The document discusses capnography monitoring, outlining clinical assessment considerations related to respiratory rates (RR) and end-tidal CO2 (ETCO2) levels, including interpretation of alarms. It emphasizes the importance of monitoring trends and intervening appropriately to ensure effective ventilation and CO2 removal. Key steps for patient monitoring are provided, including educating the patient and family, establishing baselines, and analyzing waveform data.

1. Capnography Monitoring
By:
Ahmad Amirdash
MS, APRN, AG-ACNP-BC, CCRN, BBA
You are Welcome to use slides but please reference my post
when you do so to maintain the integrity of authorship

2. What do the alarms mean?
Does the patient have: Clinical Assessment Considerations:
• Low RR alarms
• Decreasing RR
• Hypoventilation
• Shallow breathing
• Periods of “No Breath” or Apnea
• Check if etCO2 level is increasing
• High etCO2 alarm
• Increasing etCO2
• Hypoventilation/CO2 accumulating
• Low RR
• Recent ingestion of carbonated
beverages/antacids
• Low etCO2 alarm
• Decreasing etCO2
• RR increasing/hyperventilating
• Shallow breathing
• No Breath or Apnea alarm • Apnea
• Complete airway obstruction
• FilterLine needs repositioning
• Extreme shallow breathing

3. Possible Clinical Intervention
Intervention Outcome
 Ensure an open airway  Allows ventilation, thus the removal
of CO2
 Stimulate your patient to take
deep breaths  Removes CO2
 Reposition FilterLine® if
necessary
 Provides accurate sample
 Follow your policy  Know when to assist ventilation or
withhold PCA medications
Remember: CO2 removal must keep-up with production!

4. What do I look for?
• Significant changes in the values (trends
greater than 10 mmHg)
• Alarms:
– etCO2 trending too high
– etCO2 trending too low
– RR decreasing
– Periods of No Breath Detected (apnea)
• Can be any one or a combination of all

5. 1. Educate pt/family while placing FilterLine®
2. Note baseline RR, etCO2, etc
3. Monitor trend data (e.g. RR & etCO2)
Patient Monitoring – 3 simple steps!

6. Normal Waveform (35-45 mmHg)
A-B: Baseline = no CO2 in breath
B-C: Rapid rise in CO2 (clearing dead space)
D-E: Inhalation
C-D: Alveolar plateau (gas exchange)
D
D: End expiration (etCO2 measured)
Normal Waveform