Ch 15 what points on a capnographic waveform represens a misture of alveolar gas and dead space gas11/14/2023 ![]() ![]() There’s lots of good work and some debate about absolute or relative CO2 changes or qualitative waveform changes that might predict impending apnea, but for me, the best use is that I can just glance at the monitor for a second or two and see yes, the patient is breathing. ![]() If you really don’t believe it, check with good VL but a flatline = esophagus.Ģ. There is always *some* CO2 coming out if there is effective CPR if there isn’t, the tube is in the wrong place. ![]() ![]() The mistake I have seen here is assuming a lack of waveform is due to low cardiac output, ie there’s no waveform because the patient is being coded, not because of esophageal intubation. There are so many uses, it’s good to have, I don’t see why some are resistant to use this better plastic adapter connected to the monitor vs the other, worse, plastic adapter.Ī. Waveform capnography uses mass spec or IR spec to detect CO2 molecules. Further, colorimetric capnographs require persistent change over 6 breaths, not just a single change. Also, in low output states, it may not pick up. Color change is good but it’s just litmus paper and gets easily defeated by vomit. For novices, I recommend a few basic places to start:Ĭonfirmation of intubation. This is a nice review of many of the intermediate and qualitative uses of ETCO2 in the ED. Nassar & Schmidt, Capnography During Critical Illness. Capnography in the Emergency Department: A Review of Uses, Waveforms, and Limitations. Interpreting Waveform Capnography: Pearls and Pitfalls. 2019 American Heart Association Focused Update on Advanced Cardiovascular Life Support. This website provides a tutorial and quiz on some of the basic capnography waveforms. “Hey, perhaps we should buy a capnography instead of a baby monitor,” you ask your wife at dinner. Walking away from the shift, you think about how many times capnography has assisted you during those critical moments. The waveform reveals a high respiratory rate and relatively low EtCO2.Īs much as you are a little embarrassed by putting the patient into florid withdrawal, you know it could have been a lot worse. She was quite upset and hyperventilating. ![]()
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