On Saturday, August 17th, A Promise to Amanda Foundation held its first ever fundraiser and awareness campaign to commemorate 18 year-old Amanda Abbiehl, who tragically died while connected to a patient-controlled analgesia (PCA) pump. Her parents believe she would still be here with us today had there been a protocol in place that mandated CO2 monitoring of all opioid induced patients.

Amanda experienced respiratory depression and died while connected to a PCA pump. On August 17th supporters gathered to celebrate her life and to raise awareness about the dangers of PCA pumps and opioid analgesics.

Thanks to the incredible support of all those who participated and contributed, A Promise to Amanda Foundation was able to raise awareness about opioid-induced respiratory depression which can cause serious injury or death if patients are not adequately monitored.

Opioid-induced respiratory depression can occur when a patient is receiving pain medication through a PCA pump. These pumps deliver a powerful narcotic that, without adequate monitoring, can adversely affect the patient’s ability to breathe. This can lead to anoxic brain damage and even death.

The Joint Commission in its Sentinel Event Alert about safe opioid use states:

“Opioid analgesics rank among the drugs most frequently associated with adverse drug events.”

In his recent presentation at the Patient, Safety Science Technology Summit, Robert Stoelting, MD (President, Anesthesia Patient Safety Foundation) stated that more than 13 million patients each year receive PCA in the United States. Estimates of respiratory depression range from 0.16 percent to 5.2 percent, which means that between 20,800 to 676,000 PCA patients will experience opioid-induced respiratory depression. These patients are at risk of serious injury or death without adequate monitoring.

Adequate monitoring with pulse oximetry and capnography helps nurses and doctors prevent serious adverse events.

A Promise to Amanda Foundation is on a mission to make sure every hospital administrator, doctor, nurse, and respiratory therapist in the country knows about the dangers of PCA and the potential life-saving impact of continuous electronic monitoring.

As Dr. Cheryl Wibbens, Chief Medical Officer at Memorial Hospital in South Bend has stated:

“Monitoring patients for how much carbon dioxide they are breathing out with capnography provides us with the earliest possible indicator to detect the onset of opioid-induced respiratory depression.”

Memorial Hospital joins many hospitals across the country now monitoring with capnography – for some of these hospitals, please view this interactive map.

As Dr. Wibbens further explains:

“Every patient at Memorial that has opioids is a little safer now. Continuously electronically monitoring with capnography will save lives.”

Capnography saves lives. Hospitals across the country need to make it a priority to save lives.

Hospitals can do so by making a promise to Amanda that no patient on a PCA pump, under sedation, or requiring a stay in the PACU following general anesthetic or sedation goes without continuous electronic monitoring with capnography and pulse oximetry.