QUICK REFERENCE GUIDE CAPNOGRAPHY DURING PROCEDURAL SEDATION

Transcription

1 QUICK REFERENCE GUIDE CAPNOGRAPHY DURING PROCEDURAL SEDATION

2 Changes in capnography values and waveforms may help clinicians understand a patient s level of comfort, sedation, and respiratory function during procedural sedation. Diagnosis 1 Values 1 Intervention 1 SpO2 None required, continue sedation mmhg CO2 (mmhg) seconds Diagnosis 1 Values 1 Intervention 3 Ineffective breathing pattern mmhg CO2 (mmhg) SpO2 Reassess patient and continue sedation Variable 0 Time 2

3 Hyperventilation SpO2 Reassess patient and continue sedation Hyperventilation Decreased can be a sign of anxiety, pain or and width metabolic issues 3 1 <35 mmhg 3

4 Hypopneic hypoventilation (shallow breathing) 1 <35 mmhg SpO2 Reassess patient and continue sedation Decreased SpO2 Reassess patient Decreased administration or reduce dosing Assess for airway Consider supplemental oxygen Diagnosis 1 Values 1 Intervention 1 Hypopneic hypoventilation with periodic breathing 1 <35 mmhg SpO2 Other or Decreased Apneic pauses Reassess the patient administration or reduce dosing Assess for airway Consider supplemental oxygen Time 4

5 Bradypneic hypoventilation 1 >45 mmhg SpO2 Reassess patient and continue sedation Increased and width SpO2 Reassess patient Increased and width administration or reduce dosing Assess for airway Consider supplemental oxygen 5

6 Bronchospasm SpO2 or Reassess patient, or depending on duration and severity of bronchospasms 1 <35 mmhg Other, or depending on duration and severity of bronchospasms Curved Wheezing Bronchodilator therapy administration Diagnosis 1 Values 1 Intervention 1 Partial airway Partial laryngospasm 1 SpO2 administration Other <35 mmhg or Variable Noisy breathing and/or inspiratory stridor Full airway patency restored with airway alignment Noisy breathing and stridor resolve Airway not fully patent with airway alignment Noisy breathing and stridor persist Reassess patient Establish IV access Consider supplemental O2 6

7 Apnea SpO2 or depending on duration Complete airway Complete laryngospasm 1 Other SpO2 Zero Zero Absent No chest wall movement or breath sounds or depending on duration Zero Reassess patient Use: Stimulation Bag mask ventilation Reversal agents (as appropriate) administration Airway patency restored with airway alignment present Zero Airway not Absent patent with airway alignment Other Chest wall No waveform movement and breath Positive pressure sounds ventilation present 15 seconds 7

8 1. Krauss B, Hess DR. Capnography for procedural sedation and analgesia in the emergency department. Ann Emerg Med. 2007;50(2): Epub Jan. 12, Gravenstein JS, editor. Capnography: Clinical Aspects. Cambridge University Press. 2004, MedicineNet.com. Definition of hyperventilation. script/main/art.asp?articlekey=3853. Accessed April 10, , 2018 Medtronic. All rights reserved. Medtronic, Medtronic logo and Further, Together are trademarks of Medtronic. All other brands are trademarks of a Medtronic company. 08/ PM-0104(1) [WF# ] 6135 Gunbarrel Avenue Boulder, CO medtronic.com/covidien 8