TCM problems

Specialties NICU

Published

Anybody have any tips for getting reliable readings consistently from a transcutaneous CO2 monitor???

Last night, taking care of a 2 week-old former 26+6 weeker, I was ready to kill the TCM.

The last gas on dayshift had a CO2/TCCO2 correlation of +2 (53/51). At 4 pm, I re-callibrated the sensor and changed the site. Membrane looked fine, so left it alone as I have gotten really wacky readings after re-membraning (now I re-cal at least 3 times in a row after re-membraning...)

Next ABG to be at 5pm. TCCO2 climbed from 50s to 60s and gas was delayed until 5:30 pm due to brief brady/desat (gave her time to recover). TCCO2 at time of gas reading 64 CO2 on gas = 50. OKAY, crappy correlation. :(

7pm, I change site (no re-cal -we usually only do it q shift). TCM reading 57-69 over next 3 hours. Next gas 10 pm: TCCO2 64 again), ABG: 63.:confused:

Changed site again after the 10pm gas and TCCO2s in sixties. Report at 11 pm: TCCO2 starts dropping to the mid 40s. I'll find out this afternoon what the 12mn gas was...

What am I doing wrong??? :confused: :confused: :confused:

sounds great but not all out vented babe's have art lines

Specializes in NICU, PICU, PACU.

Neither do ours. We use them on the most critical and the smallest ones. We do CAP gases on the others, usually q12-24 hours if we aren't making a lot of moves. We were all dancing when they got rid of the TCM :lol:D

Weve had 2 big problems recently with art lines

One in a 25 wk twin when they couldnt get an umbilical line in (major prob twin twin transfusion the poor kid had an hb of 4) they just managed periphal canula to put blood and fluids through. I've never seen that consultant fail to get a line in before but thank god the TCP02 was acurate.

The other was a singleton who must have the worst veins ever the umbilical line had to be removed due to toes discolouring paripheral art line dito with fingers. we ran this kid on tcp02 too no one dares put another art line in.

Neither was well enough to be on 12 hourly gases

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