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The BBAC Protocol

Lesson 1
What is BBAC?

The Beta Blocker & Clonidine Protocol
(a.k.a. How to avoid death for a dollar)

Art Wallace, M.D., Ph.D
Associate Professor of Anesthesiology
University of California, San Francisco
Veterans Affairs Medical Center San Francisco

Greetings. I am Art Wallace and I have given this lecture many times and decided it needed to be made more widely available. It has been titled many things, and although "How to Avoid Death for a Dollar" was one of my favorites, we finally decided on BBAC: the Beta Blocker and Clonidine protocol. The reason I am not just calling this the Beta Blocker protocol is several fold. First, there are other medications that are not beta blockers that can be used in patients who are intolerant of beta blockade. Perioperative beta blockade now includes a second line agent, clonidine, that is useful in patients who have a contraindication to beta blockers. Moreover, I want to emphasize that BBAC is intended to do something very different from risk stratification, which is the classic approach to patients with cardiac risk coming for surgery. BBAC is risk reduction therapy. There is still risk, it is just reduced by BBAC.

Perioperative beta blockade has been in use since 1996 to reduce perioperative morbidity and mortality. Clonidine was more recently found to have the same effect for patients who have a contraindication to beta blockers. BBAC has been proven to significantly lower rates of perioperative mortality.

If the Sitepal animation above does not load, please click below for audio.
Click here if you want sound narration.

This course has four goals:

bullet Teach you to recognize when BBAC should be used.
bullet Teach you how to implement BBAC as part of a perioperative risk reduction plan for your hospital
bullet Track the course's efficacy in teaching you, and your clinical implementation of the course's guidelines.
bullet Help you monitor your hospital's efficacy in implementing BBAC.

The first two goals require that you read and study the materials in this course. The third objective requires that you complete the following form so that we can track your institute's response to this training over time. At the end of the course you will be asked to fill out a short course assessment which will reflect your attitudes towards the material presented.

Please complete the following short form and press the "Submit form" button when you are done.: Register for BBAC


Content by Art Wallace MD PhD
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