Should Capnographic Monitoring Be Standard Practice During Emergency Department Procedural Sedation and Analgesia? Pro and Con

Green, Steven M. MD
Pershad, Jay MD

^aDepartment of Emergency Medicine, Loma Linda University Medical Center and Children's Hospital, Loma Linda, CA
^bDepartment of Pediatrics, University of Tennessee Health Sciences Center and LeBonheur Children's Medical Center, Memphis, TN

Address for correspondence: Steven M. Green, MD, Department of Emergency Medicine, Loma Linda University Medical Center, 11234 Anderson St, Loma Linda, CA 92354; 805-886-6593, fax 805-351-4697; E-mail [email protected].

Supervising editor: Michael L. Callaham, MD

Dr. Callaham was the supervising editor on this article. Dr. Green did not participate in the editorial review or decision to publish this article.

Funding and support: By Annals policy, all authors are required to disclose any and all commercial, financial, and other relationships in any way related to the subject of this article that might create any potential conflict of interest. The authors have stated that no such relationships exist. See the Manuscript Submission Agreement in this issue for examples of specific conflicts covered by this statement.

Earn CME Credit: Continuing Medical Education is available for this article at: http://www.ACEP-EmedHome.com.

Reprints not available from the authors.

Publication date: Available online October 12, 2009.

SEE RELATED ARTICLE, P. 258.

[Ann Emerg Med. 2010;55:265-267.]

Annals of Emergency Medicine 55(3):p 258-264, March 2010.

What question this study addressed: Does the addition of capnography to standard monitoring decrease the rate of sedation-associated hypoxia (defined as SpO₂ <93)? What this study adds to our knowledge: In this randomized controlled trial of 132 adults undergoing propofol sedation, the addition of capnography to standard monitoring reduced hypoxia (by 17%), increased interventions to improve respiratory status (by 18%), and identified in advance all occurrences of hypoxia.