ASA’s Perioperative Resuscitation and Life Support Certificate, or PeRLS, offers advanced cardiac life support training designed specifically for anesthesiologists. Adapted from the American Heart Association’s Advanced Life Support curricula, PeRLS offers a more anesthesia-centric solution to address perioperative crisis training. But because health care continues to evolve, the program must advance, too. To learn about recent changes, the ASA Monitor asked PeRLS Chair Michael O’Connor, MD, FCCM, FASA, about the program enhancements ASA has recently rolled out.

We have updated the content of PeRLS. PeRLS is still outcomes-focused and tailored to the perioperative setting, but the style, content, and questions have all been changed to better meet the needs of today’s practitioners. For example, we are analyzing 12 PICO (population, intervention, control, and outcome) questions selected by our editorial board and outsourcing some questions to the Cochrane group for a formal grade analysis. The goal is to give learners concrete knowledge with real-world value, and we think the changes we’ve made enhance the offering.

The program is laser focused on issues unique to patients under anesthesia or in the perioperative/periprocedural setting. Rather than revisiting skills that anesthesia care team members practice every day, PeRLS concentrates on low-frequency, high-impact events, training practitioners on how to make a meaningful difference when the unexpected occurs and stakes are high.

Cardiac arrest in the perioperative setting has a different spectrum of causes than cardiac arrest in the outpatient world. PeRLS includes on-ramps of differential diagnoses of the causes of crisis and cardiac arrest in the periprocedural setting. These include anesthetic causes, causes related to patient disease and morbidities, and surgical complications. PeRLS trains practitioners to prevent perioperative cardiac arrest. When arrest can’t be avoided, PeRLS includes suggestions about how to treat the underlying cause of the crisis. This program also proposes algorithms for emergency cardiac care and life support in the perioperative setting. Uniquely, PeRLS incorporates point-of-care ultrasound into its algorithms.

The program is pertinent and efficient. Most importantly, it works – the maintenance of expertise model is the best way to learn and retain critical knowledge that you don’t frequently use.

An increasing number of anesthesiologists and groups are using completion of PeRLS as their preferred resuscitation training program because it’s more pertinent to what they do and, therefore, more appropriate for the perioperative or periprocedural setting.

The updated, content-rich course will walk you through five modules with an emphasis on real-world perioperative scenarios and ideal patient outcomes. You’ll learn to identify less common cardiac conditions and get training on how to rescue patients in crisis. There is a prerequisite exam and a post-test. There are two learning pathways designed to meet the learner’s knowledge base. Performance on the prerequisite exam will direct learners either to a review of basic AHA ACLS or to an accelerated pathway to the advanced content of PeRLS. The PeRLS modules include scenarios such as local anesthetic toxicity, high neuraxial anesthesia, anaphylaxis, and trauma. Beyond the focus of crisis scenarios in the perioperative setting, there are interactive activities, cognitive aids, knowledge checks, and access to algorithms. And, in addition to a certificate of completion, learners can enroll in a maintenance of expertise program that awards even more CME.

Yes. We’ll offer a refresher course, a panel, and a workshop, which will be a bit different this year. Due to high demand, the workshop will be a hybrid problem-based learning, hands-on experience where every group of learners will engage in tabletop group simulations. The group simulations will allow us to expand the number of people who can participate and will also be valuable for those who need to demonstrate hands-on training experience, in addition to demonstrating mastery of knowledge content. The experiences will be available Saturday and Sunday.

The program is pertinent and efficient. Most importantly, it works – the maintenance of expertise model is the best way to learn and retain critical knowledge that you don’t frequently use. PeRLS is not only useful to physician anesthesiologists but to CRNAs, anesthesiologist assistants, proceduralists, surgeons, scrub techs, recovery nurses, circulating nurses, and even intensive care clinicians. PeRLS is used in the United States and has also expanded into other countries. PeRLS meets The Joint Commission’s recent mandate for training and resuscitation for hospital-based providers. All in all, it’s a valuable program we’re proud to offer.