Treat the Patient, Not the Monitor
Re: "The Case for Capnography" (November, page 55). Just finished reading Mr. Snyder's article on capnography for use during "MAC or IV sedation cases." I have a couple of quick comments. I do these cases on almost a daily basis and have done so for more than 20 years. I have rarely used, nor felt the need to use, capnography to increase the level of safety I provide for my patients. I feel that the routine use of this technology may lead to treating the monitor rather than treating the patient. I use a cheap and simple device known as a pre-tracheal or pre-cordial stethoscope on every case. Changes in respiratory patterns are recognized in a more timely fashion than with capnography and require no expensive monitor or fancy cannula. I also do not send my patients to PACU in a condition where they run much of a risk for further airway obstruction. In fact, most walk with me, even after an eight-hour procedure, or would be capable of walking.