Capnography
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96 Minutes Without a Heartbeat
A little-known device is shaking conventional wisdom for reviving people who suffer sudden cardiac arrest: People may be able to go much longer without a pulse than the 20 minutes previously believed.
The capnograph, which measures carbon dioxide being expelled from the mouth of the patient, can tell rescuers when further efforts at cardiopulmonary resuscitation, or CPR, are futile or whether they should be continued. It is the latest effort that cardiology experts and emergency teams are devising that aim to improve a patient's odds.
The American Heart Association recently revised its guidelines for first responders, with particular emphasis on initiating hard, rapid chest…
Resources
Reversible Causes of Low ETCO2
If the EtCO2 is low early in cardiac arrest, look for a reversible cause...
Why Capnography is Replacing Pulse Oximetry
Factors like high incidence of respiratory failure in pediatric patients and pulse oximeter limitations have led to the increased use of capnography throughout the world. Major regulatory bodies are endorsing the use of capnography, causing the global capnography market to expand rapidly.
Be All End-Tidal: The Expanding Role of Capnography in Prehospital Care
Similar to the role of pulse oximetry in guiding the prehospital provider through both management decisions and differential diagnosis, end-tidal capnography can provide invaluable physiologic information that can be used to enhance prehospital patient care in both intubated and non-intubated patients.
Capnography and CO2 Detectors
Normally ETCO2 is up to 5 mmHg/0.7kPa lower than PaCO2 as some alveolar dead space is always present. Test quantitative devices by blowing on them and seeing am ETCO2 trace before placing in the patient circuit
Capnography in Cardiac Arrest
The presence of capnograph CO2 trace in cardiac arrest tells us the endotracheal tube is in the right place. It tells us the cells´metabolism to some extent is working. It tells us the circulation to some extent transports CO2 to the lungs where it to some extent is eliminated. It indirectly give us an idea of the quality of the life support we provide.
Capnography The Future
Sedation is a major practice growth area as new procedures are developed.
Even the dead exhale CO2
Cardiac arrest patients sometimes have unrecognised oesophageal intubations because clinicians omit capnography, based on the assumption that circulatory arrest leads to an absence of exhaled CO2. This is wrong, and reassuringly the latest ILCOR cardiac arrest guidelines recommend waveform capnography during resuscitation.
How capnograph monitors work explained simply.
The capnograph is able to measure the expelled CO2. This is an extremely useful measurement as it can help detect problems along the pathway taken by the CO2. For an example, if the patient stops breathing (e.g. due to morphine) , CO2 will not be able to “get out “. This problem will make the capnograph show a low CO2 reading and trigger an alarm that alerts medical staff to the problem.
So much hot gas – ETCO2 for non-anaesthetists
It is my belief that ETCO2 should be used not just in intubated patients, but as a valuable adjunct for procedural sedation, for monitoring patients ‘at risk’ and to help guide resuscitation.
The Revolution in EMS Care
Thanks to new technology, new life-saving techniques and new missions, ambulance crews are far from the ‘horizontal taxicabs’ they once were.
What Is the Utility of End-Tidal Capnography for Procedural Sedation and Analgesia in the Emergency Department?
The addition of capnography to standard monitoring in emergency department (ED) procedural sedation and analgesia does not appear to reduce the rate of clinically significant adverse events.
96 Minutes Without a Heartbeat
The capnograph, which measures carbon dioxide being expelled from the mouth of the patient, can tell rescuers when further efforts at cardiopulmonary resuscitation, or CPR, are futile or whether they should be continued. It is the latest effort that cardiology experts and emergency teams are devising that aim to improve a patient's odds.
5 things to know about capnography
Waveform capnography can now be used at all provider levels to better assess patients in respiratory distress, cardiac arrest and shock. Capnography offers reliable feedback about the severity of a patient’s condition and how they respond to treatment. Here are five things you should know about waveform capnography.
Capnography
Capnography is synonymous with patient safety during anesthesia and sedation, and a boon during CPR. Since the introduction of the first infrared CO2 measuring and recording apparatus by Luft in 1943, capnography has evolved into an essential component of standard anesthesia monitoring armamentarium.
Jeremy Jaramillo's Blog
Capnography (end-tidal CO2 monitoring) is a non-invasive measurement of carbon dioxide in exhaled air to assess a patients’ ventilatory status. It may also be referred to as partial pressure end tidal carbon dioxide monitoring (PETCO2).
Sedation Resource
It’s important to know if your patient—sedated or not—is adequately ventilating. But as you know, at a certain level of sedation, the natural drive to breathe can be inhibited. So it’s critical to pay close attention to a patient’s breathing when he/she is sedated.
WikEM
Capnography measures the amount of exhaled CO2. ETCO2 of 35-45mmHg is considered normal <35mmHg = Hypocapnia or Hyperventilation. >45mmHg = Hypercapnia or Hypoventilation. Directly measure the function of ventilation (not oxygenation) ETCO2 ≥ PCO2. Indirectly measures overall metabolism (or lack there of in cardiac arrest).
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