Waveform Capnography | ACLS-Algorithms.com

Comments

  1. Kristin says

    Is there a “normal” EtCO2 reading immediately after ROSC? Would I see an immediate spike to WNL or will it take several minutes?

  2. PR Do says

    After reading all these comments , is there anyone who can comment on the accuracy of capnagraphy during CPR being performed with an extraglottic device such as an LMA or King LMA combitube. Since many out of hospital cardiac arrests arrive at our ED with these devises in place, with CPR in progress, it would be interesting to know.

    • Jeff with admin. says

      I would say any airway device which is placed properly will give an accurate CO2 level. In turn, this would give you a good capnography reading. I think that the LMA or King LMA combitube when placed properly would give ETCO2 results.
      In fact, ETC02 readings may help with better placement of these types of airways. Here is one study:

      Kind regards,
      Jeff

      • Kb says

        Hey. Swedish medic here. Thanks for a great post. Follow up q regarding etco2 and Lma…in our protocol we are using a ratio of 30 comp. /2 vent during cpr when igel is placed. Can we still use the etco2 or is it only reliable when used in continuous compressions and 6-10 vent? Thanks for som input regarding This question.

  3. Margaret Mullin says

    It is intuitive that increased velocity would account for increased EtCO2 and increased EtCO2 correlates with increased number of survivors. But I have some numbers that do not show this – can anyone speculate a reason why increased velocity is not correlated with improved survivor rate

    • Jeff with admin. says

      All of the questions are developed from the AHA ACLS provider manual. They cover the content that you will see when you take the test. However, they are not the same questions as on the test. All of the practice questions are unique questions developed for this site.

      Kind regards,
      Jeff

    • Jeff with admin. says

      The BVM would probably give you inaccurate results if you were using the BVM over a capnography cannula. For best results during cardiac arrest, waveform capnography should be performed with an ET tube in place.

      Kind regards,
      Jeff

  4. jennacleaveland says

    How can you use waveform capnography to confirm ET tube placement during CPR. Would it look different than patients without an ET tube. Confused???

    • Jeff with admin. says

      If an ET tube is not properly placed, you will not see the waveform that should be present as you administer breaths with a bag-vaulve-mask. It is that simple. No waveform=No proper intubation.
      Once the tube is in its proper place, the ETCO2 will be able to be read, but until the ET tube is in place, you will not see the proper waveform that is seen when breaths are administered.

      Kind regards,
      Jeff

  5. John says

    Haven’t seen the video but have enjoyed this page. Btw, as an anesthesia doc who’s intubated more than ten, probably less than 20k patients, code intubations can be very challenging at times. Especially in an indulgent population (ours) with skyrocketing BMIs. Prepare for the worst and don’t waste time figuring out that you’re in trouble. Call for help early, it’s a sign of intelligence.

    • drsharini says

      i agree! deferring moments are when sometimes you’re thought incompetent if you call for help. Sigh.. better safe than sorry the saying goes.

      • CCRNCENPHRN says

        Personally I believe we should be placing supraglottic airways during arrests and then swapping them out for an ETT should ROSC occur. Most folks don’t intubate nearly enough, especially with chest compressions ongoing, to be skillful enough to keep pauses in compressions < 10sec. SALT airways are an option.

    • Laura says

      capnography.com is a great start (covers the basics as well as how to troubleshoot some interesting waveforms). If you have access and the ability to pay for it, I just completed the physio-control university’s 5hr course on waveform capnography….very very VERY informative and helpful and provides you with CEs upon completion and passing an evaluation!

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