Editor’s note: In this personal message from the Founder and Executive Director, Physician-Patient Alliance for Health & Safety, Michael Wong invites you to listen to 3 must view podcasts on reducing opioid-related adverse events.
By Michael Wong, JD (Founder and Executive Director, Physician-Patient Alliance for Health & Safety)
Watch and share these 3 Clinical Education Podcasts on how to reduce opioid-related adverse events.
Our podcasts feature health and safety experts on the latest recommendations and best practices:
Millions of gastrointestinal endoscopy are performed each year in the US, with colonoscopies making up the majority of such procedures. Research conducted by Michael W. Jopling, MD and Qiu Jiejing published in BMC Anesthesiology concluded that capnography use associated with reduction of adverse outcomes during procedural sedation.
Their research sought to “estimate the incidence of pharmacological rescue events and death at discharge from an inpatient or outpatient hospitalization where [gastrointestinal endoscopic procedures] GEP was performed with sedation, and to determine if capnography monitoring was associated with reduced incidence of these adverse outcomes.”
Nursing recommendations from ARIN and AORN encouraged Sunnybrook Health Sciences Centre to monitor with capnography patients undergoing procedural sedation.
In a podcast with the Physician-Physician Alliance for Health Safety, Barbara McArthur, RN, BScN, CPN(C), an advanced practice nurse at Sunnybrook Health Sciences Centre in Toronto, Canada, discussed why Sunnybrook Health Sciences Centre decided to monitor with capnography.
The Physician-Physician Alliance for Health Safety has released a clinical education podcast on capnography monitoring during conscious sedation with Barbara McArthur, RN, BScN, CPN(C). Ms. McArthur is an advanced practice nurse at Sunnybrook Health Sciences Centre in Toronto, Canada.
Capnography Monitoring: An Early Indicator of Patient Deterioration
After reviewing the current literature, Sunnybrook decided that monitoring with capnography resulted in safer patient care. Capnography monitoring provides an early indicator of patient deterioration, which can be crucial in averting adverse events and patient deaths. Capnography monitoring, says Ms. McArthur, is monitoring in “real time. With pulse oximetry, there is a delay, which could be up to a minute in healthy patients. So, that’s a significant sort of time that is delayed that reaction could happen.”
Today, the Physician-Patient Alliance for Health Safety released a clinical education podcast with Matt Kurrek, MD, FRCPC (Professor, Department of Anesthesia, University of Toronto) and Richard Merchant, MD, FRCPC (Clinical Professor, University of British Columbia, Department of Anesthesia, Pharmacology & Therapeutics).
Drs. Kurrek and Merchant coauthored an editorial, “Yesterday’s Luxury, Today’s Necessity” after the Canadian Anesthesiologists’ Society [CSA] published its revised 2012 guidelines to the practice of anesthesia. The CSA guidelines recommend capnography monitoring during conscious sedation. In the podcast, Drs. Kurrek and Merchant discuss why capnography monitoring may have been considered yesterday’s luxury, but is now a necessity during conscious sedation.
Editor’s Note: This research was presented as a poster at the 2017 ANCC National Magnet Conference.
By Eric Griffin MSN, RN, CEN (Magnet Program Director, Baystate Medical Center) and Laura Bolella MSN, RN (Assistant Nurse Manager, Baystate Medical Center)
For over a hundred years nurses have monitored the same vital signs. Unfortunately these vital signs can be slow to change, inaccurate, and misleading. Although there have been modern advances in physiological monitoring devices, their acceptance has been limited. Pulse oximetry developed in the early 1970’s is extremely useful in measuring oxygenation, although it has limitations related to the following factors: poor signal strength, fingernail polish, anemia, patient motion, calloused skin, hypoperfusion, time lag, and vasoconstriction.
The recent case of five-year old Amber Athwal is a reminder yet again of the dangers of dental sedation without the availability of adequate personnel and patient monitoring. Unfortunately, what happened to Amber is not an isolated event, as other pediatric deaths have recently occurred, tragically with 6 year-old Caleb Sears, as well as 9-year old Solomon Womack, 17-Year Old Mariah Edwards, and 17-year-old girl, Sydney Gallegher. Read More
Written by James Welch, CEO Arc Biomedical Consultants (email@example.com)
Mr. Welch is a Clinical Engineer with 17 yrs experience in hospitals and over 24 yrs as an executive in the medical device industry. His focus has been on applying technologies to improve patient safety through continuous surveillance monitoring. Mr. Welch has ten patents and articles in the field of wireless physiologic monitoring, surveillance systems and alarm management. He regularly contributes to the AAMI Foundation on alarm safety and is a voting member on a number of International Standards committees.
Early detection of physiologic deterioration is essential in improving patient safety in acute care hospital settings. Patients in non-ICU settings who are recovering from surgery or special procedures are especially vulnerable because of private or semi-private room settings prevents direct observation and nurse to patient ratios are often 1:6. Experts in Rapid Response Systems (RRS) have arrived at a consensus that strengthening early detection through continuous monitoring is essential in improving the effectiveness of RRS but only if such systems do not impose a burden on the clinical staff. The high incidence of nuisance alarms and cost are two of the major barriers preventing broader adoption of continuous monitoring on the general care floor. Read More
This weekend marked the 7th anniversary of Amanda Abbiehl’s tragic death. Her story continues to remind us of the need for continuous electronic monitoring for all patients receiving opioids.
Amanda was 18-years-old when she was admitted to hospital for a severe case of strep throat. To help her manage the pain, she was placed on a patient-controlled analgesia (PCA) pump. The next morning, she was found unresponsive and died. Though PCA pumps are designed to deliver an exact dosage of opioid – in Amanda’s case, hydromorphone – getting the ‘right’ dosage is not a simple task. Too high a dosage can lead to respiratory depression, sometimes in minutes. Read More
The following is an excerpt of an article first published on The Doctor Weighs In on June 28, 2017. To read the full article, please click here.
In 2005, Paul Buisson, a celebrated Quebec animator and cameraman died as a result of opioid-related respiratory depression. What lessons can we learn more than a decade later? Read More