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Capnography. Taken from Zoll Medical Corp pamphlet on Capnography. Odorless, colorless gas Gives carbonated drinks their fizz Used to extinguish fires Created as a byproduct of cellular metabolism. Co2. Produced in our tissues Diffuses into our venous blood
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Capnography Taken from Zoll Medical Corp pamphlet on Capnography
Odorless, colorless gas • Gives carbonated drinks their fizz • Used to extinguish fires • Created as a byproduct of cellular metabolism Co2
Produced in our tissues • Diffuses into our venous blood • Travels through the right side of the heart • Eventually reaches the lungs where it is exchanged for oxygen Once Metabolized
Co2 levels peak at the end of exhalation • This is when it is at maximum concentration • Can be measured quickly and noninvasively with Capnography End Tidal Co2
Capnography uses infrared technology to provide a continuous waveform called a capnogram • It also provides a digital readout of Exhaled Co2 How it works
Pulse Ox • Measures oxygen saturation levels • 30-60 second delay in detecting deterioration • Can be affected by temperature and carbon monoxide • Capnography • Reflects actual ventilations • Changes are seen rapidly and in as little as a half second *the 2 should always be used together Why not just a pulse ox?
Although Capnography is the gold standard for intubated patients, it is also good for: • Conscious sedations • Patients with acute respiratory events Not just for intubation
A reading between 35-45 mmHg is generally considered normal • Levels greater than 45 indicate respiratory acidosis which may be due to inadequate ventilations or over sedation • Levels less than 35 signal respiratory alkalosis typically caused by hyperventilation What is normal?
Can verify placement of the ET tube • Can provide feedback regarding ventilations • Can indicate adequate or inadequate perfusion The intubated patient
Can be an early indicator of bronchospasms in Asthma patients, COPD exacerbations or Anaphylaxis • Can indicate hypoventilation from chronic heart failure, drug intoxication, respiratory failure or circulatory compromise The Non-Intubated Patient
2011 Zoll Medical Corporation • Capnography in Resuscitation: Peaks, Valleys, And Trends-Do They Signal the End? • Mike Chumpner, BS MBA, CHF, NREMT-P Reference