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Risks for Surgical Patients Persist Beyond the Operating Room

For a family with a loved one who needs surgery, the most trying period is typically while the patient is undergoing the surgical procedure. New guidelines released by the Anesthesia Patient Safety Foundation, or APSF, stress the importance of being vigilant about life-threatening risks that continue even after the patient has left the operating room.

The APSF recently recommended the increased use of electronic respiratory monitoring on all patients after surgery, not only those with a heightened risk of respiratory distress. The recommendations suggest that periodic checks of a patient's respiratory vital signs are not frequent enough to identify a patient in respiratory distress before preventable personal injuries or death occur.

In its recommendations, the APSF indicated the periodic checks were not "adequate for reliably recognizing clinically significant evolving drug-induced respiratory depression in the postoperative period."

After surgery, patients are commonly put on patient-controlled analgesia, or PCA, pumps, which allow them to manage their own pain. Unlike in the operating room, though, their respiratory vital signs typically are not continuously monitored while on the pumps. This failure to monitor has led to unobserved respiratory distress in postoperative patients.

"A patient experiencing respiratory depression, if undetected, can easily progress to respiratory arrest and consequent brain damage or death," said Dr. Daniel Sessler, Professor and Chair of the Department of Outcomes Research at the Cleveland Clinic.

Experts have identified patients who have died as a result of preventable medical errors when their PCA pumps were not continuously electronically monitored. The APSF's recommendations suggest some of those cases of medical malpractice could have been avoided if the patients' respiratory vital signs had been continuously monitored while on the PCA pumps.

Source: SF Gate, "Don't Post-Surgical Patients Deserve Better Care?: Patient Deaths Underscore Need for Continuous Electronic Monitoring," May 31, 2012.

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