John’s Troubleshooting Tip of the Month: Capnography Monitors (ETCO2)

PHS understands how stressful it can be when a piece of equipment isn’t working properly, and we want to help resolve any issues as soon as possible for you. So, once a month, PHS Respiratory Therapist, John Sheahan will post a tip on how to troubleshoot a common error with a piece of equipment.

Capnographs or ETCO2 monitors as they are sometimes called are extremely valuable machines for monitoring your patient or child’s carbon dioxide as they breathe. Of course with any machine there can be problems. This month I will focus on a few troubleshooting steps that will insure you always getting the most accurate readings when using a capnograph to trach.

Novametrix Capnogard ETCO2 Monitor

Novametrix Capnogard ETCO2 Monitor

When using the Novametrix Capnogard monitor be sure to always calibrate before use by following the step-by-step instructions below:

Calibrating the Sensor

  1. Press CAL key. The message “PLACE ON ADAPTER IN ROOM AIR” displays.
  2. Place sensor and adapter away from all CO2 sources.
  3. Press START key. The “TIME REMAINING” number counts down and main menu displays.
  4. At the end of countdown, remove Patient Airway Adapter and place Capnostat on “0” rear cell. Wait for the countdown.
  5. When “PLACE REFERENCE CELL” message displays, move to (front) “REF” cell.
  6. When “CALIBRATION VERIFIED” displays, remove from reference cell and place Patient Airway Adapter on Capnostat.
  7. Press CAL key.
  8. Press START key. Wait for the countdown.

Tidal Wave Novametrix Capnograph

TIDAL WAVE Novametrix Monitor

When using the TIDAL WAVE Novametrix monitor be sure to always zero before use by following the step-by-step instructions below:

Zeroing a new patient airway adapter

  1. Attach a new patient airway adapter to the TIDAL WAVE patient cable.
  2. Press POWER button to turn machine ON.
  3. Make sure light below NEO key is OFF.
  4. Wait for the sensor on the patient cable to warm up. NOTE! The text SENSOR WARMING displays on screen.
  5. Press and hold NEO key until the ZERO menu screen displays.
  6. Press the PAGE button to “zero” the adapter. NOTE! Pressing this button starts a process that allows the machine to read your child’s carbon dioxide levels accurately. This process is occurring when the machine’s screen shows a numerical countdown.
  7. When the zero process is complete, the machine automatically switches to monitoring mode.
  8. You can now use the machine as ordered by your child’s doctor.

Troubleshooting tips for your TIDAL WAVE monitor

If the carbon dioxide, or ETCO2, results seem inaccurate (for either monitor):

  • Make sure patient cable is tight and not damaged.
  • Check Patient Airway Adapter for cracks or water spots.
  • If you need to disconnect and reattach the patient cable (Novametrics Capnograph only) or change the Patient Airway Adapter recalibrate or Zero the machine.
  • If ETCO2 results are still low check for leak around the trach. This can give a false low reading.
  • If these steps do not correct the problem call PHS.

John Sheahan, RRT-NPS, LRTJohn Sheahan, RRT-NPS, LRT is a Licensed Respiratory Therapist at PHS and would love to hear from you if you have a tip that you’ve found helps when working with your equipment, or have an idea for a Troubleshooting Tip post. Share your tip or idea through a comment here or an email to John at

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