Canadian Agency for Drugs and Technologies in Health (CADTH) has called for feedback on its report, “Capnography for Monitoring End-Tidal CO2 in Hospital and Pre-hospital Settings: A Health Technology Assessment”.
CADTH was created in 1989 by “Canada’s federal, provincial, and territorial governments, CADTH was born from the idea that Canada needs a coordinated approach to assessing health technologies.” As the tagline on CADTH’s website proclaims – “When Canada’s health care decision-makers need to know, they ask CADTH. We’re a trusted source for evidence on drugs and medical devices.”
CADTH explains why it is conducting an assessment of the benefits of capnography monitoring:
CADTH is undertaking a health technology assessment on capnography for monitoring end-tidal CO2 (ETCO2), the level of carbon dioxide (CO2) in a human breath at the end of an exhalation. An ETCO2 measurement can indicate a patient’s cardiac output and pulmonary blood flow. One way to measure ETCO2 is using capnography — a non-invasive method that displays the measurement in both graphical and numerical forms. With capnography, a patient’s ventilation status is monitored in real time, enabling health care providers to instantly identify if a patient is having breathing complications. Anesthesiologists have been using capnography for decades to monitor ETCO2 in patients receiving general anesthesia. More recently, advances in capnography have expanded its use beyond anesthesiology — it is now being used in several clinical areas within hospitals and pre-hospital settings (e.g., in ambulances). Depending on the clinical area, the technology is at various stages of adoption.
The growing use and potential of ETCO2 monitoring technology, uncertainty in the benefits and cost-effectiveness of capnography devices, and implementation issues were the main drivers for this CADTH health technology assessment.
CADTH has asked for input on its draft report by February 16, 2016.
The Physician-Patient Alliance for Health & Safety (PPAHS) believes that patients should be continuously electronically monitored for greater patient safety:
Opioid Safety, for patients receiving opioids in hospital and healthcare facilities, is the management and minimization of the risks of respiratory compromise, adverse events, and death through continuous respiratory monitoring with pulse oximetry for oxygenation and with capnography for adequacy of ventilation.
PPAHS has shared the experiences of hospitals in improving patient safety, reducing adverse events, and decreasing hospital costs:
- Joseph/Candler Hospitals (Savannah, Georgia) celebrated more than 10 years of “event free” years of patient safety. As reported in the Anesthesia Patient Safety Foundation (APSF) newsletter, St. Joseph/Candler estimated that its potential expenses averted (not including potential litigation costs) was $4 million and its 5-year return on investment was $2.5 million.
- Wesley Medical Center (Wichita, Kansas) reduced its severe adverse events from 13% to 0%.
- White Memorial Medical Center (Los Angeles, California) has experienced a “better than fifty percent reduction in calls of rapid responses”, according to Richard Kenney, MSM, RRT, NPS, ACCS, RCP (Director, Respiratory Care Services, White Memorial Medical Center).
Please help out the Canadian healthcare system – let them know your comments on CADTH’s draft report.