title: Emergency capnography monitoring: comparing ergonomic design of intensive care unit ventilator interfaces and specific training of staff in reducing time to activation.
abstract: Modern ventilators provide capnography monitoring in patients with tracheal tubes, in compliance with national and international recommendations. This technology is often not used when patients' lungs are non-invasively ventilated; however, it should be accessed immediately following tracheal intubation to confirm tube placement. This study assessed the effect of ventilation interface design on the speed with which capnography can be activated by comparing the Dräger Evita 4 and Dräger V500 before and after a specific training episode. We configured the V500 to have a capnography activation button on the front screen in contrast to the Evita 4 which requires a sequence of actions to access capnography monitoring. We used a randomised crossover design, measuring time to monitoring activation, and repeated the study after 3 months. Survival analysis showed significantly quicker activation associated with ventilator choice (V500, p < 0.0001) and training (p = 0.0058). The training improved activation speed with both machines, though this was only significant for the Evita 4 (p = 0.0097).
authors.affiliation: Critical Care Unit, Queen Elizabeth Hospital, King's Lynn, Norfolk, UK.
authors.forename: E
authors.initials: E
authors.lastname: Hodges
authors.forename: A
authors.initials: A
authors.lastname: Griffiths
authors.forename: J
authors.initials: J
authors.lastname: Richardson
authors.forename: M
authors.initials: M
authors.lastname: Blunt
authors.forename: P
authors.initials: P
authors.lastname: Young
mesh_terms: D019296:Capnography / Q000295:instrumentation / Q000379:methods*; D018592:Cross-Over Studies; D004630:Emergencies; D004867:Equipment Design; D006801:Humans; D007362:Intensive Care Units; D008991:Monitoring, Physiologic; D012122:Ventilators, Mechanical