Healthcare Leaders Look to Define Warning Signs of Respiratory Compromise

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Physician-Patient Alliance for Health & Safety joins prominent healthcare organizations in roundtable to discuss guidelines for identifying and preventing respiratory compromise

any patient can develop respiratory compromise, so early detection is key

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Healthcare Leaders met in February 2015 to define the warning signs of respiratory compromise. The meeting was hosted by the National Association for Medical Direction of Respiratory Care (NAMDRC).

Organizations that participated in the roundtable discussion were:

  •          American Association for Respiratory Care (AARC)
  •     American Association of Critical-Care Nurses (AACN)
  •     American College of Emergency Physicians (ACEP)
  •     American Thoracic Society (ATS)
  •     National Association for Medical Direction of Respiratory Care (NAMDRC)
  •     Physician-Patient Alliance for Health & Safety (PPAHS)
  •     Society of Critical Care Medicine (SCCM)

Reports Patient Safety Monitor Journal:

"Although respiratory compromise can lead to intensive care and mortality, it’s still a common occurrence among surgical patients. A 2013 Healthgrades, Inc. report evaluated Medicare hospitalizations from 2009 to 2011 and found that respiratory failure following surgery occurred at a rate of 13.79 per 1,000 cases. Respiratory compromise (consisting of insufficiency, distress, arrest, and failure) leads to higher mortality rates and higher rates of ICU admissions, which increases costs and leads to additional complications for patients.”

Respiratory compromise is often difficult to detect. Sandra K. Hanneman, PhD, RN, FAAN, a Jerold B. Katz (Distinguished Professor for Nursing Research, University of Texas Health Science Center), who represented AACN at the roundtable, explained that any patient can develop respiratory compromise, so early detection is key:

“You might have a patient sitting in a bed and everything is hunky dory, and a few minutes later there is a change in status. Then a few minutes or hours later, there are further signs that things are deteriorating. At some point that is recognized and some level of intervention is initiated. I think some feel that if we could pick up earlier, we could prevent that acceleration to the point of massive intervention.”

The possible rapid deterioration of seemingly healthy patients was also emphasized by Michael Wong, JD (Executive Director, Physician-Patient Alliance for Health & Safety), who said that PPAHS established the Respiratory Compromise Institute to develop tools and resources geared toward eliminating preventable adverse events associated with respiratory depression. He described the need for pointing the need to identify the earliest possible onset of respiratory compromise:

“If you can picture a graph with death on the right side and on the left is when the patient is admitted, somewhere from admittance to end point there is a time sequence in which clinicians could have intervened. The real problem is when do you identify that possible moment?”

About Physician-Patient Alliance for Health & Safety

Physician-Patient Alliance for Health & Safety is a non-profit 501(c)(3) whose mission is to promote safer clinical practices and standards for patients through collaboration among healthcare experts, professionals, scientific researchers, and others, in order to improve health care delivery. For more information, please go to

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