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Quantitative waveform capnography is used in ACLS to objectively assess good CPR;confirm placement of an endotracheal tube; identify return of spontaneous circulation; and during post-cardiac arrest care.We can use waveform capnography with, and without, an advanced airway in place.Monitoring end tidal CO2 during rescue breathing.Use of capnography to objectively measure good CPR.Capnography is a preferred method of confirming endotracheal tube (ETT) placement over x-ray during a code.During CPR, a sudden increase in ETCO2 may indicate ROSC.Quantitative waveform capnography use in the post-cardiac arrest algorithm.Good luck with your ACLS class!Links: Buy Me a Coffee at https://buymeacoffee.com/paultaylor Practice ECG rhythms at Dialed Medics - https://dialedmedics.com/Free Prescription Discount Card - Download your free drug discount card to save money on prescription medications for you and your pets: https://safemeds.vipPass ACLS Web Site - Episode archives & other ACLS-related podcasts: https://passacls.com@Pass-ACLS-Podcast on LinkedIn
Along with early defibrillation, high quality CPR with minimal interruptions is one of the two factors that has been shown to improve cardiac arrest outcomes.How do we know if high quality, effective CPR is being performed?Objective measures of high-quality CPR include:Compression rate;Compression depth & recoil;ETCO2; and Chest Compression Fraction (CCF).The role of the CPR Coach on the code team.The advantages and use of real-time feedback devices to monitor the rate, depth, and chest recoil of CPR compressions.The use of end tidal waveform capnography. (ETCO2)A no-tech way to monitor effective CPR if no compression feedback device or ETCO2 capnography isn't available.Good luck with your ACLS class!Links: Buy Me a Coffee at https://buymeacoffee.com/paultaylor Practice ECG rhythms at Dialed Medics - https://dialedmedics.com/Free Prescription Discount Card - Download your free drug discount card to save money on prescription medications for you and your pets: https://safemeds.vipPass ACLS Web Site - Episode archives & other ACLS-related podcasts: https://passacls.com@Pass-ACLS-Podcast on LinkedIn
Even good CPR is far less efficient at circulating blood than a functioning heart.The indicators of high-quality CPR that were identified at the 2012 AHA CPR Quality Summit in order of importance include:Chest compression fraction (CCF);Chest compression rate;Chest compression depth;Allowing for full recoil; andAdequate ventilations.Using real-time feedback devices and ETCO2 to assess CPR quality.Three tips to limit pauses in CPR compressions to 10 seconds or less.Good luck with your ACLS class!Links: Buy Me a Coffee at https://buymeacoffee.com/paultaylor Practice ECG rhythms at Dialed Medics - https://dialedmedics.com/Free Prescription Discount Card - Download your free drug discount card to save money on prescription medications for you and your pets: https://safemeds.vipPass ACLS Web Site - Episode archives & other ACLS-related podcasts: https://passacls.com@Pass-ACLS-Podcast on LinkedIn
Our primary focus immediately following return of spontaneous circulation (ROSC) is aimed at ensuring adequate perfusion of the patient's vital organs and decreasing cerebral damage.Post-arrest goals for O2 saturation, ETCO2, and BP/MAP.Indications for use of an antiarrhythmic after ROSC.Determining which antiarrhythmic to use post cardiac arrest. Administration of Amiodarone or Lidocaine to control ventricular ectopy after ROSC.The use of Amiodarone post arrest if no antiarrhythmics were administered prior to obtaining ROSC.Links to other medical podcasts that cover antiarrhythmics and other ACLS-related topics are on the Pod Resource page at PassACLS.com.Good luck with your ACLS class!Links: Buy Me a Coffee at https://buymeacoffee.com/paultaylor Practice ECG rhythms at Dialed Medics - https://dialedmedics.com/Free Prescription Discount Card - Download your free drug discount card to save money on prescription medications for you and your pets: https://safemeds.vip/savePass ACLS Web Site - Episode archives & other ACLS-related podcasts: https://passacls.com@Pass-ACLS-Podcast on LinkedIn Discover medical podcasts with CE at https://conveymed.io
The tongue is the most common airway obstruction in an unconscious patient.For patients with a decreased level of consciousness that can't control their airway, yet have an intact gag reflex, the nasopharyngeal airway (NPA) should be used as an alternative to the oropharyngeal airway (OPA).Examples of when a NPA should be considered.Contraindications and considerations for nasal airway insertion.Measuring a nasal airway for appropriate length and diameter.Insertion of a nasopharyngeal airway into the right vs left nostril.Patients with a NPA in place can receive supplemental O2, be ventilated with a BVM, have ETCO2 monitored, and have their upper airway suctioned as needed. Good luck with your ACLS class!Links: Buy Me a Coffee at https://buymeacoffee.com/paultaylor Practice ECG rhythms at Dialed Medics - https://dialedmedics.com/Free Prescription Discount Card - Download your free drug discount card to save money on prescription medications for you and your pets: https://safemeds.vip/savePass ACLS Web Site - Episode archives & other ACLS-related podcasts: https://passacls.com@Pass-ACLS-Podcast on LinkedIn
Quantitative waveform capnography is used in ACLS to objectively assess good CPR;confirm placement of an endotracheal tube; identify return of spontaneous circulation; and during post-cardiac arrest care.We can use waveform capnography with, and without, an advanced airway in place.Monitoring end tidal CO2 during rescue breathing.Use of capnography to objectively measure good CPR.Capnography is a preferred method of confirming endotracheal tube (ETT) placement over x-ray during a code.During CPR, a sudden increase in ETCO2 may indicate ROSC.Quantitative waveform capnography use in the post-cardiac arrest algorithm.Good luck with your ACLS class!Links: Buy Me a Coffee at https://buymeacoffee.com/paultaylor Practice ECG rhythms at Dialed Medics - https://dialedmedics.com/Safe Meds VIP - Learn about medication safety and download a free drug discount card to save money on prescription medications for you and your pets: https://safemeds.vipPass ACLS Web Site - Episode archives & other ACLS-related podcasts: https://passacls.com@Pass-ACLS-Podcast on LinkedIn
Along with early defibrillation, high quality CPR with minimal interruptions is one of the two factors that has been shown to improve cardiac arrest outcomes. How do we know if high quality, effective CPR is being performed?Objective measures of high-quality CPR include:Compression rate;Compression depth & recoil;ETCO2; and Chest Compression Fraction (CCF).The role of the CPR Coach on the code team. The advantages and use of real-time feedback devices to monitor the rate, depth, and chest recoil of CPR compressions.The use of end tidal waveform capnography. (ETCO2)A no-tech way to monitor effective CPR if no compression feedback device or ETCO2 capnography isn't available.Connect with me:Website: https://passacls.com@Pass-ACLS-Podcast on LinkedInOther Links: Buy Me a Coffee at https://buymeacoffee.com/paultaylor Practice ECG rhythms at Dialed Medics - https://dialedmedics.com/Save money on prescription medications for you and your pets: https://nationaldrugcard.com/ndc3506*Commissions may be earned from the above links.Good luck with your ACLS class!
Even good CPR is far less efficient at circulating blood than a functioning heart. The indicators of high-quality CPR that were identified at the 2012 AHA CPR Quality Summit in order of importance include: Chest compression fraction (CCF);Chest compression rate;Chest compression depth;Allowing for full recoil; andAdequate ventilations.Using real-time feedback devices and ETCO2 to assess CPR quality. Three tips to limit pauses in CPR compressions to 10 seconds or less. Limiting interruptions to chest compressions to less than 10 seconds so we can maintain a CCF of 80% requires teamwork and communication.Connect with me:Website: https://passacls.com@Pass-ACLS-Podcast on LinkedInGive Back & Help Others: Your support helps cover the monthly cost of software and podcast & website hosting. Donations at Buy Me a Coffee at https://buymeacoffee.com/paultaylor are appreciated and will help ensure others can benefit from these tips as well.Good luck with your ACLS class!Helpful Listener Links:Practice ECG rhythms at Dialed Medics - https://dialedmedics.com/
Listener discretion is advised (language). References: Abdo WF, Heunks LM. Oxygen-induced hypercapnia in COPD: myths and facts. Crit Care. 2012 Oct 29;16(5):323. Bonilla Arcos D, Krishnan JA, et al. High-Dose Versus Low-Dose Systemic Steroids in the Treatment of Acute Exacerbations of Chronic Obstructive Pulmonary Disease: Systematic Review. Chronic Obstr Pulm Dis. 2016 Feb 17;3(2):580-588. Fawzy A, Wise RA. Pulse Oximetry Misclassifies Need for Long-Term Oxygen Therapy in Chronic Obstructive Pulmonary Disease. Ann Am Thorac Soc. 2023 Nov;20(11):1556-1557. Goldberg P, Reissmann H, Maltais F, Ranieri M, Gottfried SB. Efficacy of noninvasive CPAP in COPD with acute respiratory failure. Eur Respir J. 1995 Nov;8(11):1894-900. Jennifer T. Thibodeau, Mark H. Drazner. The Role of the Clinical Examination in Patients With Heart Failure,JACC: Heart Failure, Volume 6, Issue 7, 2018, Pages 543-551. Kartal M, Goksu E, Eray O, et al. The value of ETCO2 measurement for COPD patients in the emergency department. Eur J Emerg Med. 2011 Feb;18(1):9-12. Ni, H., Aye, S., Naing, C. Magnesium sulfate for acute exacerbations of chronic obstructive pulmonary disease. Cochrane Database Syst Rev. 2022 May 26; 2022(5):CD013506. Pertzov, B., Ronen, M., Rosengarten, D. et al. Use of capnography for prediction of obstruction severity in non-intubated COPD and asthma patients. Respir Res 22, 154 (2021). Pu X, Liu L, Feng B, Wang M, Dong L, Zhang Z, Fan Q, Li Y, Wang G. Efficacy and Safety of Different Doses of Systemic Corticosteroids in COPD Exacerbation. Respir Care. 2021 Feb;66(2):316-326. Tyagi D, Govindagoudar MB, et al. Correlation of PaCO2 and ETCO2 in COPD Patients with Exacerbation on Mechanical Ventilation. Indian J Crit Care Med. 2021 Mar;25(3):305-309. van Gestel AJ, Steier J. Autonomic dysfunction in patients with chronic obstructive pulmonary disease (COPD). J Thorac Dis. 2010 Dec;2(4):215-22. doi: 10.3978/j.issn.2072-1439.2010.02.04.5.
Our primary focus immediately following return of spontaneous circulation (ROSC) is aimed at ensuring adequate perfusion of the patient's vital organs and decreasing cerebral damage.Post-arrest goals for O2 saturation, ETCO2, and BP/MAP. Indications for use of an antiarrhythmic after ROSC. Determining which antiarrhythmic to use post cardiac arrest. Administration of Amiodarone or Lidocaine to control ventricular ectopy after ROSC.The use of Amiodarone post arrest if no antiarrhythmics were administered prior to obtaining ROSC. Links to other medical podcasts that cover antiarrhythmics and other ACLS-related topics are on the Pod Resource page at PassACLS.com.Connect with me:Website: https://passacls.com@Pass-ACLS-Podcast on LinkedInGive Back & Help Others: Your support helps cover the monthly cost of software and podcast & website hosting. Donations at Buy Me a Coffee at https://buymeacoffee.com/paultaylor are appreciated and will help ensure others can benefit from these tips as well.Good luck with your ACLS class!Helpful Listener Links:Practice ECG rhythms at Dialed Medics - https://dialedmedics.com/*FREE to anyone in the U.S. Save $$ on prescription medications for you and your pets with National Drug Card - https://nationaldrugcard.com/ndc3506 *Indicates affiliate links. I may get paid a small commission if you purchase products or memberships using my link. It doesn't affect the price you pay.Discover medical podcasts with CE at https://conveymed.io
The tongue is the most common airway obstruction in an unconscious patient. For patients with a decreased level of consciousness that can't control their airway, yet have an intact gag reflex, the nasopharyngeal airway (NPA) should be used as an alternative to the oropharyngeal airway (OPA).Examples of when a NPA should be considered. Contraindications and considerations for nasal airway insertion. Measuring a nasal airway for appropriate length and diameter. Insertion of a nasopharyngeal airway into the right vs left nostril.Patients with a NPA in place can receive supplemental O2, be ventilated with a BVM, have ETCO2 monitored, and have their upper airway suctioned as needed. Connect with me:Website: https://passacls.com@Pass-ACLS-Podcast on LinkedInGive Back & Help Others: Your support helps cover the monthly cost of software and podcast & website hosting so that others can benefit from these ACLS tips as well. Donations via Buy Me a Coffee at https://buymeacoffee.com/paultaylor are appreciated.Good luck with your ACLS class!
Quantitative waveform capnography is used in ACLS as a way to confirm good CPR and placement of an endotracheal tube; identify return of spontaneous circulation; and during post-cardiac arrest care.We can use waveform capnography with, and without, an advanced airway in place.Monitoring end tidal CO2 during rescue breathing.Use of capnography to objectively measure good CPR.Capnography is a preferred method of confirming endotracheal tube (ETT) placement over x-ray during a code. During CPR, a sudden increase in ETCO2 may indicate ROSC. Quantitative waveform capnography use in the post-cardiac arrest algorithm.Connect with me:Website: https://passacls.com@Pass-ACLS-Podcast on LinkedInGive Back & Help Others: Your support helps cover the monthly cost of software and podcast & website hosting so that others can benefit from these ACLS tips as well. Donations via Buy Me a Coffee at https://buymeacoffee.com/paultaylor are appreciated.Good luck with your ACLS class!
Along with early defibrillation, high quality CPR with minimal interruptions is one of the two factors that has been shown to improve cardiac arrest outcomes.How do we know if high quality, effective CPR is being performed?Objective measures of high-quality CPR include: Compression rate;Compression depth & recoil;ETCO2; and Chest Compression Fraction (CCF).The role of the CPR Coach on the code team.The advantages and use of real-time feedback devices to monitor the rate, depth, and chest recoil of CPR compressions. The use of end tidal waveform capnography. (ETCO2) A no-tech way to monitor effective CPR if no compression feedback device or ETCO2 capnography isn't available.Connect with me:Website: https://passacls.com@Pass-ACLS-Podcast on LinkedInGive Back & Help Others: Your support helps cover the monthly cost of software and podcast & website hosting so that others can benefit from these ACLS tips as well. Donations via Buy Me a Coffee at https://buymeacoffee.com/paultaylor are appreciated.Good luck with your ACLS class!
Even good CPR is far less efficient at circulating blood than a functioning heart. The indicators of high-quality CPR that were identified at the 2012 AHA CPR Quality Summit in order of importance include:Chest compression fraction (CCF);Chest compression rate;Chest compression depth;Allowing for full recoil; andAdequate ventilations.Using real-time feedback devices and ETCO2 to assess CPR quality. Three tips to limit pauses in CPR compressions to 10 seconds or less. Limiting interruptions to chest compressions to less than 10 seconds so we can maintain a CCF of 80% requires teamwork and communication.Connect with me:Website: https://passacls.com@Pass-ACLS-Podcast on LinkedInGive Back & Help Others: Your support helps cover the monthly cost of software and podcast & website hosting so that others can benefit from these ACLS tips as well. Donations via Buy Me a Coffee at https://buymeacoffee.com/paultaylor are appreciated.Good luck with your ACLS class!
Our primary focus immediately following return of spontaneous circulation (ROSC) is aimed at ensuring adequate perfusion of the patient's vital organs and decreasing cerebral damage.Post-arrest goals for O2 saturation, ETCO2, and BP/MAP. Indications for use of an antiarrhythmic after ROSC. Determining which antiarrhythmic to use post cardiac arrest. Administration of Amiodarone or Lidocaine to control ventricular ectopy after ROSC. The use of Amiodarone post arrest if no antiarrhythmics were administered prior to obtaining ROSC. Links to other medical podcasts that cover antiarrhythmics and other ACLS-related topics are on the Pod Resource page at PassACLS.com.Connect with me:Website: https://passacls.com@Pass-ACLS-Podcast on LinkedInGive Back & Help Others: Your support helps cover the monthly cost of software and podcast & website hosting so that others can benefit from these ACLS tips as well. Donations via Buy Me a Coffee at https://buymeacoffee.com/paultaylor are appreciated.Good luck with your ACLS class!Discover medical podcasts with CE at https://conveymed.io
The tongue is the most common airway obstruction in an unconscious patient. For patients with a decreased level of consciousness that can't control their airway, yet have an intact gag reflex, the nasopharyngeal airway (NPA) should be used as an alternative to the oropharyngeal airway (OPA).Examples of when a NPA should be considered. Contraindications and considerations for nasal airway insertion. Measuring a nasal airway for appropriate length and diameter. Insertion of a nasopharyngeal airway into the right vs left nostril.Patients with a NPA in place can receive supplemental O2, be ventilated with a BVM, have ETCO2 monitored, and have their upper airway suctioned as needed. Connect with me:Website: https://passacls.com@Pass-ACLS-Podcast on LinkedInGive Back & Help Others: Your support helps cover the monthly cost of software and podcast & website hosting so that others can benefit from these ACLS tips as well. Donations via Buy Me a Coffee at https://buymeacoffee.com/paultaylor are appreciated.Good luck with your ACLS class!
Quantitative waveform capnography is used in ACLS as a way to confirm good CPR and placement of an endotracheal tube; identify return of spontaneous circulation; and during post-cardiac arrest care.We can use waveform capnography with, and without, an advanced airway in place. Monitoring end tidal CO2 during rescue breathing. Use of capnography to objectively measure good CPR. Capnography is a preferred method of confirming endotracheal tube (ETT) placement over x-ray during a code. During CPR, a sudden increase in ETCO2 may indicate ROSC. Quantitative waveform capnography use in the post-cardiac arrest algorithm.Connect with me:Website: https://passacls.com@Pass-ACLS-Podcast on LinkedInGive Back & Help Others: Your support helps cover the monthly cost of software and podcast & website hosting so that others can benefit from these ACLS tips as well. Donations made via Buy Me a Coffee at https://buymeacoffee.com/paultaylor are appreciated.Make a difference in the fight against breast cancer by donating to my Men Wear Pink fundraiser for the American Cancer Society (ACS) at http://main.acsevents.org/goto/paultaylor Every dollar helps in the battle with breast cancer.Good luck with your ACLS class!
In this episode of 'The Ten Minute Medic,' host Dr. Bill Young takes us on a journey into the world of end-tidal CO2 monitoring - a critical but often misunderstood tool in emergency medicine. From cardiac arrests to traumatic brain injuries, Dr. Young breaks down how this simple measurement of exhaled breath can tell us everything from whether chest compressions are effective to when a patient is coming back to life.
Along with early defibrillation, high quality CPR with minimal interruptions is one of the two factors that has been shown to improve cardiac arrest outcomes. How do we know if high quality, effective CPR is being performed? Objective measures of high-quality CPR include: Compression rate; Compression depth & recoil; ETCO2; and Chest Compression Fraction (CCF).The role of the CPR Coach on the code team. The advantages and use of real-time feedback devices to monitor the rate, depth, and chest recoil of CPR compressions. The use of end tidal waveform capnography. (ETCO2) A no-tech way to monitor effective CPR if no compression feedback device or ETCO2 capnography isn't available.Connect with me:Website: https://passacls.com@Pass-ACLS-Podcast on LinkedInGive Back & Help Others: Your support helps cover the monthly cost of software and podcast & website hosting so that others can benefit from these ACLS tips as well. Donations made via Buy Me a Coffee at https://buymeacoffee.com/paultaylor are appreciated.Make a difference in the fight against breast cancer by donating to my Men Wear Pink fundraiser for the American Cancer Society (ACS) at http://main.acsevents.org/goto/paultaylor Every dollar helps in the battle with breast cancer.Good luck with your ACLS class!
Even good CPR is far less efficient at circulating blood than a functioning heart. The indicators of high-quality CPR that were identified at the 2012 AHA CPR Quality Summit in order of importance include:Chest compression fraction (CCF);Chest compression rate;Chest compression depth;Allowing for full recoil; andAdequate ventilations.Using real-time feedback devices and ETCO2 to assess CPR quality. Three tips to limit pauses in CPR compressions to 10 seconds or less. Limiting interruptions to chest compressions to less than 10 seconds so we can maintain a CCF of 80% requires teamwork and communication.Connect with me:Website: https://passacls.com@Pass-ACLS-Podcast on LinkedInGive Back & Help Others: Your support helps cover the monthly cost of software and podcast & website hosting so that others can benefit from these ACLS tips as well. Donations made via Buy Me a Coffee at https://buymeacoffee.com/paultaylor are appreciated.Make a difference in the fight against breast cancer by donating to my Men Wear Pink fundraiser for the American Cancer Society (ACS) at http://main.acsevents.org/goto/paultaylor Every dollar helps in the battle with breast cancer.Good luck with your ACLS class!
Cardiac arrest in the prehospital setting continues to be a critical area of focus for EMS clinicians, especially when it comes to measuring ventilation and perfusion. In this episode, we'll do a deep dive on new research investigating the role of end tidal carbon dioxide (ETCO2) as a potential indicator of survival in out-of-hospital cardiac arrests. The study looks at how both high and low ETCO2 levels affect mortality and why these numbers alone may not be enough to guide resuscitation decisions. Stick around for all the insights! In this podcast, we interview the lead author Tanner Smida MD/PhD Candidate AEMT West Virginia University on the manuscript: The Association of Prehospital End-Tidal Carbon Dioxide with Survivial Following Out-of-Hospital Cardiac Arrest Click here to download it today! As always THANK YOU for listening. Hawnwan Philip Moy MD (@pecpodcast) Scott Goldberg MD, MPH (@EMS_Boston) Jeremiah Escajeda MD, MPH (@jerescajeda) Joelle Donofrio-Odmann DO (@PEMems) Maia Dorsett MD PhD (@maiadorsett) Lekshmi Kumar MD, MPH(@Gradymed1) Greg Muller DO (@DrMuller_DO) Ariana Weber MD (@aweberMD4) Rebecca Cash PhD (@CashRebeccaE) Michael Kim MD (@michaelkim_md) Rachel Stemerman PhD (@steminformatics) Nikolai Arendovich MD Elijah Robinson MD
It's not the wave of the future, it is the standard of care. The "answer" to saving lives is right under our nose! Eric Chase has a conversation with Don Guillette, RN, paramedic, educator and author of “Capnography Capstone,” about the significance of ETCO2 in EMS, hospitals and more.
Our primary focus immediately following return of spontaneous circulation (ROSC) is aimed at ensuring adequate perfusion of the patient's vital organs and decreasing cerebral damage.Post-arrest goals for O2 saturation, ETCO2, and BP/MAP. Indications for use of an antiarrhythmic after ROSC. Determining which antiarrhythmic to use post cardiac arrest. Administration of Amiodarone or Lidocaine to control ventricular ectopy after ROSC.The use of Amiodarone post arrest if no antiarrhythmics were administered prior to obtaining ROSC.Links to other medical podcasts that cover antiarrhythmics and other ACLS-related topics are on the Pod Resource page at PassACLS.com.Connect with me:Website: https://passacls.com@Pass-ACLS-Podcast on LinkedInGive Back & Help Others: Your support helps cover the monthly cost of software and podcast & website hosting so that others can benefit from these ACLS tips as well. Donations made via Buy Me a Coffee at https://buymeacoffee.com/paultaylor are appreciated.Make a difference in the fight against breast cancer by donating to my Men Wear Pink fundraiser for the American Cancer Society (ACS) at http://main.acsevents.org/goto/paultaylor Every dollar helps in the battle with breast cancer.Good luck with your ACLS class!
The tongue is the most common airway obstruction in an unconscious patient. For patients with a decreased level of consciousness that can't control their airway, yet have an intact gag reflex, the nasopharyngeal airway (NPA) should be used as an alternative to the oropharyngeal airway (OPA).Examples of when a NPA should be considered. Contraindications and considerations for nasal airway insertion. Measuring a nasal airway for appropriate length and diameter. Insertion of a nasopharyngeal airway into the right vs left nostril.Patients with a NPA in place can receive supplemental O2, be ventilated with a BVM, have ETCO2 monitored, and have their upper airway suctioned as needed. Connect with me:Website: https://passacls.com@Pass-ACLS-Podcast on LinkedInGive Back & Help Others: Your support helps cover the monthly cost of software and podcast & website hosting so that others can benefit from these ACLS tips as well. Donations made via Buy Me a Coffee at https://buymeacoffee.com/paultaylor are appreciated.Make a difference in the fight against breast cancer by donating to my Men Wear Pink fundraiser for the American Cancer Society (ACS) at http://main.acsevents.org/goto/paultaylor Every dollar helps in the battle with breast cancer.Good luck with your ACLS class!
Quantitative waveform capnography is used in ACLS as a way to confirm good CPR and placement of an endotracheal tube; identify return of spontaneous circulation; and during post-cardiac arrest care.We can use waveform capnography with, and without, an advanced airway in place.Monitoring end tidal CO2 during rescue breathing. Use of capnography to objectively measure good CPR.Capnography is a preferred method of confirming endotracheal tube (ETT) placement over x-ray during a code.During CPR, a sudden increase in ETCO2 may indicate ROSC.Quantitative waveform capnography use in the post-cardiac arrest algorithm.Connect with me:Website: https://passacls.com@Pass-ACLS-Podcast on LinkedInGive Back & Help Others: Your support helps cover the monthly cost of software and podcast & website hosting so that others can benefit from these ACLS tips as well. Donations made via Buy Me a Coffee at https://buymeacoffee.com/paultaylor are appreciated.Make a difference in the fight against breast cancer by donating to my Men Wear Pink fundraiser for the American Cancer Society (ACS) at http://main.acsevents.org/goto/paultaylor Every dollar helps in the battle with breast cancer.Good luck with your ACLS class!
Along with early defibrillation, high quality CPR with minimal interruptions is one of the two factors that has been shown to improve cardiac arrest outcomes. How do we know if high quality, effective CPR is being performed? Objective measures of good, high-quality CPR include:Compression rate;Compression depth & recoil;ETCO2; and Chest Compression Fraction (CCF).The role of the CPR Coach on the code team.The advantages and use of real-time feedback devices to monitor the rate, depth, and chest recoil of CPR compressions.The use of end tidal waveform capnography. (ETCO2)A no-tech way to monitor effective CPR if no compression feedback device or ETCO2 capnography isn't available.Connect with me:Website: https://passacls.com@PassACLS on X (formally known as Twitter)@Pass-ACLS-Podcast on LinkedInGive back & help others. Your support will help cover the monthly cost of software and podcast & website hosting. Donations made via Buy Me a Coffee at https://buymeacoffee.com/paultaylor are appreciated.Good luck with your ACLS class!
Even good CPR is far less efficient at circulating blood than a functioning heart. The indicators of high-quality CPR that were identified at the 2012 AHA CPR Quality Summit in order of importance include: Chest compression fraction (CCF);Chest compression rate;Chest compression depth;Allowing for full recoil; andAdequate ventilations.Using real-time feedback devices and ETCO2 to assess CPR quality.Three tips to limit pauses in CPR compressions to 10 seconds or less.Limiting interruptions to chest compressions to less than 10 seconds so we can maintain a CCF of 80% requires teamwork and communication.Connect with me:Website: https://passacls.com@PassACLS on X (formally known as Twitter)@Pass-ACLS-Podcast on LinkedInGive back & help others. Your support will help cover the monthly cost of software and podcast & website hosting. Donations made via Buy Me a Coffee at https://buymeacoffee.com/paultaylor are appreciated.Good luck with your ACLS class!
The tongue is the most common airway obstruction in an unconscious patient. For patients with a decreased level of consciousness that can't control their airway, yet have an intact gag reflex, the nasopharyngeal airway (NPA) should be used as an alternative to the oropharyngeal airway (OPA).Examples of when a NPA should be considered. Contraindications and considerations for nasal airway insertion.Measuring a nasal airway for appropriate length and diameter. Insertion of a nasopharyngeal airway. Patients with a NPA in place can receive supplemental O2, be ventilated with a BVM, have ETCO2 monitored, and have their upper airway suctioned as needed. Connect with me:Website: https://passacls.com@PassACLS on X (formally known as Twitter)@Pass-ACLS-Podcast on LinkedInGive back & help others. Your support will help cover the monthly cost of software and podcast & website hosting. Donations made via Buy Me a Coffee at https://buymeacoffee.com/paultaylor are appreciated.Good luck with your ACLS class!
Quantitative waveform capnography is used in ACLS as a way to confirm good CPR and placement of an endotracheal tube; identify return of spontaneous circulation; and during post-cardiac arrest care.We can use waveform capnography with, and without, an advanced airway in place.Monitoring end tidal CO2 during rescue breathing. Use of capnography to objectively measure good CPR. Capnography is a preferred method of confirming endotracheal tube (ETT) placement over x-ray during a code.During CPR, a sudden increase in ETCO2 may indicate ROSC. Quantitative waveform capnography use in the post-cardiac arrest algorithm.Connect with me:Website: https://passacls.com@PassACLS on X (formally known as Twitter)@Pass-ACLS-Podcast on LinkedInGive back - buy Paul a bubble tea hereGood luck with your ACLS class!
Along with early defibrillation, high quality CPR with minimal interruptions is one of the two factors that has been shown to improve cardiac arrest outcomes. How do we know if high quality, effective CPR is being performed?Objective measures of high-quality CPR include: Compression rate;Compression depth & recoil;ETCO2; and Chest Compression Fraction (CCF).The role of the CPR coach on the code team.The advantages and use of real-time feedback devices to monitor the rate, depth, and chest recoil of CPR compressions. The use of end tidal waveform capnography.A no-tech way to monitor effective CPR if no compression feedback device or ETCO2 capnography isn't available.Connect with me:Website: https://passacls.com@PassACLS on X (formally known as Twitter)@Pass-ACLS-Podcast on LinkedInGive back - buy Paul a bubble tea hereGood luck with your ACLS class!
Even good CPR is far less efficient at circulating blood than a functioning heart. The indicators of high-quality CPR that were identified at the 2012 AHA CPR Quality Summit in order of importance include: Chest compression fraction (CCF);Chest compression rate; Chest compression depth; Allowing for full recoil; andAdequate ventilations.Using real-time feedback devices and ETCO2 to assess CPR quality.Three tips to limit pauses in CPR compressions to 10 seconds or less.Limiting interruptions to chest compressions to less than 10 seconds so we can maintain a CCF of 80% requires teamwork and communication.Connect with me:Website: https://passacls.com@PassACLS on X (formally known as Twitter)@Pass-ACLS-Podcast on LinkedInGive back - buy Paul a bubble tea hereGood luck with your ACLS class!
What value does EtCO2 have when it comes to predicting survival from cardiac arrest? We all know a sharp spike in EtCO2 is associated with ROSC, but what about persistently elevated levels? What does this mean for decision making when it comes to termination of resuscitation? Join Drs. Jeff Jarvis, Remle Crowe, and Heidi Abraham for the first episode of “Between Two Nerds”, a subgenre of the EMS Lighthouse Project podcast suggested in episode 82 by Dr. CJ Winckler, as they run through a new paper that may shed some light on this question. Citation:1. Smida T, Menegazzi JJ, Crowe RP, Salcido DD, Bardes J, Myers B: The Association of Prehospital End-Tidal Carbon Dioxide with Survival Following Out-of-Hospital Cardiac Arrest. Prehospital Emergency Care. 2024;April 2;28(3):478–84.2. Levine RL, Wayne MA, Miller C: End-Tidal Carbon Dioxide and Outcome of Out-of-Hospital Cardiac Arrest. N Engl J Med. 1997;337:301–6.3. Page, J. The Magic of 3 AM. PennWell Books. Tulsa, OK. 2017 FAST24 | June 10 - 12, 2024 | Wilmington, North CarolinaFAST24 is our annual conference for pre-hospital and critical care transport professionals, including nurses, paramedics, and other disciplines. It features engaging workshops, talks by industry leaders, and focused sessions on air and surface critical care transport medicine. The event also offers a unique vendor experience, special guest appearances from notable talent in the industry, catered lunches, as well as relaxing and entertaining networking and social opportunities. Tickets are limited so don't wait! Visit https://fastsymposium.com for more information.
Welcome to PICU Doc On Call, A Podcast Dedicated to Current and Aspiring Intensivists.Hosts:Dr. Pradip Kamat: Children's Healthcare of Atlanta/Emory University School of MedicineDr. Rahul Damania: Cleveland Clinic Children's HospitalIntroduction:Pediatric Intensive Care Unit (PICU) physicians passionate about medical education in the acute care pediatric settingEpisode focus: A case of a 23-month-old ex-28 week premie presenting with sudden high fever and rapidly rising ETCO2 during surgeryCase Presentation:Presented by Dr. Rahul Damania23-month-old ex-28 week premie intubated during hernia repair surgeryNoticed rapidly rising ETCO2, unprovoked tachycardia, and elevated temperatureTransferred to PICU, exhibiting rigidity, clenched jaw, metabolic acidosis, and elevated lactate.Consideration of Malignant Hyperthermia (MH) crisisKey Points:Elevated temperature, hypercapnia, metabolic acidosis, and unprovoked tachycardia raise concern for MHOrganized discussion on pathophysiology, clinical signs, symptoms, and managementMultiple Choice Question:Diagnosis of MH crisis during scoliosis repairCorrect Answer: D) Sarcoplasmic reticulumDantrolene acts on the sarcoplasmic reticulum to inhibit calcium release, crucial in MH managementClinical Presentation of MH Crisis:Tachycardia, acidosis, muscle stiffness, and hyperthermia are hallmark featuresPotential life-threatening complications underscore the urgency of recognition and treatmentTriggers and Pathophysiology of MH Crisis:Triggered by inhalational agents and depolarizing neuromuscular blocking agentsPathophysiology involves defective Ryanodine receptor leading to uncontrolled calcium releaseDifferential Diagnosis:Includes sepsis, thyroid storm, pheochromocytoma, and neuroleptic malignant syndromeDifferentiation from similar conditions crucial for accurate managementDiagnostic Approach:High clinical suspicionGenetic testing (ryanodine...
In this podcast episode, Doug discusses the use of End-tidal CO2 monitoring in medical practice. End-tidal CO2 is used to monitor the percent of carbon dioxide in blood that has been returned to the lungs. It is commonly used to confirm the placement of an endotracheal tube and to monitor ventilation during surgery. In the field, End-tidal CO2 monitoring is particularly useful for trauma patients and those with severe traumatic brain injuries. However, it is important to note that End-tidal CO2 should be used as part of a comprehensive approach to patient care, and clinical judgment is still crucial in making treatment decisions. Takeaways End-tidal CO2 monitoring is used to confirm the placement of an endotracheal tube and to monitor ventilation during surgery. In the field, End-tidal CO2 monitoring is particularly useful for trauma patients and those with severe traumatic brain injuries. End-tidal CO2 should be used as part of a comprehensive approach to patient care, and clinical judgment is still crucial in making treatment decisions. Other markers of resuscitation, such as lactate levels, may provide more valuable information in certain situations. Thank you to Delta Development Team for in part, sponsoring this podcast. deltadevteam.com For more content go to www.prolongedfieldcare.org Consider supporting us: patreon.com/ProlongedFieldCareCollective or www.lobocoffeeco.com/product-page/prolonged-field-care
Welcome back to the podcast! Three more papers covering topics that are relevant to all of our practice. The importance of removing wet clothes from patients is often discussed, both to prevent hypothermia and increase patient comfort. But how important is it to get wet clothes off and is it something we can defer to a different point? We start off taking a look at an RCT on this very question. Next up another RCT, this time looking at the efficacy of morphine, ibuprofen and paracetamol for patients with closed limb injuries. Which one, or combination, would you think would be most efficacious… Lastly, following on from our most recent Roadside to Resus episode, we take a look at a paper on the association between end tidal CO2 levels and mortality in prehospital patients with suspected traumatic brain injury. This paper highlights really well the need understand the fundamentals that contribute to ETCO2 when applying to clinical practice. Once again we'd love to hear any thoughts or feedback either on the website or via X @TheResusRoom! Simon & Rob
End Tidal CO2, or ETCO2 for short, is something that's talked about pretty often in Emergency and Critical Care and that's because it's used a lot in the assessment and treatment of patients! It's got a big part to play in airway management, resuscitation, sedation and is also increasingly used in other situations. Some of these applications have some pretty strong evidence to back them up but others are definitely worth a deeper thought, because without a sound understanding of ETCO2 we can fall foul of some traps… ETCO2 is a non-invasive measurement of the partial pressure of CO2 in expired gas at the end of exhalation. Ideally we'd like to know what's really going on arterially with the partial pressure of arterial CO2 but we can use the end tidal because that's an easy reading to get from exhaled breath, when it will most closely resemble the alveolar CO2 concentration. Its value is reflective of ventilation but also really importantly is affected by the circulation, the circuit and how it's applied. In the podcast we run through all of these aspects, its application to clinical care and also some of its pitfalls. Once again we'd love to hear any thoughts or feedback either on the website or via X @TheResusRoom! Simon, Rob & James
Our primary focus immediately following return of spontaneous circulation (ROSC) is aimed at ensuring adequate perfusion of the patient's vital organs and decreasing cerebral damage.Post-arrest goals for O2 saturation, ETCO2, and BP/MAP. Indications for use of an antiarrhythmic after ROSC. Determining which antiarrhythmic to use post cardiac arrest. Administration of Amiodarone or Lidocaine to control ventricular ectopy after ROSC. The use of Amiodarone post arrest if no antiarrhythmics were administered prior to obtaining ROSC. Links to other medical podcasts that cover antiarrhythmics and other ACLS-related topics are on the Pod Resource page at PassACLS.com.Connect with me:Website: https://passacls.com@PassACLS on X (formally known as Twitter)@Pass-ACLS-Podcast on LinkedInGive back - buy Paul a bubble tea hereGood luck with your ACLS class!
The tongue is the most common airway obstruction in an unconscious patient. For patients with a decreased level of consciousness that can't control their airway, yet have an intact gag reflex, the nasopharyngeal airway (NPA) should be used as an alternative to the oropharyngeal airway (OPA).Examples of when a NPA should be considered. Contraindications and considerations for nasal airway insertion. Measuring a nasal airway for appropriate length and diameter.Insertion of a nasopharyngeal airway. Patients with a NPA in place can receive supplemental O2, be ventilated with a BVM, have ETCO2 monitored, and have their upper airway suctioned as needed. Connect with me:Website: https://passacls.com@PassACLS on X (formally known as Twitter)@Pass-ACLS-Podcast on LinkedInGive back - buy Paul a bubble tea hereGood luck with your ACLS class!
Quantitative waveform capnography is used in ACLS as a way to confirm good CPR and placement of an endotracheal tube; identify return of spontaneous circulation; and during post-cardiac arrest care.We can use waveform capnography with, and without, an advanced airway in place.Monitoring end tidal CO2 during rescue breathing. Use of capnography to objectively measure good CPR. Capnography is a preferred method of confirming endotracheal tube (ETT) placement over x-ray during a code. During CPR, a sudden increase in ETCO2 may indicate ROSC.Quantitative waveform capnography use in the post-cardiac arrest algorithm.Connect with me:Website: https://passacls.com@PassACLS on X (formally known as Twitter)@Pass-ACLS-Podcast on LinkedInGive back - buy Paul a bubble tea hereGood luck with your ACLS class!
In this follow-up episode, Bruce and the team continue their discussion on ventilation and airway management. This episode goes into much greater depth on how ETCO2 can be used to manage an array of patients effectively and how a thorough understanding and monitoring of end-tidal during a resuscitation attempt can help ensure a patient remains neurologically intact, assuming ROSC is achieved.
Along with early defibrillation, high quality CPR with minimal interruptions is one of the two factors that has been shown to improve cardiac arrest outcomes. How do we know if high quality, effective CPR is being performed? Objective measures of high-quality CPR include: Compression rate; Compression depth & recoil; ETCO2; and Chest Compression Fraction (CCF).The role of the CPR coach position on the code team. The advantages and use of real-time feedback devices to monitor the rate, depth, and chest recoil of CPR compressions. The use of end tidal waveform capnography. A no-tech way to monitor effective CPR if no compression feedback device or ETCO2 capnography isn't available.Connect with me:Website: https://passacls.com@PassACLS on X (formally known as Twitter)@Pass-ACLS-Podcast on LinkedInGive back via PayPal Good luck with your ACLS class!
Join me as we unravel the mysteries of End-Tidal CO2 (ETCO2) on this episode of The Nurse Dose Podcast. ETCO2 isn't just a clinical parameter – it's a dynamic storyteller, offering insights into the respiratory and circulatory intricacies of our patients. In this episode, we'll kick things off with a fundamental exploration of ETCO2, breaking down its definition and understanding its significance in the healthcare landscape. From there, we'll delve deep into the physiology behind ETCO2, exploring the incredible journey of carbon dioxide in the human body and how it shapes our approach to patient care. But we're not stopping at the basics. I'll guide you through the clinical applications of ETCO2 in critical care scenarios, shedding light on how this parameter becomes a beacon for healthcare professionals navigating the complexities of patient management. Whether it's intubated patients on mechanical ventilation or those in respiratory distress without intubation, ETCO2 monitoring plays a crucial role in shaping clinical decisions. www.NurseDose.org -Sign up for tutoring/mentorship while there are still spots! Instagram: @nursedosepodcast ICU Resources and Cheat Sheets This podcast is intended for informational and educational purposes only. It is not intended to provide medical advice or to substitute for the advice provided by your own physician or other medical professionals. The information contained herein is not intended to diagnose, treat, cure, or prevent any disease. If you have any concerns or questions about your health, you should always consult with a physician or other healthcare professional. The opinions expressed in this podcast are those of the host and guests and do not necessarily reflect the views of any medical institution, organization, or employer. By listening to this podcast, you agree to hold harmless the host, guests, and any associated parties from any and all liability or damages arising from your use of the information provided.
The JournalFeed podcast for the week of Jan 1-5, 2024.These are summaries from just 2 of the 5 article we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.MondayThe best articles of 2023!!Friday Spoon Feed:A prospective, observational study demonstrated that giving sodium bicarbonate to patients undergoing mechanical ventilation or CPR resulted in an increase in end-tidal CO2 values in as quickly as 17 seconds and lasted for 7 minutes
Thanks to Yusuf Ahady for his suggestion on this week's episode. I'll be in touch with Yusuf to get his SWAG package headed his way. End-tidal CO2 (ETCO2) monitoring, a noninvasive technique measuring the concentration of carbon dioxide in exhaled air, is emerging as a valuable tool in the management of sepsis, a systemic response to infection with potentially life-threatening consequences. In sepsis, the body's response to infection can lead to altered cellular metabolism and changes in respiratory function, both of which can affect CO2 levels. ETCO2 monitoring provides real-time insights into a patient's respiratory status and metabolic activity, which are crucial in sepsis management. I'd love to hear from you as to the topics that you would like to hear covered. Visit the Ten Minute Medic Facebook page and leave a post on that topic. If it is selected, I'll send you some awesome SWAG!
Even good CPR is far less efficient at circulating blood than a functioning heart. The indicators of high-quality CPR that were identified at the 2012 AHA CPR Quality Summit in order of importance include: Chest compression fraction (CCF); Chest compression rate; Chest compression depth; Allowing for full recoil; and Adequate ventilations.Using real-time feedback devices and ETCO2 to assess CPR quality. Three tips to limit pauses in CPR compressions to 10 seconds or less. Limiting interruptions to chest compressions to less than 10 seconds so we can maintain a CCF of 80% requires teamwork and communication.Connect with me:Website: https://passacls.com@PassACLS on X (formally known as Twitter)@Pass-ACLS-Podcast on LinkedInGive back via PayPal Good luck with your ACLS class!
Our primary focus immediately following return of spontaneous circulation (ROSC) is aimed at ensuring adequate perfusion of the patient's vital organs and decreasing cerebral damage.Post-arrest goals for O2 saturation, ETCO2, and BP/MAP. Indications for use of an antiarrhythmic after ROSC. Determining which antiarrhythmic to use post cardiac arrest. Administration of Amiodarone or Lidocaine to control ventricular ectopy after ROSC. The use of Amiodarone post arrest if no antiarrhythmics were administered prior to obtaining ROSC. Links to other medical podcasts that cover antiarrhythmics and other ACLS-related topics are on the Pod Resource page at PassACLS.com.Connect with me:Website: https://passacls.com@PassACLS on X (formally known as Twitter)@Pass-ACLS-Podcast on LinkedInGive back via PayPal Good luck with your ACLS class!
The tongue is the most common airway obstruction in an unconscious patient. For patients with a decreased level of consciousness that can't control their airway, yet have an intact gag reflex, the nasopharyngeal airway (NPA) should be used as an alternative to the oropharyngeal airway (OPA).Examples of when a NPA should be considered. Contraindications and considerations for nasal airway insertion. Measuring a nasal airway for appropriate length and diameter. Insertion of a nasopharyngeal airway. Patients with a NPA in place can receive supplemental O2, be ventilated with a BVM, have ETCO2 monitored, and have their upper airway suctioned as needed. Connect with me:Website: https://passacls.com@PassACLS on Twitter@Pass-ACLS-Podcast on LinkedInGive back & support the show:via PayPal Good luck with your ACLS class!
Quantitative waveform capnography is used in ACLS as a way to confirm good CPR and placement of an endotracheal tube; identify return of spontaneous circulation; and during post-cardiac arrest care.We can use waveform capnography with, and without, an advanced airway in place. Monitoring end tidal CO2 during rescue breathing. Use of capnography to objectively measure good CPR. Capnography is a preferred method of confirming endotracheal tube (ETT) placement over x-ray during a code. During CPR, a sudden increase in ETCO2 may indicate ROSC. Quantitative waveform capnography use in the post-cardiac arrest algorithm.Connect with me:Website: https://passacls.com@PassACLS on Twitter@Pass-ACLS-Podcast on LinkedInGive back & support the show:via PayPal Good luck with your ACLS class!
Coco Wham is a paramedic at the Denver Health Paramedic Division. She is also a 4th year medical student and has a masters in integrated sciences. She is an author on a recent study in the American Journal of Surgery with our previous guest, Dr. Eric Campion. Their latest study looked at prehospital ETCO2 values and if they were predictive of death and need for massive transfusion as compared to commonly accepted measurements, such as systolic blood pressure and shock index. The new study is titled, "Prehospital ETCO2 is predictive of death in intubated and non-intubated patients." We discuss this study with her and what's next for this research. We also touch on why prehospital providers should get involved with research.