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The Ultimate Vital Sign? Importance of Capnography in EMS. Joshua Erdman, BS, CCEMT-P UW Emergency Education Center. CO2. CO2. CO2. O2. O2. O2. The full cycle. CO2. CO2. CO2. O2. O2. O2. The full cycle and our other vital signs. Capnography. EKG. RR. Pulse. BP. Pulse ox.
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The Ultimate Vital Sign?Importance of Capnography in EMS Joshua Erdman, BS, CCEMT-P UW Emergency Education Center
CO2 CO2 CO2 O2 O2 O2 The full cycle
CO2 CO2 CO2 O2 O2 O2 The full cycle and our other vital signs Capnography EKG RR Pulse BP Pulse ox
The full cycle • Measuring CO2 allows us to look at: • Ventilation • Perfusion • Cellular metabolism • And all instantly!
Capnography • Technology uses the Infrared absorbing capability of CO2 to determine the amount in a sample of air • Gives us a measurement in mmHg • Can graph this amount over time
Technology • Two types • Mainstream • Advantage: Fast • Disadvantages: Bulky, usually only for intubated patients • Sidestream • Advantages: Small samples, able to be used for spontaneous breathers • Disadvantages: Slight time delay (<0.5 seconds)
Intubations • The #1 reason most paramedics know to use capnography • AHA now identifies as the BEST way to confirm your tube (2010 guidelines)
Ventilation rates • Normal value should be 35-45 mmHg • When ventilating, • if too LOW, you need to SLOW • if too HIGH, you need to FLY (go faster) Vent. rate ETCO2
CPR uses • Effective compressions • ROSC • Termination of CPR • Should I even have started?
Spontaneous breathers • Asthma vs. hyperventilation
Spontaneous breathers • Overdose • CHF • Ketoacidosis • Sepsis • Hyperthermia • MI, especially right-sided or inferior wall
In summary…. • Legal defense for intubations • Immediate indication of changes in ventilation or perfusion • Many clinical diagnosis possibilities when taken in consideration of other signs and symptoms
Thanks! • Joshua Erdman • UW Emergency Education Center • jerdman@uwhealth.org