Anesthesiology's journal-based CME program is open to all readers. Members of the American Society of Anesthesiologists participate at a preferred rate, but you need not be an ASA member or a journal subscriber to take part in this CME activity. Please complete the following steps:
Read the article by Mauermann and Nemergut entitled “The anesthesiologist's role in the prevention of surgical site infections” on page 413 of this issue.
Review the questions and other required information for CME program completion (published in both the print and online journal).
When ready, go to the CME Web site: http://www.asahq.org/journal-cme. Submit your answers, form of payment, and other required information by December 31 of the year following the year of publication.
The American Society of Anesthesiologists is approved by the Accreditation Council for Continuing Medical Education (ACCME) to sponsor continuing medical education programs for physicians.
The American Society of Anesthesiologists designates this educational activity for a maximum of 1 AMA PRA Category 1 Credit ™. Physicians should only claim credit commensurate with the extent of their participation in the activity.
Purpose: The focus of the journal-based CME program, and the articles chosen for the program, is to educate readers on current developments in the science and clinical practice of the specialty of Anesthesiology.
Target Audience: Physicians and other medical professionals whose medical specialty is the practice of anesthesia.
Learning Objectives: After reading this article, participants should have a better understanding of some of the factors contributing to surgical site infections and what anesthesiologists can do to reduce this complication.
Disclosure Information:
Authors –William J. Mauermann, M.D., and Edward C. Nemergut, M.D. Grants or research support: None Consultantships or honoraria: None The article authored by Drs. Mauermann and Nemergut was supported solely from institutional and/or departmental sources.
Question Writer –Peter L. Bailey, M.D. Dr. Bailey has no grants, research support, or consultant positions, nor does he receive any honoraria from outside sources, which may create conflicts of interest concerning this CME program.
Article Questions
Based on the article by Mauermann and Nemergut entitled “The anesthesiologist's role in the prevention of surgical site infections”http://content.wkhealth.com/linkback/openurl/trusted?issn=0003-3022&volume=105&issue=2&spage=413&part=fulltextin the August issue of Anesthesiology, choose the one correct answer for each question:
1. Which of the following statements concerning surgical site infections is most likely true?
A. They account for the vast majority of all hospital-acquired infections.
B. They become established within a few hours of contamination.
C. They typically present later than 48 hours after surgery.
D. They are not related to surgical technique.
2. Compared to normothermia (37 ± 0.3 °C), mild perioperative hypothermia (34–36 °C) is most likely to be associated with
A. A decrease in cardiac complications
B. Improved intraoperative hemostasis
C. An increase in surgical site infections
D. Shorter hospital length of stay
3. Compared to normothermia (37 ± 0.3 °C), mild perioperative hypothermia (34–36 °C) is associated with all of the following except
A. A greater degree of subcutaneous tissue vasoconstriction
B. Delayed postoperative food intake
C. A greater incidence of surgical site infections
D. Earlier collagen deposition in surgical wounds
4. Which of the following statements is most likely true?
A. Decreased subcutaneous tissue oxygen tensions are associated with surgical site infections.
B. Hypothermia enhances the killing of bacteria by neutrophils.
C. Hypothermia decreases nitrogen loss.
D. Subcutaneous tissue oxygen requirements are high.
5. Which of the following statements concerning glucose and the risk for surgical site infections is most likely true?
A. Hyperglycemia increases surgical site infections only in diabetic patients.
B. Hyperglycemia decreases immune defense mechanisms against infection.
C. Keeping glucose levels less than 250 mg/dl eliminates the increased risk of infection associated with hyperglycemia.
D. Hyperglycemia is not associated with an increase in mortality in hospitalized patients.
6. Which of the following statements concerning preoperative antibiotic prophylaxis for surgical site infections is most likely true?
A. Prophylaxis should target as many pathogens as possible.
B. Prophylaxis with a cephalosporin is not adequate for surgery requiring gram-negative and anaerobic coverage.
C. Patients reporting any reaction to penicillin should not receive a cephalosporin.
D. The most effective time for antibiotic administration is within 1 hour prior to skin incision.
