Tag: respiratory depression

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” →

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” →

5 Key Steps to Assessing and Identifying At-Risk Patients for Respiratory Compromise

The cost of opioid-related adverse events, in terms of both human life and hospital expenses, remains at the forefront of the public eye. It has been estimated that yearly costs in the United States associated with opioid-related post-operative respiratory failure were estimated at $2 billion.

The Society of Hospital Medicine, which is the largest organization representing hospitalists and a resource for hospital medicine, recently released a comprehensive guide, “Reducing Adverse Drug Events Related to Opioids” (otherwise known as the RADEO guide).

To better understand the RADEO guide, the Physician-Patient Alliance for Health & Safety interviewed its lead author, Thomas W. Frederickson MD, FACP, SFHM, MBA. Continue reading “5 Key Steps to Assessing and Identifying At-Risk Patients for Respiratory Compromise” →

Drawn Curtains, Muted Alarms, And Diverted Attention Lead To Tragedy In The Postanesthesia Care Unit

By Institute for Safe Medication Practices (ISMP)

Editor’s Note: This article first appeared on the ISMP website. It discusses the role that inadequate monitoring and muted alarms played in the recent tragic recent death of a 17-year old following a tonsillectomy. PPAHS has previously discussed deaths of pediatric patients following dental or oral procedures. We welcome your thoughts and comments on this issue.

Problem: Last April, a 17-year-old girl died following an uncomplicated tonsillectomy performed in an outpatient ambulatory surgery center after receiving a dose of IV fentaNYL in the postanesthesia care unit (PACU). The case made headline news again recently when a civil lawsuit filed by the teen’s parents was resolved. While it is too late to reverse the tragic outcome of this case, we call upon all hospitals and outpatient surgery centers to learn from the event and take action to prevent a similar tragedy in your facility. Continue reading “Drawn Curtains, Muted Alarms, And Diverted Attention Lead To Tragedy In The Postanesthesia Care Unit” →

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)” →

Factors Related to Postoperative Respiratory Depression

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. Continue reading “Factors Related to Postoperative Respiratory Depression” →

The Intertwined Stories of Amanda Abbiehl and Continuous Electronic Monitoring

In the recent article, “Silent Danger: PCA Pumps and the Case for Continuous Monitoring” published by Association for the Advancement of Medical Instrumentation in Biomedical Instrumentation & Technology, the story of 18-year old Amanda Abbiehl is told as a powerful reminder of the need for continuous electronic monitoring. Continue reading “The Intertwined Stories of Amanda Abbiehl and Continuous Electronic Monitoring” →

For Improving Patient Safety and Reducing Nuisance Alarms, Evidence Points to Revising Default Settings

by Sean Power and Michael Wong

Alarm fatigue and nuisance alarms put patient safety at risk. The Joint Commission’s Sentinel Event Alert on alarm safety states that between 85 percent and 99 percent of alarm signals do not require clinical intervention — and these nuisance alarms desensitize clinicians. Continue reading “For Improving Patient Safety and Reducing Nuisance Alarms, Evidence Points to Revising Default Settings” →

Children Undergoing Sedation Need Better Monitoring

by Sean Power

Researchers have found that the majority of adverse events that happen during opioid infusions in children occur in patients not being treated by clinicians in acute pain service, according to an article by Michael Vlessides in Anesthesiology News.

According to the Society for Pediatric Anesthesia, many different types of procedures may require a patient who is a child to stay still or may cause them discomfort if no anesthesia is used. For example, procedures such as MRI scans require the child to be completely still to ensure adequate quality of the scans. Continue reading “Children Undergoing Sedation Need Better Monitoring” →