New Developments in End-Tidal CO2 Monitoring

Over the last few years the two most rapidly growing new EMS
product technologies have been CPAP and ETCO2 devices. While the range of CPAP
devices suitable for EMS providers has not changed recently, the choices of
ETCO2 devices are growing. Two reputable manufacturers that understand the
needs of Emergency Professionals have just introduced new ETCO2 monitors.

There are three basic types of ETCO2 Monitor, sidestream,
mainstream, and colorimetric. Sidestream devices pull a small gas sample into
the machine. They are usually a little more sophisticated and can display
waveforms and trends. Until this month only sidestream devices were
quantitative, or could display a numeric CO2 value. Sidestream units are a little
more complicated to maintain and service, but give more information and can be
used with a special cannula on breathing patients. Mainstream units measure CO2
using light reflectance photometry right at the ETT. They commonly display a
CO2 sample strength indicator. They usually cannot display an actual numeric
value. Colorimetric devices are disposable adjuncts that use a litmus style
paper filter that changes color when exposed to CO2. Mainstream and
Colorimetric devices are usually used just for verifying ETT placement on
non-breathing patients.

Nonin Medical, the company that launched EMS Pulse Oximeters
in the United States, has announced the introduction of their new LifeSense
. The LifeSense is a full-featured device that combines Medair EtCO2
with Nonin PureSAT® Pulse Oximeter technologies. This is a
sidestream type ETCO2 device that can display waveforms and trends. This
product features;

  • Widescreen touch panel

  • NONIN PureSAT SpO2

  • Medair EtCO2
    Technology rate display

  • Numerical EtCO2
    and SpO2 display

  • 4-hour waveform trending
  • Capnograph and plethysmograph

  • Backlit LCD display
  • Audible and visual alarms
  • Data output via RS-232 port

The brand
new The BCI®
capnometer is a small portable capnometer that monitors carbon
dioxide concentrations and respiratory rate in one easy-to-use device. This is
the first quantitative mainstream ETCO2 device. It’s very small and light, and
engineered to go directly between your ETT and ventilatory device. It gives
providers not only verified ETT placement, but also provides a constant
assessment of ventilation performance. When using a BVM, the Capnocheck will
provide a constant display of both respiratory rate and ETCO2 numeric value,
helping you to maintain the proper ventilation rate and minute volume. I really love this product, but wish it was 500 bucks and 5$ per use instead of a grand and 10$. Still, it’s just too cool ignore. This
product features;

  • Pocketsize, lightweight (2.1

  • Easy to use
  • Fully quantitative
  • Miniaturized mainstream

  • Battery powered – 2 AAA
  • No routine calibration

  • No warm up time needed

Either of these new monitors can help you do a
better job of safely managing the airway and ventilation. Many EMS agencies
today have mandated ETCO2 for lots of good reasons. It is rapidly evolving into
a new standard of care that either of these two devices can help you meet. The
benefits should be fewer critical airway management failures that go
unrecognized, and better compliance with the latest CPR standards.

About Dan White

I'm a retired Paramedic and EMS Instructor with 35 years EMS and emergency medical product experience. I love canoes, cars and EMS. I have written a lot about EMS Technology on the Paramedic Blog, the Insights on Innovation column for, on and I can be reached directly at 573-240-0002.
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2 Responses to New Developments in End-Tidal CO2 Monitoring

  1. Eric says:

    Hi Dan – great information as usual.  Peter Canning has a great capnography website at, and there\’s a link to a PowerPoint presentation that I put together.  It\’s getting to be standard now, and you can use capnography to monitor many different illnesses & injuries.  TTFN

  2. Dan says:

    Thanks a Lot Eric, I downloaded and viewed –
    Awesome, and obviously a lot of work went into it. It\’s going out to all my people.

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