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Alaris® EtCO2 module
Topic 5: Responding to Alarms
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High EtCO2 Alarms - Responding to Alarms Using the "APIE" Nursing
Process1
Assess:
- Fever2
- Hypermetabolic state2
- Respiratory distress or shortness
of breath
- Overmedicated
- Increased sedation
- Were PCA doses recently increased3
- Unauthorized
use of PCA (PCA by proxy)
- Snoring or possible obstruction (poor
head/neck alignment
Plan:
- Review PCA doses & physicians orders
- Review
temperature RR and EtCO2 waveform
- Review PCA/EtCO2 trend data
for previous alarm/history
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Intervention:
- Always follow hospital protocols
- Correct fever/hypermetabolic state2
- Improve airway obstruction/positioning
- Adjust PCA therapy as needed/ordered
- Consult RT/MD/other clinical
resources
- Re-educate family/patient on unauthorized PCA button use
(PCA by proxy)
Evaluate:
Reevaluate patient
- response (RR & EtCO2 waveform)
- pain level
- sedation level
- unauthorized use of PCA
- airway management (snoring, obstruction)
- cannula placement
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1Brunner & Suddarth’s Textbook of Medical Surgical Nursing 9th edition.
Smltzer, S.C. & Bare, B.G. Ed. (2000). p. 29 Lippincott
2AACN Procedure Manual for Critical Care 4th Ed. (2001). Ed. Lynn-McHale,
D.J. & Carlson K.K.. American Association of Critical-Care Nurses.
3McCaffery, M., Pasero, C Pain Clinical Manual, Second Edition (1999) Mosby.