We’re bringing back a weekly review of the trending topics in patient safety from PPAHS and around the world. In this week, we highlight 2 guest contributors to PPAHS, the latest in opioid monitoring technology, and developments to the culture of patient safety. Continue reading “Patient Safety Weekly Must Reads (Aug 26, 2016)”
Tag: Pulse Oximetry
5 Keys to Safer Hospital Sedation
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. Continue reading “5 Keys to Safer Hospital Sedation”
Three Must Knows Before Using Naloxone to Reverse the Effects of Opioid-Induced Respiratory Depression
To reverse the effects of opioid-induced respiratory depression, the FDA recommends the use of naloxone:
When someone overdoses on an opioid, it can be difficult to awaken the person, and breathing may become shallow or stop – leading to death if there is no medical intervention. If naloxone is administered quickly, it can counter the overdose effects, usually within two minutes.
However, there are three must knows before using naloxone to reverse the effects of opioid-induced respiratory depression. Continue reading “Three Must Knows Before Using Naloxone to Reverse the Effects of Opioid-Induced Respiratory Depression”
Reducing Rapid Response Calls by 50% and Avoiding Respiratory Depression During Conscious Sedation: An Interview with Richard Kenney, RRT
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%.
The Risk of Opioids in Post-Surgical Settings
This is the fourth article in a series exploring the impact of pulse oximetry alarm thresholds in hospitalized patients.
By J. Paul Curry, MD (anesthesiologist)
In the first article, “Improving the Safety of Post-Surgical Care,” I introduced the concept that, although the current approach to physiologic threshold monitoring (triggering an alarm when oxygen saturation falls below 90%) works well in the OR, it is unreliable on post-surgical floors. Continue reading “The Risk of Opioids in Post-Surgical Settings”
Detecting Deadly Post-Surgical Respiratory Dysfunction
It is crucial to understand this type of respiratory dysfunction so that it can be detected and the patient is treated as early as possible in order to save lives.
By J. Paul Curry, MD (anesthesiologist)
This is the third article in a series exploring the impact of pulse oximetry alarm thresholds in hospitalized patients. In the first article, “Improving the Safety of Post-Surgical Care,” I introduced the concept that, although the current approach to physiologic threshold monitoring (triggering an alarm when oxygen saturation falls below 90%) works well in the OR, it is unreliable on post-surgical floors. Continue reading “Detecting Deadly Post-Surgical Respiratory Dysfunction”
Weekly Must Reads in Patient Safety and Health Care (September 18, 2015) – Blood Clots & Pulse Oximetry
Mother fell into a coma due to a blood clot that broke loose during an emergency C-section.
This might have been the headline last September, when 23-year-old nursing student Shelly Cawley experienced complications during labor that resulted in an emergency c-section and left her in a coma: Continue reading “Weekly Must Reads in Patient Safety and Health Care (September 18, 2015) – Blood Clots & Pulse Oximetry”
Pulse Oximetry False Alarms on Post-Surgical Floors
Adjusting pulse oximetry alarm thresholds to avoid false alarms and universally monitoring all triggered alarms improves patient safety—so why don’t we do it?
By J. Paul Curry, MD (anesthesiologist)
This is the second article in a series exploring the impact of pulse oximetry alarm thresholds in hospitalized patients. In the first article, “Improving the Safety of Post-Surgical Care,” I introduced the concept that, although the current approach to physiologic threshold monitoring (triggering an alarm when oxygen saturation falls below 90%) works great in the OR, it is unreliable on post-surgical floors. Continue reading “Pulse Oximetry False Alarms on Post-Surgical Floors”
Weekly Must Reads in Patient Safety and Health Care (August 28, 2015)
Patient safety and health care should be improved for post-operative patients.
This is particularly true regarding respiratory compromise, where researchers have found that better monitoring of patients could have prevented adverse event cases. Continue reading “Weekly Must Reads in Patient Safety and Health Care (August 28, 2015)”
Improving the Safety of Post-Surgical Care
Although physiologic threshold monitoring works great in the OR, it is unreliable on post-surgical floors
By J. Paul Curry, MD (anesthesiologist)
Up to 750,000 cardiopulmonary arrests occur in hospitals every year in the United States. According to a review in Intensive Care Medicine, only 15 to 20 percent of these patients will survive.
Tragically, the survival rate following in-hospital cardiopulmonary resuscitation has changed little in the last 40 years, even though much has been done to improve respiratory monitoring and the deployment of competent resuscitation. One study of 139 in-hospital deaths showed that 62 percent could have been prevented if deterioration had been detected earlier, and nearly half (48 percent) of these patients had clear clinical signs of deterioration that went unnoticed. Continue reading “Improving the Safety of Post-Surgical Care”