Capnography

[John]

Does your system use Capnography?

We are doing some show research and would like to hear your comments about Capnography.

Does it have a place in EMS?

Does your system have a protocols for the nonintubated patient?

Do you see Capnography coming to your system?

John Bignell

EMS Live Online Radio

http://www.emslive.com

[THE_DITCH_DOCTOR]

Yes it has it's place, both in the assessment of proper ET tube placement and in the management of head injuries.

[RichmondMedik]

it is a great tool in our toolbox-- not only for the things already listed but also for the management of medical patients that are intubated -- helps to maintain the proper ventalation rate by knowing if they need more or less O2

Paul

[THE_DITCH_DOCTOR]

O2? ETCO2 is useful as a measure of proper ventilation, not oxygenation (although severe metabolic derangements can affect ETCO2) at least it's not as useful for oxygenation assessment as clinical assessment and SpO2.

It reflects whether the patient is having CO2 washed out, which is largely separate from whether the patient is getting enough O2 (although they occur in the same way, you are looking at a reflection of something completely separate from the patient's oxygenation). A high ETCO2 can be managed by increasing the ventilatory rate or tidal volume (with or without an increase in FiO2). Likewise, a low ETCO2 can be managed by decreasing the RR or Vt with or without messing with the FiO2.

[RichmondMedik]

Your right and to get into the technical aspects of ventalations and get drawn out it probably was more beneficial to people to understand the way I wrote it --- am I misleading -- not to the uninformed because the 2 are tied into each other -- hmmmmmmm if I need to lower or raise the respiratory buffer system to maintain hemeostasis ,it also goes that the other needs to be lowered or raised

I have had FF's and EMT's when I have pointed out the CO2 wave forms and #'s not have a clue on what I was trying to achieve --and would make statements as " how can this effect CO2 if I am bagging with O2"

so all I was trying to point out is that you can us capnography for the management of medical patient and RR/TV and not just to see if the tube is placed correctly -- there are also N/C with CO2 detectors to use with the LP12-- work great with COPDers and pulmonary pt's

Paul

[THE_DITCH_DOCTOR]

Your right and to get into the technical aspects of ventalations and get drawn out it probably was more beneficial to people to understand the way I wrote it --- am I misleading -- not to the uninformed because the 2 are tied into each other -- hmmmmmmm if I need to lower or raise the respiratory buffer system to maintain hemeostasis ,it also goes that the other needs to be lowered or raised

I have had FF's and EMT's when I have pointed out the CO2 wave forms and #'s not have a clue on what I was trying to achieve --and would make statements as " how can this effect CO2 if I am bagging with O2"

so all I was trying to point out is that you can us capnography for the management of medical patient and RR/TV and not just to see if the tube is placed correctly -- there are also N/C with CO2 detectors to use with the LP12-- work great with COPDers and pulmonary pt's

Paul

You are technically correct....but it needs to be pointed out (and this goes for any medical diagnostic tool) that you shouldn't rely upon a single instrument to diagnose a particular condition. And ETCO2 would not be my first choice if I had a patient who I thought had an oxygenation issue.

[Whelson_P._Monroe]

USAF,

:oops: :roll: Perhaps too many toys and too little education is the problem? You think?

MLAR

WPM

[emtmoira]

I know what capnography is but it is definitely not used up in my neck of the woods rural VT. Maybe other parts of the state, but we don't intubate in my district so it's not used.

[tunnelrat83]

There is talk about it comming to our county... and it is closer than most times when "there is talk" cause they have a class for 12 leads and Capnography comming in may.....

[RichmondMedik]

And ETCO2 would not be my first choice if I had a patient who I thought had an oxygenation issue.

I agree wholeheartedly !! I firmly believe more education and relying on assessment is a much better tool -- I just spent last week up in Philly at the JEMS conference and one of the best seminars was with the medical directors lightning round -- the main focus was using your training and assessment tools and not all the toys that have come out -- to rely on our instincts as pre hospital care providers and an extension of the docs

Paul