I have a question about Capnography, I have heard that we (fire departments with ALS providers) need to have this in place by 1-1-09. Then I was told the following
"Capnography will not be in our January, 2009 protocols as a mandatory procedure. It will be a Standard of Care starting June 2009. A recommended procedure for anytime ALS technicians use an Endotrachial tube for intubation. We were explained that a standard of care means that New York State recommends the agencies to get Capnography and start using it".
no problem. they also just had a nassau county protocol meeting 2 weeks ago. the minuets of that meeting should be printed up with in the next 2 weeks i think. so their might be more info
Ifyour Department Does Not Have Capnography At This Point You Can Apply For A Temporary Waiver. If You Use A Life Pak 12 It Can Be Upgraded For Wave Form Capnography. If Not You Can Use A Seperate Piece Of Equipmnet.
The conversion of the Lifepak 12 is pricey,,, like 4-5 grand or more per unit,, I'll have to check the exact numbers with the guy who specced out our stuff, might have been even more... so we use a propaq for ET CO2.. we also have a portable monitor.
If you need more info. on ETCO2 check out www.capnography.com for further info.
The SEMAC issued an Advisory statement....not a protocol. The Advisory states that it's required as of 6/1. However, each local REMSCO sets protocol for its own ALS system. Has Nassau ReMAC met yet to make this Advisory a Protocol statement?
The SEMAC issued an Advisory statement....not a protocol. The Advisory states that it's required as of 6/1. However, each local REMSCO sets protocol for its own ALS system. Has Nassau ReMAC met yet to make this Advisory a Protocol statement?
See where I'm going w/ this?
suffolk advisory is now manditory for use of ETCO2 for ALL intubated patients. even if you see the tube pass the cords, have good breath sounds and negitive epigastric sounds, and you dont use the etco2 then the tube is unsuccessful.
the thought process is that if you have a good wave form on the monitor then you know your in the treacha you wil not get a wave in the stomach.
Waveform capnograhpy has been mandatory in NYC REMAC since Jan 2009,
Nassau REMAC has voted that Waveform capnography will replace the colormetric devices currently in protocol "when available". This will be posted for public comment per the usual process and then take effect if all in order. I would suspect that the "if available" may disappear in the near future once NCPD goes online with their Phillips monitors. It would be hard for REMAC to mandate a technology right now that the NCPD doesn't have (by no means a dig at the NCPD).
SEMSCO and SEMAC are not legally able to require specific equipment, but REMAC can. The State is able to set a "standard of care". They feel, as I'm sure any court would, that this is compelling enough to mandate the use without mandating it...if that makes sense...
There are classes available in the Nassau region for capnography..but I must state that I do teach one of them...just a disclaimer..
Waveform capnograhpy has been mandatory in NYC REMAC since Jan 2009,
Nassau REMAC has voted that Waveform capnography will replace the colormetric devices currently in protocol "when available". This will be posted for public comment per the usual process and then take effect if all in order. I would suspect that the "if available" may disappear in the near future once NCPD goes online with their Phillips monitors. It would be hard for REMAC to mandate a technology right now that the NCPD doesn't have (by no means a dig at the NCPD).
SEMSCO and SEMAC are not legally able to require specific equipment, but REMAC can. The State is able to set a "standard of care". They feel, as I'm sure any court would, that this is compelling enough to mandate the use without mandating it...if that makes sense...
Their are classes available in the Nassau region for capnography..but I must state that I do teach one of them...just a disclaimer..
Be safe.
Don
So as I said earlier, we're really no where w/ it yet in Nassau.
Welcome to the 21 century, many protocols have requiried this since "tube placement" has become such a hot button topic lately. It has truely become the standard of care.
Actually, the state made it the "standard of care" which puts the liability on the agency for not having the capability. It is not physically mandated, as the state cannot enforce the lack of capnography on an ambulance. For that, the state must add it to part 800.
The remac and remsco voted NOT to mandate the equipment as some regions have, rather to leave the issue on the state advisory level.
Capnography
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