High spinal anesthesia and Etco2
November 2, 2015 | 15,00 EUR | answered by Dr. med. Ralf Berg
Hello Doctor, I am back with a question. A few months ago, I wrote some posts about the high/total Epidural Anesthesia (Spinal Anesthesia) that I underwent.
Can you explain to me how it is possible that apparently no ETCO2 was measured in my monitor values?
However, on another sheet, there is clearly a line in the etco2 range that also goes down towards the end around 22:16. Note: The line then continues briefly at the very bottom.
In your opinion, was the ETCO2 parameter measured on the AN diagram?
Are there sidestream methods where ETCO2 can be measured using a small nasal cannula? Could it be that the AN diagram parameter is showing exactly that, hence the existing line?
Is it possible that while no ETCO2 was measured in the monitor values themselves, the patient was connected to a measuring tube on the AN diagram parameter which records the measurement?
Thank you for your advice and interpretation.
1.
http://workupload.com/file/aQv5xQOJ
2.
http://workupload.com/file/ZOHsbpa6
3.
http://workupload.com/file/WAj8bqEc
Hello,
Thank you for the enlargement, now the curve is clearly visible.
Now to your questions:
Question 1: If it was the same monitoring system, I also do not understand the absence of values in the list for ETCo2. Without knowing the system, there is only one explanation for me: The measurement of ETCo2 was continuous and is not transferred as a measurement value to the data storage at specific times, but only recorded as a curve on the graph. (Medically this makes sense)
Question 2: I believe so. Values are displayed. The decrease by approximately 2216 can be interpreted as follows: Assuming you were manually ventilated via a mask and the CO2 was measured in a side stream above the mask, the value decreases once the mask is removed and you start breathing spontaneously again. (The mask, including the measuring system, was removed, oxygen continued to flow, but CO2 decreased because you were no longer exhaling into the mask. Can anyone tell you whether you were ventilated assisted via mask or LAMA tube?
Question 3: No, I am not aware of that.
Question 4: Like question 1: It was measured, but the device is set up so that no CO2 measurement values are transferred to the list. Only the line is recorded in the protocol.
Have you been able to obtain a handwritten anesthesia protocol with a signature, or is something like that simply not kept in this hospital? (I can't imagine that).
Best regards, Ralf Berg
