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In recent years capnography has gained a foothold in the medical field and is fast becoming a standard of care in anaesthesiology and critical care medicine. In addition, newer applications have emerged which have expanded the utility of capnographs in a number of medical disciplines. This new edition of the definitive text on capnography reviews every aspect of this valuable diagnostic technique. An introductory section summarises the basic physiology of carbon dioxide generation and transport in the body. A technical section describes how the instruments work, and a comprehensive clinical section reviews the use of capnography to diagnose a wide range of clinical disorders. Edited by the world experts in the technique, and with over 40 specialist contributors, Capnography, second edition, is the most comprehensive review available on the application of capnography in health care.
Focusing on the interpretation of data commonly available to anesthesiologists, this book presents a data point, followed by discussion in a question and answer format. Covering EKG's, X-Rays, MRI's, graphs, paper recordings, blood gas results, laboratory results, patient case histories and more, Data Interpretation in Anesthesia provides an enhanced and stimulating learning format for residents in training and practitioners alike.
What should a book on cardiac diseases tell us about? We are not cardiologists in most instances, nor ordinary patients preparing to be catheterized. This book tries to explain to the average medical reader about the causes, diagnostic advances, and therapeutic opportunities in the context of cardiac diseases in the modern era. The topics covered in this project will enlighten research pathways while rendering clinicians practical solutions to everyday problems in recognition and management of these entities. In brief, students, nurses, paramedical personnel, researchers, junior doctors, and experienced practitioners will benefit from this book when translating theory into practice.
Sudden cardiac arrest (SCA) is the sudden cessation of the heart,Äôs effective pumping function, confirmed by the absence of pulse and breathing. Without appropriate treatment, it leads to sudden cardiac death, considered responsible for half of the global cardiac disease deaths. Cardiopulmonary resuscitation (CPR) is a key intervention during SCA.¬†Current resuscitation guidelines emphasize the use of waveform capnography during CPR in order to enhance CPR quality and improve patient outcomes. Capnography represents the concentration of the partial pressure of carbon dioxide (CO2) in respiratory gases and reflects ventilation and perfusion of the patient. Waveform capnography should be used for confirming the correct placement of the tracheal tube and monitoring ventilation. Other potential uses of capnography in resuscitation involve monitoring CPR quality, early identification of restoration of spontaneous circulation (ROSC), and determination of patient prognosis. An important role of waveform capnography is ventilation rate monitoring to prevent overventilation. However, some studies have reported the appearance of high-frequency oscillations synchronized with chest compressions superimposed on the capnogram. This chapter explores the incidence of chest compression artifact in out-of-hospital capnograms, assesses its negative influence in the automated detection of ventilations, and proposes several methods to enhance ventilation detection and capnography waveform.
"Waveform capnography has been successfully used as a standard of care in the operating room setting for decades. Sedation related respiratory depression is a patient safety risk costing the health care system millions. Only recently has the technology begun to breach the sterile corridor and become a standard of care in areas outside the operating room theater. After one hospital identified an increasing patient safety concern for emergency department patients receiving intravenous sedation and analgesia, a literature review was conducted to identify technological advances to increase clinician recognition for respiratory depression. After an intensive literature review significant, congruent evidence supported a pilot policy change to utilize waveform capnography in conjunction with pulse oximetry to monitor both oxygenation and ventilation of the at-risk patient population. Utilizing the Problem-Evaluation- (PET) portion of John Hopkins Nursing Evidence Based Practice Model, a project plan was formulated incorporating best practices elicited from the literature review. Volunteer participants were recruited to participate in an educational offering on the use, interpretation, and application of waveform capnography. In conjunction with the anesthesiology department, the intensive education program was developed. Pre and post test scores were assessed in areas of written and scenario based applications. Competency demonstration was required before participants could utilize the technology on patients. After education was provided and competency assessed, participants incorporated waveform capnography use on patients 18-65 years of age receiving intravenous sedation and analgesia in the emergency department. Educational effectiveness was determined using a pre and post test model with a paired t-test analysis for statistical significance. Evaluation of adherence to use, respiratory depression occurrence rates, and adverse respiratory events were conducted. Pre-implementation rates were compared to post implementation rates to determine if waveform capnography affected patient care and improved patient safety with an intended outcome of a 93% reduction in occurrences. An eight week evaluation period was used to determine if the intervention was effective in improving recognition of respiratory depression and allowing intervention time to reduce incidence of medication reversals and advanced airway interventions. Outcomes for the project were deemed successful in both the education and utilization phases. Every participant had a score of 90% or higher on the educational post-test. Application of the knowledge was evident with the reduction in adverse respiratory events and medication reversals related sedative and narcotic medications in the emergency department resulting in a zero occurrence rate. In an effort to share the patient safety gains with other similar organizations, next steps for the project administrator and facility include a more longitudinal evaluation and dissemination of outcomes and implications from the project implementation. Translating the change to a larger platform locally and nationally with educational offerings, manuscripts, and conferences will be a top priority. With the success of this project future evidence-based practice change projects will follow a similar format." -- Abstract.
WRITTEN BY A PARAMEDIC FOR PARAMEDICS, THIS TEXT IS AN ALL INCLUSIVE LOOK INTO EVERY FACET OF CAPNOGRAPHY AS IT RELATES TO PREHOSPITAL PATIENT CARE. Capnography texts have been written in the clinical settings of anesthesiology, critical care and ventilator management ad nauseum, but never for the paramedic....unti l now. This book is the first of its kind written by a paramedic for paramedics to use in their everyday medicine. Capnography is arguably one of the most powerful tools in a paramedics' repertoire. From the basics to V/Q ratio assessment, hopefully this book will serve as the educational foundation for paramedics to realize the full capabilities of capnography as it relates to EMS.
Thi2nd Edition, expertly authored by an authority in respiratory physiology, presents a straightforward discussion of the pathophysiology, pre-, peri- and post-operative management of thoracic anesthetic practice. Topics include staging and prognosis of carcinoma of the lung; alevolar hypoxia; pulmonary edema; anesthesia for esophageal surgery; and much more!
An illustrative and educational guide to the new OSCE component of the ABA Applied exam.
A quick reference to basic science for anaesthetists, containing all the key information needed for FRCA exams.
This portable and practical pocket guide explains how capnography works both physiologically and electronically and helps clinical staff to apply the tool promptly and correctly, and to interpret appropriately the numeric and graphic displays, providing vital information when viewed in the context of the patient’s clinical presentation, history, and other diagnostic data that will improve and enhance care. Initial chapters explain how to interpret the data displayed in the context of various conditions, and how the care provider may respond to that data. Later chapters provide partial differential diagnoses based on the displayed capnometry data, an algorithm for interpreting waveforms, and clinical scenarios to illustrate the application of capnography in emergency medical practice. Ensuring that the value of capnography can be maximized to the benefit of patients, the book is an essential primer to capnography for those studying for and practicing within the emergency medical services, and a convenient reference for other emergency department personnel.