Opioid Safety, Patient Safety, Respiratory Compromise

3 Recommendations to Implement to Improve Patient Safety During Sedation PPAHS Wishes You a Safe and Happy New Year!

The Physician-Patient Alliance for Health & Safety wishes you a safe and Happy New Year!

To help make 2019 patient safe, please implement the following 3 recommendations to keep your patients safe:

Patients Receiving Opioids Must Be Monitored With Continuous Electronic Monitoring

Much of the public attention has been focused on the harm caused by prescription use and abuse of opioids. However, there is another facet that must be focused on: opioid-induced respiratory depression in clinical settings. This includes patients undergoing moderate and conscious sedation, or recovering from procedures and managing pain using a patient-controlled analgesia (PCA) pump, particularly those during the postoperative period.

To read the PPAHS Position Statement on Continuous Electronic Monitoring, please click here.

All patients receiving #opioids in-hospital should be monitored Click To Tweet

Position Statement on Concomitant Use of Benzodiazepines and Opioids

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.

To further emphasize that the concomitant use of benzodiazepines and opioids may be a deadly combination, the Physician-Patient Alliance for Health & Safety released a position statement, “Patients Receiving Benzodiazepines, in Combination with Opioid Analgesics, May Suffer from Respiratory Compromise and Death.”

To read the PPAHS Position Statement on Concomitant Use of Benzodiazepines and Opioids, please click here.

Concomitant Use of #Benzodiazepines and #Opioids is Not #patientsafe Click To Tweet

Position Statement on Procedural Sedation

Although procedural sedation is generally safe, the Physician-Patient Alliance for Health & Safety recommends that all procedural sedation follow at least these five precautions:

  1. Administration of Procedural Sedation Must Be With Trained Personnel, Who SHOULD NOT Also Be Performing the Procedure
  2. Equipment and Supplies Must Be On-Hand in Case of Oversedation and Respiratory Compromise – and Clinicians Need to Practice How to Use Them!
  3. Early Detection of Respiratory Compromise Will Decrease Adverse Events and Patient Deaths
  4. All Patients Undergoing Procedural Sedation Should be Monitored with Capnography
  5. Recovery and Discharge of the Patient Must be Supervised by Trained Anesthesia Providers

To read the Position Statement on Procedural Sedation, please click here.

All procedural #sedation follow at least these five precautions Click To Tweet
Opioid Safety, Respiratory Compromise

Monitoring with Capnography Improves Patient Safety

In this article published in the December 2018 issue of the British Columbia Medical Journal, Drs Richard Merchant and Matt Kurrek encourage the use of capnographic monitoring to improve the safety of patients undergoing procedural sedation.

By Richard Merchant, MD, FRCPC (Clinical Professor, University of British Columbia, Department of Anesthesia, Pharmacology, & Therapeutics) explained in a clinical education podcast with Matt Kurrek, MD, FRCPC (Professor, Department of Anesthesia, University of Toronto)

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Opioid Safety, Patient Safety, Physician-Patient Relationship

3 Key Patient Safety Initiatives for 2019 PPAHS Presents at the AARC Respiratory Patient Advocacy Summit

At the recent 4th Annual AARC Respiratory Patient Advocacy Summit, Michael Wong, JD (Founder and Executive Director, Physician-Patient Alliance for Health & Safety) discussed 3 key patient safety initiatives for PPAHS for 2019.

Key #patientsafety initiatives for 2019 discussed at @aarc_tweets Respiratory‏Patient Advocacy Summit Click To Tweet

Also speaking with Mr. Wong on the panel discussion were:

Tim Myers (Chief Business Officer, AARC) moderated the session.

The 3 key patient safety initiatives for 2019 emphasized by Mr. Wong are:

  • Opioid Safety – PPAHS is one of the few patient safety advocates, if not the only, advocating for safer in-hospital use of opioids (no matter what mode of administration – IV, oral, intramuscular, transdermal, etc). Said Mr. Wong, “Most patient advocates concentrate on opioid overdoses, misuse, and diversion that occurs outside of a medical setting. While “street overdoses and users” deserve care and sympathy, by looking at in-hospital opioid safety, PPAHS focuses on what we consider is the root cause of the issue.” PPAHS recommends that all patients receiving opioids in hospital should be continuously electronically monitored.
all patients receiving #opioids in hospital should be continuously electronically #monitored #patientsafety Click To Tweet
  • Open Access – Access by patients to physician-recommended treatments, so that all patients are able to receive such treatments in a timely and affordable manner is a growing concern, said Mr. Wong. He emphasized that without access to treatments, patients will not see improved care.
without access to physician-recommended treatments, patients will not see improved care #patienthealth @aarc_tweets Respiratory‏Patient Advocacy Summit Click To Tweet
  • Sanctity of the Physician-Patient Relationship – To ensure that patients receive physician-recommended treatments, physicians must be able to prescribe medications that they believe are in the best interests of their patients. Interference with this physician-patient relationship by individuals or companies who are not the patient’s doctor may be illegal practices of medicine, said Mr. Wong, which may be subject to criminal and civil liabilities.
physicians must be able to prescribe medications that they believe are in the best interests of their patients #patienthealth @aarc_tweets Respiratory‏Patient Advocacy Summit Click To Tweet

 

Opioid Safety, Respiratory Compromise

Can Negligence Result in Safer Patient Care? Steward Health Care Owned Holy Family Hospital Nurse Found Negligent in Helen Bousquet Sleep Apnea Case

The recent jury finding that a Holy Family Hospital nurse was negligent in the care of Helen Marie Bousquet raises the question whether negligence can result in safer patient care.

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

According to recently released press release by the Estate of Helen Marie Bousquet:

“A jury in the Essex County Superior Court in Lawrence, Massachusetts found that a Steward Health Care owned Holy Family Hospital nurse was negligent in her care of Helen Marie Bousquet on Monday, Sept. 17.”

Helen Marie Bousquet tragically passed away after what has been described by her son, Brian Evans, singer and nominee for Hawaii’s 2nd congressional district, as “a basic routine procedure” for knee surgery. Mr. Evans said that her tragic and avoidable death highlights the need for better assessment of patients for sleep apnea and for better treatment and monitoring of such patients before, during and after surgery.

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Opioid Safety, Respiratory Compromise

Hospitals to be Evaluated on Their Sleep Apnea Preparedness Brian Evans and The Physician-Patient Alliance for Health & Safety Announce Creation of the Helen Marie Bousquet Fund

Brian Evans, singer and nominee for Hawaii’s 2nd congressional district, and the Physician-Patient Alliance for Health & Safety (PPAHS) announce plans to evaluate hospitals on their sleep apnea preparedness.

Helen Marie Bousquet tragically passed away after what is being described by her son, Mr. Evans, as “a basic routine procedure” for knee surgery. Mr. Evans said that her tragic and avoidable death highlights the need for better assessment of patients for sleep apnea and for better treatment and monitoring of such patients before, during and after surgery.

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Opioid Safety, Respiratory Compromise

Opioids Can Kill People in the Hospital Too

In an article for DoctorWeighsIn, Michael Wong, JD, discusses why opioids don’t just cause harm on the “street”. Opioids can kill people in hospital too!

Much of the public attention on the opioid-epidemic has been focused on the harm caused by prescription use and abuse of opioids. However, there is another facet that must be focused on: opioid-induced respiratory depression in clinical settings.

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Opioid Safety

Detection of Opioid-Induced Respiratory Depression Through Continuous Electronic Monitoring ATS Conference "where today’s science meets tomorrow’s care"

The theme of this year’s American Thoracic Society annual conference was “where today’s science meets tomorrow’s care.” In keeping with that theme, we would like to highlight one poster on detection of opioid-induced respiratory depression through continuous electronic monitoring. To view a copy of the poster, please go to the ATS website or see an image of the poster below.

“Measuring vital signs every four hours is an outdated and dangerous practice. Patients on our hospital wards deserve continuous vital sign monitoring so they are not found ‘dead in bed,’” said Dr. Frank Overdyk, a Charleston-based anesthesiologist and expert on respiratory compromise. Dr. Overdyk is also a member of our board of advisors.

The study analyzed 6,590 hospitalization days and detected 91 events of respiratory depression. The positive predictive value of 70% of events were classified as respiratory depression or sleep apnea related. Additionally, the study indicated a very low false alarm rate – less than one in 5,000 hours of monitoring, translating to just one false alarm every seven months The study also covered a range of care units and highlighted the variance in incidence rate. Long term care units had the lowest incidence rate of respiratory depression, while post-op units had the highest. Please see an image of the poster presented at the ATS conference:

Detection of Opioid-Induced Respiratory Depression Through Continuous Electronic Monitoring

Detection of Opioid-Induced Respiratory Depression Through Continuous Electronic Monitoring

“One of the key complications resulting from opioid use in hospitalized patients is respiratory distress that can lead to ICU transfers and sadly, even death. Moreover, respiratory depression is a key risk factor across the healthcare continuum, from hospitals to skilled nursing facilities,” explained Michael Wong, JD, Executive Director of The Physician-Patient Alliance for Health & Safety (PPAHS). “For this reason, all patients receiving opioids should be continuously electronically monitored, to help provide early detection of the risk of respiratory depression and enable timely intervention.”

 

Opioid Safety, Patient Safety

8 Signs You May Have an Opioid Addiction

Freelance writer and in recovery himself, Peter Lang discusses 8 signs that you may have an opioid addiction. To learn more and get help, please visit The Recovery Village.

Opiate addiction is a crisis in America. The proportion of the abusers of pain medication is not just alarming; it has reached critical levels. According to research, about one in every four opioid prescriptions ends up in the hands of abusers. About 35,000 people die every year from this menace. Further studies show that at least 12.5 million people abused opioids in 2015 alone. These pain-relieving medications include methadone, oxycodone, hydrocodone, codeine, fentanyl, and morphine. Some are legal, while others are not.

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Opioid Safety, Respiratory Compromise

Patient Monitoring Guide Features Manufacturers’ Answers on Their Monitoring Solutions Physician-Patient Alliance for Health & Safety Celebrates 7th Anniversary by Releasing Patient Monitoring Guide

On the 7th anniversary of the Physician-Patient Alliance for Health & Safety (PPAHS), PPAHS is pleased to release the Patient Monitoring Guide.

Since its first blog post 7 years ago, Michael Wong, JD (Founder and Executive Director, PPAHS) says PPAHS has advocated for continuous electronic monitoring of all patients receiving opioids. Mr. Wong explained that the primary motivation behind the Patient Monitoring Guide is to help answer questions posed by clinicians, hospital executives and risk managers about patient monitoring systems and to help them make decisions on which patient monitoring system best suits their clinical needs:

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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.”

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