A case for capnographic monitoring as a standard of care

Vascello, Luis; Bowe, Edwin A.

doi:10.1016/s0278-2391(99)90874-1

Cited by 16 publications

(8 citation statements)

References 34 publications

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“…141,142 Capnography Expired carbon dioxide monitoring is valuable to diagnose the simple presence or absence of respirations, airway obstruction, or respiratory depression, particularly in patients sedated in less-accessible locations, such as MRI or computerized axial tomography devices or darkened rooms. 47,49,50,143,[164][165][166][167][168][169][170][171][172][173] The use of expired carbon dioxide monitoring devices is encouraged for sedated children, particularly in situations where other means of assessing the adequacy of ventilation are limited. Several manufacturers have produced nasal cannulae that allow simultaneous delivery of oxygen and measurement of expired carbon dioxide values.…”

Section: Pulse Oximetrymentioning

confidence: 99%

Guidelines for Monitoring and Management of Pediatric Patients During and After Sedation for Diagnostic and Therapeutic Procedures: An Update

Coté¹,

Wilson²

2006

Pediatrics

512

150

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The safe sedation of children for procedures requires a systematic approach that includes the following: no administration of sedating medication without the safety net of medical supervision; careful presedation evaluation for underlying medical or surgical conditions that would place the child at increased risk from sedating medications; appropriate fasting for elective procedures and a balance between depth of sedation and risk for those who are unable to fast because of the urgent nature of the procedure; a focused airway examination for large tonsils or anatomic airway abnormalities that might increase the potential for airway obstruction; a clear understanding of the pharmacokinetic and pharmacodynamic effects of the medications used for sedation, as well as an appreciation for drug interactions; appropriate training and skills in airway management to allow rescue of the patient; age-and size-appropriate equipment for airway management and venous access; appropriate medications and reversal agents; sufficient numbers of people to carry out the procedure and monitor the patient; appropriate physiologic monitoring during and after the procedure; a properly equipped and staffed recovery area; recovery to presedation level of consciousness before discharge from medical supervision; and appropriate discharge instructions. This report was developed through a collaborative effort of the American Academy of Pediatrics and the American Academy of Pediatric Dentistry to offer pediatric providers updated information and guidance in delivering safe sedation to children. INTRODUCTIONInvasive diagnostic and minor surgical procedures on pediatric patients outside the traditional operating room setting have increased in the last decade. As a consequence of this change and the increased awareness of the importance of providing analgesia and anxiolysis, the need for sedation for procedures in physician offices, dental offices, subspecialty procedure suites, imaging facilities, emergency departments, and ambulatory surgery centers has also markedly increased. In recognition of this need for both elective and emergency use of sedation in nontraditional

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Section: Pulse Oximetrymentioning

confidence: 99%

Guidelines for Monitoring and Management of Pediatric Patients During and After Sedation for Diagnostic and Therapeutic Procedures: An Update

Coté¹,

Wilson²

2006

Pediatrics

512

150

View full text Add to dashboard Cite

show abstract

“…Pulse oximetry detects arterial desa- turation only after a period of hypoventilation [10,11], whereas capnography provides objective btime-sensitiveQ monitoring of active ventilation and airway obstruction, as well as active assessment of depth of sedation [5,6,12]. In our case, the patient was presumably receiving 5 L/min of supplemental oxygen via simple face mask to optimize Fio 2 delivery with minimal disturbance of the capnogram.…”

Section: Detection Of Oxygen Face Mask Defect By Gas Analysis During mentioning

confidence: 99%

Detection of oxygen face mask defect by gas analysis during ambulatory surgery

Choi

Kim

2005

Journal of Clinical Anesthesia

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“…1 When it comes to respiratory monitoring, a considerable amount of variability exists in various dental procedures being carried out in different dental clinics in relation to the type of anesthesia and analgesia used. 2,3 In the world of modern-day oral surgery, ventilation has been overpowered by oxygenation therapy by the advancements and use of pulp oximetry. One of the techniques that are increasingly becoming popular these days in the field of procedural sedation is capnography.…”

Section: Introductionmentioning

confidence: 99%

Assessment of Alteration in Capnometry Monitoring during Intravenous Sedation with Midazolam for Oral Surgical Procedures

Kavitha

Kakade

Singh³

et al. 2017

The Journal of Contemporary Dental Practice

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Introduction Capnography is routinely used for monitoring of patients subjected to sedation for different surgical procedures. There is still paucity of data highlighting the capnographic assessment of patients on midazolam sedation undergoing oral surgical procedures. Hence, we planned the present study to assess the alterations occurring in the end-tidal carbon dioxide (ETCO2) values monitored during intravenous (IV) sedation with midazolam during various oral surgical procedures. Materials and methods The present study included assessment of alteration in ETCO2 values occurring during oral surgical procedure. After meeting the inclusion and exclusion criteria, a total of 40 participants were included in the present study. Pulse oximeter with capnograph (EmcoMeditek Pvt., Ltd., India) device was used for assessment of respiratory rate (RR) and ETCO2 values. The mean of 12 readings over a period of 1 minute before the starting of first infusion was referred to as baseline time. By evaluating the first four readings at an interval of 15 seconds during the 1st minute of infusion, we obtained the 1 minute average reading. All the data were compiled and recorded and assessed by the Statistical Package for the Social Sciences (SPSS) software. Results A total of 40 participants were included, out of which, 20 were males and 20 were females. At the baseline time, mean value of ETCO2 was 31 mm Hg, while mean value of oxygen saturation (SpO2) was 36%. Out of total 40 participants, 15 showed the presence of respiratory depression. Out of these 15 participants, ETCO2 changes from baseline were observed in 13 participants. Conclusion No oxygen should be delivered, unless until required, to the healthy participants undergoing dental sedation procedures, for marinating the sensitivity of pulse oximetry during assessment of respiratory depression. Clinical significance In patients undergoing sedation procedures, various monitoring techniques should be employed as respiratory depression is a commonly encountered risk factor. How to cite this article G Kavitha, Kakade PK, Singh M, Ahire M, Augustine M, Jain KD. Assessment of Alteration in Capnometry Monitoring during Intravenous Sedation with Midazolam for Oral Surgical Procedures. J Contemp Dent Pract 2017;18(11):1025-1028.

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A case for capnographic monitoring as a standard of care

Cited by 16 publications

References 34 publications

Guidelines for Monitoring and Management of Pediatric Patients During and After Sedation for Diagnostic and Therapeutic Procedures: An Update

Guidelines for Monitoring and Management of Pediatric Patients During and After Sedation for Diagnostic and Therapeutic Procedures: An Update

Detection of oxygen face mask defect by gas analysis during ambulatory surgery

Assessment of Alteration in Capnometry Monitoring during Intravenous Sedation with Midazolam for Oral Surgical Procedures

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