Which monitoring modality is essential to detect early respiratory compromise during procedural sedation?

• A. ECG monitoring.
• B. Continuous capnography (end-tidal CO2) monitoring.
• C. Intermittent pulse oximetry.
• D. Blood gas analysis.

Answer: (B)

Continuous capnography provides real-time measurement of ventilation by monitoring exhaled CO2 and showing a waveform. This lets you detect hypoventilation, apnea, airway obstruction, or disconnections the moment they begin, so you can intervene before oxygen levels drop. Oxygen saturation can stay normal for a while because of supplemental oxygen and the body's reserve, so relying on pulse oximetry alone may miss early respiratory problems. ECG monitors cardiac rhythm, not ventilation, and blood gas analysis is invasive and not continuous, so it won’t alert you promptly to changing ventilation. For these reasons, continuously monitoring end-tidal CO2 is the best way to detect early respiratory compromise during procedural sedation.