Release Date: October 2008
Expiration Date: October 31, 2009

NEEDS STATEMENT
Despite the advances made to reduce postoperative complications, blood loss remains a significant problem and can lead to morbidity and mortality. Traditional surgical techniques (eg, cautery and suture ligation) may not adequately control bleeding, or it may not be possible to use them during certain surgical procedures. During the past few decades, biologic hemostatic agents that mimic and enhance stages of the coagulation cascade have emerged. This special report discusses these agents, which can be categorized as systemic and topical agents.

ACCREDITATION STATEMENTS
Physician: This activity has been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of AKH Inc. and Applied Clinical Education. AKH Inc. is accredited by the ACCME to provide continuing medical education for physicians. AKH Inc. designates this educational activity for a maximum of 2.0 AMA PRA Category 1 Credits™. Physicians should only claim credit commensurate with the extent of their participation in the activity.

Nurse:AKH Inc. is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center’s Commission on Accreditation.

AKH Inc. designates this educational activity for 2.0 contact hours (0.2 CEU).

LEARNING OBJECTIVES
At the completion of this activity, participants should be able to:

1. Outline the clinical importance of achieving hemostasis during surgery, and the role of biologic hemostatic agents in controlling surgical bleeding.
2. Evaluate the different types of biologic hemostatic agents that are commonly used in surgery.
3. Examine controversial issues surrounding the use of biologic hemostatic agents.
4. Analyze evidence-based findings on the safety and efficacy of biologic hemostatic agents.
5. Compare the risk profiles of topical biologic hemostatic agents, including the development and clinical relevance of factor V/thrombin antibodies
6. Critically appraise new developments in topical biologic hemostatic agents.

TARGET AUDIENCE
This activity is intended for physicians, pharmacists, and nurses involved in the care of surgical patients.

CONFLICT OF INTEREST STATEMENT
It is the policy of AKH Inc. to ensure independence, balance, objectivity, scientific rigor, and integrity in all of its continuing education activities. The faculty must disclose to the participants any significant relationships with commercial interests whose products or devices may be mentioned in the activity or with the commercial supporter of this continuing education activity. Identified conflict of interest is resolved by AKH Inc. prior to certification of the activity. AKH planners and reviewers have no relevant financial relationships to disclose.

DISCLOSURE OF UNLABELED USE
This educational activity contains discussion of published and/or investigational uses of hemostatic agents and devices used in the management of perioperative bleeding. Some uses of these agents have not been approved by the FDA. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.

ESTIMATED TIME OF COMPLETION
This activity should take approximately 2 hours to complete.

METHOD OF PARTICIPATION
There are no fees for participating in and receiving credit for this activity. The participant should, in order, read the objectives and monograph, answer the multiple-choice online post-test and complete the evaluation form. The evaluation form provides each participant with the opportunity to comment on the quality of the instructional process, the perception of enhanced professional effectiveness, the perception of commercial bias, and his/her views on future educational needs. A score of at least 70% is required to successfully complete this program. One retake is allowed. A statement of credit may be printed immediately for successful completion. Credit is available through October 31, 2009.

FACULTY
Christopher Lomax, PharmD
Pharmacy Consultant
Easton, Pennsylvania

Fred A. Weaver, MD
Professor of Surgery
Chief, Division of Vascular Surgery and Endovascular Therapy
Associate Director, CardioVascular Thoracic Institute
University of Southern California Keck School of Medicine
Los Angeles, California

FACULTY REVIEWER
Charles Hogue, MD
Associate Professor of Anesthesiology
Department of Anesthesiology and Critical Care
Johns Hopkins Medical Institutions
Baltimore, Maryland

MEDICAL WRITER
Oren Traub, MD, PhD

FACULTY DISCLOSURE
Dr. Hogue has disclosed that he has served on the speakers' bureau of Hospira, Inc, and The Medicines Company and has served on the advisory committee of The Medicines Company.

Dr. Lomax has disclosed that he has served on the speakers' bureau of ZymoGenetics, Inc.

Dr. Weaver has disclosed that he has received grant support from and served as consultant for ZymoGenetics, Inc.

Dr. Traub has no relevant commercial interests to disclose.

DISCLAIMER
This course is designed solely to provide the health care professional with information to assist in his/her practice and professional development and is not to be considered a diagnostic tool to replace professional advice or treatment. The course serves as a general guide to the health care professional and therefore cannot be considered as giving legal, nursing, medical, or other professional advice in specific cases. AKH Inc., the authors, and the publisher specifically disclaim responsibility for any adverse consequences resulting directly or indirectly from information in the course, undetected error, or the reader's misunderstanding of the content.

SOFTWARE REQUIREMENTS
PC
Microsoft Windows 2000 SE or above.
Internet Explorer (v5.5 or greater), or Firefox
Adobe Acrobat Reader*

MAC
MAC OS 10.2.8
Safari
Adobe Acrobat Reader*
Internet Explorer is not supported on the Macintosh.

* Required to view printable (PDF) version of the lesson.

Jointly sponsored by AKH Inc. and Applied Clinical Education.

Copyright © Applied Clinical Education and AKH Inc. 2008.

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