CAPNOGRAPHY: A STANDARD OF CARE FOR PROCEDURAL SEDATION MONITORING

Course overview

SEDATION AND ANESTHESIA ARE IMPORTANT RISK FACTORS FOR PATIENT MORBIDITY AND MORTALITY DURING OPERATIVE PROCEDURES. THE PATIENT’S LEVEL OF SEDATION IS DYNAMIC AND ALWAYS CHANGING, WITH THE LIKELIHOOD OF SEDATION DEPTH DEEPENING OR LESSENING IN AN UNPREDICTABLE MANNER. WHILE MODERATE SEDATION DOES NOT USUALLY PUT A PATIENT’S BREATHING OR HEART FUNCTION AT RISK, DEEPLY SEDATED PATIENTS OFTEN REQUIRE VENTILATOR SUPPORT AND MAY HAVE IMPAIRED CARDIOVASCULAR FUNCTION. THEREFORE, CONSTANT, VIGILANT MONITORING OF SEDATION LEVEL AND PATIENT CONDITION ARE ESSENTIAL IF ADVERSE EVENTS SUCH AS RESPIRATORY DEPRESSION ARE TO BE AVOIDED. CAPNOGRAPHY ENHANCES SURVEILLANCE FOR RESPIRATORY DEPRESSION DURING PROCEDURAL SEDATION AND ANALGESIA. THIS TECHNOLOGY ALLOWS CLINICIANS TO DETECT SUBTLE CHANGES AND TRENDS INDICATING HYPOVENTILATION BEFORE THE ADVENT OF LIFE-THREATENING CARDIAC ARREST OR RESPIRATORY FAILURE. IN FACT, MONITORING ETCO2 HAS BEEN SHOWN TO DETECT HYPOVENTILATION BEFORE CLINICIAN OBSERVATION OR CHANGES IN THE PATIENT’S VITAL SIGNS. SEVERAL ORGANIZATIONS NOW ADVOCATE MONITORING VENTILATION DURING PROCEDURAL SEDATION VIA CAPNOGRAPHY TO IMPROVE PATIENT SAFETY AND OUTCOME. THIS ACTIVITY WILL DISCUSS PROCEDURAL SEDATION AND HOW IT IMPACTS PATIENT SAFETY; THE IMPORTANCE OF MONITORING DURING PROCEDURAL SEDATION AND THE REGULATORY AGENCY/GUIDELINE RECOMMENDATIONS THAT GUIDE MONITORING; AND HOW TO RECOGNIZE AND RESPOND TO ABNORMAL CAPNOGRAPHY WAVEFORMS DURING A PROCEDURE.