Capnostream™ 35 Portable Respiratory Monitor

Yes. Several published studies have shown a correlation between etCO2 and sepsis etCO2 and outcomes in asthmatic patients. The Capnostream™ 35 portable respiratory monitor was submitted to the FDA with the following data:

• End-tidal carbon dioxide has been shown to be useful as a non-invasive, pre-hospital marker for suspected shock^1,2 and sepsis³.
• Pre-hospital end-tidal carbon dioxide has been shown to differentiate between cardiac and obstructive causes of dyspnea and to correlate with outcomes in adult asthmatic patients.⁴

Yes. The Capnostream™ 35 portable respiratory monitor is intended for use in Emergency Medical Service applications, including ground and air transport. It is also intended for use in-hospital, across the continuum of care: resuscitation/crash cart, procedural suites, general care floor, emergency room, and intra-hospital transport. Because of the monitor’s design, it is not indicated for home care use.

An advisory message, BATTERY LOW, appears when approximately 30 minutes of battery time remains.

Both batteries charge when the monitoris plugged in. Charging time takes up to 5 hours when the unit is plugged in and turned off, and takes up to 8 hours when the monitor is plugged in and the unit is powered on.

The removable battery may also be charged with the battery charger accessory, available for purchase (SKU#: PM35CHG). When using the battery charger, the battery icon will show the approximate charge level. 

Yes. The monitor can be upgraded for updates as new software, algorithms, parameters, and features become available.

The Capnostream™ 35 portable respiratory monitor rugged, ergonomic design is engineered for demanding environments and challenges.

Portable design features include:

• Lightweight (2.2 lbs.)
• Internal and external battery for hot swappable battery capability

Durable and rugged design features include:

• Shockproof to 1.25 meters
• 4.3” color sunlight-readable screen with multiple display views
• Liquid and solid ingress protection (iP54)

Ease of use design features include:

• ‘EMS Mode’ — immediately initiates monitoring to eliminate additional steps
• Data storage: USB/micro SD card and/or transfer to other data systems
• 9 screen layouts with optional parameter color change
• Three levels of alarms and advisories (high priority alarms, medium priority alarms, and advisories), each defined by a set of audible and/or visual indications
• Integrated Pulmonary Index™ algorithm*, integrates four parameters (SpO2, etCO2, respiration rate and pulse rate) into a single number, offering an indication overall respiratory status on a scale of 1-10

The calibration interval for the Capnostream™ 35 portable respiratory monitor is to initially calibrate after 1,200 operating hours, then once a year or after 4,000 operating hours, whichever comes first.*

‘EMS Mode’ is the default mode for the Capnostream™ 35 portable respiratory monitor. ‘EMS Mode’ was developed specifically for emergency situations and/or resuscitation to bypass the start-up screen and immediately monitor the patient. In ‘EMS Mode,’ the Capnostream™ 35 portable respiratory monitor is immediately ready for monitoring when a CO2 sampling line and a SpO2 sensor are attached, and the monitor is powered on. The home screen appears immediately, eliminating additional steps.

IMPORTANT NOTE: In ‘EMS Mode,’ prior patient data will automatically be cleared when the monitor is powered on and begins monitoring a new patient.

To disable ‘EMS Mode’ as the default, please contact a Medtronic representative or the biomedical engineer for your institution. *

IMPORTANT NOTE: Any institutional defaults that are set while the monitor is in EMS-enabled mode will remain relevant only as long as the monitor is in ‘EMS Mode.’ When ‘EMS Mode’ is disabled, defaults will be either factory defaults or institutional defaults (if previously set).

Likewise, if changes are made to defaults while ‘EMS Mode’ is disabled on the monitor, these changes will not be relevant in ‘EMS Mode.’ If desired, an institution can maintain two sets of institutional defaults: one for ‘EMS Mode’ and one for when ‘EMS Mode’ is disabled.*

If the monitor is set to ‘Disable EMS Mode,’ every time the monitor is powered on, a message prompt to clear trend memory will be displayed. The user can press the ENTER button to continue monitoring the same patient. If a new patient will be monitored, and information regarding the previous patient should be cleared, select YES and press ENTER. 

Yes, there is an option of placing the monitor in a separate standby mode parameter for capnography and for pulse oximetry. Once ‘Parameter Standby Mode’ is enabled, it can be activated as required. The purpose of this option is so the monitor will alarm when a sampling line and/or sensor is disconnected from the monitor, while still permitting the user to turn off this option.

IMPORTANT NOTE: In factory default, ‘Parameter Standby Mode’ is disabled.

When ‘Parameter Standby Mode’ is enabled, after a sampling line (FilterLine™ sampling line) has been connected and then removed from the monitor, a medium priority alarm FILTERLINE DISCONNECTED will sound.

Likewise, after a pulse oximetry sensor/extension cable has been connected and then disconnected from the monitor, a medium priority alarm, SpO2 SENSOR DISCONNECTED will sound. The purpose of this alarm is to prevent unauthorized disconnection of a sampling line or SpO2 sensor from the monitor, perhaps by a patient or a patient’s visitor.

Yes. The monitor can be connected wirelessly via the Vital Sync™ virtual patient monitoring platform, providing the flexibility to view patient information on any web-enabled device, EMR or clinical information system. In addition, patient data can be stored on USB drive or microSD card and then transferred to other data systems.

Yes, the monitor can be connected to EMR via the Vital Sync™ virtual patient monitoring platform.

IMPORTANT NOTE: EMR systems vary and customers should work directly with the EMR provider to determine connectivity requirements.

The monitor can export stored and current data to external devices, such as USB flash drives and microSD cards. Steps to download data are as follows:

1. Click the ‘Menu’ button on the front panel of the monitor
2. Select ‘Report’ on the Menu screen
3. Select ‘Store Report’ on the ‘Report Menu’ screen
4. Select the report you want to store
5. Choose the device on which you want to store the report
6. Select ‘Save Report’ and then insert external drive
7. Press ‘Next’to export the required data

The Capnostream™ 35 portable respiratory monitor has a patient ID feature that enables the user to admit a new patient and avoid confusion

Yes. You will need to use date and time on the trend data to determine appropriate patient identification.

Trends are automatically stored. The monitor stores the previous 48 hours of monitored data regardless of whether there is a period of time during which the monitor is turned off. Data is saved once per second, and real-time, continuous CO2 waveform data is saved 20 times a second.

Trend data is displayed in two different formats — graphical and tabular. The ‘Graphical Trend’ screen displays patient data over a longer time scale (1, 2, 4, 8, or 12 hours at a time), giving you the option to scroll through the data for patterns, specific events or alarms. The ‘Tabular Trend’ screen displays 1 sec, 5 sec, 15 sec, 30 sec, 1 min, 5 min, 15 min, 30 min, and 1 hour, offering you greater detail of patient respiratory status.*

The monitor provides the opportunity to view or store various reports. Included are ventilation, desaturation, alarm review, case, and trend reports.*

Smart alarm features are always activated on the Capnostream™ 35 portable respiratory monitor. These include:

• Smart Alarm for Respiratory Analysis™ algorithm (SARA) is an embedded capnography alarm management technology, engineered to help reduce clinically insignificant alarms. Functioning in combination with the Smart Breath Detection™ algorithm (SBD), SARA is dynamically adjusts respiratory rate averaging during periods of breath-to-breath cycle variability.
• SBD is a proprietary filter and pattern recognition algorithm that screens out low amplitude “non-breath” etCO2 excursions, helping to reduce the frequency of clinically insignificant respiratory rate alarms due to a patient snoring, talking or crying.
• Nellcor™ SatSeconds alarm management technology is designed to monitor both the degree and duration of desaturation as an index of desaturation severity. This may help distinguish significant clinical events from minor events and brief desaturations. This feature can be programmed for each patient. 

Explain that the medication they will be given can make their breathing slow or shallow. Explain that a capnography monitor will alert clinicians to small changes in breathing before any problems can occur. Because the patient may be sedated, it is also important to educate family or friends who are present.

Let your patients and their family members know that alarms alert clinicians to a change in breathing. Explain that alarms can serve as a reminder to the patient to take a few deep breaths if they are awake.

Routine post-surgical activity, like sipping water or eating ice chips, does not interfere with monitoring.

Generally, patients will be monitored until the physician believes there is no longer a risk of slow or shallow breathing. This period depends on the type and duration of medication prescribed, as well as the patient’s response to the medication.