Capnography

Implementation of Capnography Monitoring in Patients under Opioid Sedation: Evidence Based Practice Project Opioid-induced respiratory depression (OIRD) is the most dangerous and frightening of the opioid adverse effects (Pasero, 2012). Opioids slow down the central nervous system (CNS), which can lead to fatal respiratory depression, sedation, and coma (Zedler et al., 2015). The Joint Commission noted that 29% of opioid-related respiratory depression events were associated with improper patient monitoring (Carlisle, 2015). Older patients with co-morbidities like obesity and chronic obstructive pulmonary disease (COPD) are at higher risk to develop OIRD (Zedler et al, 2015). Even though pain management is a critical aspect during patient care,…

Group A: Lubricating gel is used to lubricate the tube during passage through the nose until it reaches the pharynx, then we use the laryngoscopy to view the vocal cords, modified pediatric Magill forceps is used to help advancing the tube into the trachea by firm grasping of the tube then elevation and down ward rotation of the tube which makes the tube in line with the axis of the trachea facilitating its passage into the trachea preventing it from getting caught on the anterior…

indicate that the most frequent reason for transfer of a sedated patient to an emergency room was respiratory distress.[2] Capnography is a non-invasive and real time monitor of ventilatory status and has been shown to be effective in early detection of hypoventilation, respiratory depression and adverse respiratory events, enabling remedial measures to be taken to reverse or correct critical condition.[3] Capnography monitoring has been in routine use in hospital operating rooms since 1988.[4]…

pack-years of exposure), Mallampati classification (I,II,III,IV), and body mass index (BMI). Procedure-related variables consisted of preoperative level of anxiety (not anxious, some anxiety, anxious), procedure types (dentoalveolar, pathology, other), anesthesia level grouped as MS or , DS/GA, anesthesia time, monitoring techniques (capnography, blood pressure, pulse oximetry, pericardial stethoscope, pretracheal stethoscope, electrocardiography (ECG), monitoring chest movement,…

exposure), Mallampati classification (I,II,III,IV), and body mass index (BMI). Procedure-related variables consisted of preoperative level of anxiety (not anxious, some anxiety, anxious), procedure types (dentoalveolar, pathology, other), anesthesia level grouped as MS or , DS/GA, anesthesia time, monitoring techniques (capnography, blood pressure, pulse oximetry, pericardial stethoscope, pretracheal stethoscope, electrocardiography (ECG), monitoring chest movement, electroencephalogram (EEG),…

ear to the nose, leaving the tube barely within the stomach. Another factor that contributes to error is inappropriate verification of tube placement or the misinterpretation of radiographs by clinicians. Nasogastric tube misplacement accounts for multiple complications such as pulmonary aspiration, malnutrition and death. Studies are conducted to assist with ensuring accurate and safe placement. Bedside testing methods do not offer definitive proof or confirmation of tube position. The…

chest to completely recoil between compressions. Rescue breaths are ideally delivered over 1 second each, via a ventilation bag and mask with oxygen supply, but use a pocket mask, or mouth-to-mouth or mouth-to-nose technique if not available. The two breaths should take more than a total of 5 seconds. Use simple airway adjuncts (oropharyngeal or nasopharyngeal airways) when available (but ensure chest compressions are interrupted for as little time as possible). If rescue breaths do not cause…

Intraoperative monitoring: A consensus on standard monitoring requirements has not yet established in the literature. Routine monitoring includes electrocardiography, pulse oximetry, capnography, temperature and urine output monitoring. There are many authors who recommend invasive blood pressure monitoring by indwelling arterial catheter in all patients, irrespective of their age 18.Abrupt changes in cerebral blood flow due to changes in intracranial pressure (ICP) is possible during the…

them down or make any silly errors. The Health and Care Professions Council (HCPC), of which I hope to become a registrant, state that I should act within the limits of my knowledge and skills (see appendix). From the moment we arrived I feel I very much went into ‘automatic pilot’ following the instructions of my colleagues. Chest compressions were immediately started and I was shocked by the sound of the ribs cracking but I continued with the task of inserting the airway. I was able to…

According to Lancaster et al. (2015), evaluating the successes and potential downfalls related to the new Alaris System will indeed require collaboration on all levels. Additionally, to determine the effectiveness of training, patient satisfaction, and overall improvement in PCA pump safety, evaluation must come about immediately after installation and while training is in progress. Next, the committee will review the capnography data and determine improved patient safety and quality of care…