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Skills Assessment Report

Date:

Skill Assessment - Capnography

Step Pass Unsatisfactory
Knowledge
States Contraindications and Relative Contraindications of procedure.
Preparation
Clinical Standards for Procedures and Interventions.
Verifies provider order or protocol; reviews chart for indications, goals, contraindications, and recent response to therapy.
Identifies and gathers required equipment: capnograph/capnometer, appropriate sampling line (nasal/oral cannula or inline adaptor), monitor with alarm limits.
Calibrates and warms the capnograph sensor according to manufacturer's instructions to ensure accurate baseline measurements prior to patient connection.
Assessment
Assesses Vital Signs.
Assesses indication (airway verification, ventilation monitoring, sedation monitoring) and baseline ventilation/perfusion status.
Implementation
Connects sampling line or inline sensor; confirms waveform and numeric ETCO2 values.
Verifies proper placement of airway devices using sustained ETCO2 waveform.
Sets alarm limits and trends ETCO2 to evaluate ventilation and perfusion changes.
Monitoring & Modifications
Monitors patient tolerance, work of breathing, and oxygenation/ventilation response during the intervention.
Correlates device ETCO2 values with arterial blood gas PaCO2 measurements to assess accuracy, determine the PaCO2 -ETCO2 gradient, and evaluate trends in CO2 elimination.
Post-Intervention
Post-Intervention Management Steps.

Summary Performance Evaluation

Evaluator

Student Signature

Evaluator Signature