Medic and Portable Pulse Oximeter Respiratory Rate Measurement Comparison to Waveform Capnography: A Prospective,...

Area of Science:

• Military Medicine
• Emergency Medical Services
• Physiological Monitoring

Background:

• Airway management is critical in battlefield care, with respiratory rate (RR) measurement a key TCCC guideline.
• Current US Army medic practice relies on manual RR counting, which is operator-dependent and affected by combat stressors.
• No prior studies have evaluated alternative RR measurement methods for medics in tactical settings.

Purpose of the Study:

• To compare the accuracy of Army medic respiratory rate (RR) assessments against waveform capnography and commercial finger pulse oximeters.
• To evaluate the time efficiency of different RR measurement methods in a tactical context.

Main Methods:

• Prospective, observational study comparing Army medic RR assessments with pulse oximetry and waveform capnography.
• Measurements taken at 30 and 60 seconds, both pre- and post-exertion.
• Included end-user surveys to gather medic feedback.

Main Results:

• Manual RR did not significantly differ from waveform capnography at rest (p=0.523).
• Post-exertion, manual RR was significantly lower than waveform capnography (p<0.001).
• Medic RR acquisition was slower than pulse oximetry at rest (p<0.001) and exertion (p<0.001).

Conclusions:

• Medic-obtained RR deviates significantly from advanced monitoring at elevated rates.
• Commercial pulse oximeters with plethysmography show no significant difference from waveform capnography.
• Pulse oximeters with RR plethysmography warrant further investigation for battlefield deployment.