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Cleveland, Ohio
This Web site is an unparalleled educational resource on the topic of capnography. It is vast and comprehensive, covering almost every imaginable aspect of the topic. The site is authored by Bhavani Shankar Kodali, M.D. of the Department of Anesthesia at Harvard Medical School and Brigham and Women’s Hospital in Boston, Massachusetts. The author dedicates the site "to enhancing the safety of patient care, inside as well as outside of the operating rooms" and emphasizes that "capnography is much more than simply checking the position of endotracheal tube." As such, it is his goal that this effort "not only addresses the basic principles but also be a forum for active discussion on issues related to capnography in all medical fields."
What makes this site particularly special is the use of animated graphical techniques to assist in the understanding of capnographic concepts. These animations show capnographic tracings moving across the computer screen as they do in real life, with special areas of interest highlighted and labelled for easy comprehension. This makes this Web resource far more valuable than an ordinary textbook.
Use of Microsoft Internet Explorer under Windows is recommended for the site; because of potential problems with the scripting language used, parts of the presentation (such as the "Capno-Magic Screen") may not work in other environments.
I found the site to be intuitive and easy to navigate. Earlier versions of the site employed strange highlighting of text with various garish background colours that seriously detracted from the site’s quality. In fact, I was so offended by the esthetics of the original site that I originally decided not to review it. Fortunately, the November 2002 revision of the site completely corrects this problem.
The site includes many sections. The section "ASA Guidelines" discusses clinical standards pertaining to capnographic monitoring. Another section "Why Capnography?" discusses terminology, definitions, physics, physiology, and clinical matters. An atlas of capnograms is also provided, as well as a quiz section for personal knowledge testing. Other sections include: clinical tips, frequently asked questions, and discussions on capnography concerning pediatrics, laparoscopic surgery, thoracic surgery, and intensive care medicine. Links to other capnography sites (e.g., www.capnography.net) are also provided. Finally, there is also a "guest book" where readers can post their comments and suggestions.
One peculiar aspect of the site is a series of stern legal disclaimers to the effect that there is no claim made that "the information supplied ... is sufficient to enable a reader to pass any credentialing exam", that the information "is NOT intended to be used for clinical practice or patient care", and that "there is also no intent to enter into any physician-patient relationship." It is not clear whether these disclaimers are a parody offered for the amusement of readers or whether Dr. Kodali is simply mistrustful of the American legal system.
It is apparent, however, that Dr. Kodali has put forth many hours of dedicated effort (indeed, over 1,000 hours, according to the author) to produce what is essentially a free, unsponsored, electronic textbook of capnography. This is an example of a new kind of high-quality medical education resource that we hopefully will see more of in the future: interactive, animated, unbiased and free. Highly recommended.
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