The theme of this year’s American Thoracic Society annual conference was “where today’s science meets tomorrow’s care.” In keeping with that theme, we would like to highlight one poster on detection of opioid-induced respiratory depression through continuous electronic monitoring. To view a copy of the poster, please go to the ATS website or see an image of the poster below.
“Measuring vital signs every four hours is an outdated and dangerous practice. Patients on our hospital wards deserve continuous vital sign monitoring so they are not found ‘dead in bed,’” said Dr. Frank Overdyk, a Charleston-based anesthesiologist and expert on respiratory compromise. Dr. Overdyk is also a member of our board of advisors.
The study analyzed 6,590 hospitalization days and detected 91 events of respiratory depression. The positive predictive value of 70% of events were classified as respiratory depression or sleep apnea related. Additionally, the study indicated a very low false alarm rate – less than one in 5,000 hours of monitoring, translating to just one false alarm every seven months The study also covered a range of care units and highlighted the variance in incidence rate. Long term care units had the lowest incidence rate of respiratory depression, while post-op units had the highest. Please see an image of the poster presented at the ATS conference:
Detection of Opioid-Induced Respiratory Depression Through Continuous Electronic Monitoring
“One of the key complications resulting from opioid use in hospitalized patients is respiratory distress that can lead to ICU transfers and sadly, even death. Moreover, respiratory depression is a key risk factor across the healthcare continuum, from hospitals to skilled nursing facilities,” explained Michael Wong, JD, Executive Director of The Physician-Patient Alliance for Health & Safety (PPAHS). “For this reason,all patients receiving opioids should be continuously electronically monitored, to help provide early detection of the risk of respiratory depression and enable timely intervention.”
With the permission of the Association for the Advancement of Medical Instrumentation (AAMI), the Physician-Patient Alliance for Health & Safety (PPAHS) is pleased to release the AAMI video on how to keep patients and their families safe, “Only Continuous Electronic Monitoring Can Ensure Patients Receiving Opioids Are Safe.”
This weekend marked the 7th anniversary of Amanda Abbiehl’s tragic death. Her story continues to remind us of the need for continuous electronic monitoring for all patients receiving opioids.
Amanda was 18-years-old when she was admitted to hospital for a severe case of strep throat. To help her manage the pain, she was placed on a patient-controlled analgesia (PCA) pump. The next morning, she was found unresponsive and died. Though PCA pumps are designed to deliver an exact dosage of opioid – in Amanda’s case, hydromorphone – getting the ‘right’ dosage is not a simple task. Too high a dosage can lead to respiratory depression, sometimes in minutes.Read More →
Written by Michael Wong, JD, Founder & Executive Director of PPAHS
As founder and executive director PPAHS, when I speak at conferences about the Physician-Patient Alliance for Health & Safety support for continuous electronic monitoring of patients receiving opioids, I am often asked two questions:
Is PPAHS suggesting or recommending that technology replace nurses?
Why has continuous monitoring been so slow to be adopted by hospitals?
The following is a position statement published by PPAHS. If you would prefer to view our statement as a PDF, please click here.
Much of the public attention has been focused on the harm caused by prescription use and abuse of opioids. However, there is another facet that must be focused on: opioid-induced respiratory depression in clinical settings. This includes patients undergoing moderate and conscious sedation, or recovering from procedures and managing pain using a patient-controlled analgesia (PCA) pump, particularly those during the postoperative period.Read More →
Written by Lynn Razzano RN, MSN, ONC-C (Clinical Nurse Consultant, Physician-Patient Alliance for Health & Safety).
When preventable medical errors occur, one of the very first questions asked by patients, families, the legal system, the press, and the public is: “were appropriate care standards met?”. As a professional Registered Nurse, I look at this question from a quality and patient safety perspective to ask what could have been done differently? What are the best practice medical standards, and why are they not applied across the US health care systems? How applicable should the medical standard of care be? And how do we, as clinicians and patient advocates, define the best practice standard of care?
The reality is that the definition of best practice and standard of care differs between acute care hospital settings and outpatient surgery centers. And, even then, the standard of care being applied by the ambulatory surgical center, anesthesiologist and the gastroenterologist may not be the same. Read More →
Tyler was 18-years old when he was admitted to hospital for a pain in his chest.
It was a collapsed lung – the second time he had experienced one that year, and a condition that tall, young, slim males like Tyler can be prone to. To permanently correct the problem, Tyler underwent a procedure called pleurodesis, a common procedure to permanently prevent his lung from collapsing again. Upon the successful completion of the surgery, Tyler’s mother, Victoria Ireland said that she “breathed a sigh of relief”. Her son was going to be OK; all he needed to do was recover.Read More →