TY - JOUR T1 - Home Monitoring of Post-Operative High-Risk Opioid Adult and Pediatric Patients JF - Respiratory Care VL - 64 IS - Suppl 10 SP - 3225397 AU - Kimberly J. Bennion AU - Shaylynn Uresk Y1 - 2019/10/01 UR - http://rc.rcjournal.com/content/64/Suppl_10/3225397.abstract N2 - Background: Opioid related deaths are rapidly increasing and are a national focus1. Uintah Basin Medical Center is a 49-bed hospital located in eastern Utah. Following 3 unplanned home deaths in patients taking opioids as prescribed post-operatively who had undergone Ear, Nose and Throat (ENT) procedures, we piloted an initial study of a home monitoring protocol to earlier identify and intervene with pts most at risk for opioid induced respiratory depression (OIRD). This is our second study. Methods: From July 2017-June 2018, all pediatric and adult ENT post-op pts prescribed opiates were discharged with a Masimo RAD 8 or Masimo Rad 97 monitor for 7 days. Data was recorded during sleep/naps and analyzed after device return. Pts were educated on risks of opioid use, the relation between OIRD and falling blood oxygen levels. They were instructed to call/come to the hospital if oxygen saturation (SpO2) alarmed and read < 85%. Results: Two-hundred fifteen pts were monitored. Results are reported in Table One. Conclusions: It was our impression that using the Masimo technology would diminish false alerting since it differentiates between artifact and actual out-of-range alerting. Our collaborating hospital is conducting a side-by-side study comparing SpO2 and end-tidal carbon dioxide in home monitoring of pts. With 210 (98%) of the patients studied being opioid naive, we agree with guidelines from the CDC which recommends short-acting opioids rather than long-acting or extended release opioids for the treatment for acute pain in opioid naïve patients. Other factors such as age, gender, hepatic/renal impairment, comorbidities, polypharmacology and drug metabolism should also be considered. We have identified the need for more education to ED staff regarding protocol compliance and recognize that relying on patients/caregivers to identify and respond to out of range parameters is not ideal. We are considering remote monitoring in the home via Telemedicine for our higher risk pts. It is our impression that opioid related deaths are under diagnosed and reported and are often reported as “pneumonia” by medical examiners. We are pursuing validation of this impression. Our initial work facilitated Utah SCR004 being signed into law March 2018. Utah legislators requested more studies regarding home monitoring of high-risk opioid patients, and our goal is to meet that request. RTs are in a unique position to further this work. Reference: https://www.cdc.gov/drugoverdose/epidemic/index.html View this table:2017-2018 Post-Operative High Risk Opioid Patient Home Monitoring Outcomes ER -