early settlers that called this rough wilderness home. Learn more and register at (Login: SAMBA, password: SAMBA) If the minimum of 10 participants is not met, tour will be cancelled and registrants will be notified and reimbursed. Business Meeting and Awards Luncheon Saturday, May 6 12:00 pm 1:30 pm White Mountain Awards Resident Travel Awards Excellence and Innovation Presentation and Awards SAMBA Social Event: Cinco de Mayo Celebration Saturday, May 6 6:30 pm 9:30 pm Scottsdale Camelback Inn Resort & Spa North Garden Celebrate Cinco de Mayo with your colleagues and friends in the North Garden with beautiful blooms and a stunning view of Camelback Mountain. Enjoy this tribute to Mexican culture with traditional Mexican cuisine and music! Exhibit Hall SAMBA has an exciting exhibit hall with a variety of companies to help improve your practice. Attendees can get hands-on experience with new products and technologies, network with colleagues, browse the abstract posters and win great raffle prizes during the following exhibit hours: Thursday, May 4 5:00 pm 7:00 pm Welcome Reception with Exhibitors Friday, May 5 7:00 am 3:15 pm Exhibit Hall Open 10:00 am 11:00 am Refreshment Break with Exhibitors Saturday, May 6 7:00 am 10:30 am Exhibit Hall Open 9:45 am 10:30 am Refreshment Break in Exhibit Area Register online at 7

8 Program Faculty Co-Chairs Brian Parker, M.D. Associate Chief Medical Officer, Allegheny Health Network Pittsburgh, PA Michael Walsh, M.D. Assistant Professor of Anesthesia, Mayo Clinic School of Medicine Rochester, MN Faculty Basem Abdelmalak, M.D. Associate Professor of Anesthesiology, Cleveland Clinic Lerner College of Medicine; Director, Anesthesia for Bronchoscopic Surgery; Director, Center for Sedation Department of General Anesthesiology, Anesthesiology Institute, Cleveland Clinic Cleveland, OH Fatima Ahmad, M.D. Associate Professor of Anesthesiology, Loyola University Medical Center Maywood, IL Alberto Ardon, M.D. Director of Acute Anesthesia Services, University of Florida North, Assistant Professor, Department of Anesthesiology, University of Florida College of Medicine Jacksonville, FL Donald E. Arnold, M.D. Western Anesthesiology Associates St. Louis, MO Kumar Belani, MBBS, MS, FACA, FAAP Professor of Anesthesiology, Medicine & Pediatrics; Professor of Environmental Health Sciences, University of Minnesota Medical School And School of Public Health Minneapolis, MN Manuel Bonilla, M.S. Chief Advocacy Officer, American Society of Anesthesiologists Washington, DC Arthur Boudreaux, M.D. Professor, Department of Anesthesiology and Perioperative Medicine, University of Alabama at Birmingham School of Medicine Birmingham, Alabama Christopher Burkle, M.D., J.D. Associate Professor of Anesthesiology, Mayo Clinic College of Medicine Rochester, MN Steve Butz, M.D. Medical Director, Children s Hospital of Wisconsin Surgicenter; Associate Professor, Department of Anesthesiology, Medical College of Wisconsin Milwaukee, WI Katherine Dobie, M.D. Assistant Professor of Clinical Anesthesiology, Vanderbilt University Medical Center Nashville, TN Tong J. Gan, M.D., M.H.S., F.R.C.A. Professor and Chairman, Department of Anesthesiology, Stony Brook Medicine Stony Brook, NY Irina Gasanova, M.D. Associate Professor, UT Southwestern Medical Center Dallas, TX Ralf E. Gebhard, M.D. Director, Division of Regional Anesthesia and Acute Perioperative Pain Management; Professor of Clinical Anesthesiology, University of Miami Health System Miami, FL Barbara Gold, M.D. Professor of Anesthesiology, Executive Vice President of Medical Affairs, University of Minnesota Health, Department of Anesthesiology, University of Minnesota Minneapolis, MN Roy A. Greengrass, M.D. Professor of Anesthesiology, Program Director, Regional Anesthesiology Fellowship Program, Mayo Clinic College of Medicine Jacksonville, FL Ruchir Gupta, M.D. Assistant Professor, Stony Brook School of Medicine Stony Brook, NY Barys Ihnatsenka, M.D. Assistant Professor of Anesthesiology, University of Florida College of Medicine Gainesville, FL Girish Joshi, M.B., B.S., M.D., F.F.A.R.C.S.I. Professor of Anesthesiology and Pain Management, University of Texas Southwestern Medical School; Director of Perioperative Medicine and Ambulatory Anesthesia, Parkland Health and Hospital Systems Dallas, TX Michael Lam, M.D., A.P.C. Anesthesiologist Los Altos Hills, CA Keira Mason, M.D. Harvard Medical School Associate Professor of Anesthesia Department of Anesthesiology, Perioperative and Pain Medicine Boston Children's Hospital Boston, MA Linda Mason, M.D. First Vice President, American Society of Anesthesiologists Sharon Merrick, M.S., C.C.S.-P. Director of Payment and Practice Management, American Society of Anesthesiologists Schaumburg, IL Douglas G. Merrill, M.D., M.B.A. Executive Vice President, Chief Medical Officer, Renown Health Reno, NV Arun Prasad, M.B.B.S., FRCA, FRCPC Director, Ambulatory & Regional Anesthesia Fellowship, Women's College Hospital Assistant Professor, University of Toronto Michael Presta, D.O. Assistant Professor of Anesthesiology, Stritch School of Medicine, Loyola University Maywood, IL Srini Pyati, M.D. Assistant Professor, Department of Anesthesiology, Duke University Medical Center Durham, NC Niraja Rajan, M.D. Penn State Hershey Medical Center Anesthesiology Hershey, PA Rosalind Ritchie, M.D. Associate Professor, Department Anesthesiology; Medical Director, Center for Advanced Surgery, University of Kentucky Chandler Medical Center Lexington, KY Leopoldo V. Rodriguez, M.D., F.A.A.P. Medical Director, Chief of Anesthesia, Surgery Center of Aventura Boca Raton, FL Kai Schoenhage, M.D. Mayo Clinic Scottsdale, AZ Stephen R. Smith, M.D. Western Anesthesiology Associates Incorporated St. Louis, MO Hanae Tokita, M.D. Memorial Sloan Kettering Cancer Center New York, NY Richard Urman, M.D. Associate Professor of Anesthesia, Brigham and Women s Hospital Boston, MA Hector Vila, Jr., M.D. Pediatric Dental Anesthesiology Associates, Florida Office Anesthesia Tampa, FL Eugene Viscusi, M.D. Director, Acute Pain Management, Professor of Anesthesiology, Jefferson Medical College Philadelphia, PA Thomas Wherry, M.D. Board of Managers, First Colonies Anesthesia Associates; Co-Founder of Principal Total Anesthesia Solutions, LLC Olney, MD 8 Register online at

9 Program and Hotel/Travel Information Conference Accommodations JW Marriott Scottsdale Camelback Inn Resort & Spa 5402 East Lincoln Drive Scottsdale, AZ Experience the true spirit of Arizona at the JW Marriott Scottsdale Camelback Inn Resort & Spa. Situated on 125 acres in the gorgeous Sonoran Desert, the resort's immaculately manicured grounds offer the perfect backdrop for rejuvenation. Unwind in style here in Scottsdale in the hotel's spacious, elegantly appointed private casita rooms, each overflowing with luxury amenities. The resort features a full-service spa, two championship golf courses, exceptional onsite dining, and a heated outdoor pool. The room rate for SAMBA Annual Meeting attendees is $ for single/ double occupancy, plus applicable taxes. All SAMBA attendees will receive complimentary wireless internet in their sleeping rooms. during their stay. Hotel reservations can be made at All reservations must be guaranteed with a major credit card. The deadline to make your hotel reservation is April 13, The SAMBA group rate at the JW Marriott is only for those persons that are attending the SAMBA Annual Meeting. SAMBA reserves the right to revoke the group rate for those not registered for the Annual Meeting. Program Information TARGET AUDIENCE This meeting is designed for anesthesiologists, anesthesia providers, practitioners, nurses and administrators who work and specialize in ambulatory, office-based or non-operating room anesthesia. ABOUT THIS MEETING The purpose of this meeting is to educate and share information that will enable anesthesiology practitioners to provide the highest level of ambulatory anesthesia services and improve patient outcomes. Topics for this meeting were selected by various methods. Suggestions for topics were derived from evaluations of the 2016 and other previous Annual and Mid-Year Meetings. In addition, the Annual and Mid-Year Meeting Committees and Board members review the published literature with the highest impact on the specialty, and solicit suggestions from members of SAMBA active in the clinical practice of ambulatory anesthesia. These suggestions were discussed with educators who attended previous Annual, Mid-Year and SAMBA Board meetings. DISCLAIMER The CME activities and information provided at the SAMBA Annual Meeting is for continuing medical education purposes only and is not meant to substitute for the independent medical judgment of a physician relative to diagnostic and treatment options of a specific patient s medical condition. DISCLOSURE The American Society of Anesthesiologists remains strongly committed to providing the best available evidence-based clinical information to participants of this educational activity and requires an open disclosure of any potential conflict of interest identified by our faculty members. It is not the intent of the American Society of Anesthesiologists to eliminate all situations of potential conflict of interest, but rather to enable those who are working with the American Society of Anesthesiologists to recognize situations that may be subject to question by others. All disclosed conflicts of interest are reviewed by the educational activity course director/chair to ensure that such situations are properly evaluated and, if necessary, resolved. The American Society of Anesthesiologists educational standards pertaining to conflict of interest are intended to maintain the professional autonomy of the clinical experts inherent in promoting a balanced presentation of science. Through our review process, all American Society of Anesthesiologists CME activities are ensured of independent, objective, scientifically balanced presentations of information. Disclosure of any or no relationships will be made available for all educational activities. STATEMENT OF NEED The SAMBA Annual Meeting provides a forum devoted to ambulatory and office-based anesthesia offering clinically relevant lectures, panels and workshops; highlights of innovative ambulatory and office-based practices; networking opportunities with peers and experts in the field; and exposure to relevant products/services of interest to our attendees in the exhibits area. SPECIAL NEEDS The Society for Ambulatory Anesthesia fully complies with the legal requirements of the Americans with Disabilities Act and the rules and regulations thereof. If any attendee in this educational activity is in need of accommodations, please contact SAMBA at COMMERCIAL SUPPORT ACKNOWLEDGEMENT The CME activity is supported by educational grants. A complete list of supporters will be made available in the program guide. CME ACCREDITATION 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 American Society of Anesthesiologists and the Society for Ambulatory Anesthesia. The American Society of Anesthesiologists is accredited by the ACCME to provide continuing medical education for physicians. The American Society of Anesthesiologists designates this live activity for a maximum of AMA PRA Category 1 Credits. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Register online at 9

10 Registration Form (1 of 2) For quick and easy online registration, visit today! Remember to select your workshops on page 2 of this registration form! Please make a copy for your records. Early registration deadline is March 24, Early registration is recommended as space is limited. On-site registration for the Annual Meeting will be open at 5:00 p.m. on Wednesday, May 3, Please complete all information accurately as any incomplete and/or inaccurate information may delay your registration from being processed. First Name M.I. Last Name Credentials Title Institution/Hospital/ASC Address ASA Member # ABA# City State ZIP code Country Phone Number Fax Number Address Annual Meeting Registration (Annual Meeting registration does not include the Hands-on Workshops) Registration includes: all educational presentations (excluding optional workshops), online course syllabus, coffee breaks, continental breakfasts, business and awards luncheon and social activity. FULL CONFERENCE ONE DAY REGISTRATION** On or Before March 24 After March 24 On or Before March 24 After March 24 SAMBA Member Active $ $ $ $ SAMBA Member Affiliate $ $ $ $ Non-member* $ $ $ $ AA and Nurse Anesthetists (CRNA) $ $ $ $ Other, Non-Physician (Administrator) $ $ $ $ Nurse (RN) $ $ $ $ Resident $99.00 $99.00 $ $ Registration Subtotal $ $ $ $ * Registration for the Annual Meeting includes one year free SAMBA membership. This only applies to those attendees that have not been a SAMBA member within the past 5 years. ** Attendees may only purchase (1) one-day pass. Any attendees planning to stay for ore than one day must purchase a full conference registration. One day registrants, please specify which day you will attend: Thursday, May 4 Friday, May 5 Saturday, May 6 10 Register online at

11 Registration Form (2 of 2) First Name M.I. Last Name Credentials City State Phone Number Optional Workshops (Annual Meeting registration is required) Please select your workshops below. Friday, May 5 Hands-on Workshop: Basic Regional Ultrasound (Max 40) 1:00 pm 3:00 pm SAMBA Member $75.00 Non-member $75.00 Resident $15.00 Hands-on Workshop: Advanced Regional Ultrasound (Max 40) 3:30 pm 5:30 pm SAMBA Member $ Non-member $ Saturday, May 6 No additional fee Office Based Anesthesia Mini Symposium Resident Hands-On Workshop: Regional Ultrasound Techniques (Max 30) 1:30 p.m. 3:30 p.m. Optional Workshops Subtotal $ $ *Residents will be accommodated on a space-available basis SAMBA Social Event: Cinco de Mayo Celebration Saturday, May 6 from 6:30 pm - 9:30 pm (Dinner, drinks, and entertainment included) Yes, I will attend (Social evening fees included in the registration fee for attendees) Additional adult and child tickets are required and may be purchased as follows: Number of Adults (other than yourself) Number of Children (ages 13 and older) x $75 $ x $50 $ Number of Children (ages 12 and under) No charge Social Event Subtotal $ $ (Tickets will be collected onsite when entering this event) Dietary or Special Needs I will need special assistance. I will require vegetarian meals. I will require kosher meals. I will require gluten free meals. Registration Subtotal (page 1) Optional Workshops Subtotal (page 2) Social Event Subtotal (page 2) GRAND TOTAL $ $ $ $ Payment (Discover not accepted) Check (Make checks payable to Society for Ambulatory Anesthesia. Must be drawn in U.S. funds from a U.S. bank). Mail to: SAMBA 8584 Solutions Center Chicago, IL Please check here if you wish to pay with a credit card, and a SAMBA representative will send payment instructions in your confirmation . Cancellation Policy Cancellation of meeting registration must be received in writing and will be accepted until March 24, After March 24, there will be no refunds. Your refund, less a $200 administrative fee, will be sent after the conclusion of the meeting. Register online at 11

12 SAMBA HQ 330 N. Wabash, Suite 2000 Chicago, IL Place Postage Become a SAMBA member and gain access to: SAMBA Annual Meeting our yearly three day meeting features education sessions from leading industry professionals, networking events and receptions with fellow anesthesiologists and an exhibit show floor that features the latest innovations and products. Webinar Series held during the evenings after most practices close, our webinars focus on key interest areas within the profession and are presented by experts in our field. Discussion Forums connect with fellow anesthesiologists, residents, nurses and educators to learn real-world solutions to the questions and challenges you are facing. Clinical Practice Guidelines consensus statements on ambulatory anesthesia as they relate to specific conditions and treatments. Learn more about SAMBA and how to become a member at