Archive Anesthesia 2018

Patient Monitoring Essentials

Capnography and pulse oximetry provide additional reassurance whenever anesthesia is administered.

Jason Warren

Jason Warren, MD


BREATHE EASY Capnography is the best way to monitor ventilation of a patient and the standard of care whenever patients are sedated.

Pulse oximetry and capnography are anesthesia's peanut butter and jelly — I won't use one without the other. Why? Because capnography helps monitor respiration and pulse oximetry monitors blood oxygen levels. Those real-time readings provide reassurance that patients' respiration rates are normal and their airways are secure. The monitors also provide the earliest warning signs of respiratory depression.

It's impossible to overstate the importance of that feedback, especially in the outpatient setting, where many procedures are performed under IV sedation or monitored anesthesia care (MAC). The primary goal of anesthesia is to minimize risks. Capno- graphy and pulse oximetry do that during procedures done under light sedation or major surgeries involving general anesthetics. If your providers aren't using both, they're not providing safe patient care. It's that simple.

Here's how each monitoring modality works:

Pulse oximetry measures the percentage of oxygen that's bound to hemoglobin. It's usually an accurate, non-invasive and reliable way to monitor the oxygen saturation level (SpO2) of a patient's blood. The measure is converted into a percentage that's displayed on the pulse oximeter, usually along with the patient's heart rate. Acceptable SpO2 ranges from 95% to 100%. Providers will take notice and begin to take action when the reading starts to decrease and creep toward 90%.

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