| Knowledge |
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States Relative Contraindications of procedure.
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| Preparation |
| Clinical Standards for Procedures and Interventions. |
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| Verifies the indication and selects mainstream, sidestream, or nasal-oral sampling appropriate to the airway, patient size, interface, clinical setting, and acceptable added dead space. |
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| Inspects the sensor, sampling line, airway adapter, water trap, cannula, calibration or zero status, battery, and alarm function and follows the device instructions for setup. |
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| Implementation |
| Positions the sensor or sampling interface at the correct patient connection, prevents kinks, leaks, excessive dead space, and condensate, and confirms gas flow through the sampling system. |
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| Verifies a sustained, recognizable waveform and numeric end-tidal carbon dioxide value over multiple breaths before interpreting the measurement. |
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| For endotracheal-tube placement, uses continuous waveform capnography as the primary confirmation of tracheal ventilation and treats chest rise, auscultation, and tube depth as adjuncts. |
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| Monitoring & Modifications |
| Sets appropriate respiratory-rate and end-tidal carbon dioxide alarms and continuously trends respiratory rate, ETCO2, and waveform morphology when the clinical indication requires continuous monitoring. |
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| Interprets the waveform and trend with the patient examination, oxygen saturation, perfusion, ventilation mode, and arterial blood gas when available rather than treating ETCO2 as interchangeable with PaCO2. |
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| For a sudden loss or sharp decline, assesses the patient first for apnea, disconnection, extubation, obstruction, severe leak, low perfusion, or cardiac arrest, then checks the sampling system and monitor. |
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| During CPR, uses ETCO2 trends as one component of ventilation, compression-quality, and return-of-spontaneous-circulation assessment; an abrupt sustained rise may indicate return of circulation, but a single value does not determine care. |
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| During sedation, transport, or noninvasive support, maintains the selected interface and responds to apnea or hypoventilation earlier than pulse-oximetry change when detected. |
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| Post-Intervention |
| Documents device and sampling method, airway or interface, respiratory rate, ETCO2 value and trend, waveform interpretation, alarm limits, related oxygen or ventilator settings, interventions, and response. |
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| Post-Intervention Management Steps. |
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