Capnography

Question 1

the device that measures CO2

Answer 1

capnometer

Question 2

the measurement of CO2 in respiratory gases

Answer 2

capnometry

Question 3

the graphic display of CO2 levels as they change during breathing.

Answer 3

Capnography

Question 4

T/F PETCO2 is an accurate measurement of PaCO2!

Answer 4

False The most significant error is assuming that the end-expired CO2 levels can substitute for actual PaCO2 measurements

Question 5

The most common problem is contamination or obstruction of the sampling system or monitor by secretions or condensate. What are good ways to prevent these problems?

Answer 5

Proper use of water traps and regular changing of sample tubing or chambers can help prevent this problem.

Question 6

What is PET CO2

Answer 6

The CO2 at the end of an exhaled tidal volume

Question 7

Exhaled tidal volume can be divided into thirds (which portion) all alveoli, contains the highest concentration of CO2

Answer 7

Last Third

Question 8

Exhaled tidal volume can be divided into thirds from dead space contains only atmospheric CO2, typically 0.3%

Answer 8

First third

Question 9

Exhaled tidal volume can be divided into thirds more CO2, transitional zone from small airways and alveoli

Answer 9

Second third

Question 10

What are 2 pieces Measuring equipment? Which is the most common?

Answer 10

Mass spectrometry Infrared capnometer (Most Common)

Question 11

When looking at a capnograph. What is revealed on the X-axis?

Answer 11

x-axis which records time

Question 12

When looking at a capnograph. What is revealed on the Y-axis?

Answer 12

Y. axis records partial pressure of CO2

Question 13

What are the two types of capnographs?

Answer 13

Mainstream Sidestream

Question 14

Inaccurate readings with high frequencies of breathing is more of a problem for which system?

Answer 14

sidestream

Question 15

What is an advantage of a Mainstream system?

Answer 15

Response time

Question 16

What is an disadvantage of a Mainstream system?

Answer 16

weight on ET tube

Question 17

What is an advantage of a Sidestream System?

Answer 17

Light weight on airway

Question 18

What are disadvantages of a Sidestream System?

Answer 18

delay time in sample rate thin tube, blocked with water and mucus

Question 19

Where is capnography most often used?

Answer 19

Anesthesia

Question 20

Speed of tracing

Answer 20

12.5 mm per second

Question 21

Trend speed

Answer 21

25 mm per minute

Question 22

What does the trend speed provide?

Answer 22

Provides peak value & breathing frequency

Question 23

Whats great about speed of tracing !!!

Answer 23

Real-time tracing Provides diagnostic shape and best detail

Question 24

Under these conditions the patient cannot change their respiratory rate or tidal volume?

Answer 24

Anesthesia Rebreathing circuit based on patients sedated in Operating Room

Question 25

What is A, B, C?

Answer 25

A. End Tidal CO2 B. Tidal Volume C. ERV

Question 26

What conditions represent D,E,F,G?

Answer 26

D. V/Q mismatch E. Normal F.LHF or COPD G. Pulmonary Emboli

Question 27

What is H, J, I, K, and L

Answer 27

H. Percent CO2 J. Time I. Normal End of inhalation VT K. End of exhaltion VT L. End (maximium exhalation)

Question 28

What can cause high PET CO2?

Answer 28

Hypoventilation –Low minute volume Patient Can not compensate –sedation An increase in CO2 production Rapidly rising body temp –malignant hyperthermia

Question 29

If you have low minute ventilation how will the capnograph read?

Answer 29

High PETCO2

Question 30

What can cause Low PETCO2

Answer 30

Anesthesia induced Hyperventilation High minute volume Induction of hypothermia

Question 31

Expiratory Airflow Problem will appear as what?

Answer 31

Shark Fin

Question 32

What causes a shark fin?

Answer 32

Increased Expiratory Airway Resistance bronchospasm –Asthma Kinked ET tube Herniated ET tube cuff

Question 33

What is this ?

Answer 33

Curare Cleft A whale comming out the ocean to eat a bird.

Question 34

What causes a curare cleft?

Answer 34

Seen during reversal of anesthesia, after surgery Lack of Coordination between Intercostal muscles and diaphragm Recovery from neuromuscular block spontaneous breath fighting the vent

Question 35

Camel capnogram can occur with spontaneous or controlled ventilation?

Answer 35

BOTH During spontaneous or controlled ventilation

Question 36

Where abouts can Camel capnogram occur?

Answer 36

Lateral position on the Operating Table

Question 37

What can cause a sudden drop on the capnograh?

Answer 37

Problem with CO2 analyzer – Occluded sample line * sidestream * kink * water * mucus * disconnect or big leak

Question 38

Causes of Exponential decrease "Wash Out"

Answer 38

–1 to two min sudden decrease in pulmonary circulation massive Pulmonary Emboli Circulatory arrest

Question 39

Cause of Gradual Increase

Answer 39

Increasing CO2 production (dereased VE) rapidly rising body temperature Developing hypoventilation

Question 40

Causes of Sudden Increase

Answer 40

Injection of Sodium Bicarbonate Sudden increase in blood pressure intravenous adrenaline Sudden release of tourniquet

Question 41

Cause of Upward shift in baseline

Answer 41

Patient Rebreathing CO2 * Increase in dead space CO2 absorber * switched off * saturated Problem with CO2 analyzer * calibration

Question 42

Causes of Gradual Lowering

Answer 42

Gradual hyperventilation Lowering body Temperature Decreasing perfusion

Question 43

During monitor failure what happens?

Answer 43

Plethysmogram- decrease in amplitude Arterial line Blood pressure, decreasing

Question 44

how is the Capnogram affected with BP?

Answer 44

Drops with BP

Question 45

What are the "really bad" causes of monitor failure?

Answer 45

Severe blood loss cardiac malfunction * cardiac tamponade * dissecting aneurysm Anaphylactic shock

Question 46

Is capnometery useful as a weaning index? Yes and No

Answer 46

Yes if the patient has normal lungs * Postoperative No if pt has parynchmal or airway disease.

Question 47

What is this and the causes?

Answer 47

Gradual Lowering Gradual hyperventilation Lowering body Temperature Decreasing perfusion

Question 48

What is this?

Answer 48

Expiratory Airflow Problem

Question 49

Question 50

What is this?

Answer 50

Camel Capnogram