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Use End-Tidal Capnography for Placing Orogastric, Nasogastric Tubes, and CPR

By Katrina D’Amore, DO, MPH, Justin McNamee, DO, and Terrance McGovern, DO, MPH | on December 14, 2016 | 0 Comment
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ACEP Now: Vol 35 – No 12 – December 2016

Conclusion

End-tidal capnometry wasn’t meant to be kept in the stable and only used for the occasional procedural sedation. Try taking it out for a ride on your next shift, whether it’s for screening the next hyperglycemic patient for diabetic ketoacidosis, monitoring for disposition of a wheezing asthmatic, resuscitating or terminating an active cardiac arrest, or confirming placement of an NGT. Remember to use caution in patients with underlying lung disease such as chronic obstructive pulmonary disease. Throughout each shift, emergency physicians make critical decisions by pooling myriad data points from the history, physical exam, labs, imaging studies, and many other variables that we may subconsciously consider. End-tidal capnometry provides us with another data point that can aid in these crucial choices and requires few resources, money, or time.


Dr. D’AmoreDr. D’Amore is an emergency medicine resident at St. Joseph’s Regional Medical Center in Paterson, New Jersey.

Dr. Justin McNameeDr. McNamee is an attending physician at Emergency Medicine Professionals in Ormond Beach, Florida.

Dr. McGovernDr. McGovern is an emergency medicine resident at St. Joseph’s Regional Medical Center in Paterson, New Jersey.

References

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  13. Poon KM, Lui CT, Tsui KL. Prognostication of out-of-hospital cardiac arrest patients by 3-min end-tidal capnometry level in the emergency department. Resuscitation. 2016;102:80-84.
  14. Deakin CD, Morrison LJ, Morley PT, et al. Part 8: advanced life support: 2010 international consensus on cardiopulmonary resuscitation and emergency cardiovascular care science with treatment recommendations. Resuscitation. 2010;81(Suppl 1):e93-e174.
  15. TLui CT, Poon KM, Tsui KL. Abrupt rise of end tidal carbon dioxide level was a specific but non-sensitive maker of return of spontaneous circulation in patient with out-of-hospital cardiac arrest. Resuscitation. 2016;104:53-58.

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Topics: CapnographyCPRED Critical CareEmergency DepartmentEmergency MedicineEmergency PhysicianNasogastricOrogastricPractice ManagementProcedures and SkillsPulmonaryResuscitation

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