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.
Abstract: The lesson learned from the death of Michelle McNamara – taking opioids can kill you. The opioid fentanyl can cause delayed respiratory depression and tragically death, particularly when used in combination with other sedating drugs.
Michelle McNamara, the writer and wife of comedian Patton Oswalt, died unexpectedly in her sleep in April 2016. Mr. Oswalt says that her death was caused by a toxic mixture of fentanyl and other drugs. As reported by People:
From the articles we have been reading this week, here are 3 tips for managing pain and using opioids safely.
#1 Tip for Managing Pain and Using Opioids Safely – Premier Safety Institute new toolkit helps providers manage pain, curb opioid use
In 2017, we had many interesting patient safety articles – from the PPAHS staff, our Executive Director, guest clinicians and patient safety advocates. Our top 12 patient articles for 2017 focus on the use and management of opioids, and the tragic loss of patient lives from failure to monitor opioid use appropriately:
Physician-Patient Alliance for Health & Safety clinical education podcasts feature interviews on their practices and recommendations for improving patient safety and health outcomes.
Our top 5 patient safety podcasts are:
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.”
Despite the focus on appropriate use of opioids for pain management, ECRI Institute Patient Safety Organization (PSO) found that there are many hospitals that continue to experience opioid-related adverse events and deaths. To help prevent further patient harms and deaths, PSO conducted a deep dive analysis of adverse events related to opioids in the acute care setting.
By Michael Wong, JD (Founder and Executive Director, Physician-Patient Alliance for Health & Safety)
According to the Bozeman Daily Chroncle’s article, “Wrongful death lawsuit filed against Bozeman surgeon,” Erik Nelson underwent surgery to correct his chronic nasal obstruction and severe obstructive sleep apnea. Discharged the day after surgery, Mr, Nelson was sent home with a prescription of Oxycodone to manage his pain. Oxycodone is a semisynthetic opioid, which is prescribed for moderate to severe pain.
Six years ago on July 27, 2011, I posted the first article on a free WordPress blog for the Physician-Patient Alliance for Health & Safety. It was titled “Is it possible to survive 96-minutes without a heart beat?”. Howard Snitzer, a man who suffered a heart attack survived after two volunteer paramedics responded and began a 96-minute CPR marathon. The ordeal involved 20 others, who took turns pumping his chest. This life-saving feat was only possible with the use of capnography readings, which told the volunteer paramedics that Howard was still alive and that they needed to continue their efforts.
Little would I know that that article would lead to an invitation by the University of Notre Dame and the beginnings of a 6-year friendship with the parents of Amanda Abbiehl. Amanda was admitted to hospital for “severe strep throat.” Read More