![]() Let’s face it, not all of our patients within the prehospital environment are NPO (without having food in their system) for greater than 12 hours. These inaccuracies may result in an inappropriate clinical diagnosis and subsequent treatment.Īssuring that your capnography sampling line connection is secure at the monitor, confirming you are not getting an occlusion or blockage message on your monitor and you are attached to the patient are three key elements to consider. In such instances, using a supraglottic airway device, or providing passive oxygenation to your patient with an inappropriate sampling device in place may provide you with false readings that aren’t caused by the patient’s condition. While many connections may look the same, different manufacturers may have slight variances in their sampling line capabilities that can alter the accuracy of the waveforms and values that are produced. Starting with proper connections, it’s imperative to make sure that your sampling devices are compatible with your receiving monitor, as this is key to providing accuracy and reliability in your measurements. ![]() So, how can we tell if the CO 2 that we’re acquiring is an accurate value? High-quality chest compressions are continued, intravenous or intraosseous access is obtained, defibrillation is performed, and an advanced airway is inserted. You arrive on the scene to find your patient in cardiac arrest. How has the patient’s decreased respiratory rate – through coaching – been able to affect their EtCO2? Or, has their deteriorating blood pressure correlated to a deteriorating EtCO2 as well? What about your nebulizer therapy, has it improved their capnograph waveform? Or, is it time to switch to CPAP therapy? By asking these questions, you’re establishing a baseline and then monitoring trends will certainly help to keep your clinical decision making on track, as well as indicate when (or if) troubleshooting may be necessary. But, if you have the ability to take a step back to obtain a “clean” set of vitals, a capnograph tracing, and a 12-lead ECG, then this will help you establish a clinical baseline for your patient’s EtCO2 value, waveform shape and respiratory rate when you arrive on-scene, compared to their vitals when you arrive at the hospital.ĭuring this timeframe, you will more clearly be able to monitor trends. By all means, if the patient needs emergent treatment or therapy, then attending to it is a must. First, Two Starting PointsĮstablishing a baseline for capnograph findings – just as you would for initial vital signs – is an important start to every clinical situation. Here are some situations where troubleshooting can be helpful, especially when your clinical diagnostics may not seem to align with your patient’s presentation. Is it the device you are monitoring with or the patient presentation? Taking all of this into consideration will help to guide you down the best path.ĭuring times where the waveforms don’t seem to cooperate, or the numbers don’t seem to add-up, you may need to take a step back to troubleshoot a little bit. The reasoning behind this is the diagnostics - the waveform, the EtCO 2 values, and the patient’s clinical presentation. Just like you would obtain a 12-lead ECG for a patient experiencing chest pain, you should equally obtain a capnograph for your patient experiencing dyspnea. ![]() Simply relying – or depending – upon the end-tidal carbon dioxide (EtCO 2) value, however, is not enough! Clinicians, we need to look at the whole picture, literally!Īcquiring a capnograph is an essential component of this equation. March 31st, 2020 CapnoAcademy Articles, Learnįollowing these capnography hacks will help set your care apartĬapnography has become a staple EMS assessment tool not just for providers who want to investigate what’s causing the patient’s symptoms, but also for those who want to resuscitate patients experiencing cardiac arrest. Learn Troubleshooting common capnography challenges: 3 tips for better results
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