1. Waveform capnography
Version: Jan 2016

2. Why use capnography during resuscitation ?
carbon dioxide (CO2) produced in the tissues
CO2 transported from tissues in blood to lungs
ventilation excretes CO2 through lungs

3. Why use capnography during resuscitation ?
Measurement of end-tidal CO2 therefore requires:
venous return (CO2 from tissues to heart)
pulmonary blood flow (CO2 from heart to lungs)
ventilation (effective movement of gas in and out of the lungs)

4. Role of waveform capnography during CPR
confirmation of tracheal tube placement in the airway
rate of ventilation
quality of chest compressions
ROSC during CPR
guide to prognostication

5. Normal waveform capnography
indicates rate of ventilation 11 breaths min-1

6. High quality CPR
end-tidal CO2 > 15 mmHg
consistent waveform

7. Chest compression provider tiring
end-tidal CO2 value diminishing over time

8. Sudden increase in end-tidal CO2
return of spontaneous circulation

9. Persistently low end-tidal CO2
check quality of chest compressions
check ventilation volume
if persistent, may be a guide to prognosis

10. Waveform capnography during resuscitation
patient is ventilated at 10 breaths min-1 and chest compressions (indicated by CPR) at about two per second
significant increase in the end-tidal CO2 value during chest compressions at around 3.5 min, (from 10mmHg to mmHg), cardiac monitor shows sinus rhythm and a pulse indicates ROSC. Ventilation continues at 10 min-1

11. Any questions ?

12. Advanced Life Support Course Slide set
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