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.
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“Measuring vital signs every four hours is an outdated and dangerous practice.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
“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.”
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.
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:
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.”
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.
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.
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.
Articles we have been reading this past week of May 7, 2018 focus on opioids and preventing “dead-in-bed.”
How Often Does “Dead-In-Bed” Happen in Hospitals?
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: