Initiation of capnography in a rural EMS system.

Objective: Capnography is an effective means of monitoring cardiopulmonary resuscitation and managing endotracheal intubation. Numerous studies have validated its use in urban settings, but none have described its integration into a rural EMS system. The authors describe the process of integrating capnography training and use in Jackson County, West Virginia.

Methods: Two CO2SMOS capnography/ pulse oximeters were placed on the lead ambulances in Jackson County, West Virginia. Training in the operation and application of the equipment was provided, and providers used the monitors for a period of six months. A questionnaire was administered to assess their understanding of the equipment and its utility in prehospital care. Results were compiled and summarized.

Results: Ninety percent of the EMS providers subjectively felt that they understood capnography and its clinical application. They answered questions designed to test their understanding with 65% accuracy.

Conclusion: In this model, capnography was successfully integrated into a rural EMS system. Reasonable proficiency in the use of the CO2SMOS monitor and an understanding of the information obtained were demonstrated, although the EMS providers tended to overestimate their actual understanding of the clinical application of capnography. This supports the need for ongoing, targeted education. The authors feel that capnography provides information that is uniquely relevant in rural EMS systems.