Clinical Evidence
Ten Year Study Using Continuous Monitoring Devices to Eliminate Preventable Deaths
Read the most recent study from Dartmouth-Hitchcock Medical Center demonstrating how continuous patient monitoring with Masimo SET® pulse oximetry was key to achieving zero preventable deaths from opioid-induced respiratory depression.
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Preventable deaths or brain damage due to opioid-induced respiratory depression in monitored patients over 10 years1
Oxygen monitoring has been shown to help reduce harm associated with opioid-induced respiratory depression (OIRD). Multiple studies over 10 years at Dartmouth-Hitchcock Medical Center have shown that after implementing continuous patient monitoring with Masimo SET® pulse oximetry and a remote clinician notification system, clinicians were able to achieve zero preventable deaths or brain damage due to opioid overdose among monitored patients in post-surgical wards.1-4
Continuous Home Monitoring for Prescription Opioid Patients
Researchers at Uintah Basin Medical Center studied continuous home monitoring technology in two independent studies of postoperative patients at high risk for opioid-induced respiratory depression (OIRD). In the first study, four patients were saved when alarms alerted home caregivers. EMS was called, naloxone was administered, and the patients received CPR. In the second study, two patients who ignored alarms and removed the monitor died at home from OIRD. Results from the first and second studies were presented as posters at Respiratory Care in 2018 and 2019, respectively.5
Postoperative Critical Events Associated with Obstructive Sleep Apnea (OSA) More Likely
A study found that death and brain damage were more likely to occur during unwitnessed events, without supplemental oxygen, without respiratory monitoring, and with the co-administration of opioids and sedatives. The researchers concluded, “It is important that efforts be directed at providing more effective monitoring for OSA patients following surgery, and clinicians consider the potentially dangerous effects of opioids and sedatives—especially when combined—when managing OSA patients postoperatively.”6
Clinical Guidance
Advocacy
References:
McGrath S et al. Inpatient Respiratory Arrest Associated With Sedative and Analgesic Medications: Impact of Continuous Monitoring on Patient Mortality and Severe Morbidity. J Patient Saf. 2020 14 Mar. DOI: 10.1097/PTS.0000000000000696.
Taenzer AH, Pyke JB, McGrath SP, Blike GT. Impact of pulse oximetry surveillance on rescue events and intensive care unit transfers: a before-and-after concurrence study Anesthesiology. 2010;112(2):282-287.
Taenzer A et al. Postoperative Monitoring – The Dartmouth Experience. Anesthesia Patient Safety Foundation Newsletter. Spring-Summer 2012.
McGrath S et al. Surveillance Monitoring Management for General Care Units: Strategy, Design, and Implementation. The Joint Commission Journal on Quality and Patient Safety. 2016 Jul;42(7):293-302.
Bennion KJ, Uresk S, Catten M. Home Monitoring of Adult and Pediatric Patients on Opioids for Pain Post-Surgery Respiratory Care. 2018;63(10): 2979779.
Bolden, Norman et al. “Postoperative Critical Events Associated With Obstructive Sleep Apnea: Results From the Society of Anesthesia and Sleep Medicine Obstructive Sleep Apnea Registry.” Anesthesia and analgesia vol. 131,4 (2020): 1032-1041. doi:10.1213/ANE.0000000000005005
PLCO-005320/PLM-13274B-0821