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Physician-Patient Alliance for Health & Safety: Monitoring the High-Acuity Patient: Does Risk Stratification Increase or Decrease Patient Safety?
Date:7/12/2012

CHICAGO, July 12, 2012 /PRNewswire/ -- According to Michael Wong of the Physician-Patient Alliance for Health & Safety, the topic of who is a suitable candidate for outpatient surgery is front and center with productivity pressures being intense at ambulatory surgery centers. However, with surgery often comes the necessity of the use of opioids for pain control.

As Mr. Wong explains, "Studies have shown that any patient receiving opioids may be at risk of postoperative respiratory depression and if undetected, respiratory arrest  (also known as "Code Blue"). The most common antecedents to cardiopulmonary arrest are of respiratory origin. Respiratory decompensation—as evidenced by tachypnea, bradypnea, hypoxia, hypercarbia or changes in mental status—are often the earliest warning signs of physiologic instability. Monitoring respiratory function and level of consciousness are especially important in detecting and preventing adverse events for patients receiving opioids and sedatives."

According to the report Ambulatory Surgery in the United States, 2006, the number of outpatient surgeries in the United States increased from 20.8 million in 1996 to 34.7 million in 2006. While outpatient surgeries only accounted for about half of all surgeries in 1996, by 2006 they made up nearly two-thirds of all surgeries in 2006.

As Frank Overdyk, MD (Professor of Anesthesiology, Medical University of South Carolina) says, "There is often a sentiment that "it's only minor surgery". While a surgery may indeed be "minor" or less intensive and complicated, and non opioid analgesics are preferred in these cases, opioids are still frequently required for adequate postoperative pain control."

The Anesthesia Patient Safety Foundation convened a symposium in 2006 on the dangers of
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SOURCE Physician-Patient Alliance for Health & Safety
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