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. Read More
This week, we refocused our attention on the subject of opioid safety. Recently, the Surgeon General issued a letter to physicians urging them to take a part in combating the opioid epidemic.
In addition to bringing our readers the most topical articles and news from PPAHS and the web, we’ve also created a brief (2 minute – 5 question) survey to understand reactions to the Surgeon General’s letter. Please take the time to complete it here.
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.
By Michael Wong, JD (Founder/Executive Director, Physician-Patient Alliance for Health & Safety)
Conscious sedation is routinely used with patients so that they can tolerate procedures that may cause them discomfort, anxiety, or pain. Some of the tests and procedures conscious sedation may be used for are:
- Breast biopsy
- Dental prosthetic or reconstructive surgery
- Minor bone fracture repair
- Minor foot surgery
- Minor skin surgery
- Plastic or reconstructive surgery
- Procedures to diagnose and treat some stomach (upper endoscopy), colon (colonoscopy), lung (bronchoscopy), and bladder (cystoscopy) conditions.
Conscious sedation may also be used with pediatric patients or adult patients who may have difficulty remaining still for certain tests and medical procedures. Read More
by Michael Wong, JD (Executive Director, Physician-Patient Alliance for Health & Safety)
White Memorial Medical Center in Los Angeles has experienced a “better than fifty percent reduction in calls of rapid responses”, according to Richard Kenney, MSM, RRT, NPS, ACCS, RCP (Director, Respiratory Care Services, White Memorial Medical Center).
To better understand what Adventist Health hospitals have done to reduce rapid response calls and improve patient safety and health outcomes, the Physician-Patient Alliance for Health & Safety (PPAHS) interviewed Mr. Kenney.
In this interview titled, “Avoiding Respiratory Depression During Conscious Sedation”, Mr. Kenney says using capnography monitoring has reduced rapid response calls by more than 50%.
Recent research by the Pennsylvania Patient Safety Authority has concluded that overrides of medical technology may impact the safety of patients.
The PA Authority analyzed 583 events reported during the period January 2013 to December 2014. Key findings from this analysis:
- The majority (77%) were related to automated dispensing cabinets.
- The most common classes of medications involved antibiotics (12.0%), opioids (12.0%), anticoagulants (7.4%), and high alert medications (26.4%).
Recent research has found that 70 percent of women in labor using patient-controlled analgesia (PCA) experienced oxygen desaturation. Oxygen desaturation is defined as a “decrease in oxygen concentration in the blood resulting from any condition that affects the exchange of carbon dioxide and oxygen”.
A podcast interview soon to be released by the Physician-Patient Alliance for Health & Safety will detail one hospital’s experience in avoiding respiratory depression during conscious sedation. The podcast will feature Richard Kenney, MSM, RRT, NPS, ACCS, RCP (Director, Respiratory Care Services, White Memorial Medical Center, Los Angeles).
Mr Kenney recently wrote an article for Advance for Respiratory Care and Sleep Medicine, “Essential Capnography” in which he describes how patient monitoring is a fundamental tool of the care team at White Memorial Medical Center.
By Gina Pugliese, RN, MS, FSHEA (Vice President, Premier Safety Institute)
18-year-old Amanda came down with strep throat after her high school graduation party. Her parents never thought the treatment she received in the hospital would abruptly end her life.
I recently heard Cindy Abbiehl share the heartbreaking story of her daughter Amanda who died from treatment for strep throat. Read More
by Bradley T. Truax, MD
(The Truax Group consults with hospitals to improve patient safety and procedures.)
Two of our most frequent topics have been opioid-induced postoperative respiratory depression and perioperative obstructive sleep apnea (OSA). See the extensive list of our prior columns at the end of today’s column. This past month there have been a number of significant articles pertinent to both conditions. Read More