Category: Respiratory Compromise

Today’s Must-Have: Capnography Monitoring During Conscious Sedation

Today, the Physician-Patient Alliance for Health Safety released a clinical education podcast with Matt Kurrek, MD, FRCPC (Professor, Department of Anesthesia, University of Toronto) and Richard Merchant, MD, FRCPC (Clinical Professor, University of British Columbia, Department of Anesthesia, Pharmacology & Therapeutics).

Drs. Kurrek and Merchant coauthored an editorial, “Yesterday’s Luxury, Today’s Necessity” after the Canadian Anesthesiologists’ Society [CSA] published its revised 2012 guidelines to the practice of anesthesia. The CSA guidelines recommend capnography monitoring during conscious sedation. In the podcast, Drs. Kurrek and Merchant discuss why capnography monitoring may have been considered yesterday’s luxury, but is now a necessity during conscious sedation.

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Capnography

Editor’s Note: This research was presented as a poster at the 2017 ANCC National Magnet Conference.

By Eric Griffin MSN, RN, CEN (Magnet Program Director, Baystate Medical Center) and Laura Bolella MSN, RN (Assistant Nurse Manager, Baystate Medical Center)

For over a hundred years nurses have monitored the same vital signs. Unfortunately these vital signs can be slow to change, inaccurate, and misleading. Although there have been modern advances in physiological monitoring devices, their acceptance has been limited. Pulse oximetry developed in the early 1970’s is extremely useful in measuring oxygenation, although it has limitations related to the following factors: poor signal strength, fingernail polish, anemia, patient motion, calloused skin, hypoperfusion, time lag, and vasoconstriction.

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Standards for Dental Anesthesia Should Require Patient Monitoring

Five-year old Amber Athwal suffered brain damage after having dental surgery and receiving dental anesthesia to extract some of her teeth. For our earlier post, which provides a summary of the lawsuit , “Capnography Monitoring of Five-Year Old Amber Athwal May Have Prevented Her Brain Damage,” please click here.

Dr. William Mather Tribunal Hearing

CBC News reports that Dr. William Mather, the dentist who performed the dental procedure which resulted in “permanent brain damage because of oxygen deprivation”, faces five counts of unprofessional conduct, and has pleaded guilty to three of the charges. Dr. Mather recently retired from dental practice.

Dr. Mather’s colleague, Dr. Darren Fee recently testified at the tribunal hearing investigating the Amber case:

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7 Must Reads for Beating the Opioid Epidemic

This week even the White House took notice of the opioid epidemic, declaring opioid abuse a national public health emergency. However, the opioid epidemic was recognized as early as the 1990s, when doctors became increasingly aware of the burdens of pain.

But, saying there is a problem – the opioid epidemic has long been recognized – and doing something about it, are two completely different things.

To help do something about it, we offer 7 must reads for beating the opioid epidemic:

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Continuous Patient Monitoring Provides Early Detection of Respiratory Compromise

In a clinical education podcast produced by the Physician-Physician Alliance for Health Safety, Jeffrey S. Vender, MD. cautions that otherwise stable patients can quickly move down the dangerous path to respiratory compromise:

“There are numerous situations where patients with underlying pulmonary disease are in very chronic, but stable conditions. And, for a multitude of reasons, either a therapeutic intervention, the administration of pharmaceutical agents, in particular sedative agents and/or narcotics, as you’ve alluded to, or an underlying disease, like pneumonia, can make this stable respiratory condition and move it down the spectrum of patho-physiologic deterioration into respiratory compromise.”

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Correction – Podcast Interview with Dr. Jeffery Vender

The full podcast can now be viewed at https://youtu.be/xmOpSZaBi1w.

We had tried to have YouTube correct the previously upload which only played the first 4 minutes of the 18 minute interview, but they were unable to do that and so we have been forced to re-upload the podcast.

We apologize again for any inconvenience that this may have caused you.

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Why Have Low Safety Standards for Dental Anesthesia?

In their article, “Why Have Low Safety Standards for Dental Anesthesia?,” Annie Kaplan, MD, Michael Wong, JD, and Patricia Salber, MD, MBA provide an update on the effort to pass Caleb’s Law and improve safety standards for dental anesthesia.

The law was modified during the legislative process, signed into law and became effective in California as of January 1, 2017. It provided for collection of adverse event data, instituted a disclosure that anesthesia in dentistry is practiced differently than in medicine, and asked that the California dental board do a study on the safety for children undergoing anesthesia in dentistry and make recommendations to improve safety. Continue reading “Why Have Low Safety Standards for Dental Anesthesia?” →

Clinical Tip – Avoiding Opioid-Related Respiratory Depression

At certain dosages, the opioids you give to patients to manage surgical pain can lead to respiratory depression — and overdoses can lead to respiratory failure.

#opioid overdoses can lead to respiratory failure, insufficiency, and arrest #patientsafety Share on X

In this article published in Outpatient Surgery, Michael Wong, JD (Founder and Executive Director, Physician-Patient Alliance for Health & Safety) discusses why pulse oximetry and nursing spot checks are not enough to prevent respiratory depression and keep patients safe.

PPAHS Statement on Continuous Electronic Monitoring

Don't rely on pulse oximetry and nursing spot checks to ensure #patientsafety Share on X

To read the PPAHS Statement on Continuous Monitoring, please click here.

To read the article in Outpatient Surgery, please click here.

Is Respiratory Compromise The New “Sepsis”? An Interview with Jeffrey Vender, MD

Oct 26 update – The full podcast “Is Respiratory Compromise The New ‘Sepsis’?” can now be viewed at https://youtu.be/xmOpSZaBi1w. We had tried to have YouTube correct the previously upload which only played for 4 minutes, but they were unable to do that and so we have been forced to re-upload the podcast. We apologize again for any inconvenience that this may have caused you.

Oct 23 update – the podcast on YouTube is unfortunately only playing about 4 minutes of the more than 18 minute interview. We are working with YouTube to have this fixed as soon as possible. When this is fixed, we will post another update on this post. We apologize for any inconvenience this may have caused you.

The Physician-Patient Alliance for Health & Safety is pleased to announce the release of a clinical education podcast with Jeffrey Vender, MD.

Jeffrey S. Vender, MD is Clinical Professor at the University Of Chicago, Pritzker School of Medicine. He is also Chairman of the clinical advisory committee to the Respiratory Compromise Institute.

#RespiratoryCompromise is The New “#Sepsis”? #patientsafety Share on X Continue reading “Is Respiratory Compromise The New “Sepsis”? An Interview with Jeffrey Vender, MD” →