Pamela Parker BSN, RN, CAPA, has recently published a new article in Outpatient Surgery Magazine detailing her experiences losing her own son, Logan, to opioid-related hypoxia. Continue reading “Pamela Parker: My Son Did Not Have to Die”
Category: Respiratory Compromise
12 Years of Event-Free Opioid Use
The Physician-Patient Alliance for Health & Safety (PPAHS) recently interviewed Harold Oglesby RRT, Manager, The Center for Pulmonary Health, Candler Hospital, St. Joseph’s/Candler Health System (SJ/C).
New Guideline on Pre-Op Screening and Assessment for OSA
This article was first published in Patient Safety Solutions on October 11, 2016. As part of our efforts to bring in expert viewpoints from across the #patientsafety community, we have reposted this with permission.
By Bradley T. Traux, MD
Our regular readers are well aware of the numerous controversies and limited evidence base regarding perioperative issues in patients with known obstructive sleep apnea (OSA) or those suspected as being at high risk for OSA (see the list of prior columns at the end of today’s column).
The Society of Anesthesia and Sleep Medicine has just published “Guidelines on Preoperative Screening and Assessment of Adult Patients with Obstructive Sleep Apnea”. This is a most thorough evaluation of the evidence base regarding multiple issues related to OSA in patients about to undergo surgery. One is struck by the lack of strong evidence for almost all the recommendations in the guideline, though we are not surprised since we’ve previously discussed most of the controversial issues. Yet this consensus guideline uses common sense and is very practical and appropriately balances concerns for patient safety with utilization of resources and concerns over timing of surgery.
Below is their executive summary of the recommendations: Continue reading “New Guideline on Pre-Op Screening and Assessment for OSA”
3 Keys To Successfully Implementing Capnography
As a follow-up to our latest podcast interview with Thomas W. Frederickson, MD, FACP, SFHM, MBA – lead author of the Society of Hospital Medicine RADEO guide (“Reducing Adverse Drug Events Related to Opioids”) – we focused on the advantages and limitations of pulse oximetry in monitoring patients for opioid-induced respiratory depression.
Most importantly, Dr. Frederickson highlighted that the alerts provided by pulse oximetry can be a lagging indicator of patient ventilation, particularly when supplemental oxygen is administered. One solution to improving the care provided to patients is to understand that pulse oximetry is one part of a comprehensive monitoring strategy. Continue reading “3 Keys To Successfully Implementing Capnography”
Infograph: What Physicians Think About Fighting the Opioid Epidemic
We recently conducted an online survey to better understand what clinicians and the public think about how to solve the opioid epidemic. The survey was prompted by the recent letter sent by the Surgeon General to physicians in the US urging them to take a part in combating the opioid epidemic. On the Surgeon General website, healthcare providers are encouraged to help solve the opioid epidemic – “Our nation faces an opioid crisis. Health care providers are uniquely positioned to help communities and their patients #TurnTheTide on the opioid epidemic.
More than 85% of the survey respondents were either a doctor or other clinician.
Here are two preliminary results about they thought about what is the major cause of the opioid epidemic and who should take the lead in solving it (please note: these are preliminary results of the survey, so final results may differ from these preliminary findings): Continue reading “Infograph: What Physicians Think About Fighting the Opioid Epidemic”
5 Strategies to Keep Patients Safe When Receiving Opioids
The Physician-Patient Alliance for Health & Safety (PPAHS) had the pleasure of interviewing Thomas W. Frederickson, MD, FACP, SFHM, MBA – lead author of the Society of Hospital Medicine RADEO guide (“Reducing Adverse Drug Events Related to Opioids”). The guide is a comprehensive clinician manual created with the aim to decrease opioid-related adverse events in an inpatient setting.
In the first of this two-part interview, Dr. Frederickson discusses five key steps to identify and address patient conditions that pose a greater risk of respiratory depression. For readers that have yet to listen to the podcast, please click here; it’s an insightful interview relevant for any clinician working in quality improvement or directly with patients prescribed opioids.
In part two, interviewer Pat Iyer and Dr. Frederickson switches gears and focuses on monitoring issues associated with caring for at-risk patients. You can watch/listen to the interview below: Continue reading “5 Strategies to Keep Patients Safe When Receiving Opioids”
5 Key Resources to Reduce the Risk of Respiratory Compromise with Patients with Sleep Apnea
In a recent interview with a spotlight on the RADEO guide, Dr. Thomas Frederickson, MD, FACP, SFHM, MBA highlighted obstructive sleep apnea (OSA) as a key contributing condition to greater opioid use risk.
“Sleep apnea is the number one risk factor for respiratory depression associated with the use of opioids.
[…] Patients with obstructive sleep apnea are dependent upon their arousal mechanism in order to avoid respiratory depression and eventual respiratory failure.”
In addition to being the #1 contributing risk to opioid-induced respiratory depression, OSA is also common and often under diagnosed. Dr. Frederickson states that between 7% and 22% of the adult population has a degree of sleep apnea.
The key question that arises, then, is how to better identify and account for OSA in patients receiving opioids? Here are 5 key resources to reduce the risk of respiratory compromise in this group. Continue reading “5 Key Resources to Reduce the Risk of Respiratory Compromise with Patients with Sleep Apnea”
Opioids and Benzodiazepines Make a Deadly Combination for Hospitalized Patients
The combination of opioids and benzodiazepines can be a deadly combination. According to Baltimore’s City Health Commissioner Leana Wen, of the 44 people who die each day in the United States, approximately one in three of these unintentional overdose deaths from opioids also involves benzodiazepines.
As a result, the FDA recently issued its strongest warning about combined use of opioids and benzodiazepines, saying: Continue reading “Opioids and Benzodiazepines Make a Deadly Combination for Hospitalized Patients”
Prince and the Opioid Epidemic: 5 Ways for Addressing this National Crisis
Prince was not the first, nor unfortunately the last, person to die due to an opioid-related event. According to the medical examiner, Prince died from a self-administered fentanyl overdose.
While Prince may have become the poster child for the opioid epidemic and a call for restrictions on the use of opioids, it must not be forgotten that opioids play a vital role in the management of pain, such as during surgery or to relieve chronic pain. Continue reading “Prince and the Opioid Epidemic: 5 Ways for Addressing this National Crisis”
3 Ways to Make Opioids Safer
Last week we released an interview with Peggy Lange, RT, Director of the Respiratory Care Department at St. Cloud Hospital, on her team’s use of capnography in procedural and conscious sedation. Since then, it’s proven to be the most popular interview in our podcast series to-date.
The subject of the interview with Ms. Lange is a particularly topical one. Both the institutional and public eye has been focused on opioids and the ‘opioid epidemic’. And along with this, the body of knowledge related to their safe use continues to grow. Readers and listeners interested in additional content about capnography and opioid safety will be happy to find other interviews and webinars from PPAHS and across the web.