Patients in the hospital often suffer from significant pain. To ease their patient's suffering, hospitals attempt to manage this pain with narcotic pain relievers.
These medications are not risk free, however. A major concern created by the use of narcotic pain relievers is that they depress a person's drive to breathe. The medical term for this is respiratory depression.
When the drive to breath is significantly suppressed through narcotic medication, a patient does not exhale as vigorously as they should, and they don't breathe as often or as deeply as they should. As a result, the amount of carbon dioxide in their system rises, and the amount of oxygen pumping through their arteries drops. In severe cases, these processes cause a patient to stop breathing all together, or to go into cardiac arrest.
These problems are worse with people with respiratory problems, such as COPD or sleep apnea. Patients with sleep apnea often suffer these types of breathing problems in the absence of narcotic medication. Narcotic medications only make their breathing problems worse.
For these reasons, a hospital staff must reasonably monitor patients following the administration of narcotic pain relievers. It is a nurse's obligation to keep his or her patients safe. At regular intervals following the administration of narcotic pain medications, they must ensure their patient continues to breathe regularly and deeply, and that their oxygen saturations do not drop to dangerously low levels. In cases where a patient suffers from a respiratory problem like sleep apnea, this monitoring must be even more vigilant, and it often requires a nursing staff to use constant oxygen level monitoring. The Joint Commission has issued guidelines to help ensure that patients are kept safe following the administration of pain medication.
Failure to adequately monitor a patient is medical malpractice, and can be an unnecessary cause of death.
Unfortunately, we continue to see otherwise relatively healthy Tucson patients that pass away unexpectedly following pain medication administration and negligent monitoring. Often, the investigation of these types of medical malpractice cases goes beyond review of the medical records. All hospitals must tightly control the dispensing of narcotic medications, and their release is monitored by special computer systems. The records for these systems are maintained separately and must be specifically requested. When reviewed by a toxicologist, we have been able to determine the medication caused respiratory depression that lead to death. These types of deaths are especially tragic because they are entirely avoidable with proper monitoring.