By Christina Orlovsky Page, contributor
June 11, 2013 - Capnography, a tool most commonly used in the operating room to monitor patient respiration while under anesthesia, is expanding into other patient care areas including the cardiac catheterization lab, intensive care unit and the emergency room, as well as into the field with first responders--helping everyone breathe easier about patient safety. This technology measures exhaled carbon dioxide, which can give providers early knowledge of respiratory depression and the ability to perform life-saving interventions before adverse events occur.
“Capnography provides the earliest indication of hypo- and hyperventilation, airway obstruction, and cessation of breathing in all patient types and across all care environments, allowing the clinician to intervene sooner in order to reduce and/or eliminate near misses and sentinel events,” explained Erich Faust, senior manager of global product marketing for Covidien, a Mansfield, Massachusetts-based innovator in patient monitoring systems. “To put it in simpler terms, capnography monitoring provides the only real-time, non-invasive measure of adequacy of ventilation.”
According to Faust, Oridion Microstream Capnography from Covidien also provides additional innovative and proprietary technological benefits including:
- Smart Alarm Respiratory Analysis (SARA), an alarm management technology that recognizes and reduces respiratory rate nuisance alarms while accurately reflecting the patient’s condition and preserving caregiver alarm vigilance.
- Smart Breath Detection Algorithm (BDA), which mitigates the effect of artifact, enabling quality monitoring of non-intubated general floor patients.
- Integrated Pulmonary Index (IPI), which utilizes various markers to provide an uncomplicated, inclusive assessment of a patient’s oxygenation and ventilation status, as well as an early indication of changes in a patient’s respiratory status that may not be indicated by the values of individual parameters.
Nurses, whose daily work involves monitoring patients’ vital signs, are routinely involved in the use of capnography.
“Across all areas of care where capnography is used, nurses are directly involved with managing both the patient as well as the monitoring technology,” said Faust. “Whether it is assessing the change in values or customizing the settings for each specific patient, nursing is on the front line of utilizing the capnography solution to improve patient outcomes. Nurses also assist with patient compliance and patient education about the monitor settings, alarms and sampling lines.”
At Oschner Medical Center, in Baton Rouge, La., which recently expanded its use of capnography to monitor patients using patient-controlled analgesia (PCA), nursing leadership feels a greater assurance that the hospital is taking seriously precautions recommended by The Joint Commission, the Anesthesia Patient Safety Foundation, the Institute for Healthcare Improvement, and the Institute for Safe Medication Practices with regard to the risk of respiratory distress associated with strong opioid medications. Nurses caring for patients using PCA must be extra vigilant about monitoring their respiration.
“Continuous electronic monitoring of patients provides valuable information about their condition,” said Dawn Pevey Mauk, RN, BSN, MBA, Oschner Medical Center’s chief operating officer and chief nursing officer. “The more you know about a patient’s condition, the better we are equipped to ensure their safety and provide optimal patient care.”
In 2010, the American Heart Association (AHA) adapted its guidelines for Advanced Cardiac Life Support (ACLS) and Pediatric Advanced Life Support (PALS) to include the use of capnography during CPR to confirm and monitor endotracheal tube placement, assess the quality of compressions and detect the return of spontaneous circulation. Capnography monitors are now AHA-required technology on the crash carts of hospitals that follow ACLS/PALS guidelines.
Torrance Memorial Medical Center, in Torrance, Calif., is one such hospital that referred to the AHA guidelines when recently implementing its capnography technology.
“As a Magnet facility, we knew a multidisciplinary approach to implementation would be key to our success,” said Patrick Moore, RRT, respiratory therapy clinical educator at Torrance Memorial Medical Center. “A team comprised of anesthesiologists, registered nurses and respiratory therapists worked together, devising an implementation plan. All team members were dedicated to improving patient safety and outcomes for the community we serve.”
For more information, visit the Smart Capnography Technology Center.
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