Capnography in the Emergency Department: A Review of Uses, Waveforms, and Limitations

Brit Long, Alex Koyfman, Michael A. Vivirito

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Background: Capnography has many uses in the emergency department (ED) and critical care setting, most commonly cardiac arrest and procedural sedation. Objective of the Review: This review evaluates several indications concerning capnography beyond cardiac arrest and procedural sedation in the ED, as well as limitations and specific waveforms. Discussion: Capnography includes the noninvasive measurement of CO2, providing information on ventilation, perfusion, and metabolism in intubated and spontaneously breathing patients. Since the 1990s, capnography has been utilized extensively for cardiac arrest and procedural sedation. Qualitative capnography includes a colorimetric device, changing color on the amount of CO2 present. Quantitative capnography provides a numeric value (end-tidal CO2), and capnography most commonly includes a waveform as a function of time. Conditions in which capnography is informative include cardiac arrest, procedural sedation, mechanically ventilated patients, and patients with metabolic acidemia. Patients with seizure, trauma, and respiratory conditions, such as pulmonary embolism and obstructive airway disease, can benefit from capnography, but further study is needed. Limitations include use of capnography in conditions with mixed pathophysiology, patients with low tidal volumes, and equipment malfunction. Capnography should be used in conjunction with clinical assessment. Conclusions: Capnography demonstrates benefit in cardiac arrest, procedural sedation, mechanically ventilated patients, and patients with metabolic acidemia. Further study is required in patients with seizure, trauma, and respiratory conditions. It should only be used in conjunction with other patient factors and clinical assessment.

Original languageEnglish (US)
JournalJournal of Emergency Medicine
DOIs
StateAccepted/In press - 2017

Fingerprint

Capnography
Hospital Emergency Service
Heart Arrest
Seizures
Equipment Failure
Tidal Volume
Wounds and Injuries
Emergency Medical Services
Critical Care
Pulmonary Embolism
Ventilation

Keywords

  • Capnography
  • Capnometer
  • Carbon dioxide
  • End-tidal
  • Monitoring
  • Resuscitation
  • Waveform

ASJC Scopus subject areas

  • Emergency Medicine

Cite this

Capnography in the Emergency Department : A Review of Uses, Waveforms, and Limitations. / Long, Brit; Koyfman, Alex; Vivirito, Michael A.

In: Journal of Emergency Medicine, 2017.

Research output: Contribution to journalArticle

@article{09f08f6e3656479d974bfacd907378eb,
title = "Capnography in the Emergency Department: A Review of Uses, Waveforms, and Limitations",
abstract = "Background: Capnography has many uses in the emergency department (ED) and critical care setting, most commonly cardiac arrest and procedural sedation. Objective of the Review: This review evaluates several indications concerning capnography beyond cardiac arrest and procedural sedation in the ED, as well as limitations and specific waveforms. Discussion: Capnography includes the noninvasive measurement of CO2, providing information on ventilation, perfusion, and metabolism in intubated and spontaneously breathing patients. Since the 1990s, capnography has been utilized extensively for cardiac arrest and procedural sedation. Qualitative capnography includes a colorimetric device, changing color on the amount of CO2 present. Quantitative capnography provides a numeric value (end-tidal CO2), and capnography most commonly includes a waveform as a function of time. Conditions in which capnography is informative include cardiac arrest, procedural sedation, mechanically ventilated patients, and patients with metabolic acidemia. Patients with seizure, trauma, and respiratory conditions, such as pulmonary embolism and obstructive airway disease, can benefit from capnography, but further study is needed. Limitations include use of capnography in conditions with mixed pathophysiology, patients with low tidal volumes, and equipment malfunction. Capnography should be used in conjunction with clinical assessment. Conclusions: Capnography demonstrates benefit in cardiac arrest, procedural sedation, mechanically ventilated patients, and patients with metabolic acidemia. Further study is required in patients with seizure, trauma, and respiratory conditions. It should only be used in conjunction with other patient factors and clinical assessment.",
keywords = "Capnography, Capnometer, Carbon dioxide, End-tidal, Monitoring, Resuscitation, Waveform",
author = "Brit Long and Alex Koyfman and Vivirito, {Michael A.}",
year = "2017",
doi = "10.1016/j.jemermed.2017.08.026",
language = "English (US)",
journal = "Journal of Emergency Medicine",
issn = "0736-4679",
publisher = "Elsevier USA",

}

TY - JOUR

T1 - Capnography in the Emergency Department

T2 - A Review of Uses, Waveforms, and Limitations

AU - Long, Brit

AU - Koyfman, Alex

AU - Vivirito, Michael A.

PY - 2017

Y1 - 2017

N2 - Background: Capnography has many uses in the emergency department (ED) and critical care setting, most commonly cardiac arrest and procedural sedation. Objective of the Review: This review evaluates several indications concerning capnography beyond cardiac arrest and procedural sedation in the ED, as well as limitations and specific waveforms. Discussion: Capnography includes the noninvasive measurement of CO2, providing information on ventilation, perfusion, and metabolism in intubated and spontaneously breathing patients. Since the 1990s, capnography has been utilized extensively for cardiac arrest and procedural sedation. Qualitative capnography includes a colorimetric device, changing color on the amount of CO2 present. Quantitative capnography provides a numeric value (end-tidal CO2), and capnography most commonly includes a waveform as a function of time. Conditions in which capnography is informative include cardiac arrest, procedural sedation, mechanically ventilated patients, and patients with metabolic acidemia. Patients with seizure, trauma, and respiratory conditions, such as pulmonary embolism and obstructive airway disease, can benefit from capnography, but further study is needed. Limitations include use of capnography in conditions with mixed pathophysiology, patients with low tidal volumes, and equipment malfunction. Capnography should be used in conjunction with clinical assessment. Conclusions: Capnography demonstrates benefit in cardiac arrest, procedural sedation, mechanically ventilated patients, and patients with metabolic acidemia. Further study is required in patients with seizure, trauma, and respiratory conditions. It should only be used in conjunction with other patient factors and clinical assessment.

AB - Background: Capnography has many uses in the emergency department (ED) and critical care setting, most commonly cardiac arrest and procedural sedation. Objective of the Review: This review evaluates several indications concerning capnography beyond cardiac arrest and procedural sedation in the ED, as well as limitations and specific waveforms. Discussion: Capnography includes the noninvasive measurement of CO2, providing information on ventilation, perfusion, and metabolism in intubated and spontaneously breathing patients. Since the 1990s, capnography has been utilized extensively for cardiac arrest and procedural sedation. Qualitative capnography includes a colorimetric device, changing color on the amount of CO2 present. Quantitative capnography provides a numeric value (end-tidal CO2), and capnography most commonly includes a waveform as a function of time. Conditions in which capnography is informative include cardiac arrest, procedural sedation, mechanically ventilated patients, and patients with metabolic acidemia. Patients with seizure, trauma, and respiratory conditions, such as pulmonary embolism and obstructive airway disease, can benefit from capnography, but further study is needed. Limitations include use of capnography in conditions with mixed pathophysiology, patients with low tidal volumes, and equipment malfunction. Capnography should be used in conjunction with clinical assessment. Conclusions: Capnography demonstrates benefit in cardiac arrest, procedural sedation, mechanically ventilated patients, and patients with metabolic acidemia. Further study is required in patients with seizure, trauma, and respiratory conditions. It should only be used in conjunction with other patient factors and clinical assessment.

KW - Capnography

KW - Capnometer

KW - Carbon dioxide

KW - End-tidal

KW - Monitoring

KW - Resuscitation

KW - Waveform

UR - http://www.scopus.com/inward/record.url?scp=85030631463&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85030631463&partnerID=8YFLogxK

U2 - 10.1016/j.jemermed.2017.08.026

DO - 10.1016/j.jemermed.2017.08.026

M3 - Article

C2 - 28993038

AN - SCOPUS:85030631463

JO - Journal of Emergency Medicine

JF - Journal of Emergency Medicine

SN - 0736-4679

ER -