Opioid Safety, Respiratory Compromise

5 Keys to Reducing Harms from Opioids: A Discussion with Stephanie Uses, PharmD, MJ, JD, Patient Safety Analyst, ECRI Institute

ECRI Institute recently released the 2016 Top 10 Patient Safety Concerns for Healthcare Organizations.

In putting together this year’s list, ECRI synthesized data from a number of sources, as set forth in their Executive Brief:

  • Routine review of events in the PSO [Patient Safety Organization] database, which contained more than 1.2 million events at the end of 2015,
  • PSO members’ root-cause analyses and research requests,
  • Topics reflected in HRC Alerts, and
  • Voting by a panel of internal and external experts.

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Opioid Safety, Respiratory Compromise

Reducing the Opioid Abuse Epidemic

by Michael Wong, JD (Executive Director, Physician-Patient Alliance for Health & Safety)

Congress has been busy trying to pass a slew of bills that may help reduce the prescription drug abuse and heroin epidemic.

To better understand why diversion, misuse, abuse, and overdose of opioids is a bipartisan issue that requires people from both sides of the aisle to come together, I interviewed Michael C. Barnes, Esq. (Executive Director, Center for Lawful Access and Abuse Deterrence). Read More

Opioid Safety, Patient Safety, Respiratory Compromise

Cost Savings with Capnography Monitoring

The recent Anesthesiology News article, “Modeling Shows Potential Cost Savings With Capnography Monitoring,” (2016;42[3]:33-34) discusses research by Rhodri Saunders, DPhil, health economist at Ossian Health Economics and Communications in Basel, Switzerland. Dr. Saunders found that monitoring patients with capnography “reduced the proportion of patients experiencing greater than one adverse event (AE) by more than 27%.” Read More

Patient Safety

3 Key Steps for Safe Moderate Sedation

In January 2016, the Association of periOperative Registered Nurses (AORN) released Guideline for Care of the Patient Receiving Moderate Sedation/Analgesia.

As stated by AORN, the goal of moderate sedation is:

drug-induced, mild depression of consciousness achieved with the use of sedatives or a combination of sedatives and analgesic medications, most often administered intravenously, and titrated to achieve a desired effect … to reduce the patient’s anxiety and discomfort.

AORN in releasing this guideline warns that the “patient may slip into a deeper level of sedation than intended; therefore, practitioners who administer moderate sedation/analgesia should be able to rescue a patient who enters deep sedation/analgesia.”

There are three keys to AORN’s Guideline for Care of the Patient Receiving Moderate Sedation/Analgesia: Read More

Opioid Safety, Respiratory Compromise

Keeping Patients Safe During Moderate Sedation

There are millions of medical procedures involving conscious or moderate sedation completed each year. In 2002, for example, there were 14.2 million colonoscopies performed. According to the U.S. National Library of Medicine, some of the moderate sedation procedures include:

  • 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.

In order to ensure the safety of patients undergoing procedures requiring moderate sedation, in January 2016, the Association for Radiologic & Imaging Nursing (ARIN) issued a Position Statement on Use of Capnography for Patients Who Receive Moderate Sedation/Analgesia.
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Opioid Safety, Respiratory Compromise

Are Hospitals Giving Away Money?

At a recent presentation in Washington DC, Michael Wong, JD (Executive Director, Physician-Patient Alliance for Health & Safety) asked, “Are hospitals giving away money?”

An analysis of more than 3,300 closed claims of the American Society of Anesthesiologists by Julia I. Metzner, MD, “Risks of Anesthesia at Remote Locations” shows that:

  • Almost 1 in 10 events were preventable with monitoring (8.6%)
  • About 1 in 4 events were due to substandard care (37.4%)

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Opioid Safety, Respiratory Compromise

Did an Opioid Overdose Kill Prince?


As the world of music mourns the passing of Prince, the media’s attention has shifted to speculation around the true cause of the Purple Prince’s death.  Official channels from the pop singer’s side have cited complications due to the flu; TMZ tells a different story – one that implicates opioid-related overdose as a cause.  This is not a cliched story of superstar overuse for recreation.  Rather, the Percocet in Prince’s possession has been reported to have been prescribed to treat hip pain.  

While the truth will be revealed with formal autopsy, the dangers of opioid-related adverse effects are not limited to overdoses on private jets.  There are real risks for real people. Read More

Respiratory Compromise

Can Failure-to-Rescue be Improved?

There is a need to improve rapid response teams and code blue activations. 50% of Code Blue events involve patients receiving opioids. Moreover, unrecognized postoperative respiratory failure that results in cardiopulmonary arrest is a daily occurrence at healthcare facilities across the United States.

In a recent interview with the Physician-Patient Alliance for Health & Safety (PPAHS), Eyal Zimlichman, M.D., MSc., spoke at length about improving rapid response teams and code blue activations. Read More