EtCO2 in acute resp events

[mobey]

SpO2 is a great tool when one knows the limitations. That has been discussed greatly on these boards.

I am wondering if anyone uses capnography waveforms and EtCO2 values when treating exacurbations of such conditions as Asthma, CHF, Emphasema, etc....

I am not talking about intubated pt's here.... I mean the nasal cannula style detectors.

Please withold the statements about treating the Pt not the monitor, and whether I am able to assess without a machine.

[Arctickat]

I use it every chance I get, it's a useful tool. By using technology it allows one to be comfortable and proficient in its use. The waveform on etCO2 provides the opportunity to evaluate changes in the condition of the patient that may not be immediately apparent. In addition, when one interprets the wave forms properly, identification of the exact cause of the respiratory distress can be determined more accurately and a more appropriate treatment can be provided.

[funkytomtom]

I use it every chance I get, it's a useful tool. By using technology it allows one to be comfortable and proficient in its use. The waveform on etCO2 provides the opportunity to evaluate changes in the condition of the patient that may not be immediately apparent. In addition, when one interprets the wave forms properly, identification of the exact cause of the respiratory distress can be determined more accurately and a more appropriate treatment can be provided.

We use it as well in just such a manner.

[HellsBells]

Hey Mobey, how are ya?

I'm curious, are you aware of any services in Alberta that use ETC02 in non-intubated pts?

[p3medic]

I use it on all acute respiratory patients, its a great tool.

[chbare]

This may sound like nit picking; however, it is important we use proper terminology because different concepts apply in this situation. EtCO2 is a form of capnometry. Capnometry is simply a number. This number is obtained at the peak/end of the expiratory plateau. Hence, the term "end tidal." When we monitor and appreciate a waveform, this is known as waveform capnography or simply capnography. Many devices combine these concepts; however, some are stand alone. Therefore, capnometry is simply looking at a number. While trending this number and applying it to our overall assessment of the patient can be helpful, I assume people are also talking about monitoring for waveform changes.

For the sake of people who do not know, perhaps we could discuss the normal waveform plateau and abnormal findings such as shark fin patterns, then associate these patterns with conditions?

Take care,

chbare.

[CBEMT]

I have to pick and choose when to use it, because chances are I won't be able to get anymore than the two I have on the truck for a while (long story).

Also, most if not all of my respiratory patients seem to need NRBs, and we don't have the ones that will hook up to the ETCO2. I've used the ETCO2 nasal cannula underneath the NRB with mixed results. I wasn't sure if I could trust the reading, since I was putting more O2 near the sensor than would be there otherwise.

Edited November 27, 2009 by CBEMT

[Arctickat]

I've been told by physio control that application of high flow O2 via a NRB over the nasal sensor would not result in inaccurate readings.

www.capnography.com has great info.

[mobey]

Hey Mobey, how are ya?

I'm curious, are you aware of any services in Alberta that use ETC02 in non-intubated pts?

Just the one I work at......

Well I do!!

I may be a trend-setter I suppose

[kohlerrf]

Entidal C02 and waveform capnography is a must use tool for any pat in respiratory distress. There are volumes written about this and I suggest every medic bone up on it. we all lknow the limitations of ETCO2 especially in trauma but knowing knowing that its still usfull in trauma. To take it to the next step and to more fully evaluate the respiratory system we use pulsox in conjunction with capnography and interprete the figure together