Physician-Patient Alliance for Health & Safety Says Two Reasons for Supporting Canadian Agency for Drugs and Technologies in Health (CADTH) on Capnography

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The Physician-Patient Alliance for Health & Safety (PPAHS) today released two reasons for supporting the Canadian Agency for Drugs and Technologies in Health (CADTH) report, “Capnography for Monitoring End-Tidal CO2 in Hospital and Pre-hospital Settings: A Health Technology Assessment”.

CADTH Report on Capnography - Patients Stories

CADTH Report on Capnography - Patients Stories

Despite strong clinical evidence for the use of capnography in general anesthesia and moderate to deep sedation, preliminary scoping discussions suggested that there may be a low rate of access or use of this technology in Canada.

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The Physician-Patient Alliance for Health & Safety (PPAHS) today released two reasons for supporting the Canadian Agency for Drugs and Technologies in Health (CADTH) report, “Capnography for Monitoring End-Tidal CO2 in Hospital and Pre-hospital Settings: A Health Technology Assessment”.

As the CADTH report states:

In 2012, the Canadian Anesthesiologists’ Society (CAS) updated its guidelines to make capnography part of the standard of care in the practice of anesthesia in Canada. Specifically, the CAS guidelines require continuous use of capnography in monitoring patients during general anesthesia and sedation that corresponds to levels 4 through 6 on the Ramsay Sedation Scale. Despite strong clinical evidence for the use of capnography in general anesthesia and moderate to deep sedation, preliminary scoping discussions suggested that there may be a low rate of access or use of this technology in Canada.

“The Physician-Patient Alliance for Health & Safety encourages the adoption of the CADTH report recommending the use of capnography monitoring by hospitals for monitoring the adequacy of ventilation of their patients receiving opioids for two major reasons - to save patient lives and to reduce hospital expenses and malpractice claims. Both of these reasons may not have been emphasized enough in the report,” said Michael Wong, JD (Executive Director, PPAHS).

Mr. Wong pointed out that the use of technology alone cannot improve patient safety and reduce adverse events - “The involvement of people and process must also be considered, and may be missed by readers of the report who might adopt technology without an accompanying improvement of process.”

As Eric Coleman, MD (Professor of Geriatric Medicine and Director of the Care Transitions Program, University of Colorado at Denver), said: “The value of medical checklists lies in their consolidation of a considered body of knowledge in one simple document.” As well, checklists assist with transitions of care and collaboration between different caregivers.

An example of such a checklist in the administration of opioids is the PCA Safety Checklist. The checklist was developed in conjunction with renowned medical experts, including intensive care specialist and a leader in medical checklist development Peter J. Pronovost, MD, PhD, FCCM, Professor, Departments of Anesthesiology/Critical Care Medicine and Surgery, The Johns Hopkins University School of Medicine and Medical Director, Center for Innovation in Quality Patient; and Atul Gawande, MD, Professor in the Department of Health Policy and Management at the Harvard School of Public Health, who is a surgeon at Brigham and Women's Hospital Professor of Surgery at Harvard Medical School and author of "The Checklist Manifesto."

The PCA Safety Checklist reminds caregivers of the essential steps needed to be taken to initiate patient-controlled analgesia (PCA) with a patient, and to continue to assess that patient’s use of PCA. The PCA Safety Checklist is a free download at http://www.ppahs.org/pca-safety-checklist-download/

To read the open letter by PPAHS to CADTH, please click here.

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 http://www.ppahs.org

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