![]() ![]() ![]() Whereas, if your numbers cut in half, the tube maybe too deep,” said Kahn. “It is not just the presence or absence of end-tidal carbon dioxide that you can get with a qualitative colorimetric device, but if we’re looking to see that the actual value is about the same, then that’s a pretty good indication that your tube is right where it needs to be. For instance, if CO 2 levels decrease drastically after intubation, then the tube may be placed incorrectly. If only using a qualitative colorimetric CO 2 detector, which attaches to the endotracheal tube, providers may miss critical information about tube placement. This differs from basic qualitative colorimetric CO 2 detectors, which may only show the presence or absence of CO 2, leaving clinicians with less information. When intubating a patient, a capnography monitor shows the actual value of CO 2. If there is no CO2, then you probably put it in the stomach, if there is CO2, then it is in the lung,” said Krauss, an associate professor in pediatrics and emergency medicine at Harvard Medical School. “So if you want to figure out if you put the tube in the right place: in the trachea as opposed to the esophagus, then you check the CO2 levels. “The principle behind this is that the esophagus has no carbon dioxide, but obviously the lungs have a lot of carbon dioxide,” said Baruch Krauss, MD, EdM, senior associate physician in medicine in the Division of Emergency Medicine of Boston Children’s Hospital. Intubation is a honed skill and clinicians can lean on capnography data to ensure that the endotracheal tube is placed correctly. The Importance of Capnography During Intubation Here are four things you should know about capnography and how it can help you provide better care in prehospital settings: 1. This shows the end-tidal CO2 (EtCO2) reading, which in healthy people is around 35-45 mm Hg, according to information from medical device company Medtronic. The number represents the partial pressure of CO 2 that is normally found following an exhalation. ![]() A waveform called the capnograph will display how much CO2 is present at each stage of the respiratory cycle, which normally has a rectangular shape. On the monitor, a number and graph will represent the amount of CO 2 in exhaled air. Either nasal prongs can be used to capture exhaled air from patients who are breathing or those who need assisted ventilation can use an adapter that is attached to a bag valve mask and advanced airway device. When using capnography monitors, CO 2 data is captured by a sensor. The data gathered from these monitors can also help guide clinicians when they are intubating a patient, which is one of many of capnography’s critical functions, explains emergency medicine physician Christopher Kahn, MD, MPH, who is the chief of the Division of Emergency Medical Services and Disaster Medicine at UC San Diego Health. These monitors are regularly used to better understand the status of patients in respiratory distress, cardiac arrest, and shock. The most commonly used method to monitor CO 2, a capnography monitor, is a mainstay in emergency medicine. Fluctuations in this waste product of the human body can provide important insights into respiratory health, disease, and can even help providers understand how patients are responding to treatments or if the patients’ conditions are improving. With every exhalation, the lungs emit the colorless gas carbon dioxide (CO 2). Here are four things to remember when monitoring EtCO 2 in prehospital settings. Capnography is an essential monitoring technique in for cardiac patients requiring resuscitation and respiratory support. ![]()
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