Tuesday, February 13, 2024

EMS Patient Monitoring - Capnography 3

ETCO2 monitoring is a valuable tool for EMS Providers as it provides real-time information about a patient's respiratory status and overall physiological condition. Here's how ETCO2 is useful for EMS providers:
Ventilation Assessment: ETCO2 levels reflect the adequacy of ventilation. Monitoring ETCO2 helps EMS providers assess whether a patient is effectively eliminating CO2 through ventilation.
Confirmation of Airway Placement: ETCO2 is commonly used to confirm proper placement of an endotracheal tube or other advanced airway devices. A sudden increase in ETCO2 during intubation indicates successful placement within the trachea, whereas low or absent readings may suggest esophageal or misplaced airway.
Circulatory Status Indicator: Changes in ETCO2 levels can provide insight into the patient's circulatory status. A sudden decrease in ETCO2 may indicate reduced cardiac output, potentially signaling cardiac arrest or severe shock.
Monitoring During CPR: ETCO2 monitoring is crucial during cardiopulmonary resuscitation (CPR). A sudden increase in ETCO2 levels during CPR may indicate return of spontaneous circulation (ROSC), while persistently low levels may suggest poor perfusion and the need for intervention.
Detection of Respiratory Distress or Failure: ETCO2 is a sensitive indicator of respiratory distress or failure. A sudden decrease in ETCO2 may signal respiratory compromise, allowing providers to intervene promptly.
Prognostic Tool: Persistent low ETCO2 levels during CPR are associated with a poorer prognosis. Monitoring ETCO2 trends can help providers make informed decisions about the effectiveness of resuscitative efforts.
Guidance During Procedural Sedation: EMS providers can use ETCO2 monitoring to ensure adequate ventilation during procedural sedation. This is particularly important when administering sedatives or analgesics that may depress respiratory function.
Trauma Assessment: In trauma patients, ETCO2 monitoring can aid in identifying respiratory distress due to thoracic injuries or other traumatic conditions.
Early Detection of Respiratory Complications: Monitoring ETCO2 allows for the early detection of respiratory complications, such as hypoventilation or respiratory depression, enabling timely intervention.
Further Reading:
Capnography: Principles and Practice by Michael K. Copeland
Capnography, King of the ABC’s: A Systematic Approach for Paramedics" by Troy Valente

Paramedic Care: Principles & Practice" by Bryan E. Bledsoe, Robert S. Porter, and Richard A. Cherry 

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