Opioid Safety, Practices & Tips, Respiratory Compromise

Minnesota RTs Help Implement Continuous Capnography Program

peggy lange

Peggy Lange, BA, RRT (RT Department Director, St. Cloud Hospital in St. Cloud, MN)

A recent article published by the American Association for Respiratory Care (AARC) has highlighted how respiratory therapists (RT) can play an integral role in using capnography to detect the signs of respiratory depression.  The post focuses on the experiences of Peggy Lange, BA, RRT (RT Department Director, St. Cloud Hospital in St. Cloud, MN).

Over a three month period, St. Cloud Hospital ran a pilot program to test the effectiveness of continuous capnography monitoring Center for Surgical Care, PACU, surgical care units, interventional radiology, electrophysiology lab, and emergency trauma center.  The trial was successful, proving the monitors gave an early alert to the signs of respiratory distress, as well as resolving issues caused by nuisance alarms – particularly with patients experiencing sleep apnea or periods of hyperventilation.  As a result, continuous capnography monitoring was implemented hospital-wide.

For Ms. Lange, RTs played a large role in a successful implementation of the technology.  The AARC writes:

“RTs have a keen understanding of assessing the quality of ventilation and detecting respiratory compromise,” says Lange. “RTs were involved in the educational resources available for the house, and an RT was involved in the development of the computer based education module, too.”

Ms. Lange’s experiences in developing the right multi-disciplinary implementation team – including RTs – mirror the learnings found in one of PPAHS’ most recent podcast interviews.  For Harold Oglesby, RRT (Manager, St. Joseph/Candler Hospital), RTs played a large part in keeping SJ/C free from opioid-related events for the last 12 years.  He found that RTs serve as key touch points for both patients and staff during education and tailoring monitor settings to individual patient needs.

Ms. Lange also had four key messages for respiratory care specialists:

  1. Narcotics and sedatives can cause respiratory depression in postop/procedure recovery periods.
  2. Intermittent monitoring may stimulate a patient to a higher level of consciousness, but when left alone that patient could experience respiratory depression.
  3. Capnography is an excellent and beneficial tool to use for patient assessment of early respiratory distress and may be used for any patient where respiratory compromise is suspected.
  4. RTs can explain the purpose of capnography monitoring to peers and patients and education is key for understanding the benefits and safety of this technology.

To read the full article at AARC, please click here.

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