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Anesthesia Monitoring and Management
Published in Michele Barletta, Jane Quandt, Rachel Reed, Equine Anesthesia and Pain Management, 2023
The capnograph is a non-invasive device with an adaptor that connects between the endotracheal tube and the Y-piece, or samples directly from the endotracheal tube. Sidestream sampling: exhaled gas is aspirated from the adapter between the endotracheal tube and the Y-piece and delivered to the capnometer (Figure 7.13).Mainstream sampling: the measuring device itself is placed between the endotracheal tube and the Y-piece (Figure 7.14).
Retrieval and transport
Published in Ian Greaves, Keith Porter, Chris Wright, Trauma Care Pre-Hospital Manual, 2018
Ian Greaves, Keith Porter, Chris Wright
It is advisable to carry backup equipment to deal with equipment failure. A monitor can be replaced by a pulse oximeter and a portable capnometer device such as the EMMA™ (Figure 24.1). These two small pieces of equipment can provide measurements of heart rate, oxygen saturation, respiratory rate and end tidal CO2. A bag valve mask can replace the work of a non-functioning ventilator.
Sleep research recording methods
Published in Philip N. Murphy, The Routledge International Handbook of Psychobiology, 2018
The pediatric respiratory montage also includes capnometry (cannula for exhaled carbon) to capture end-tidal expiration dysfunction unique to children. Note that home-based clinical polysomnography is not currently used, due in part to the risk of entanglement during an unattended study, though some innovative investigators have been successful using attended nap polysomnography in children’s homes (Gribbin, Watamura, Cairns, Harsh, & Lebourgeois, 2012).
Characteristics and feasibility of ambulatory respiratory assessment of paediatric neuromuscular disease: an observational retrospective study
Published in International Journal of Neuroscience, 2023
Cheng Zhang, Cui-jie Wei, Zhe Jin, Jing Ma, Yan-e Shen, Qing Yu, Yan-bin Fan, Hui Xiong, Cheng-li Que
NMD progression leads to respiratory muscle weakness. Timely provision of non-invasive ventilation (NIV) is important to improve the survival and quality of life of the affected children [10, 11]. Although there is a lack of validated and uniform criteria [12], generally speaking, hypercapnia hypoventilation during sleep stage is an important indicator for initiation of NIV. For example, peak nocturnal transcutaneous carbon dioxide (TcCO2) ≥49 mmHg should be considered as a criterion to start home mechanical ventilation (HMV) in patients with NMDs, who have symptoms of hypoventilation, daytime hypercapnia, abnormal nocturnal oximetry results, and a diminished forced vital capacity [13]. Therefore, carbon dioxide (CO2) monitoring (nocturnal capnometry) is also an important aspect of respiratory assessment in NMDs. However, limited availability of equipment and expansive disposable consumables made TcCO2 impractical, especially in developing countries and underdeveloped regions. SDB have a gradual progression in NMD children and can broadly include SDB at its onset, nocturnal hypoventilation, and diurnal respiratory failure [14].
Prehospital Cardiac Arrest Airway Management: An NAEMSP Position Statement and Resource Document
Published in Prehospital Emergency Care, 2022
Jestin N. Carlson, M. Riccardo Colella, Mohamud R. Daya, Valerie J. De Maio, Philip Nawrocki, Dhimitri A. Nikolla, Nichole Bosson
The monitoring of the flow of carbon dioxide through the airway has many potential applications in cardiac arrest patients. More than just a measure of ventilatory status or alveolar gas-exchange at the lungs, end-tidal carbon dioxide (ETCO2) correlates with cardiac output and provides an indication of tissue perfusion, including both pulmonary and cerebral perfusion (81). In addition to ETCO2 level (capnometry), continuous wave-form capnography may guide resuscitation, specifically for the continuous assessment of advanced airway placement, ventilation and compressions quality, and for the detection of ROSC or re-arrest. EMS clinicians should be aware that ETCO2 can be influenced by many factors, such as compressions (82), ventilations (83), etiology of arrest, medications administered (84), and acid contaminants in the airway (e.g., gastric contents) (85), making it challenging to interpret isolated values without incorporating other information and trends. Colorimetric devices are inferior given that they are limited in use to initial confirmation of advanced airway placement and cannot provide continuous monitoring required to guide resuscitation and ventilations.
Prehospital Supraglottic Airways: An NAEMSP Position Statement and Resource Document
Published in Prehospital Emergency Care, 2022
John W. Lyng, Kimberly T. Baldino, Darren Braude, Christie Fritz, Juan A. March, Timothy D. Peterson, Allen Yee
While recommended by some experts, colorimetric end-tidal carbon dioxide detection is unreliable for confirming SGA placement. First, it is possible to qualitatively detect enough residual carbon dioxide through an SGA to result in a “positive” colorimetric result even when the position of the device is suboptimal. Second, colorimetric EtCO2 devices can give false-positive results in some settings and are not reliable if they become contaminated with liquids (48–50). Therefore, qualitative colorimetric EtCO2 detection should not be used in isolation to assess the proper position and function of an SGA on either an initial or ongoing basis. The use of devices that provide continuous quantitative capnometry may help avoid these pitfalls of colorimetric devices, though there are no focused studies on use of such technology by BLS clinicians.