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Digital Seminar

Module 1: Post-Op Emergencies

Michael Greco, DNP, CRNA, CPAN, CAPA
1 Hour 04 Minutes
Audio and Video
Feb 13, 2015
Product Code:
Media Type:
Digital Seminar


  • Confidently respond to the respiratory and cardiovascular emergencies that occur after surgery
  • Take away essential post-op assessment strategies to identify early concerns
  • How can the medications used during surgical cases present challenges afterwards when the patients admit to the floor?
  • Emergent interventions for patients with known or unknown sleep apnea
  • Documentation strategies for the crisis post-op patient situations
  • Anticipate the unique needs for your Obese, Pediatrics, Geriatrics & Obstetrics patients

Post-operative complications can be fatal if not recognized and treated rapidly. Complications can lead to extended hospital stays, increased cost, and diminished quality of life. If you care for patients who have received sedation, anesthesia and analgesia in the operative, interventional or diagnostic setting, this seminar is for you. Utilizing case studies and the latest evidence-based practice guidelines, Michael Greco, DNP, CRNA, CPAN, CAPA, will sharpen your understanding of the factors associated with post-operative risk.

Many post-operative complications, including potentially-fatal malignant hyperthermia, can occur in the immediate post-operative period. While other potential complications may present a little later into the follow-up care provided. Plan on attending this seminar and learn the many components needed to adequately evaluate patients following surgery, including: current (sometimes subtle) assessment findings that could flag something more significant, increased patient safety considerations, and strategies to prevent crisis situations from even happening.


* Credit Note - **

NOTE: Tuition includes one free CE Certificate (participant will be able to print the certificate of completion after completing the on-line post-test (80% passing score) and completing the evaluation). 

Continuing Education Information:  Listed below are the continuing education credit(s) currently available for this non-interactive self-study package. Please note, your state licensing board dictates whether self-study is an acceptable form of continuing education. Please refer to your state rules and regulations. If your profession is not listed, please contact your licensing board to determine your continuing education requirements and check for reciprocal approval. For other credit inquiries not specified below, please contact or 800-844-8260 before the event.

Materials that are included in this course may include interventions and modalities that are beyond the authorized practice of your profession.  As a licensed professional, you are responsible for reviewing the scope of practice, including activities that are defined in law as beyond the boundaries of practice in accordance with and in compliance with your profession's standards.  

All members of the PESI, Inc. planning committee have provided disclosures of financial relationships with ineligible organizations and any relevant non-financial relationships prior to planning content for this activity. None of the committee members had relevant financial relationships with ineligible companies or other potentially biasing relationships to disclose to learners.  For speaker disclosures, please see the faculty biography.

California Nurses

PESI, Inc. is a provider approved by the California Board of  Registered Nursing, Provider #: 17118 for 5.5 self-study contact hours. 

** You will need to provide your license number to PESI. PESI must have this number on file in order for your hours to be valid.

Florida Nurses

PESI, Inc. is an approved provider by the Florida Board of  Nursing. Provider #: FBN2858. These materials qualify for 5.5 self-study contact hours.

CE Broker

Iowa Nurses

PESI, Inc. is an approved provider by the Iowa Board of Nursing. Provider #: 346. Nurses successfully completing these self-study materials will earn 7.0 self-study contact hours. Please email with your license number, include the title, speaker name and date. PESI must have this number on file in order for your hours to be valid.

California Physical Therapists & Physical Therapist Assistants

PESI, Inc. is recognized by the Physical Therapy Board of California as an approval agency to approve providers. This self-study lecture qualifies for 5.75 continuing competency hours.

Texas Physical Therapists & Physical Therapist Assistants

This activity is provided by the Texas Board of Physical Therapy Examiners Accredited Provider #2106032TX and meets continuing competence requirements for physical therapist and physical therapist assistant licensure renewal in Texas. This activity will provide 5.75 CCUs. The assignment of Texas PT CCUs does not imply endorsement of specific course content, products, or clinical procedures by TPTA or TBPTE. Full attendance is required; no partial credits will be offered for partial attendance.

Physical Therapists & Physical Therapist Assistants

This self-study course consists of 5.75 clock hours of instruction that is applicable for physical therapists. CE requirements for physical therapists vary by state/jurisdiction. Please retain the certificate of completion that you receive and use as proof of completion when required.

Illinois Physical Therapists & Physical Therapist Assistants

PESI, Inc. is a Registered Physical Therapy Continuing Education Sponsor through the State of Illinois Department of Financial and Professional Regulation, Division of Professional Regulation. License #: 216.000270. This self-study course qualifies for 5.5 CE credit hours.

New York Physical Therapists & Physical Therapist Assistants

PESI, Inc. is recognized by the New York State Education Department, State Board for Physical Therapy as an approved provider for physical therapy and physical therapy assistant continuing education. This self-study course qualifies for 7.0 contact hours.

Other Professions

This self-study activity qualifies for 5.75 continuing education clock hours as required by many national, state and local licensing boards and professional organizations. Save your activity advertisement and certificate of completion, and contact your own board or organization for specific requirements.



Michael Greco, DNP, CRNA, CPAN, CAPA Related seminars and products

Michael Greco, DNP, CRNA, CPAN, CAPA, is a certified registered nurse anesthetist, a certified post-anesthesia nurse and a certified ambulatory perianestheisa nurse who currently practices at The New York Presbyterian Medical Center in New York City. He has provided anesthesia care for cases ranging from outpatient ambulatory care to complex open-heart cases. He has also covered labor and delivery services as well as serving as a PACU liaison. His extensive experience in the perianesthesia/critical care arena has not just been limited to the hospital setting. As a past critical care staff educator, Michael had the opportunity to take his skills to the sky and educate flight attendants around the continental US and South America through his involvement with the American Airlines AED program. Recently, he received an honorary discharge from the US Army after serving ten years in the reserves as a nurse anesthetist. Michael has had the opportunity to present to and empower nurses and anesthesia providers not only nationally, but internationally as well.

Michael received his Doctor of Nursing Practice degree from The University of Alabama, his Masters in Nurse Anesthesia at SUNY Health Science Center at Brooklyn, and his undergraduate BSN training at Niagara University. He is dedicated to nursing education and has completed a research study on adult learning. He currently holds an academic appointment at Columbia University as a professor in the graduate Nurse Anesthesia program. His current research interests include anesthetic management of cardiac electrophysiology patients as well as computer-mediated distance education. He is a member of Sigma Theta Tau, American Association of Nurse Anesthetists and American Society of Perianesthesia Nurses. Utilizing his minor in theater arts, Michael has appeared on National TV on the Jerry Lewis Telethon, on TLC’s Trauma Life in the ER, and has done voice over work for local and national television commercials.

Speaker Disclosures:

Financial: Michael Greco receives a speaking honorarium from PESI, Inc.

Nonfinancial: Michael Greco has no relevant nonfinancial relationships to disclose.

Additional Info

Access for Self-Study (Non-Interactive)

Access never expires for this product.

Target Audience

Nurses, Physical Therapists, Physician Assistants, and other Healthcare Professionals


  1. Develop response plans for the most likely respiratory and cardiovascular emergencies to occur post-operatively.
  2. Communicate the regulatory issues and standards driving changes in post-anesthesia practice today.
  3. Assess strategies to identify concerns early on in the patient following surgery.
  4. Evaluate the key elements involved in related malpractice cases.
  5. Appraise how the medications used during surgical cases can present challenges afterwards when the patients admit to the floor.
  6. Formulate effective documentation samples for emergent post-op patient cases.
  7. Analyze why certain populations pose unique challenges post-operatively to be able to anticipate needs.
  8. Plan for emergent interventions for patients with known or unknown sleep apnea.


Critical Elements in Perianesthesia Care

  • Co-existing disease process and anesthesia
  • Levels of sedation and advantages/ disadvantages (conscious sedation, MAC, general)
  • Intubation techniques and equipment (standard versus emergency)
  • Differentiating spinal and epidural blocks
    • Safe management of catheters
    • Emergency identification and management of complications
    • Regional nerve blocks (Neck, upper and lower extremity, eyes)
  • Identifying potential emergencies and complications resulting from regional blocks
    • Horners syndrome
    • Pneumothorax, vertebral artery injection
    • Hematoma and intravascular injection


Anesthetic Medication Complications

  • Pharmacokinetics and pharmacodynamics
  • Benzodiazepines
  • Opioids
  • Induction agents
  • Inhalation agents and physiology
  • Depolarizing and non-depolarizing muscle relaxants
  • Acetylcholine receptor competitive antagonists
  • Antiemetics
  • Common emergency medications in the perianestheisa setting


Post-operative Complications with Clinical Application (Real Life Case Studies)

  • Modulation of pain
    • Pharmacologic and non-pharmacologic methods to employ
    • Physiologic complications from pain
  • Local Anesthetic Systemic Toxicity (LAST)
    • Signs and symptoms (early and late)
    • Treatment algorithm
    • Post-op Nausea and Vomiting (PONV):
    • Risk factors, medication management, prophylaxis, rescue therapy
    • Hypothermia: Heat loss physics, delayed awakening, warming interventions
    • Perform a focused yet thorough physical assessment (systems review)


Respiratory Emergent Complications (Real Life Case Studies)

  • Airway obstruction: Upper and lower
  • Pharyngeal muscular weakness
  • Laryngospasm vocal cord paralysis
  • Airway edema
  • Other airway emergencies:
    • Postoperative cervical hematoma
    • Foreign bodies
    • Residual effects of anesthesia
    • Pharmacologic reversal
    • Compromised oxygen exchange
    • Bronchospasms
    • Non-cardiogenic pulmonary edema
    • Hypoventilation and hypoxia
    • Pulmonary embolism
    • Pseudeocholinesterase deficiency
    • Atelectasis
    • Aspiration
    • Pneumothorax
    • Emergency tracheotomy


Obstructive Sleep Apnea Airway Emergent Complications (Real Life Case Studies)

  • Physiology of OSA
  • Comorbidities of concern
  • Diagnosis
  • Planning for treatment
  • Emergency interventions
  • Effects on airway management and ventilation
  • Implications for care across the perianesthesia setting


Cardiovascular Emergent Complications (Real Life Case Studies)

  • Pulmonary edema
    • Fluid overload
    • LV failure
    • MV dysfunction
  • Hypertension and hypotension
  • Postoperative dysrhythmias
  • Myocardial infarction
  • Hypervolemia and hypervolemia


Neuropsychiatric Emergent Complications (Real Life Case Studies)

  • Emergence delirium/excitement
  • Somnolence
  • Visual disturbances
  • Intraoperative awareness
  • Malignant hyperthermia


Post-operative Urinary Retention Concerns

  • Risk factors to heighten awareness
  • Evaluation and the latest in treatment


High Risk Populations: Tips to Reduce Potential Complications

  • Obese patients
  • Pediatric patients
  • Obstetric patients
  • Geriatric patients



Overall:      5

Total Reviews: 2


Debra G

"Very good very knowledgeable!"

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