Apnea

Capnography to Monitor for Apnea:

We intercepted with a basic unit for a possible cardiac arrest. It turned out to be a patient with end-stage cancer who was a DNR, but the family didn't have the paperwork. She had become unresponsive and they thought she had stopped breathing.

When I climbed in their ambulance she was breathing, but responsive only to pain. The crew said her BP was 80/50. I put her on the monitor to see a sinus rythmn and put her on capnography.

While I was going for an IV line, the apnea alarm went off.

I gave a sternal rub and she started breathing again.

Here's a strip of her declining respirations:

She had several episodes of apnea, but now by watching her we were able to keep her aroused enough to get her to the hospital without having to do any advanced airways or to bag her. There they were able to contact her doctor and affirm she was a DNR.

Here's the trend summary: