Better Patient Care Decisions Begin with Accurate Capnography Sampling

Every day, clinicians make patient care decisions based on assessments and available patient monitoring. Determinations on intervention and treatment paths also stem from information derived from our clinical experiences and every day lives, both in and out of the healthcare setting. Take, for example, the speed displayed on your car’s dashboard or the temperature reading on your oven when baking a cake. When you cruise by your local patrol officer, you’re assuming the reading on your speedometer is correct. But what if it isn’t?

When you put your cake into the oven assuming the temperature gauge is giving you an accurate reading, you don’t expect to get a burnt cake on the outside and a raw middle. In both of these scenarios, you thought you were making correct decisions based on the information provided. Had the information been accurate, you would have been correct.

When it comes to the healthcare setting, it’s vital to access all patient information and ensure accuracy of that data. The stakes are high in the clinical setting and informing on a patient’s treatment requires precision in patient data — a necessity to avoid inadvertently made choices that are incorrect. If not, the potential consequences and outcomes are great.

You may be able to handle the unintended costs of a destroyed cake or a speeding ticket, but in healthcare it’s unacceptable to make decisions using inaccurate information. Again, the stakes are too high.

Using capnography to monitor patients for changes in circulation, airway status, and the respiratory system requires accuracy from the sampling lines. Capnography continues to expand to more clinical settings as a monitoring tool, yet there is a need for increased awareness on the value of accurate etCOmeasurements due to the important decisions informed by this information.

Capnography provides early indicators of respiratory compromise and can alert you to patient distress1, which is why it is imperative that the monitor and disposable gas sampling components, known as sampling lines, provide accurate and meaningful measurements, trends, and waveform data.

The importance of quality capnography sampling lines

Reliance on capnography sampling lines made with quality components is important in my clinical assessments as a certified registered nurse anesthetist (CRNA). Maintaining confidence in the information provided by the monitoring equipment helps better inform my patient treatment decisions.

A key to obtaining accurate measurements largely depends on the quality and design of the sampling line, as the monitor requires an optimal exhaled gas sample to provide true and accurate readings.

Comparing sampling lines from different manufacturers reveals highly varied quality of materials and functionality. This may result in sampling lines failing to detect exhaled gases in mouth-breathing patients signaling false alarms. Even subtle details and variations in sampling line design may have a substantial impact on the performance of the sampling line in real-world clinical setting.A reduction in capnography value, for example, may occur when supplemental oxygen is administered from lower quality sampling lines resulting in inaccurate information.

Related: Read more on the importance of advanced sampling for accurate etCO2 measurement.

Why my clinical practice maintains consistent use of Microstream™ capnography sampling lines

The clinical testing and study data on Microstream™ capnography sampling lines supports the use of these sampling lines in my practice. Microstream™ capnography sampling lines use Uni-junctiontechnology providing continuous etCO2 sampling from either nare, the mouth, or both. Ensuring that proper samples are obtained, the dual-nare is even able to obtain samples when variations or obstructions in nasal anatomy are present. The oral scoop also provides accurate sampling for mouth breathers.

Microstream™ capnography sampling lines can be used with or without oxygen, which is similar in other products. But Microstream™ capnography sampling lines are engineered with the oxygen delivery lumen separate from CO2 sampling, resulting in accurate capnography value readings — unique to these sampling lines. Many sampling lines currently on the market exhibit reduced etCO2 accuracy when supplemental oxygen is added due to the design causing gas dilution.2 This isn’t the case with Microstream™ capnography sampling lines.

Related: Learn how to get the most out of your capnography monitoring and sampling line technology.

Ensuring patient data accuracy improves clinical decisions

How do you determine if information such as airway status, capnography value, and respiratory rate is accurate? Unless data is tested and validated in real clinical scenarios, it’s difficult to ensure accurate information. Microstream™ capnography sampling lines have demonstrated reliability and accuracy.3-4

A recent Medtronic white paper reporting on the results of a study analyzing Microstream™ capnography sampling lines from Medtronic as compared to other commercially available competitors, found that only Microstream™ capnography sampling lines met required standards around tensile strength, rise time, respiration rate accuracy, and supplementary oxygen accuracy.2

Related: Read the white paper bench comparison study etCO2 sampling lines.

References:
1. Lynn LA, Curry JP. Patterns of unexpected in-hospital deaths: a root cause analysis. Patient Saf Surg. 2011;5(1):3. Published Feb 11, 2011.
2. Karpenkop I, Peri D. Not all cannulas are created equal: the influence of sampling line design on capnography performance. Internal Medtronic Study. 2020. https://www.medtronic.com/content/dam/covidien/library/us/en/product/capnography-monitoring/microstream-sampling-line-design-comparison-white-paper.pdf.
3. Colman Y, David U. Comparison of Capnography Filter Lines for Nose and Mouth Breathing of End Tidal Carbon Dioxide Sampling With and Without Supplemental Oxygen. STA Annual Meeting Abstracts, January 2009.
4. Dungan G, Colman J, Lain D. Evaluation of oxygen delivery via a novel smart CapnoLine delivery system during simultaneous oxygen therapy and carbon dioxide monitoring. Presented at the Society for Technology in Anesthesia 2012 Conference, Palm Beach, FL

The Microstream™ capnography monitoring system should not be used as the sole basis for diagnosis or therapy and is intended only as an adjunct in patient assessment.

© 2020 Medtronic. All rights reserved. Medtronic, Medtronic logo and Further, Together are trademarks of Medtronic. All other brands are trademarks of a Medtronic company. 12/2020-US-PM-2000281

Topics: Microstream™ Capnography Monitoring, Procedural Sedation, Non-Operating Room Anesthesia

About the Author

Susan Thibeault, DNAP, CRNA, MBA

Susan has a Doctorate in Nurse Anesthesia Practice, Masters of Science in Biology and a Masters in Business. She is a Certified Registered Nurse Anesthetist at Yale in New Haven, CT and the Lead CRNA of Safety and Quality for Yale New Haven Health. Formerly; Sue was a Flight Nurse/paramedic for Life Star, a helicopter critical care transport team. Sue has a background in intensive care and emergency room nursing. Most notably, she has been a passionate educator and facilitator for programs supporting patient safety in the areas of capnography and respiratory compromise for over ten years. She has an engaging style, makes complex concepts easy to understand and apply to clinical practice all while having fun.

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