The Joint Society for Pediatric Anesthesia (SPA)/American Academy of Pediatrics (AAP) Winter Scientific Meeting was held in Las Vegas, NV, from March 14 to 17, 2013. The meeting began on Thursday, March 14, with workshops for Clinical Competence Committees, Junior Faculty Research, and Advanced Ultrasound Guided Regional Anesthesia. The Congenital Cardiac Anesthesia Society (CCAS) and Special Interest Group for Pediatric Pain Management (SIGPPM) Annual Meetings were also held on Thursday; the detailed program for all these meetings can be obtained from the CCAS and SPA Web sites at www.ccasociety.org and www.pedsanesthesia.org, respectively. The CCAS annual program was guided by the 7 elements of the Society’s mission: education, collaboration, coordination, research, database, training, and advocacy. Faculty included a surgeon, cardiologist, intensivist, and perfusionist—illustrating the collaborative nature of congenital cardiac care. Educational topics covered basic science (cardiopulmonary bypass), controversial issues (choice of anesthetic agents for electrophysiology studies), and challenging clinical problems (double outlet right ventricle). Current relevant literature was reviewed by an international panel. New research was presented at oral and poster sessions, and many sessions used information from the recently developed multi-institutional CCAS anesthetic database. Two innovative discussions were Patient Safety (teamwork—essentials and common problems) and CCAS advocacy (provision of appropriate anesthesia care to pediatric and adult congenital cardiac patients throughout their lifespan). SIGPPM held its third meeting “Frontiers in Pediatric Pain Medicine,” with record attendance. Highlights included presentations on innovations in local anesthetics by Dr. Charles Berde, cutting edge pharmacogenomics by Dr. Jeffrey Galinkin, a robust pro/con debate on the routine use of ketamine in the operating room between Drs. Constance Monitto and Stephen Hays without a clear “winner” due to insufficient evidence, the multidisciplinary approach to the child with cancer with Drs. Yuan-Chi Lin, Kenneth Goldschneider and Tonya Palermo, a comprehensive review of opioid-induced hyperalgesia by Dr. Navil Sethna, and a local plus remote Q&A session via Skype with Dr. Anjana Kundu, truly integrating technology and pediatric pain medicine. Dr. Sabine Kost-Byerly also announced that SIGPPM has been voted to officially become the new Society for Pediatric Pain Medicine, allowing for a formal organizational structure, increased independence, and inclusion of pain practitioners who are not also pediatric anesthesiologists. SPA broke new ground with a record of 910 registrants for the Winter Scientific Meeting; 24% of respondents were private practitioners, and 83% of respondents indicated that they had been through fellowship training. The theme for this year’s SPA meeting was Childhood Obesity. The meeting commenced with Problem Based Learning Discussions (PBLDs), followed by talks on the “Anesthetic Challenges of Pediatric Obesity Surgery,” “Obstructive Sleep Apnea Syndrome,” and “Surgical vs. Medical Treatment of Childhood Obesity.” In addition, the AAP Advocacy lecture on Childhood Obesity was delivered by Dr. Thomas Robinson from Stanford University (Palo Alto, CA) who is a Professor of Child Health, Pediatrics, and Medicine, Director of the Center for Healthy Weight, and an international expert on prevention of pediatric obesity. Dr. Robinson discussed the societal implications of the current childhood obesity epidemic and the use of “stealth” interventions to motivate children to lose weight, often as a “side effect” of the primary intervention. The program also included a Simulation demonstration of a trauma scenario that incorporated principles of Anesthesia Crisis Resource Management, debriefing tips, and a brief overview of the American Board of Anesthesiology Maintenance of Certification in Anesthesiology requirements. The afternoon sessions included Refresher Course lectures on “Cardiomyopathy” and “Challenges with Patient Controlled Analgesia in Children,” as well as workshops on financial planning, vascular access, ultrasound-guided regional anesthesia, and the difficult pediatric airway. Interactivity was a highlight of this year’s program. Extensive use of the Audience Response System with audience questions accompanied almost every presentation, and some sessions were completely interactive, such as the popular sessions on “Ethical Dilemmas in Pediatric Anesthesiology,” “Crisis Resource Management, Simulation and MOCA [Maintenance of Certification in Anesthesiology],” and the ever popular “Jeopardy” hosted by Dr. Myron Yaster. Attendees also had the opportunity to pose questions or comments via the Web site in advance of the meeting to authors of the 355 posters accepted for presentation. The Robert M. Smith Award was presented to Dr. John Christian Abaijan from Vermont for his work creating the Vermont Infant Spinal Registry and a career spent mystifying patients and residents with his magical distractions. Social media made its debut at SPA with an official SPA Twitter feed (@PediAnesthesia) that was used for important announcements during the meeting, as well as to host tweets by attendees (#SPAVEGAS2013). In addition, this was the first SPA meeting to have a downloadable app for attendees to follow the program. On the second day, the meeting commenced with a session entitled “Frontiers in Pediatric Neuroanesthesia: Seizures, Synostosis and Stimulation” that dealt with challenges of anesthesia for intraoperative brain mapping, craniosynostosis, and intraoperative neural monitoring. Dr. Nicholas Carling discussed common techniques for awake craniotomy, the effect of drugs on electrocorticography and brain mapping, and the challenges of providing anesthesia for deep brain stimulation. This was followed by oral presentations by the young faculty and trainee recipients of the “Best Abstract” awards for Young Investigators and Residents, respectively. The AAP “Ask the Experts” Panel featured talks on anesthesia for patients with pulmonary, hepatic, and renal disease, and was sponsored by the Children’s Hospitals of Cincinnati, Arkansas, and Texas. The next session featured Dr. Matthew Weinger with his insights on “The Role of Technology in Patient Safety.” He emphasized that the vast majority of critical incidents related to medical devices were as a result of poor design, not device failure; in this context, he stressed the importance of the design of the user interface and discussed principles of “human factors” as they relate to automation, device complexity, vigilance, and communication. Following two excellent Refresher Course lectures on “Mitochondrial Disease” and “Acute Intraoperative Emergencies,” the day concluded with PBLDs and workshops on acupuncture, mission anesthesia, giving feedback, designing and moderating PBLDs, investigating adverse events, single-lung ventilation, scientific writing, echocardiography, and epidemiology. The third day began with the popular “Editors’ Best Picks” from Anesthesiology, Anesthesia & Analgesia, and Pediatric Anesthesia presented by Dr. Lance Lichtor, Dr. Peter Davis, and Dr. Charles Cote, respectively. Dr. Peter Davis announced that he will be stepping down next year as the Section Editor for Pediatric Anesthesia of the journal Anesthesia & Analgesia after a 10-year term and asked that individuals who are interested in the position should forward their resumes to him for consideration. A concerted effort to engage and involve the younger generation of SPA attendees resulted in a special reception for promising fellows and faculty within 10 years of graduation from fellowship, as nominated by Department Chairs. “The Young Turks: SPA Needs You” was held in the stunning Presidential Suite and included face-to-face time with senior SPA leaders and short presentations by younger faculty describing their pathway to involvement with SPA. The underlying theme and take-home message was “show up, be seen, be interested, volunteer to work, do the work you volunteered to do, and above all, take the opportunity to cultivate professional relationships and make friends.” The warm sunshine provided a brief respite for attendees from regions still in the icy grip of winter. Kirk Lalwani, MD, FRCA, MCR Departments of Anesthesiology and Perioperative Medicine, and Pediatrics Oregon Health and Science University Portland, Oregon [email protected] Glyn D. Williams, MBChB, FFA Department of Anesthesiology Stanford University Palo Alto, California Rosalie Tassone, MD, MPH Department of Anesthesiology University of Illinois Hospital and Health Sciences System Chicago, Illinois