Co2

yowzer

yowzer

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I had my first experience with cagnography yesterday.

Working on a CCT car with a nurse, and a brand new, all the bells and whistles LP12. Our patient's a guy who had a morphine pump surgically implanted a few days ago. The general consensus is that its dosage is a bit too high. On a steady narcan drip, he's alternating between being perfectly lucid and zonked out. Turn off the IV pump, and he's out within seconds. Turn it on again, and he's back awake just as fast. It was pretty impressive.

Anyways, when the morphine overpowered the narcan, he sometimes stopped breathing. Looking at the capnography display, it was easy to predict when he'd go under and hav a BVM ready to give him a few puffs of air until he started breathing again -- his CO2 output would start dropping, the waveforms deteriorate, way before his O2 saturation started dropping. When he was ventilated, you could see spikes on the monitor, and then the return to normal as he woke up again.

It was pretty nifty. I wish we had it on BLS cars, but I don't see that happening anytime soon because of the cost...
 
Cool, transfer calls are fun. Except if your pt. randomly starts tanking on you. But its good that it was an easy fix.
 
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well like mr TJ asked me, endtitle co2 isn't usually used with BVMs except for DKA and stuff..


I don't see why not though. Its nothing too fancy. Just gotta identify colours.
 
EtC02 can be used in all respiratory cases. It is a great tool for diagnostics between CHF and Obstructive diseases such as COPD & Asthma. If one uses sidestream (looks like a nasal cannula). Very true that it can be used for patients in DKA.

More and more research is revealing that "non-workable" patients can be made by EtC02 numbers by simply attaching the adapter to an BVM and bagging about 6 times (wash out Co2) and then obtaining the number. More research is being obtained, but I do look for this to be another way of field termination on codes.

The nice thing about EtC02 is it can be used on neonate to adults and there is no interference such as in seizures, etc.. the wave form will still be smooth. As well it is one of the few detectors that can be used in a possible WMD attack using gases.

I predict within 5 years, all units will have EtC02 in addition to Sp02. Actually EtC02 is more beneficial than the SP02 device.

The main difference is EtC02 monitors the respiratory system where as the Sp02 measures oxygen absorption, two distinct differences.

Yes, one have a decreased wave form for up to 4 minutes prior to Sp02 detecting it due to the time hypoxia has to occur... so, see the value of it ?

They are making new models with ranges made on them for basic levels, and from what I understand, the new basic curriculum is considering teaching it in the new program.

R/r 911
 
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I wanted it for our new monitors at the Fire Dept. but cost around 9-10k extra. So being a Volly Dept. we could not afford it. But is is great. I want it.
 
ETCO2 has been added to the vitals of the intermediates too. Skin color/condition, LOC, PEARRL, resps, pulse, temp., BP, BGL, SpO2, ECG, and ETCO2....



I don't think you can add it onto an NRB though...
 
MeaganIV said:
ETCO2 has been added to the vitals of the intermediates too. Skin color/condition, LOC, PEARRL, resps, pulse, temp., BP, BGL, SpO2, ECG, and ETCO2....



I don't think you can add it onto an NRB though...
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Disconnected cannula with an attached sensor under the mask seems to work well enough.
 
No kidding.


I only think i'd use it on an unconsciouse pt that I'm ventilating.
 
MeaganIV said:
No kidding.


I only think i'd use it on an unconsciouse pt that I'm ventilating.
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You have been trained on it but not educated on the uses of CO2 monitoring. It has alot of uses other than a play toy on some that is no longer breathing on there own. Check out Bob Page's class "Riding the Waves"
 
It is a pretty amazing piece of equipment!!! :) :) :)
 
MeaganIV said:
ETCO2 has been added to the vitals of the intermediates too. Skin color/condition, LOC, PEARRL, resps, pulse, temp., BP, BGL, SpO2, ECG, and ETCO2....



I don't think you can add it onto an NRB though...
Click to expand...

Actually, ETCO2 monitoring is available for both NRB's and NC's. I routinely use it, especially with my COPD'rs. Provides an excellant "rough guestimate" baseline of where they are and where they are potentially going!
 
that really would be...


I'm gonna have to check these gadgets out.
 
Why worry about CO2 when you can't intubate?
 
jeepmedic said:
Why worry about CO2 when you can't intubate?
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You know, we discuss things, put in our two cents and listen to what others have to say. No where in the world does it say you have to listen and be bitter about my disagreeing with you. It will happen. People disagree all the time.

Again, just because I don't like that doesn't mean that you can't do it. take it in stride. Don't be so bitter about it. It's not that big of a deal.
 
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