Registration How to Register
Transcription
Registration How to Register
Registration To register for the 18th Annual Winterlude Anesthesia Symposium this registration form with payment must be received. Please remember if paying by cheque it must be received before December 15th, 2011. On Site registration will be available Registration Information: Family Name: Given Name: Mailing Address: How to Register There are four easy ways to register for Winterlude Symposium 2012. Payment must accompany form. Cheques should be payable to “Anesthesia CME Fund.” 1. Register Online http://www.anesthesia.org/winterlude 18th Annual Anesthesia Winterlude Symposium Registration Form 2. Register by Fax Simply complete this form and fax to 613- 761-5032. Fax registrations must include payment by credit card. 3. Register by Mail Complete this form and mail the completed form and your payment to the address below. 4. Onsite Registration City: Province/ State Winterlude Symposium c/o Lynne McHardy Postal / Zip Code Telephone: Department of Anesthesiology, The Ottawa Hospital& University of Ottawa 1053 Carling Avenue, B309, Ottawa, Ontario, K1Y 4E9 Fax: Email: If mailing, please ensure your cheque and registration are received before December 15th, 2011 to ensure proper processing. Hospital Affiliation: Cancellation policy: Professional Status: A refund will be made (less $50 processing fee) if a cancellation request is received in writing no later than December 15st, 2011. No Refunds will be given after December 15st, 2011. The Planning Committee reserves the right to cancel or move the conference should this become necessary. In this circumstance, each registrant will be notified by telephone or email and a full refund will be given. Winterlude Anesthesia 2012 is not responsible for any other costs incurred, such as airline or hotel penalties. The Science and PracƟce of PerioperaƟve Medicine February 4th and 5th, 2012 The WesƟn Hotel 11 Colonel By Drive OƩawa, Ontario hƩp://www. anesthesia.org/winterlude uOSSC- University of Ottawa Skills and Simulation Centre, 724 Parkdale Avenue, Ottawa, Ontario Westin Hotel, Ottawa, Ontario Sunday 5th February 2012 Location: Saturday 4th February 2012 Location: Workshops & PBL’s Program 0700-0800 Registration and Delegate Breakfast 0800-0810 Welcome and Opening Remarks Plenary Session-Ambulatory Surgery Dr. Naveen Eipe Moderator: Dr. Gregory Bryson 0810-0840 Dr. Alan Tallmeister 1800 laparoscopic gastric band procedures at an independent Ontario Surgicentre 0840-0910 Difficult Airway Management in an Ambulatory Setting Dr. Edward Crosby 0910-0940 Regional Anesthesia and Ambulatory Surgery Dr. Jennifer Szerb OHI- Ottawa Heart Institute, 40 Ruskin Street, Ottawa, Ontario Problem Based Learning- 2 hours (max 20 each) OHI 8:00am-10:00am and 10:00am-12:00pm Staff Registration Fees A-Full Meeting & Two PBLs: Before Dec.15/11 $350 After Dec. 15/11 $500 Medical student/ $75 $150 Resident/Fellow/RT/RN Please indicate preference for PBLs (Circle two): Acute Pain/ Bariatric/ Safety/ Transfusion/ After Dec. 15/11 $650 Staff 1. Multimodal Analgesia and Enhanced Recovery Programs Dr. Francesco Carli Dr. Lorri Lee Acute Pain/ Bariatric/ Safety/ Transfusion/ Thrombosis *Please indicate preference for 2hr Workshop (Circle One): Airway/ Neonatal/ Regional/ TEE Dr. Jeannie Callum 5. Perioperative Anticoagulation and Regional Anesthesia Dr. William Geerts Workshops - 2 hours uOSSC 8:00am-10:00am and 10:00am-12:00pm 1. Airway Surgical/Bronchoscopy (Max 12 Participants) Dr. Ted Crosby C-Full Meeting-Two 2hr Workshops or One 4hr Workshop: Before Dec.15/11 $550 Staff Medical student/ $275 Resident/Fellow/RT/RN After Dec. 15/11 $800 $450 Please indicate preference for 2hr Workshop (Circle two): Airway/ Neonatal/ Regional/ TEE OR Please indicate preference for 4hr workshop (Circle One): Adult Crises/ 2. Neonatal Resuscitation Practitioner (Max 10 Participants) Pediatric Crises/ ACLS Dr. Patti Murphy Method of Payment 3. Regional Cadaveric Ultrasound (Max 12 Participants) Cheque: Payable to CME Fund Card Type Card Number Dr. Jennifer Szerb 4. Trans Esophageal Echocardiography Basic (Max 6 Participants) Dr. Chris Hudson Workshops - 4 hours (max 10 each) uOSSC 8:00am - 12:00pm 1. Adult Crises Management (Max 10 Participants) Thrombosis B-Full Meeting-One PBL & One 2hr Workshop: Before Dec.15/11 $450 Medical student/ $175 $350 Resident/Fellow/RT/RN *Please indicate preference for PBLs (Circle One): 2. Morbidly Obese Patients for Bariatric and Non Bariatric Surgery Dr. Alan Tallmeister 3. Patient Safety and Preventable Patient Injuries 0940-1000 Panel Discussion/Question Time 4. Perioperative Transfusion Medicine 1000-1030 Coffee & Exhibits Plenary Session-Patient Safety & Outcomes Moderator: Dr. Donald Miller 1030-1110 Dr. Lorri Lee Visual Loss after Major Spine Surgery: Can we Identify Risk Factors? 1110-1150 Dr. Francesco Carli Fast Track Surgery: What is the role of the Anesthesiologist? 1150-1200 Panel Discussion/Question Time 1200-1300 Lunch & Exhibits J. Earl Wynands Lecture (Sponsored by the Royal College of Physicians and Surgeons of Canada) Introduction: Dr. Homer Yang 1300-1345 Dr. Tait Shanafelt Finding Meaning, balance and Personal Satisfaction in the Practice of Medicine 1345-1355 Open to the Floor Plenary Session- Thrombosis & Transfusion Moderator: Dr. Christopher Hudson 1400-1500 New Oral Anticoagulants: Promise, Peril and Practice Dr. William Geerts Optimizing and Treating Coagulopathies Dr. Jeannie Callum 1500-1510 Open to the Floor 1510-1530 Coffee & Exhibits 1530-1630 Debate Moderator: Dr. Kimmo Murto Out of OR Sedation Anesthesiologists or Non Anesthesiologists? Dr. Lawrence Roy Dr.Robin Cox 1630-1640 Open to the Floor 1630-1830 A Taste of Winterlude-Wine & Cheese Reception Dr. Simone Crooks Expiry Date: Signature: Total Cost: 2. Pediatric Crises Management (Max 10 Participants) I authorize Winterlude 2011 to Charge my account for: Winterlude Symposium Dr. Dylan Bould 3. ACLS Recertification (Max 10 Participants) $____________ Dr. Viren Naik