Clinical experience with patient-controlled analgesia using continuous respiratory monitoring and a smart infusion system

American Journal of Health-System Pharmacy

Volumn 63, Issue 2, 2006, Pages 157-164

  Maddox, Ray R ^a,b   Williams, Carolyn K ^b   Oglesby, Harold ^b   Butler, Betty ^b   Colclasure, Bernie ^b  

^a Research and Pulmonary Medicine ^*  (United States)

^b St Joseph's/Candler Health System   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

CARBON DIOXIDE; FENTANYL; HYDROMORPHONE; MORPHINE; NALOXONE; OPIATE; OXYGEN; PETHIDINE;

ARTICLE; BLOOD PRESSURE; BREATHING RATE; CAPNOGRAPHY; CLINICAL PRACTICE; COGNITION; CONTINUOUS RESPIRATORY MONITORING; DECISION MAKING; DRUG DELIVERY SYSTEM; DRUG INFUSION; DRUG SAFETY; DRUG SELF ADMINISTRATION; DRUG SUBSTITUTION; END TIDAL CARBON DIOXIDE TENSION; EXPERIENCE; HUMAN; HYPOXIA; MEDICATION ERROR; NAUSEA; PAIN ASSESSMENT; PATIENT CARE; PATIENT CONTROLLED ANALGESIA; PATIENT MONITORING; PATIENT SELECTION; POSITIVE END EXPIRATORY PRESSURE; PRIORITY JOURNAL; PULSE OXIMETRY; RESPIRATION DEPRESSION; SCORING SYSTEM; SEDATION; SMART INFUSION SYSTEM;

EID: 30744446485     PISSN: 10792082     EISSN: None     Source Type: Journal    
DOI: 10.2146/ajhp050194     Document Type: Article

References (23)

1. Nurse advise-ERR. Safety issues with patient-controlled analgesia. ISMP Med Saf Alert. 2005; 3(1):1-3.
2. Safety issues with patient-controlled analgesia. Part I - how errors occur. ISMP Med Saf Alert. 2003; Jul 10.
3. Frequent problems with medication systems noted during ISMP hospital evaluations. Part 2. ISMP Med Saf Alert. 1998; Jun 17.
4. More on avoiding opiate toxicity with PCA by proxy. ISMP Med Saf Alert. 2002; May 29.
5. Etches RC. Respiratory depression associated with patient-controlled analgesia: a review of eight cases. Can J Anaesth. 1994; 41(2):125-32.
6. Patient-controlled analgesia by proxy. JCAHO Sentinel Event Alert. 2004; Dec 2.
7. Maddox RR, Williams CK, Fields M. Respiratory monitoring in patient-controlled analgesia. Am J Health-Syst Pharm. 2004; 61:2628,2635. Letter.
8. Overdyk FJ. PCA presents serious risks. APSF Newsl. 2005; 20(2):33. Letter.
9. Manufacturer and User Facility Device Experience Database (MAUDE). Rockville, MD: Food and Drug Administration; 2004 Jan-Dec.
10. Patient-controlled analgesia pumps. USP Qual Rev. 2004; Sep (81).
11. University of California San Francisco. Opioid analgesics. www.ucsf.edu/~pain/Opiate.htm (accessed 2005 Mar 15).
12. Davis TA, Mathewson HS. Opioids and respiratory depression, www.rcjournal. com/contents/01.99/01.99.078.asp (accessed 2005 Mar 15).
13. Cohen MR. How to prevent errors-safety issues with patient-controlled analgesia (part 2). ISMP medication error report analysis. Hosp Pharm. 2005; 40: 210-2.
14. American Society of Anesthesiologists Task Force on Sedation and Analgesia by Non-Anesthesiologists. Practice guidelines for sedation and analgesia by nonanesthesiologists. Anesthesiology. 2002; 96:1004-17.
15. Tobias JD. End-tidal carbon dioxide monitoring during sedation with a combination of midazolam and ketamine for children undergoing painful, invasive procedures. Pediatr Emerg Care. 1999; 15:173.
16. Miner JR, Heegaard W, Plummer D. End-tidal carbon dioxide monitoring during procedural sedation. Acad Emerg Med. 2002; 9(4):275-80.
17. Williams C, Maddox RR. Implementation of an i.v. medication safety system. Am J Health-Syst Pharm. 2005; 62:530-6.
18. Cohen MR. ISMP medication error report analysis. Misprogram a PCA pump? It's easier than you think. Hosp Pharm. 2004; 39:932-9,953.
19. Colman Y, Krauss B. Microstream capnography technology: a new approach to an old problem. J Clin Monit Comput. 1999; 15:403-9.
20. Treseler K. Clinical laboratory and diagnostic tests: significance and nursing implication. Norwalk, CT: Appleton & Lange; 1995.
21. Paranjothi S, Schuller D. Pulmonary diseases, pulmonary embolism. In: Ahya SN, Flood K, Paranjothi S, eds. The Washington manual of medical therapeutics. 30th ed. Philadelphia: Lippincott Williams & Wilkins; 2001:230-3.
22. Carpenter RL. Optimizing postoperative pain management, www.aafp.org/afp/970901ap/painmgmt.html (accessed 2005 Apr 4).
23. Vlessides M. Even when observed by a gastroenterologist, nurse-administered propofol regularly puts patients at risk. www.anesthesiologynews.com/indexpub.cfm?pubid=3 (accessed 2005 Apr 17).