Monitoring for Opioid-Induced Ventilatory Impairment (OIVI) Video

Monitoring for Opioid-Induced Ventilatory Impairment (OIVI) Video

Executive Summary: Opioid-Induced Ventilatory Impairment (OIVI): Time for a change in the Monitoring Strategy for Postoperative PCA Patients

APSF has produced a 7-minute long Executive Summary video of the APSF-sponsored conference, Opioid-Induced Ventilatory Impairment (OIVI): Time for a change in the Monitoring Strategy for Postoperative PCA Patients, held in Phoenix, AZ on June 08, 2011. The intended audience is everyone who cares for patients receiving opioids in the postoperative period.

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Supplemental Information

APSF believes that clinically significant drug-induced respiratory depression (oxygenation and/or ventilation) in the postoperative period remains a serious patient safety risk that continues to be associated with significant morbidity and mortality since it was first addressed by APSF in 2006. With this background, APSF sponsored its second one-day conference on this topic bringing together 136 stakeholders from diverse backgrounds (physicians, nurses, industry representatives, family representatives, pharmacists, hospital administrators, insurers, regulators) to address the following question, Essential Monitoring Strategies to Detect Clinically Significant Drug-Induced Respiratory Depression: Why and How?

The Conclusions and Recommendations from this conference are intended to facilitate detection of clinically significant drug-induced respiratory depression in non-ambulatory adult patients receiving parenteral opioids for management of acute postoperative pain while being cared for in a healthcare facility (a full text of the conference conclusions and recommendations may be found in the Fall 2011 APSF Newsletter)

  1. All patients should have oxygenation monitored by continuous pulse oximetry.
  2. Capnography or other monitoring modalities that measure the adequacy of ventilation and airflow is indicated when supplemental oxygen is needed to maintain acceptable oxygen saturations.
  3. Applying electronic monitoring selectively based upon perceived increased risk is likely to miss respiratory depression in patients without risk factors
  4. Monitoring continuous oxygenation and ventilation from a central location (telemetry or comparable technologies) is desirable. This information needs to be reliably transmitted to the healthcare professional caring for the patient at the bedside.
  5. Structured assessment of the level of sedation/consciousness is a critical component of the nurse’s routine postoperative patient assessment for detecting respiratory depression.