Helpful Definitions

Cannula

Mask or senor that sits over the patient’s mouth and/or nose used to pick up co2 concentration and transmit it to a monitoring device for analysis.

Capnography

Non-invasive method for monitoring the level of carbon dioxide (CO2) in exhaled breath (etCO2) to assess a patients ventilatory status. Capnography is a very effective way to catch respiratory depression which may occur during PCA infusions.

COPD

Chronic obstructive pulmonary disease (COPD) is one of the most common lung diseases. It makes it difficult to breathe and these patients are also more susceptible to respiratory depression during narcotics administration.

etCO2 / end tidal CO2

etCO2 is the partial pressure or maximal concentration of carbon dioxide (CO2) at the end of an exhaled breath, which is expressed as a percentage of CO2 or mmHg.

Hypercapnia/ Hypercarbia

Excessive carbon dioxide in the bloodstream, typically caused by inadequate respiration

Narcotic/Opioid Naive Patient

Patients who have not previously received opioid drugs and now, due often to trauma or surgery, receive regular daily doses of opioids. The reaction of these patients to opiods is unknown so monitoring is critical in catching cases where a patient may show an adverse reaction.

Neuraxial Opioid Administration/ Epidural

The term epidural is often short for epidural analgesia, a form of regional analgesia involving injection of drugs through a catheter placed into the epidural space. The injection can cause both a loss of sensation (anaesthesia) and a loss of pain (analgesia), by blocking the transmission of signals through nerves in or near the spinal cord. The epidural space is the space inside the bony spinal canal.

Opiate Toxicity

An instance where a patient has overdoses on an opioid drug. Overdosing on an opioid puts the patient at great risk for respiratory depression.

Opioid

An opioid is a psychoactive chemical that works by binding to opioid receptors, which are found principally in the central and peripheral nervous system and the gastrointestinal tract. Opioid based medications like Morphine are used to relieve pain in instances like surgery, cancer, or other conditions where pain is present.

PCA

Patient Controlled Analgesic – In a hospital setting, a PCA refers to an electronically controlled infusion pump that delivers an amount of intravenous analgesic (usually an opioid /narcotic) that is set by the patient. PCA can be used for both acute and chronic pain patients. It is commonly used for post-operative pain management, and for end-stage cancer patients

PCA infusions can also be set by clinicians so the pump continuously provides the patient with narcotics or a combination of patient administered and continuous infusions can be ordered.

PCA by Proxy

Activation of a PCA infusion pump by someone other than the patient or clinician. An example is a family member of a patient using the patients PCA administration button to provide more drug in hopes of alleviating pain. This is an extremely dangerous situation in that the patient or clinical is not actively involved in administering narcotics.

Post Operative

Patients who have come out of surgery and are recovering. These patients are the mostly likely to be on an opioid via a PCA device for pain management.

Pulse Oximetry

A non-invasive method allowing the monitoring of a patient’s oxygenation levels. Pulse oximetry can be measured by a simply sensor place over the patient’s finger.

Respiratory Depression/Hypoventilation

Hypoventilation (also known as respiratory depression) occurs when ventilation is inadequate (hypo means below) to perform needed gas exchange. By definition it causes an increased concentration of carbon dioxide and respiratory acidosis.

Respiratory Rate

The rate at which a one takes breathes. In a medical setting, respiratory rate is measured by the minute. The healthy range for adults is between 12-18 breaths per minute.

Sentinel Events

A sentinel event is an unexpected occurrence involving death or serious physical or psychological injury, or the risk thereof. Drug administration errors are one type of sentinel event and can also be referred to as adverse drug events.

Sleep Apnea

A sleep disorder characterized by abnormal pauses in breathing or instances of abnormally low breathing, during sleep. Each pause in breathing, called an apnea, can last from a few seconds to minutes, and may occur 5 to 30 times or more an hour. Patients with sleep apnea are at higher risk for respiratory depression during narcotic administration.

Smart Pumps

Infusion-related medication errors expose patients to a high risk of harm. Smart infusion pumps with dose-checking technology are available to help avert these potentially harmful errors. The role of the smart pump is to remember the large number of rules (hospital-defined dosing limits and other clinical advisories) entered into the drug library, and to apply those rules during pump programming to warn clinicians about unsafe drug therapy.

Ventilation

In respiratory physiology, ventilation is the rate at which gas enters or leaves the lung.

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