J U LY 2 0 1 7 O U T P A T I E N TS U R G E R Y. N E T 3 3
Real-time feedback
Continuous capnography is a breath-to-breath measurement of exhaled carbon
dioxide at each phase of the respiratory cycle, gathered either through an
advanced airway device (intubated) or a nasal cannula-type device (non-intubat-
ed). The word continuous is important, because a respiratory depression can
occur when you're away from the patient's bedside. Continuous capnography
should be seen as a trending tool that provides a complete picture of a patient's
ventilation, perfusion and metabolism.
Opioids can cause respiratory depres-
sion that puts patients in jeopardy.
ECRI Institute, a healthcare research
firm in Plymouth Meeting, Pa., says the
condition is of particular concern in
patients who receive opioids such as
morphine, hydromorphone and fen-
tanyl, and especially if:
• they receive another drug that has
a sedating effect;
• they have sleep apnea or another
condition that predisposes them to
respiratory compromise; or
• they receive more medication than
intended, such as in the case of a
dosing error.
ECRI listed undetected opioid-
induced respiratory depression as a
top threat to patient safety in its Top 10
Health Technology Hazards for 2017
report. In the report, ECRI recom-
mends implementing measures to
"continuously monitor the adequacy of
ventilation of these patients."
— Bill Donahue
Spot the First Signs of Respiratory Compromise
• NO COMPROMISE Continuous capnography alerts staff to
opioid-induced respiratory depression, identified as a top threat
to patient safety.
EARLY WARNING SYSTEM
Pamela
Bevelhymer,
RN,
BSN,
CNOR