Capnography Positioning and Appearance on Monitoring Screens
There are well publicised recurring episodes of unrecognised oesophageal intubation continuing internationally. During a recent coronial procedure in England, it was noted that the airway pressure trace was mistaken for a capnograph trace thereby impeding timely recognition of the oesophageal intubation.
SALG performed a Delphi process with clinicians, regulatory and industry representatives and produced and approved the below statement to improve standardisation in the UK and Ireland and indeed internationally.
It is intended to improve the situation immediately where reconfiguration of monitoring is possible and over time to guide procurement decisions for individual hospitals and industry. Anaesthetic departments may consider placing non-compliant equipment on their hospital risk register.
For multiple trace monitors, where possible, the capnography trace should be standardised:
- at the bottom of the monitor screen
- white in colour
- an area graph
(Ideally all 3)
Other colours should be chosen for the other traces
- Manufacturers should work towards making this standard possible and promote its implementation with customers
- Trusts should put in place mechanisms through anaesthetic, theatre, emergency and Electrical and Biomedical Engineering (EBME) departments to implement locally
- It is envisaged that national standards (Standards of Monitoring and ACSA) will incorporate the standard in time