Identifying Patients At Risk of Opioid-Induced Respiratory Depression

Identifying Patients At Risk of Opioid-Induced Respiratory Depression

By Michael Wong, JD (Founder/Executive Director, Physician-Patient Alliance for Health & Safety)

Opioid-induced respiratory depression can lead to serious adverse events and even death, in hospitalized patients. In its Sentinel Event Alert #49, titled “Safe use of opioids in hospitals”, the Joint Commission stated, “While opioid use is generally safe for most patients, opioid analgesics may be associated with adverse effects, the most serious effect being respiratory depression, which is generally preceded by sedation.” The alert was retired as of February 2019 and is now addressed in the commission’s pain management standards for hospitals.

About half of in-hospital cardiorespiratory events occur on the general care floor. Often these events are fatal. Lars W. Andersen, MD (Department of Medicine, Regional Hospital Holstebro, Aarhus University & Department of Emergency Medicine, Beth Israel Deaconess Medical Center) and his colleagues concluded that acute respiratory events are common in inpatient wards in the US and are associated with a mortality rate of almost 40%.

Continue reading “Identifying Patients At Risk of Opioid-Induced Respiratory Depression”

CVS Caremark’s Decision Putting Eliquis Back on Its Formulary Benefits Patients

CVS Caremark’s Decision Putting Eliquis Back on Its Formulary Benefits Patients

Editor’s note: Recently, CVS Caremark reversed its decision to exclude Eliquis (apixaban) from its formulary. This is an update to previous posts on this issue – “CVS Caremark Formulary Exclusion of Eliquis is a Patient Safety Risk,” “Non-Medication Switching is a Patient Safety Issue,” and “How a Patient Battled with CVS Caremark and Won

By Michael Wong, JD (Founder & Executive Director, Physician-Patient Alliance for Health & Safety)

CVS Caremark Puts Patients First By Putting Eliquis Back on Formulary

CVS Caremark has put patients first by putting Eliquis® (apixaban) back on its formulary. By doing so, they have stayed true to their motto – “Your health is our priority. At CVS Caremark, each and every one of us is dedicated to helping you on your path to better health.”

Now, I can’t say the same thing about its decision at the end of 2021, but I’ll let you be the judge of that. In its original decision, CVS Caremark (part of CVS Health) decided to exclude Eliquis from the CVS Caremark Preferred Drug List. Eliquis is “indicated to reduce the risk of stroke and systemic embolism in patients with NVAF. Eliquis is indicated for the treatment of DVT [deep vein thrombosis] and PE [pulmonary embolism], and to reduce the risk of recurrent DVT and PE following initial therapy.” Eliquis is a Factor Xa inhibitor and is a Direct Oral Anticoagulant (DOAC). 

Continue reading “CVS Caremark’s Decision Putting Eliquis Back on Its Formulary Benefits Patients”

Not Everything in a Box is Safe

Not Everything in a Box is Safe

By Michael Wong, JD (Founder/Executive Director, Physician-Patient Alliance for Health & Safety)

The Exception to the “Everything in a Box is Safe” Rule

In today’s world of science and engineering, we have a natural tendency to assume that, if it’s been engineered and it’s “in a box”, it must be ok and safe. While this may usually be true, there are exceptions to every rule. According to the FDA (Food & Drug Administration), more than 80,000 deaths and 1.7 million injuries have been linked to medical devices in the past decade. 

One exception to the “everything in a box is safe” rule may be particularly true of a medical device called patient-controlled analgesia (PCA) pump, which when not paired with continuous monitoring may be deadly. 

Continue reading “Not Everything in a Box is Safe”

3 Myths About Strokes: Don’t Let These Misconceptions About Strokes Affect Your Health

3 Myths About Strokes: Don’t Let These Misconceptions About Strokes Affect Your Health

By Michael Wong, JD (Founder/Executive Director, Physician-Patient Alliance for Health & Safety)

Stroke Myths You Should be Aware of for National Stroke Awareness Month

This month of May is National Stroke Awareness Month. In thinking about National Stroke Awareness Month, I immediately thought of my friend, Mark McEwen, who most people know as a reporter for CBS:

Continue reading “3 Myths About Strokes: Don’t Let These Misconceptions About Strokes Affect Your Health”

Misinformation is a Patient Safety Issue

Misinformation is a Patient Safety Issue

By Michael Wong, JD (Founder/Executive Director, Physician-Patient Alliance for Health & Safety)

Misinformation is a Patient Safety Issue

As the Executive Director for the Physician-Patient Alliance for Health & Safety, I oversee our blog. I have the responsibility on a weekly basis for writing and vetting articles submitted to us for publication.

Many people rely upon PPAHS for health information (our articles receive more than 10,000 views per month). As we are not a health news agency, we don’t specialize in discussing the latest breaking news – we leave that in the hands of others. 

Rather, the PPAHS blog and website are filled with information and resources that may help improve patient safety and the quality of patient care. This information and resources are not “breaking news,” but rather a considered consolidation of best practices, clinical trial evidence, and experience. Understandably, then, the 10,000 plus website views that we receive each month are usually articles that were written months and even years ago. Hence, we must be extra diligent about citing misinformation.

Continue reading “Misinformation is a Patient Safety Issue”

4 Tips for Caregiver Burnout

4 Tips for Caregiver Burnout

Editor’s note: In this guest post, Anna Preston, a consultant with Live-In Care Hub, a UK non-profit organization, discusses how being a caregiver can be challenging and provides resources to help manage the stresses of being a caregiver.

By Anna Preston (Live-In Care Hub, a UK non-profit)

Working in the care sector can have its ups and downs, but caregivers may suffer from caregiver burnout. But, there’s no doubting that it is one of the most rewarding jobs you can ever do if you are the kind of person who is able to cope no matter what challenges and situations may arise.

Caring for someone in a professional capacity can be demanding as well as rewarding. This is especially the case if you are providing live-in care services. You’ll be expected to provide a range of care services depending on how much care the client needs. These can range from personal care and domestic support to accompanying them on outings and appointments and looking after the family pet if needed. This is why some caregivers, whether professional or family members, sometimes reach a point where they feel they can’t cope.

Continue reading “4 Tips for Caregiver Burnout”

What is COVIDSepsis?

What is COVIDSepsis?

COVIDSepsis Defined

COVIDSepis (noun): COVIDSepsis is a medical condition where the patient presents with the following conditions – coughing, shortness of breath, difficulty breathing, and fever. Patients with COVIDSepsis may also have an altered mental state, difficulty breathing, reduced urine output, rapid heart rate, a weak pulse, and cold extremities. 

According to the Sepsis Alliance, “severe COVID-19 is viral sepsis.” As a result, distinguishing between whether a patient is suffering from COVID or has sepsis can be very difficult. As researchers in their research published in December of 2021 concluded:

Continue reading “What is COVIDSepsis?”