Opioid Safety, Respiratory Compromise

PPAHS Remembers Amanda Abbiehl on Her 8th Death Anniversary PPAHS Remembers Amanda Abbiehl on Her 8th Death Anniversary

The Physician-Patient Alliance for Health & Safety remembers Amanda Abbiehl on her 8th death anniversary.

As reported by ABC News, “When Amanda Abbiehl’s parents kissed her goodnight on July 16, 2010, they never imagined it would be for the last time.”

To ensure that no other parent or family will have to “the emptiness that we have in our hearts,” Cindy and Brian Abbiehl established A Promise to Amanda Foundation, an organization dedicated “to raise awareness of respiratory depression so that it becomes mandatory to continuously electronically monitor all patients using Capnography and Pulse Oximetry.”

The Abbiehls write about what happened to Amanda:

“As parents of a teenage daughter, our worst fears were that our daughter would become pregnant, take drugs, or drink and drive. Never did we imagine that our daughter would go into a hospital with an infection, be hooked to a patient-controlled analgesia (PCA) pump to manage her pain, and never come out alive; but this is exactly what happened.

“Our 18-year old daughter, Amanda, was admitted to a local hospital on Thursday, July 15, of 2010. She was dehydrated, had lost at least 10 pounds, and had a virus that was causing a great deal of pain in her mouth and throat. Our family physician’s plan was to rehydrate her and put her on antibiotics for both viral and bacterial infection. This was to help jump start her system and hopefully she would be back home with us in a couple days.

“The rest of Thursday was a rough day for Amanda. The morphine that the hospital staff was giving her was not getting rid of the pain. Moreover, Amanda’s tonsils and uvula were extremely swollen. She was still not interested in eating; even drinking hurt. To help manage her pain, Amanda was put on a PCA pump that allowed her to control the pain medication used (hydromorphone).

“The next morning Amanda was found unresponsive and died.”

On the 8th death anniversary of Amanda, PPAHS asks that all patients receiving opioids be continuously electronic monitored to help prevent further tragedies like Amanda’s from occurring.

 

Opioid Safety

Do These 3 Efforts Help Stop the Opioid Epidemic? Articles PPAHS have been reading the week of June 25, 2018

Articles the Physician-Patient Alliance for Health & Safety (PPAHS) have been reading the week of June 25, 2018 focus on 3 efforts to help stop the opioid epidemic.

Effort #1 – Does Government Legislation Address the Opioid Epidemic?

The House of Representatives recently passed what has been called the “most expansive legislation” to address the opioid epidemic. According to CNN, the key provision would allow Medicaid to pay for certain treatments for mental illness.

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Opioid Safety, Respiratory Compromise

Use of PCA Safety Checklist Found to Reduce Pain 1 out of every 378 are harmed by PCA

Researchers at the University of Colorado Hospital recently reported that their use of a PCA safety checklist was found to reduce pain from moderate-severe pain to no-mild pain in 42% of patients within 2 days. In “Let’s Be Smart About Improving Pain,” they reported:

Our PCA safety checklist smart phrases increased use of a safety checklist and documentation of daily PCA opioid trends, and correlated with more rapid improvement in moderate-severe pain levels.

They used smart phrases in these four areas covering a patient’s continuum of care – PCA initiation, PCA titration, PCA transition to oral opioids, and PCA discharge handoff –  to facilitate standardized documentation of PCA management.

1 out of 378 post-surgical patients are harmed or die from errors related to PCA pumps.

The Physician-Patient Alliance for Health & Safety released a PCA Safety Checklist developed in conjunction with renowned medical experts, including intensive care specialist and a leader in medical checklist development Peter J. Pronovost, MD, PhD, FCCM, Professor, Departments of Anesthesiology/Critical Care Medicine and Surgery, The Johns Hopkins University School of Medicine and Medical Director, Center for Innovation in Quality Patient; and Atul Gawande, MD, Professor in the Department of Health Policy and Management at the Harvard School of Public Health, who is a surgeon at Brigham and Women’s Hospital Professor of Surgery at Harvard Medical School and author of “The Checklist Manifesto.”

“We would recommend that all patients receiving opioids be continuously electronically monitored,” said Michael Wong, JD (Founder and Executive Director, Physician-Patient Alliance for Health & Safety.

Please refer to the PPAHS position statement on continuous electronic monitoring for more information.

Opioid Safety, Respiratory Compromise

Benzodiazepines and Opioid Use May Result in Respiratory Compromise and Death Position statement on benzodiazepines and opioids by the Physician-Patient Alliance for Health & Safety

Using benzodiazepines and opioids may be a deadly combination. According to the National Institute on Drug Abuse, more than 30% of opioid overdoses involve the use of benzodiazepines.

One of the commonly overlooked complications to safe opioid administration is failing to account for the additive sedation effects of non-opioid medication. In recognition of these dangers, in August 2016, the FDA issued its strongest warning about combined use of opioids and benzodiazepines and issued another caution more recently on September 20, 2017.

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Opioid Safety, Patient Safety, Respiratory Compromise

Recommendations for Procedural Sedation Physician-Patient Alliance for Health & Safety Announces Intention to Develop Position Statement

The Physician-Patient Alliance for Health & Safety (PPAHS) announced its intention to develop a position statement on recommendations for procedural sedation.

Michael Wong, JD (Founder and Executive Director, PPAHS) explained that such a position statement on recommendations for procedural sedation would encapsulate guidelines and recommendations from leading medical organizations in Canada and the United States:

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Opioid Safety, Respiratory Compromise

Seven Keys to Preventing More Patients from Dying from Dental Sedation Dental Sedation Needs Better Standards to Prevent Further Patient Deaths

The number of patients – and, particularly, children – dying from dental sedation is indicative that there are gaps in the standard of medical care being used during dental sedation.

In this article by Bradley T. Truax, MD (The Truax Group) and Michael Wong, JD (Founder and Executive Director, Physician-Patient Alliance for Health & Safety), the  authors discuss why dental sedation needs better standards to prevent further patient deaths and provide seven keys.

To read the article in Dentistry Today, please click here.

 

Opioid Safety, Respiratory Compromise

Using Capnography and Recognizing Respiratory Compromise Could Save Patient Lives Physician-Patient Alliance for Health & Safety Releases Clinical Education Podcast with Dr. Jenifer Lightdale

The Physician-Patient Alliance for Health & Safety (PPAHS) released a clinical education podcast, “Using Capnography and Recognizing Respiratory Compromise Could Save Patient Lives.”

The podcast features an interview with Jenifer Lightdale, MPH, MD who is division chief, pediatric gastroenterology and chief quality officer at the Children’s Medical Center at the University of Massachusetts Medical School.

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Opioid Safety, Respiratory Compromise

Only Continuous Electronic Monitoring Can Ensure Patients Receiving Opioids Are Safe AAMI Video to Keep Patients and Their Families Safe

With the permission of the Association for the Advancement of Medical Instrumentation (AAMI), the Physician-Patient Alliance for Health & Safety (PPAHS) is pleased to release the AAMI video on how to keep patients and their families safe, “Only Continuous Electronic Monitoring Can Ensure Patients Receiving Opioids Are Safe.”

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Opioid Safety

How Nurses Can Fight The Opioid Epidemic

In this article published in the February 2018 issue of Hospital News, Michael Wong, JD (Founder and Executive Director, Physician-Patient Alliance for Health & Safety) discusses how nurses can fight the opioid epidemic. Mr. Wong cites resources, such as the PCA Safety Checklist, and harm reduction principles set forth in the Canadian Nurses Association paper, “Harm Reduction & Illicit Substance Use: Implications for Nursing.”

The US and Canada are both battling the opioid epidemic. As Michael Wong, JD (Founder & Executive Director, Physician-Patient Alliance for Health & Safety) writes in the article, “How Nurses Can Fight The Opioid Epidemic”:

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