Capnography During Procedural Sedation/Analgesia CPG Synopsis-Capnography During Procedural Sedation/Analgesia CPG Synopsis

Pdf Summary

This clinical practice guideline discusses the use of capnography during procedural sedation/analgesia (PSA) in the emergency department. The question addressed is whether the use of capnography improves outcomes compared to monitoring the patient using vital signs, pulse oximetry, and clinical assessment alone. <br /><br />Traditionally, PSA monitoring includes clinician observation, cardiac monitoring, pulse oximetry, and vital sign assessments. Adverse events during sedation are often related to airway or respiratory complications. Capnography, which measures exhaled end-tidal carbon dioxide (ETCO2), has been shown to detect hypoventilation before changes in vital signs or pulse oximetry. It is less likely to be affected by patient movement or low peripheral perfusion states. Additionally, the use of supplemental oxygen during sedation may delay the onset of hypoxia, leading to unrecognized hypoventilation or apnea. <br /><br />Professional organizations support the use of capnography during PSA to detect hypoventilation, but there is no universal agreement that it should be standard practice in all cases.<br /><br />The guideline describes the decision options and interventions related to using capnography during PSA. It states that capnography is a more sensitive indicator of respiratory depression compared to standard monitoring. Capnographic monitoring is associated with a decrease in the incidence and severity of hypoxia during PSA. Furthermore, using capnography in addition to standard monitoring improves patient outcomes. The level of recommendation for these interventions is categorized as Level A (high) or Level B (moderate), indicating good quality evidence and relevance to emergency nursing practice.<br /><br />The full clinical guideline, including references, can be accessed at the provided link. The purpose of clinical practice guidelines is to apply current evidence into emergency nursing practice, with the goal of improving patient care.

Meta Tag

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capnography pulse oximetry

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Keywords

clinical practice guideline

capnography

procedural sedation/analgesia

emergency department

monitoring

vital signs

pulse oximetry

clinical assessment

hypoventilation

respiratory depression