Logan had obstructive sleep apnea (OSA) with elements of central sleep apnea. He underwent surgery to have "his tonsils and his uvula removed, septum and his turbinate repaired. Basically, opening up the airway by removing the tissue in the back of his airway."
In an interview with PPAHS, Ms. Parker, who is a recovery room nurse and a certified ambulatory perianesthesia (CAPA) nurse, discusses her efforts to resuscitate her own son from opioid-induced respiratory depression (OIRD).
Ms. Parker says that there are 6 lessons she learnt from Logan's death:
Lesson 1
All patients receiving opioids should be assessed for risk for over sedation and respiratory depression.
Lesson 2
Clinicians must recognize the signs of respiratory compromise.
Lesson 3
All patients receiving opioids should be continuously electronically monitored.
Lesson 4
Do not rely upon pulse oximeters, monitor with capnography.
Lesson 5
All patients should be monitored for an extended period in an un-stimulated environment prior to discharge.
Lesson 6
Medical interventions should not be based upon human heroics, but should be based upon a process and process improvement.
She believes that clinicians can and must do better:
Each health care provider needs to consider the risk of respiratory compromise in planning a patient's care, and this includes all clinicians involved in creating and implementing a plan, including the surgeon, the anesthesiologist, and the nurses. And, it should entail frequency of respiratory assessment and the types of monitors being used. Capnography should be used on all patients who are at risk for increased carbon dioxide.
Other considerations include minimal usage of medications that increase respiratory depression, such as phenergan and benadryl. Additionally, the patient should receive full reversal medications by anesthesia at the end of surgery. Clinicians must create a better plan for the at-risk patient.
To listen to the interview with Ms. Parker, please click here.
About Physician-Patient Alliance for Health & Safety
Physician-Patient Alliance for Health & Safety is a non-profit 501(c)(3) whose mission is to promote safer clinical practices and standards for patients through collaboration among healthcare experts, professionals, scientific researchers, and others, in order to improve health care delivery. For more information, please go to www.ppahs.org.
Video - http://youtu.be/RT5uGJZgEig
Logo - http://photos.prnewswire.com/prnh/20131024/CG03341LOGO
SOURCE Physician-Patient Alliance for Health & Safety (PPAHS)
Related Links
http://www.ppahs.org
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