Capnography in non-tracheally intubated emergency patients as an additional tool in pulse oximetry for prehospital monitoring of respiration.
Victims of minor trauma transported by paramedic-based rescue systems are usually monitored with pulse oximetry. Under the difficult surroundings of prehospital trauma care, pulse oximeters show considerable periods of malfunction. We tested the hypothesis that capnography is a good, easy to use tool for monitoring in nonintubated trauma victims. Seventy nonintubated trauma victims were included in this study. Vital variables and number and time of malfunctions were sampled for oximeter and capnometer recordings. Total number of alerts (63 versus 10), number of alerts per patient (3.3 [1.9] versus 0.3 [0.9]) (mean [SD]), total time of malfunction (191.5 [216.7] s versus 11.8 [40.2] s), time of malfunction per alarm (58.3 [71.4] s versus 5.5 [14.6] s), and the percentage of malfunction time during transport (13.2% [15.3%] versus 0.8% [2.8%]) differed significantly (P < 0.01) between oximetry and capnography. Although pulse oximetry is a standard method of monitoring in emergency care, we found capnography to be helpful as a monitoring device. We consequently recommend the use of capnography on transport as an additional monitoring tool to reduce periods lacking supervision of the vital variables.


CONCLUSIONS
Capnography is a useful tool to improve respiratory monitoring in nonintubated trauma victims on emergency transport and an easy to use supplement to pulse oximetry.
Kober
Alexander
A
*Vienna Red Cross, Van Swieten and the Research Institute of the Vienna Red Cross, Vienna, Austria; †Hungarian National Emergency Service, Hungary; and the ‡Department of Anesthesiology and General Intensive Care, University Hospital of Vienna, Vienna, Austria.
Schubert
Barbara
B
Bertalanffy
Petra
P
Gorove
Laszlo
L
Puskas
Tivadar
T
Gustorff
Burkhard
B
Joldzo
Alma
A
Hoerauf
Klaus
K
D000328:Adult; D000368:Aged; D000488:Allied Health Personnel; D019296:Capnography / Q000379:methods*; D002245:Carbon Dioxide / Q000097:blood; D004632:Emergency Medical Services / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic; D010092:Oximetry / Q000379:methods*; D017060:Patient Satisfaction; D015656:Respiratory Mechanics / Q000502:physiology*; D014187:Transportation of Patients; D014947:Wounds and Injuries / Q000628:therapy
D002245:Carbon Dioxide