We added capnography to both dental suites this week, and as the assistant on monitoring I’m finding the EtCO2 trends helpful for catching hypoventilation earlier, but I’m still deciding when to bump ventilations versus tweak anesthetic depth… If you’ve made this switch recently, what practical cues or quick-reference notes helped your team keep patients steady without overcorrecting?
I keep a Sharpie note on the monitor: “EtCO2 >55 for 3 breaths + RR <8 → give 2 slow bags; if MAP <65, drop iso 0.25% first and reassess in 2 min.” If the waveform turns a little “shark fin,” I check for a kink or a wet water trap before tweaking ventilations or depth.
Since adding capnography to our dentals, I give a single slow “test breath” when EtCO2 drifts into the low 50s — if it drops by >5 mmHg and stays lower for the next two breaths, I keep assisting; if it rebounds immediately, I back the iso off a hair instead. Small caveat: in tiny patients the HME can bump dead space and mimic rebreathing, so I remove it before deciding.
Quick tip: if EtCO2 drifts >50 with a slanting plateau, I give two slow recruitment breaths (2–3 sec each) and watch for the plateau to square off; if the “shark fin” sticks, I swap the sampling line/HME because dental spray condensation fakes highs more than you’d think. @ghansen56 I’m with you on inspiratory CO2 — if it’s >3–5 mmHg I fix rebreathing first; otherwise I’ll trim iso 0.25% only after the waveform looks clean. Tiny cats get half‑volume bags to avoid overshoot — do you use a water trap on your capno line?