A patient arrives in the emergency department via ambulance following rescue from a house fire. The instrument that would be most appropriate to assist the respiratory therapist in assessing this patient's oxygenation status is which of the following?
a. Capnograph
b. Pulse oximeter
c. Calorimeter
d. CO-oximeter
ANS: D
Laboratory CO-oximeters measure four types of hemoglobin: oxyhemoglobin (O2Hb), deoxy-genated hemoglobin (HHb), carboxyhemoglobin (COHb), and methemoglobin (MetHb). This is beneficial for patients who are suffering from smoke inhalation. The CO-oximeter provides the actual O2Hb and the COHb. Carbon monoxide produces an erroneously high oxygen saturation measured by pulse oximeter (SpO2). Therefore, if smoke inhalation is suspected, a CO-oximeter should be used to evaluate the oxygen saturation. Capnography is the measurement of carbon dioxide concentrations in exhaled gases and is used to assess proper airway placement. Calorime-try allows the clinician to estimate energy expenditure from measurements of oxygen consump-tion (O2) and carbon dioxide production (CO2). This measurement may be useful when weaning a patient from mechanical ventilation.
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