UMEM Educational Pearls

End Tidal CO2 continuous capnography is being utilized more in the ED for procedural sedation. One of the best studies is a randomized control trial using propofol that showed you could see signs of hypoventiliation prior to hypoxia by about 60 seconds - which can be plenty of time to get your BVM and airway cart ready.

References

 

Does end tidal CO2 monitoring during emergency department procedural sedation and analgesia with propofol decrease the incidence of hypoxic events? A randomized, controlled trial.

Deitch K, Miner J, Chudnofsky CR, Dominici P, Latta D.

Ann Emerg Med. 2010 Mar;55(3):258-64. Epub 2009 Sep 24.