Good day my fellow ALS providers. I need alittle input on a topic. Now lets say you have a LVF/CHF patient presenting with typical s/s. Lets say you hear rales all fields accompanied by diffuse expiratory wheeze. We all know its most likely cardiac wheeze. Now, beginning with trending tx. response with ETCO2, starting point. You "should" see upright/slightly narrowed wave form. because the alveoli are still, for the most part, emptying equally. I understand that alot of these diseases will accompany one another, but still...to see bronchospasming and or lung disease (B to C upstroke slope) shark fin. It kind of defeats the purpose using ETCO2 as a diagnostic tool to choose the right first line treatment. Standard of care is aggressive nitrates and CPAP for CHF and B-2 agonists ie (Albuterol) for obstructive airway disease. What do you guys think is the best way to help differentiate between the two using ETCO2?