New Standards Mandating Capnography Monitoring! 

Click here to read the New 2009 Standards Mandating Capnography Montoring.  Monitoring patient ventilation during procedural sedation or in conjunction with pain management of the PCA patient is fast becoming a standard of care.  Contact us if you wish to review the full announcements or need additional information.  

ASA (American Society of Anesthesiologists) - 2009

Both the consultants and the ASA members disagree that pulse oximetry monitoring is more likely to detect respiratory depression than are clinical signs. The consultants and ASA members both agree that end-tidal carbon dioxide monitoring is more likely to detect hypercapnia/hypercarbia and respiratory depression than are clinical signs.

Detection of Respiratory Depression

All patients receiving neuraxial opioids should be monitored for adequacy of ventilation (e.g., respiratory rate, depth of respiration [assessed without disturbing a sleeping patient]), oxygenation (e.g., pulse oximetry when appropriate), and level of consciousness.

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State of New York; State Emergency Medical Advisory Committee - 2009

The SEMAC has endorsed and recognized as a standard of care that all out of hospital adult and pediatric patients who require ETT intubation must have waveform capnography in place at the time of intubation and throughout the entire time the ETT is in place. This advisory becomes effective state-wide on June 1, 2009.

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State of New Jersey, Office of Emergency Medical Services - 2009

Rapid Sequence Intubation Policy, October, 2008; effective January 1, 2009

All projects must have the capability of monitoring and recording the following parameters continuously with all intubation attempts. Recordings of these parameters must be documented before and after all intubation attempt for every patient treated with this protocol.

Waveform capnography (documented to confirm intubation and monitored continuously thereafter). Documentation for all intubated patients must include at least two recorded strips of the waveform capnography: (1) one post intubation to confirm successful placement and (2) one post transfer of the patient to confirm placement. A written protocol should be developed for the use of waveform capnography in intubated patients.

Ultrasound Nerve Blocks

Two recommended ultrasound nerve block websites to review are www.nysora.com which is the New York Society of Regional Anesthesia and www.neuraxiom.com .  Both websites have excellent videos of various nerve blocks that you will find helpful and interesting.

Are You Prepared For The New Guidelines Being Introduced Involving Procedural Sedation? 

All patients receiving sedation, even moderate, will be needing to have some form of monitoring of their ventilation. Pulse Oximetry is not enough anymore. Bell Medical and Oridion have several solutions to help you address this situation. It's coming, are you ready?

Published Articles

Quality Improvement Report JCAHO eye apnea...; Filterline Products for Pain ; Clinical Experience with Patient-Controlled Analgesia ; Safety During Patient-Controlled Analgesia ; Dangers of Postoperative Opioids ; Critical Care Testimonials ; Procedural Sedation Testimonials ; Removal of the ET Tube 2007 Revision & Update ; Guidelines for Obstructive Sleep Apnea Patients Established ; ISMP Acute Care Premier ; Discover the Value of Microstream Capnography ; EtCO2 Monitoring During Procedural Sedation ; Microstream Oxygen Delivery System  

Product Brochures

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