Gallant, Stephanie L.. Evaluating the impact of end-tidal carbon dioxide monitoring in emergency department sepsis patients. Retrieved from https://doi.org/doi:10.7282/t3-cge4-5m32
DescriptionSevere sepsis and septic shock remain significant international health burdens with high mortalities and financial implications. Rapid identification of the septic patient is imperative as compliance with guideline-recommended, time-specific bundles has been shown to decrease sepsis-related mortality. Despite this, compliance with the bundles remains low. Evidence has suggested that end-tidal carbon dioxide (EtCO2) monitoring may be a viable intervention to aid in overcoming some barriers to sepsis identification and initiation of treatment.
The purpose of this project was to evaluate whether the use of end-tidal carbon dioxide (EtCO2) monitoring in patients being evaluated for sepsis in the adult emergency department will result in decreased time to recognition and time to antibiotics, and increased bundle compliance, including overall, antibiotic, and intravenous fluid compliance, as compared to those who do not receive EtCO2 monitoring.
Using the Ottawa Model of Research Use as a conceptual model, this project consisted of a pilot evaluation of EtCO2 monitoring as part of an existing Code Sepsis response, followed by aggregate data review. Time to antibiotics and recognition, percent of patients receiving antibiotics in three hours, and total bundle compliance increased, while the percent of patients receiving appropriate intravenous fluids decreased. None of these results showed statistical significance. The results of the pilot evaluation do not support the addition or removal of EtCO2 monitoring. There are several indications for future research, including a longer evaluation time and evaluating potential confounders.