Question: I think a lot of paramedics have trouble telling the difference between pulmonary edema (CHF) and bronchoconstriction now. If we had capnography nasal sensors, you could see that the wave form is still flat on top for the CHF while the bronchoconstriction has the shark tooth pattern. This could be a good tool for all paramedics to learn pulse ox without capnography. It is like looking at the heart rate with out and EKG. This should be taught to all paramedics, what do you think? As of now we do not have the nasal sensors, only the ET hook ups.
Excellent review. While capnography does carry additional diagnostic information as you describe, currently waveform capnography does not form standard monitoring equipment in many emergency departments let alone EMS.
That is not to say that waveform capnography is not a valuable resource nor perhaps someday will it form part of your/our standard equipment.
Beyond that, individual EMS services are responsible for the purchase of equipment and must make decisions surrounding the finances based upon multiple other competing priorities. It is difficult for the Base Hospital to recommend additional equipment as mandatory when it exceeds the MOHLTC Minimum Equipment List for Land Ambulances. Remember, oxygen sat monitors and 12 lead ECG monitors are currently not even on the list!