Capnography for the nonintubated patient in the emergency setting

Background: Multiple studies illustrate the benefits of waveform capnography in the nonintubated patient. This type of monitoring is routinely used by anesthesia providers to recognize ventilation issues. Its role in the administration of deep sedation is well defined. Prehospital providers embrace the ease and benefit of monitoring capnography. Currently, few community-based emergency physicians utilize capnography with the nonintubated patient.

Objective: This article will identify clinical areas where monitoring end-tidal carbon dioxide is beneficial to the emergency provider and patient.

Discussion: Capnography provides real-time data to aid in the diagnosis and patient monitoring for patient states beyond procedural sedation and bronchospasm. Capnographic changes provide valuable information in such processes as diabetic ketoacidosis, seizures, pulmonary embolism, and malignant hyperthermia.

Conclusions: Capnography is a quick, low-cost method of enhancing patient safety with the potential to improve the clinician's diagnostic power.