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BCI Smiths Capnocheck Plus Capnograph
This stand-alone, bedside or transport capnograph incorporates sidestream technology for applications with both intubated and non-intubated patients. Waveforms and numeric values are easily viewed at all angles, and data can be stored and recalled with either on-screen trends, a printer, or personal computer. |
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BCI Smiths Medical CapnoCheck II Capnography System
The Capnocheck II Handheld Capnograph is a full featured, highly portable unit in your choice of configurations, delivering capnography only or capnography with pulse oximetry. Ideally suited for use in and out of the hospital, its back-lit display assures easy viewing of waveforms, numeric values and on-screen trending data. |
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Nonin Lifesense Capnograph and Digital Pulse Oximeter
The LifeSense multi-parameter monitor is ideal for continuous monitoring in critical care environments. Equipped with NONIN PureSAT SpO2 and MedAir EtCO2 technologies, LifeSense is a proven performer for ET-tube placement verifications, waveform trend monitoring, detecting breathing irregularities, gauging the efficacy of CPR and procedural sedation monitoring. Its sidestream design allows use with intubated and non-intubated patients. |
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Nellcor OxiMax N-85 Handheld Capnograph & Pulse Oximeter
Whether it's for an emergency situation, bedside monitoring or routine spot-check, the OxiMax N-85 handheld capnograph & pulse oximeter delivers accurate SpO2 and end-tidal CO2 values. This portable monitor contains Nellcor's latest OxiMax pulse oximetry and is compatible with OxiMax sensors. The N-85 monitor also features patented Microstream CO2 technology and breath sampling accessories from Oridion to ensure smooth operation, even in high humidity environments. |
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BCI Smiths Capnocheck Sleep Capnograph with Optional Oximeter
The Capnocheck Sleep Capnograph & Oximeter is specially designed for sleep screenings and lab-based sleep studies. Its 4-channel analog output capability lets you select ETCO2 numeric value, ETCO2 waveform, inspired CO2, respiratory rate, heart rate, as well as SpO2 numeric and waveform displays. |
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Capnography is increasingly being used by paramedics to aid in their assessment and treatment of patients in the prehospital environment. These uses include verifying and monitoring the position of an endotracheal tube. A properly positioned tube in the trachea guards the patient's airway and enables the paramedic to breathe for the patient. A misplaced tube in the esophagus can lead to death.
A study in the March 2005 Annals of Emergency Medicine, comparing field intubations that used continuous capnography to confirm intubations versus non-use showed zero unrecognized misplaced intubations in the monitoring group versus 23% misplaced tubes in the unmonitored group. The American Heart Association (AHA) affirmed the importance of using capnography to verify tube placement in their 2005 CPR and ECG Guidelines. The AHA also notes in their new guidelines that capnography, which indirectly measures cardiac output, can also be used to monitor the effectiveness of CPR and as an early indication of return of spontaneous circulation (ROSC). Studies have shown that when a person doing CPR tires, the patient's end-tidal CO2 (ETCO2, the level of carbon dioxide released at the end of expiration) falls, and then rises when a fresh rescuer takes over. Other studies have shown when a patient experiences ROSC the first indication is often a sudden rise in the ETCO2 as the rush of circulation washes untransported CO2 from the tissues. Likewise, a sudden drop in ETCO2 may indicate the patient has lost pulses and CPR may need to be initiated. Paramedics are also now beginning to monitor the ETCO2 status of nonintubated patients by using a special nasal cannula that collects the carbon dioxide. A high ETCO2 reading in a patient with altered mental status or severe difficulty breathing may indicate hypoventilation and a possible need for the patient to be intubated. Capnography, because it provides a breath by breath measurement of a patient's ventilation, can quickly reveal a worsening trend in a patient's condition providing paramedics with an early warning system into a patient's respiratory status. As more clinical studies are conducted into the uses of capnography in asthma, congestive heart failure, diabetes, circulatory shock, pulmonary embolus, acidosis, and other conditions, the prehospital use of capnography will greatly expand. Capnographyis the monitoring of the concentration or partial pressure of carbon dioxide (CO2) in the respiratory gases. Its main development has been as a monitoring tool for use during anaesthesia and intensive care. It is usually presented as a graph of expiratory CO2 plotted against time, or, less commonly, but more usefully, expired volume. The plot may also show the inspired CO2, which is of interest when rebreathing systems are being used. The capnogram is a direct monitor of the inhaled and exhaled concentration or partial pressure of CO2, and an indirect monitor of the CO2 partial pressure in the arterial blood. In healthy individuals, the difference between arterial blood and expired gas CO2 partial pressures is very small, and is probably zero in children. In the presence of most forms of lung disease, and some forms of congenital heart disease (the cyanotic lesions) the difference between arterial blood and expired gas increases and can exceed 1 kPa. During anaesthesia, there is interplay between two components: the patient and the anaesthesia administration device (which is usually a breathing circuit and a ventilator or respirator). The critical connection between the two components is either an endotracheal tube or a mask, and CO2 is typically monitored at this junction. Capnography directly reflects the elimination of CO2 by the lungs to the anaesthesia device. Indirectly, it reflects the production of CO2 by tissues and the circulatory transport of CO2 to the lungs. When expired CO2 is related to expired volume rather than time, the area beneath the curve represents the volume of CO2 in the breath, and thus over the course of a minute, this method can yield the CO2 minute elimination, an important measure of metabolism. Sudden changes in CO2 elimination during lung or heart surgery usually imply important changes in cardiorespiratory function. Capnographs usually work on the principle that CO2 absorbs infra-red radiation. A beam of infra-red light is passed across the gas sample to fall on to a sensor. The presence of CO2 in the gas leads to a reduction in the amount of light falling on the sensor, which changes the voltage in a circuit. The analysis is rapid and accurate, but the presence of nitrous oxide in the gas mix changes the infra-red absorption via the phenomenon of collision broadening. information provided by Wikipedia Capnography, http://en.wikipedia.org/w/index.php?title=Capnography&oldid=291878938 (last visited May 23, 2009). |
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