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psnet.ahrq.gov/web-mm/preventing-picc-complications-whose-line-it
October 01, 2017 - Her hospital course was complicated by sepsis, acute respiratory distress syndrome (ARDS), and multiorgan … According to the Centers for Disease Control and Prevention (CDC), "specialized 'IV teams' have shown … of total parenteral nutrition or other hyperosmolar solutions; (v) for patients with coagulopathies, respiratory … Emergency Departments
Health Care Providers
Nurse Managers
Gynecology
Infectious Diseases
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psnet.ahrq.gov/web-mm/pregnant-danger
January 12, 2011 - , the diagnostic challenges were made even greater by a relatively unusual presentation, even for a disease … Young women who do develop aortic dissection generally have a risk factor for the disease, such as Marfan … Medical complaint not related to pregnancy: >20 weeks’ gestation
If cardiac or respiratory: evaluate … resident or GYN resident on call if OB unavailable
Fetal monitoring mandatory
If not cardiac or respiratory … Pregnancy
July 29, 2020
WebM&M Cases
Acute Respiratory
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psnet.ahrq.gov/web-mm/thin-air
March 01, 2006 - A chest x-ray showed diffuse pulmonary infiltrates consistent with acute respiratory distress syndrome … The patient was intubated for type I (hypoxemic) respiratory failure, and placed on high flow oxygen. … Shortly thereafter, the respiratory therapist arrived and noticed that the patient was being treated … In this case, although errors occurred in providing supplemental oxygen, the patient's underlying disease
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psnet.ahrq.gov/web-mm/lot-pain-medications
September 23, 2020 - man was admitted to the hospital with a non-healing foot ulcer related to severe peripheral vascular disease … He also had a history of chronic obstructive disease and chronic pain. … He was found to have a respiratory rate of 5 breaths per minute. … Centers for Disease Control and Prevention. … WebM&M Cases
Fatal Patient-Controlled Analgesia (PCA) Opioid-Induced Respiratory
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psnet.ahrq.gov/issue/good-care-slow-enough-be-able-pay-attention-primary-care-time-scarcity-and-patient-safety
August 04, 2015 - Agency for Healthcare Research and Quality (AHRQ) Patient Safety Indicator for Postoperative Respiratory … Stakeholder perspectives on contributors to delayed and inaccurate diagnosis of cardiovascular disease
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psnet.ahrq.gov/webmm-case-studies
March 25, 2025 - Gastroenterology
(20)
Geriatrics
(38)
Hematology
(7)
Infectious Diseases … treatment with diuretics and antihypertensives, her condition deteriorated, leading to intubation due to respiratory … Copy URL
After drowning in a pool, a 19-month-old child arrived at the ED in respiratory … Attempts to intubate him to manage his respiratory distress were unsuccessful and he underwent emergency
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psnet.ahrq.gov/web-mm/pitfalls-diagnosing-necrotizing-fasciitis
March 24, 2021 - Later that day, the patient had progressive respiratory distress and developed septic shock. … However, physicians must also be mindful of other non-infective diseases that can mimic skin and soft … Necrotizing fasciitis (NF) is a rare disease. … have at least two.( 12 ) The majority of adults that acquire NF have at least one of the underlying diseases … Pulmonary diseases 6. Malignancy 7.
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psnet.ahrq.gov/web-mm/postpartum-woman-erroneous-sars-cov-2-test
December 23, 2020 - delivery, before being tested according to a universal inpatient screening protocol for severe acute respiratory … Centers for Disease Control and Prevention. … European Centre for Disease Prevention and Control. … The Limit of Detection Matters: The Case for Benchmarking Severe Acute Respiratory Syndrome Coronavirus … The Infectious Diseases Society of America Guidelines on the Diagnosis of COVID-19: Molecular Diagnostic
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psnet.ahrq.gov/web-mm/dangers-missing-epidural-abscess-multiple-visits-and-delayed-diagnosis-severely-negative
April 27, 2022 - presented to his primary care physician with complaints of new onset headache, photophobia, and upper respiratory … procedures. 2–4 Sources of distal infection most commonly include the skin and soft tissue, urinary tract, respiratory … Understanding risk factors, disease presentation and progression, and appropriate evaluation strategies … Localized pain may be the only presenting symptom early in the course of the disease when the prognosis … Further testing to evaluate for less common diseases or uncommon presentations of a disease is often
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psnet.ahrq.gov/curated-library/diagnostic-errors-case-studies
April 17, 2025 - After she was found two weeks later in severe respiratory distress, she was taken to another ED by paramedics … where the consulting pulmonary physician diagnosed her with a rare cystic lung disease. … evaluating spontaneous pneumothorax and educating providers to increase awareness of rare cystic lung diseases … An MRI scan of T11–S1 showed lumbar degenerative joint disease and a small L5–S1 disc herniation.
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psnet.ahrq.gov/web-mm/isolated-clot-real-error
December 01, 2013 - Case Objectives
Appreciate that errors are common in the management of venous thromboembolism disease … She was given multiple blood products and developed acute respiratory distress syndrome (ARDS) and respiratory … Take-Home Points
Errors are common in the management of venous thromboembolism disease. … Antithrombotic therapy for VTE disease: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: … Antithrombotic therapy for VTE disease: CHEST guideline and expert panel report.
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psnet.ahrq.gov/perspective/remote-patient-monitoring
March 15, 2023 - Mobile Health Technologies in Cardiopulmonary Disease. … show a very low level, but when looking at the patient, you see that the patient is fine and not in respiratory … Are there differences in managing acute versus chronic diseases? … That may be one way to think of that spectrum of managing chronic diseases to acute diseases. … Do you see that with other chronic diseases as well?
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psnet.ahrq.gov/perspective/conversation-dr-neal-sikka-and-dr-colton-hood-about-remote-patient-monitoring
March 15, 2023 - show a very low level, but when looking at the patient, you see that the patient is fine and not in respiratory … Are there differences in managing acute versus chronic diseases? … That may be one way to think of that spectrum of managing chronic diseases to acute diseases. … Do you see that with other chronic diseases as well? … Mobile Health Technologies in Cardiopulmonary Disease.
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psnet.ahrq.gov/web-mm/hidden-danger-insidious-postpartum-bleeding-after-emergency-cesarean-delivery
November 25, 2020 - showed systolic blood pressure around 90 mm Hg, mean arterial pressure (MAP) 60-70, pulse 110-120/min, respiratory … patient’s vital signs showed a blood pressure of 88/40, mean arterial pressure of 57, pulse 142/min, respiratory … an example, the MEWT system would have been triggered, based on 2 maternal triggers (pulse >110 and respiratory … (By comparison, MERC might not have triggered, because of its higher pulse threshold of 120 and respiratory … Atlanta, GA: Centers for Disease Control and Prevention; 2019. [ Free full text ]
Creanga AA.
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psnet.ahrq.gov/innovation/statewide-collaborative-support-vaginal-birth-and-reduce-unnecessary-cesarean-deliveries
July 23, 2024 - option in certain births, in others, the risks associated with the procedure, which include infant respiratory … make subsequent cesarean sections riskier. 13 Babies delivered via cesarean section are at risk for respiratory … Centers for Disease Control and Prevention. … Accessed March 3, 2022. [9] Department of Health and Human Services Office of Disease Prevention and … Accessed May 12, 2022. [23] Centers for Disease Control and Prevention.
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psnet.ahrq.gov/node/33606/psn-pdf
December 15, 2024 - Opioids are
extremely addictive, and—due to their adverse effect of respiratory depression—can be deadly … cdc-clinical-practice-guideline-prescribing-opioids-pain-united-states-2022
https://psnet.ahrq.gov/issue/opioid-prescribing-united-states-and-after-centers-disease-control-and-preventions … drug-and-opioid-involved-overdose-deaths-united-states-2013-2017
https://psnet.ahrq.gov/issue/opioid-prescribing-united-states-and-after-centers-disease-control-and-preventions
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psnet.ahrq.gov/node/49714/psn-pdf
August 21, 2014 - Later that day, the patient had progressive respiratory distress and developed septic shock. … However,
physicians must also be mindful of other non-infective diseases that can mimic skin and soft … Necrotizing fasciitis (NF) is a rare disease. … have at least two.(
12) The majority of adults that acquire NF have at least one of the underlying diseases … Pulmonary diseases
6. Malignancy
7. Use of injection drugs
Table 2.
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psnet.ahrq.gov/web-mm/pains-chronic-opioid-usage
April 04, 2018 - hypnotics may cause serious adverse effects including death.( 1,19 ) In 2012, the Centers for Disease … discontinuation of opioid therapy.( 1,19 ) Long-term opioid therapy also leads to hormonal, central nervous, respiratory … The first error was prescribing both long-acting morphine and oxycodone in a patient with comorbid respiratory … Centers for Disease Control and Prevention. … Centers for Disease Control and Prevention.
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psnet.ahrq.gov/web-mm/unexplained-apnea-under-anesthesia
December 01, 2005 - anesthetic agents themselves, as well as opiates, barbiturates, or benzodiazepines, and hypocarbia-induced respiratory … unplanned drug due to a syringe or an ampoule swap.( Table 1 ) While maintaining cardiovascular and respiratory … Alternatively, the patient may have a previously unrecognized metabolic disorder such as a neuromuscular disease … Treatment of medication-induced respiratory depression varies by cause.
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psnet.ahrq.gov/web-mm/dont-dismiss-dangerous-obstetric-hemorrhage
August 21, 2024 - Over the next few hours, the patient had progressive shock, respiratory failure from acute respiratory … The natural history of HELLP syndrome: patterns of disease progression and regression. … Cesarean Delivery
June 28, 2023
WebM&M Cases
Respiratory