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.
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.”
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
Three themes for this week’s must reads:
- Dangers of Amniotic Fluid Embolism
- Assess and Treat Patients for Blood Clots
- Monitor Patients Receiving Sedation
By Michael Wong
“Inexplicably left alone.”
That, according to Jury Verdict Review & Analysis, is what happened to 68-year-old Marie Golubski after she was prepped and intravenously sedated for cataract surgery in June 2010. In other words, no anesthesiologist, no nurse or no ophthalmologist was present when Ms. Golubski slipped into respiratory depression. Read More