Respiratory Compromise is a gradual, subtle imbalance in patient response that occurs prior to the onset of respiratory failure and arrest. Respiratory Compromise symptoms manifest differently in each patient. Identification of high-risk patients for Respiratory Compromise and the symptoms associated with this condition are critical to allow for early recognition, intervention and treatment. Appropriate preoperative, intraoperative and postoperative monitoring and therapeutic strategies are necessary for early recognition, intervention and treatment. Below are stories of patients who have lost their lives to Respiratory Compromise.
John underwent two procedures for a shoulder injury in 2007 – the first, a same-day procedure, left him groggy, nauseated and dizzy from the anesthesia due to intolerance to the opioids administered to him. The second cost him his life. Johns wife, Patricia, shared his story to ensure that others would know what she wished she had known at the time: that patients receiving opioids after surgery – especially those with sleep apnea – are at very real risk of fatal respiratory compromise.
In 2002, 11-year-old Leah Coufal underwent elective surgery to correct her pectus carinatum. Her mother, Lenore, who was told by her doctors that the procedure had gone well, expressed concern when she noticed her daughter was not hooked up to a patient monitor. Moreover, Leah complained of being in severe pain despite receiving epidural anesthesia. The attending medical staff reassured her that her daughter would be up and walking by the next day. After falling asleep briefly, Lenore awoke to find Leah dead in bed. In response to her daughter’s unfortunate and preventable death, Lenore started Leah’s Legacy: a nonprofit with the aim of eliminating preventable deaths from medical error through education, advocacy and improved patient monitoring.
Seventeen-year-old Logan died after undergoing routine surgery to have his tonsils and uvula removed to correct his sleep apnea. His mother, Pamela Parker, a recovery room nurse herself, was deeply shaken by the experience of losing her son. In response, she wrote six nursing lessons with the goal of educating healthcare providers so future patients may be properly monitored and cared for in hospital settings that may lend themselves to respiratory compromise.
In 1990, Matt Whitman was a state trooper when his squad car was struck by a drunk driver. Through six months of physical therapy he recovered, but still suffered from severe neck pain. In January of 2003, he was told by a neurosurgeon that his neck needed to be operated on. The night after his surgery, a passing nurse noticed that he was not breathing. The next thing Matt remembered was feeling jolted back to consciousness, and seeing bright lights and doctors bent over him. Matt had overcome a Code Blue respiratory event, something only 4 percent of patients survive. Matt was not electronically monitored, and, had that nurse not happened to stop by and check on him, Matt would have died. In his story, he urges all hospitals to monitor all patients electronically, not just patients at high risk.
At the age of 63, just nine months away from retiring from his 40-year-long career, Robert Goode died after undergoing a procedure to treat a hiatal hernia. Robert was not monitored electronically, despite his history of sleep apnea. His daughter, Malinda Loflin, a registered nurse for 22 years, shared his story stressing the importance of continuous electronic patient monitoring.