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Definitely correct. Do you know why they call it "peak" end tidal? Other than the fact that it's the highest point on the waveform ;) Why is there a gradual accelerating waveform?

Per ACLS guidelines, in general... Supplemental oxygen should be avoided if the SpO2 is normal and they have no respiratory distress. This includes ACS, STEMI, ROSC, etc.

Calcium Chloride (better than bicarb) -> Sodium Bicarb -> D50/Insulin -> Albuterol 25 mg/hr

Yeah I can't tell you how many times I've started continuous nebs to CHF patient's under a physician's order. It's not necessarily the worst thing to do, but most certainly not the most helpful. Some patients with CHF who take albuterol psychologically do better after a treatment, or at least...

This is definitely off-topic to the original post... but I have found these patients (who are on mechanical ventilation) are usually best placed in a spontaneous, pressure supported mode (which may be PS/CPAP or just SIMV with an extremely low rate). It has been my experience that their...

You're absolutely right. These patients are acidotic. The low ETCO2 is most definitely due to the hyperventilatory compensation that is occurring. An ABG may look something like this: pH 7.29 / PaCO2 25 / PaO2 89 / HCO3- 10 Just remember that the acidosis is due to the LOW bicarb... because...

No problem... Check out a more detailed discussion of ECMO in Adults attached... Love this journal (for obvious reasons)

Thanks... I find myself at a remote/slow base staring at the wall haha. What better to do than put my thoughts on a forum? :)

Sorry, I don't have any evidence to present right off the top of my head, but I will say that the mortality for ARDS/MODS in the adult patient receiving ECMO is proportionately much higher than in the pediatric world. It would seem that pediatric patients in general respond much better to ECMO...

So ETCO2 is a correlation to PaCO2, not necessarily an accurate picture of the partial arterial pressure of carbon dioxide. Actually, in normal lungs, ETCO2 reads approximately 5 mmHg lower that PaCO2. However, your question regards the retention of CO2... I'll see if I can give you an...

It's awesome that you care about your patient care enough to seek advice about this! Of course, it can be hard to differentiate between COPD/CHF exacerbation, especially if there is a documented history of both co-morbidities in the patient. First off, clinical presentation goes a long way...