9: Monitoring CO
2
Precautions for Measuring EtCO
2
100
Precautions for Measuring EtCO
2
WARNINGS: The EtCO
2
readings do not always correlate closely with blood gas values, especially in patients with
pulmonary disease, a pulmonary embolism or inappropriate ventilation.
EtCO
2
and AwRR measurements may be inaccurate when the CO
2
sensor needs to be zeroed, has
not been set to the correct barometric pressure or has not had sufficient time to warm up. Sensor
application errors and environmental conditions may also affect measurements.
Check for physical occlusions such as a kink in the sample line or the patient lying on the sample
line before measuring EtCO
2
.
Danger - explosion hazard - do not use in the presence of flammable anesthetics mixture with air or
with oxygen or nitrous oxide. Sampling line may ignite in the presence of oxygen when directly
exposed to laser, ESU devices or high heat. When performing head and neck procedures involving
laser, electrosurgical devices or high heat, use caution to prevent flammability of the sampling line or
the surrounding environment.
CO
2
measurements may be inaccurate when measured in the presence of aerosolized
pharmaceuticals or anesthetic gases.
The Sidestream CO
2
sensor port should vent into open air. Do not block the exhaust port on your
Sidestream sensor. If the port is blocked, there could be a significant delay in measurement readings
with no indication of a problem.
When using a nasal sample line, if one or both nostrils are partially or completely blocked, or the
patient is breathing through the mouth, the displayed EtCO
2
values may be significantly low.
When measuring EtCO
2
on patients who are receiving or have recently received anesthetics, connect
exhaust tubing from the CO
2
Outlet port to a scavenging system or to the anesthesia
machine/ventilator to prevent exposing medical staff to anesthetics. Use an exhaust tube attached to
the CO
2
outlet port to remove the sample gas to a scavenging system.
To avoid risk of patient cross-infection, do not connect the exhaust to the patient airway.
Use only accessories listed in the supplies chapter to ensure correct functioning of the CO
2
measurement.
Carefully route the sampling line to reduce the possibility of patient entanglement or strangulation.
Reflux of gastric contents, mucus, pulmonary edema fluid or endotracheal epinephrine introduced
into the detector can increase airway resistance and affect ventilation. Discard accessory if this
occurs.
The presence of carbonated beverage or antacids in the stomach may cause incorrect readings and
unreliable capnography in identifying esophageal intubation.
CAUTIONS: If the Sidestream sensor is used in close proximity to the ECG monitoring electrodes, you may see
noise on the ECG waveform. If this occurs, move the sensor away from the monitoring electrodes.
The Efficia DFM100 is not equipped with automatic barometric pressure compensation. The device
needs to be set to the local atmospheric pressure before being used to monitor EtCO
2
. An incorrect
pressure setting results in an incorrect reading. See your Efficia DFM100 Service Manual for more
information on setting the atmospheric pressure.
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