Opioid Safety, Respiratory Compromise

3 Ways to Make Opioids Safer

Last week we released an interview with Peggy Lange, RT, Director of the Respiratory Care Department at St. Cloud Hospital, on her team’s use of capnography in procedural and conscious sedation. Since then, it’s proven to be the most popular interview in our podcast series to-date.

The subject of the interview with Ms. Lange is a particularly topical one. Both the institutional and public eye has been focused on opioids and the ‘opioid epidemic’. And along with this, the body of knowledge related to their safe use continues to grow. Readers and listeners interested in additional content about capnography and opioid safety will be happy to find other interviews and webinars from PPAHS and across the web.

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Opioid Safety, Respiratory Compromise

5 Keys to Safer Hospital Sedation

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

Conscious sedation is routinely used with patients so that they can tolerate procedures that may cause them discomfort, anxiety, or pain. Some of the tests and procedures conscious sedation may be used for are:

  • Breast biopsy
  • Dental prosthetic or reconstructive surgery
  • Minor bone fracture repair
  • Minor foot surgery
  • Minor skin surgery
  • Plastic or reconstructive surgery
  • Procedures to diagnose and treat some stomach (upper endoscopy), colon (colonoscopy), lung (bronchoscopy), and bladder (cystoscopy) conditions.

Conscious sedation may also be used with pediatric patients or adult patients who may have difficulty remaining still for certain tests and medical procedures. Read More

Opioid Safety, Respiratory Compromise

Reducing Rapid Response Calls by 50% and Avoiding Respiratory Depression During Conscious Sedation: An Interview with Richard Kenney, RRT

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

White Memorial Medical Center in Los Angeles has experienced a “better than fifty percent reduction in calls of rapid responses”, according to Richard Kenney, MSM, RRT, NPS, ACCS, RCP (Director, Respiratory Care Services, White Memorial Medical Center).

To better understand what Adventist Health hospitals have done to reduce rapid response calls and improve patient safety and health outcomes, the Physician-Patient Alliance for Health & Safety (PPAHS) interviewed Mr. Kenney.

In this interview titled, “Avoiding Respiratory Depression During Conscious Sedation”, Mr. Kenney says using capnography monitoring has reduced rapid response calls by more than 50%.

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Opioid Safety, Patient Safety

Overriding Technology May Impact Patient Safety

Recent research by the Pennsylvania Patient Safety Authority has concluded that overrides of medical technology may impact the safety of patients.

The PA Authority analyzed 583 events reported during the period January 2013 to December 2014. Key findings from this analysis:

  • The majority (77%) were related to automated dispensing cabinets.
  • The most common classes of medications involved antibiotics (12.0%), opioids (12.0%), anticoagulants (7.4%), and high alert medications (26.4%).

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Must Reads, Patient Safety

5 Most Viewed Healthcare Posts in 2015

The 5 most viewed healthcare posts on the Physician-Patient Alliance for Health & Safety (PPAHS) blog were from previous years. Although we would like to think that these posts were just great articles – in fact, they had more views in 2015 than any other post, including those posted this year – sadly we think that it just shows that the patient safety issues discussed still remain.

The Google trends analysis of “opioids” (shown below) demonstrates, for example, an increase in interest from 2005 until now:

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Patient Safety

Patient-Controlled Analgesia Use in Labor – Weekly Must Reads in Patient Safety (Dec 4, 2015)

Recent research has found that 70 percent of women in labor using patient-controlled analgesia (PCA) experienced oxygen desaturation. Oxygen desaturation is defined as a “decrease in oxygen concentration in the blood resulting from any condition that affects the exchange of carbon dioxide and oxygen”.

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Opioid Safety, Respiratory Compromise

How to Avoid Respiratory Depression During Conscious Sedation

A podcast interview soon to be released by the Physician-Patient Alliance for Health & Safety will detail one hospital’s experience in avoiding respiratory depression during conscious sedation. The podcast will feature Richard Kenney, MSM, RRT, NPS, ACCS, RCP (Director, Respiratory Care Services, White Memorial Medical Center, Los Angeles).

Mr Kenney recently wrote an article for Advance for Respiratory Care and Sleep Medicine, “Essential Capnography” in which he describes how patient monitoring is a fundamental tool of the care team at White Memorial Medical Center.

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Opioid Safety, Respiratory Compromise

Dead in bed. What are you doing for safer pain?

By Gina Pugliese, RN, MS, FSHEA (Vice President, Premier Safety Institute)

18-year-old Amanda came down with strep throat after her high school graduation party. Her parents never thought the treatment she received in the hospital would abruptly end her life.

I recently heard Cindy Abbiehl share the heartbreaking story of her daughter Amanda who died from treatment for strep throat. Read More

Opioid Safety, Respiratory Compromise

Two Incorrect Beliefs About Pain Pumps That May Harm Patients

By Lynn Razzano RN, MSN, ONCC (Clinical Nurse Consultant)

A recent article by Gregory Hickman, MD. in Outpatient Surgery entitled: “Pump Up Your Pain Pump Knowledge: How much do you know about the potential for post-op complications?” is an eye-opener to reinforce our need to learn what we need to know in order to prevent postoperative complications. Read More

Opioid Safety, Patient Stories, Respiratory Compromise

Sleep Apnea + Opiods = Post-Surgical Preventable Death

[Editor’s note: This article first appeared in The Doctor Weighs In. The team at Physician-Patient Alliance for Health & Safety thank Pat for her tremendous courage and working with us on this tragic story of what happened to her husband. We hope that in this retelling, hospitals will be encouraged to ensure that similar events become “never events”.] Read More