Background: Multiple studies illustrate the benefits of waveform capnography in the nonintubated patient. This type of monitoring is routinely used by anesthesia providers to recognize ventilation issues. Its role in the administration of deep sedation is well defined. Prehospital providers embrace the ease and benefit of monitoring capnography. Currently, few community-based emergency physicians utilize capnography with the nonintubated patient.

Objective: This article will identify clinical areas where monitoring end-tidal carbon dioxide is beneficial to the emergency provider and patient.

Discussion: Capnography provides real-time data to aid in the diagnosis and patient monitoring for patient states beyond procedural sedation and bronchospasm. Capnographic changes provide valuable information in such processes as diabetic ketoacidosis, seizures, pulmonary embolism, and malignant hyperthermia.

Conclusions: Capnography is a quick, low-cost method of enhancing patient safety with the potential to improve the clinician's diagnostic power.

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http://dx.doi.org/10.1016/j.jemermed.2013.05.012DOI Listing

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Article Synopsis
  • This study investigates the effectiveness of measuring end tidal carbon dioxide (ETCO) in predicting mortality among trauma patients before they reach the hospital, using a nasal capnography cannula (NCC) or in-line ventilator circuit (ILVC).
  • Researchers collected ETCO data alongside other indicators like systolic blood pressure (SBP) and shock index (SI) from 550 trauma patients, finding that lower ETCO values were a better predictor of mortality compared to SBP and SI.
  • The results suggest that prehospital ETCO measurements can significantly aid in assessing the risk of mortality for injured patients, indicating their potential use in emergency medical settings.
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Respiratory monitoring of nonintubated patients in nonoperating room settings: old and new technologies.

Curr Opin Anaesthesiol

August 2022

Department of Anesthesiology, Section on Critical Care Medicine, Wake Forest School of Medicine, Atrium Health Wake Forest Baptist Medical Center, Winston-Salem, North Carolina.

Purpose Of Review: Postoperative mortality in the 30 days after surgery remains disturbingly high. Inadequate, intermittent and incomplete monitoring of vital signs in the nonoperating room environment is common practice. The rise of nonoperating room anaesthesia and sedation outside the operating room has highlighted the need to develop new and robust methods of portable continuous respiratory monitoring.

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Background: Several studies have suggested that elderly patients, as well as younger patients, can be safely treated using endoscopic retrograde cholangiopancreatography (ERCP). However, endoscopic ultrasound-guided biliary drainage (EUS-BD) has not been clinically evaluated for very elderly patients. The present multicenter, retrospective study aimed to determine the safety of EUS-BD for advanced elderly patients.

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Purpose: The objective of this review was to evaluate the effectiveness of capnography monitoring versus standard monitoring of pulse oximetry in detecting respiratory adverse events in nonintubated pediatric and adult postanesthesia care unit (PACU) patients.

Design: Experimental, quasi-experimental, and observational studies examining pulse oximetry and capnography in adult and pediatric patients in the PACU were included in this systematic review.

Methods: An initial search of MEDLINE and CINAHL, PubMed, Web of Science, Prospero, Google Scholar, and Cochrane was undertaken to identify articles on the topic.

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