Capnography

 

Clinical Indications:

 

  • Capnography shall be used when available with the use of all invasive airway procedures including endotracheal, nasotracheal, cricothyrotomy, or blind insertion airway devices (BIAD).
  • Capnography should also be used when possible with CPAP and when administering narcotics and/or sedatives.

 

Procedure:

 

  1. Select the appropriate EtCO2 accessory for the patient.
  2. Open the CO2 port door and insert the FilterLine connector; turn connector clockwise until tight.
  3. Verify that the CO2 area is displayed.
  4. Using the speed dial, select waveform in either channel 2 or 3 or select capnography after pressing the LEAD button.
  5. Connect the CO2 FilterLine set to the patient via BIAD, endotracheal tube, or oxygen delivery device.
  6. Confirm that the EtCO2 value and waveform are displayed. The monitor automatically selects the scale for the best visualization of the waveform. You can change the scale, if desired, using the speed dial knob.
  7. A CO2 waveform appears when any CO2 is detected, but CO2 must be greater than 3.5 mmHg for a numerical value to be displayed. However, the CO2 module will not recognize a breath until the CO2 is at least 8 mmHg.
  8. Note CO2 level and waveform changes on each respiratory failure, cardiac arrest, or respiratory distress patient.
  9. The capnometer shall remain in place with the airway and be monitored throughout prehospital care.
  10. Loss of CO2 detection or waveform usually indicates an airway problem and should be documented.
  11. Document the procedure and results on/with the patient care report (PCR) and the airway evaluation form.

 

Certification Requirements:

 

  • Maintain knowledge of the indications, contraindications technique, and possible complications of the procedure.  Assessment of this knowledge may be accomplished via quality assurance mechanisms, classroom demonstrations, skills stations or other mechanisms as deemed appropriate by medical control.