Combitube ?

[usalsfyre]

While I think ETCO2 is useful in the non intubated patient (i.e. esophageal tracheal tube, LMA, tracheal tube, etc.) it is worth noting that the jury is still deliberating on this issue.

In the most recent ECC and ILCOR guidelines update they mention that while the use of ETCO2 in the non intubated patient is useful, the true measure of what it actually shows us in this patient population is up for debate.

Consistently expecting the same quantitative data readings that we get with intubated patients just has not been proven or fully studied yet.

There's probably some differences to be expected in quantitative data (which let's face it, is of limited utility without a baseline ABG anyway) but what I care more about is the capnograph tracing.

 

[WTEngel]

I agree, without a baseline gas along with a tube that we know the exact location of (ET tube) the waveform is really the only thing of significance to me.

While I agree that trending the numbers you get initially is a good way to measure resuscitative efforts, I'm afraid that capnography is quickly becoming another set of numbers that people are under educated on and want to arbitrarily manage.

That's really one of the best take away points of the thread usla. Without a good gauge of where that patient "lives" normally and a good gas to compare against, ETCO2 can sometimes be just as misleading as SPO2 or any number of other parameters some providers randomly choose to fixate on.

 

[usalsfyre]

While I agree that trending the numbers you get initially is a good way to measure resuscitative efforts, I'm afraid that capnography is quickly becoming another set of numbers that people are under educated on and want to arbitrarily manage.

That's really one of the best take away points of the thread usla. Without a good gauge of where that patient "lives" normally and a good gas to compare against, ETCO2 can sometimes be just as misleading as SPO2 or any number of other parameters some providers randomly choose to fixate on.

There's a school of thought (that I personally subscribe to) that says except for cases of respiratory failure, post-intubation put the patient's ETCO2 back to where you found it pre-intubation. Even then, I would err on the hypercapenic side of normal while maintaining oxygenation. Hypercapnia takes a long time to kill somebody.

 

[cfd3091]

+1 for what MSDeltaFit said. You can actually use quantitative capnography as a quality indicator of compressions. Were the changes in ETCO2 correlating with the quality of compressions?

+2 on compressions