Capnography is an important tool in sedation dentistry because during minor to moderate sedation, a patient’s breathing depth and rate decrease. For this reason, dental professionals around the country are increasingly monitoring end tidal carbon dioxide (etCO2) as standard practice during sedation.
The Oregon Board of Dentistry is the latest to update its guidelines to require etCO2 monitoring in moderate and deep sedation in an effort to increase safety in procedures. This amendment to Section 26 of the Oregon Dental Practice Act goes into effect July 1.
Capnography provides continuous, real-time, non-invasive measurement of etCO2, producing a waveform, or capnogram, that indicates changes in exhaled CO2 concentration throughout respiration. Monitoring etCO2 enables clinicians to evaluate the current status of the patient’s ventilator, circulatory, and metabolic systems.
The Oregon Board of Dentistry requirement change follows a national trend toward required capnography monitoring.
Capnography monitoring as a growing trend
The American Association of Oral and Maxillofacial Surgeons has also updated their requirements, following the lead of the American Society of Anesthesiology (ASA), the American Heart Association and other organizations that develop parameters of care and practice guidelines for dental and medical surgical specialists. AAOMS will require etCO2 monitoring for moderate and deep sedation, as well as general anesthesia by January 2014.
The following paragraph is an excerpt from AAOMS ParCare 2012, Anesthesia in Outpatient Facilities:
“The use of capnography for patients under moderate sedation, deep sedation and general anesthesia should be instituted in OMS practice and used on these patients effective January 2014 unless precluded or invalidated by the nature of the patient, procedure, or equipment. It is anticipated that this implementation date will allow adequate time for the refinement of materials and methods so as to optimize the use of capnography in an open system.”
Types of Anesthesia that require capnography monitoring
General anesthesia is the heaviest level of anesthesia. The patient loses consciousness and cannot feel sensations. Airway support is frequently required and cardiovascular function may be impaired. General anesthesia must be administered by an anesthesiologist, nurse anesthetist or by an anesthesiologist’s assistant who is directly supervised by an anesthesiologist.
In deep sedation, the patient experiences depressed consciousness and partial loss of protective reflexes and the ability to follow verbal commands.
In moderate sedation, the patient is still conscious and can respond to commands.
Solutions for upgrading to capnography monitoring
DRE can provide medical facilities affordable options to incorporate etCO2 monitoring in their surgical protocol. We have new and refurbished options for capnography monitors and multi-parameter monitors with etCO2.
The DRE Echo CO2 Capnograph monitor is a lightweight, portable, low-cost option with a high resolution color display for SPO2 and CO2 monitoring. The Echo CO2 monitor is effective for neonatal, pediatric and adult intubated and non-intubated patients for continuous, long-term monitoring.
The DRE Waveline EZ Portable Patient Monitor with touch screen is a multi-parameter option that can come outfitted to monitor etCO2. At only six pounds, it is one of the most mobile multi-parameter monitors on the market. The Waveline EZ monitors ECG, respiration, SpO2, NIBP, etCO2 and temperature.
DRE has a variety of other new and refurbished options for capnography monitoring. For more information about etCO2 and anesthesia gas monitors, visit dremed.com or call 1-(800)-462-8195.
