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Medtronic / Clinical Solutions / Procedural Sedation Outside the Operating Room / Capnography

Staying vigilant with continuous monitoring

Sedation is a continuum.([FOOTNOTE=American Society of Anesthesiologists. Continuum of Depth of Sedation: Definition of General Anesthesia and Levels of Sedation/Analgesia. 2016.  Accessed March 8, 2017. View Abstract],[ANCHOR=],[LINK=]) A patient can move into deeper levels of sedation than intended by the clinician.([FOOTNOTE=Patel S, Vargo JJ, Khandwala F, Lopez R, Trolli P, Dumot JA, et al. Deep sedation occurs frequently during elective endoscopy with meperidine and midazolam. Am J Gastroenterol. 2005;100:2689–2695.],[ANCHOR=],[LINK=]) Respiratory compromise may be the result.

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EARLY RECOGNITION. EARLY INTERVENTION.

Addition of capnography to procedural sedation monitoring outside the OR may help clinicians rapidly identify and respond to respiratory events, potentially reducing the incidence of apnea, desaturation, respiratory depression, hypoxia, and respiratory failure.([FOOTNOTE=Long M, Green K, Bland E, et al. Capnography monitoring during procedural sedation in radiology and imaging settings: an integrative review. J Radiol Nurs. 2016;35:191-197.],[ANCHOR=],[LINK=])

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60 Seconds

Additional warning time for respiratory distress([FOOTNOTE=Deitch K, Miner J, Chudnofsky CR, et al. Does end tidal CO2 monitoring during emergency department procedural sedation and analgesia with propofol decrease the incidence of hypoxic events? A randomized, controlled trial. Ann Emerg Med. 2010;55(3):258-264.],[ANCHOR=],[LINK=])

47% reduction

In mortality([FOOTNOTE=Jopling MW, Qiu J. Capnography reduces the risk of adverse outcomes during gastrointestinal endoscopic procedures with sedation administration. In: Society for Technology in Anesthesia 2016 Annual Meeting Syllabus; January 6-9, 2016; Palm Beach, FL. Abstract 25. Accessed May 23, 2016. ],[ANCHOR=Vew Abstract],[LINK=https://www.stahq.org/userfiles/files/25_Abstract_Jopling%28217%29.pdf])

17.6 times

More likely to detect respiratory depression([FOOTNOTE=Godwin SA, Burton JH, Gerardo CJ, et al; American College of Emergency Physicians. Clinical policy: procedural sedation and analgesia in the emergency department. Ann Emerg Med. 2014;63(2):247-258.e18.],[ANCHOR=],[LINK=])

17% reduction

In hypoxic events4

AVOIDING COSTS WITH CAPNOGRAPHY

A cost-avoidance model and study examined the financial impact of adding routine capnography to GI endoscopy procedures.

Based on the rates and costs of adverse events, the investigators concluded that the cost avoidance for the reference hospital was more than $300,000 annually.

Interventional Radiology

Cardiac Cath Lab

Emergency Department

A complete view of ventilation adequacy

Capnostream™ 20p Bedside Patient Monitor

The Capnostream™ 20p patient monitor with Microstream™ technology offers a complete measure of a patient's oxygenation and ventilation status.

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Certainty with every breath

Capnostream™ 35 Portable Respiratory Monitor

This integrated monitor combines Microstream™ capnography and Nellcor™ pulse oximetry technologies with algorithms and data management to give a complete picture of respiratory status. Get certainty and versatility in monitoring with the ability to see respiratory status in a single number, track recurring apnea events, and view patient data wirelessly.

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Quality breath samples

Microstream™ Capnography Sampling Lines

A key to obtaining an accurate etCO2 measurement and quality waveforms is the sampling line. These sampling lines employ unique Uni-junction™ technology to ensure undiluted breath samples are taken from the predominant pathway of exhalation, whether nasal or oral or both.

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Unique Patients. Unique Sedations.

Capnography Monitoring Can Help.

Resources

Access valuable resources to help educate sedation providers outside the OR on safe and adequate sedation.

  • 7. Jopling MW, Kofol T, Heard L. Evaluating the cost-effectiveness of capnography monitoring in procedural sedation: a gastroenterology (GI) suite cost-avoidance model. Gastrointest Endosc. 2015;81(5 suppl):AB193.

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