One way to confirm endotracheal intubation is to monitor the patient's CO2. A good waveform on the capnogram indicates the presence of CO2 and indicates proper placement of the ET tube in the trachea. The American Heart Association states in its CPR and ECG guidelines that when exhaled CO2 is detected during cardiac arrest, it is usually a reliable indicator that the ET tube is properly positioned in the patient's trachea.
This may not necessarily be true in situations where the downtime is substantially prolonged before initiating CPR. A massive pulmonary embolism blocks blood flow to the lungs, which can also make it difficult for the patient to assess the patient's CO2 value. CPR is also required for waveform generation. Continuous waveform capnography can also assist intubation in patients with difficulty breathing spontaneously. Clinicians are able to attach a capnography filter to the ET tube prior to intubation and use a monitor to assist with placement. Ekingst has quality waveform capnography machine wholesale for you.
Knowing the capnogram allows monitoring of a patient's CO2 and also measures their cardiac output. Measuring CO2 comes in handy when you are trying to measure the effectiveness of CPR efforts. When you see the CO2 decrease, have a new person start chest compressions. If you see an increase in CO2 output, it may indicate that the last rescuer is tired and the new rescuer is able to provide better compressions. Ideally, rescuers should change every two minutes because chest compressions during CPR should be hard, fast, and deep.
Setting up the monitor, rescuers can take a capnogram where they can see the readings as well as the ECG waveform from the compressions. It is best practice to encourage rescuers to maintain CO2 levels as much as possible during this procedure. However, keep in mind that patients with prolonged downtime may have lower CO2 levels, and new rescuers may not do much to improve the readings.
During cardiac arrest, if you start to see a rapid rise in CO2, stop CPR and check for a pulse. This could be a sign of spontaneous circulation. End-tidal CO2 often exceeds baseline when circulation is restored due to the flushing of carbon dioxide from tissues. End-tidal CO2 monitoring is an effective and safe method of measuring cardiac output during CPR and is often an early indicator of ROSC in intubated patients. After the patient has been resuscitated, if you see a significant drop in CO2 levels, you should check for a pulse right away because you may need to start CPR again.