Basics of ETCO2 and Why You Need To Use It
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- Опубликовано: 16 июл 2024
- This crucial vital sign is seldom utilized to its full potential. Capnography can uncover compensated shock, give us an insight into the acid base balance, confirm out airways and even predict ROSC in cardiac arrest. This video covers the basics of ETCO2 and shows some of the situation where it is useful.
Live The Creed: ltcreed.com/ (Code: prep10)
Also a great way to help evaluate CO poisoning. If SPO2 is super high and ETCO2 is low, something is taking the place of O2 in the blood.
Every new monitor with the masimo rainbow coox measures co. It's optional on the E series and standard on the X series and LP 15.
That's why you carry a Rad-57
@@michaelfagan2086 you don't need a rad 57 when it's built into your monitor.
OR, you could just use a SpCO monitor...
Capnography is one of the most important vital signs in Dentistry. Every oral surgery patient in office is required to have an ETCO2 monitor in addition to EKG, BP, Temp, and blood pressure. During procedures like root canals or wisdom teeth, you want to assess the respiratory state of the patient as sedatives and analgesics are pushed direct IV.
This was real interesting.. not being a medic but learning a bit in the service I have always been interested in the functions of the body.. This was something I had never thought about.. I am just mad that the greedy SOB want to charge you folks so much for a little electronic device that has probably 30 bucks of electronics in it and sell it to y'all for 1400.. makes me sick.. You guys do all you can do to save folks and the greedy guys want to take advantage.. Oh well, sorry for the rant.. Bless you my brother and all of your people who do this for us... Another group of true hero's.. you make us proud...
UK student paramedic here, we use the nasal cannula with Capno line on all patients. Plugs in to a Lifepak 15 so we can measure in the patients house
How's that work? Patient should be exhaling through their mouth, no?
@@randomamerican3287 there's a little lip that directs breath up but you also exhale through your nose a little bit
I showed one in the video.
I was just listening to an EMTpro podcast episode where they were just talking about the importance of this. Great video!
Excellent presentation, very well thought out and presented.
Thanks, very helpful. I'm getting my french nurse diploma in a month, and starting right after at my local ER. This is really helpful information on something I wasnt familiar with
Awesome overview! Nice and simple.
Great general presentation on this element of care.
You might also want to clarify that the etco2 numbers are in mmhg, our monitor uses kilopascals :)
@prepmedic Great job as usual! Let's hear about its use in predicting MTP use and mortality in the atypical shock patients. Thanks again !
Fantastic video Sam! Thank you!
It’s nice to hear someone knowledgeable!! Such an under used tool !! If it’s on the truck use it !!!
Awesome video. I wish there was more of this content
I was wondering what that device was since I saw it in last episode, thanks for the clarification!
Great video. More like this please! Super helpful.
Great video! I'm not sure if you have seen it before or not but I'm pretty sure you can use the EMMA with a neb mask for non-invasive EtCO2 if you don't have sidestream cannula capabilities with a monitor
Great overview
@prepmedic Thank you so much. Super helpful and educational. Blessings to you and yours from South Africa.
We covered this in the Paramedic Assist lecture in our EMT-B class. Great for all first responders to be familiar with as it is likely the EMTs or firefighters will be providing the ventilations and compressions while working a code.
Ah the chapter our class skipped lol... Come test day I was shook lol
I never had anything like that when I took my EMT class; I guess they leave it out in some classes because there's not a whole lot that an EMT-B can do with that information as far as treatments go, as helpful as the info may be. The way my class was taught was very 2-basics-on-a-truck focused. Super interesting stuff though.
ya exactly, "hold my beer, i got this...."(starts trying to hammer in screws)@@jackkrueger4150
zilch of this stuff is for a basic. Zilch. If a basic thinks he can fly this kite? Hes in a fucking hurricane.
ETCO2 is absolutely in the scope of practice for EMTs and it should be used by them liberally. For starters BLS providers have been using superglotic airways for the last decade and while the chances of a “missed tube” are low it is still standard of care to confirm with waveform ETCO2. Second most all BLS service carry nebulizers and albuterol to treat asthma exacerbations so why should we withhold a diagnostic tool for that exact pathophysiology? Finally ETCO2 is used in CPR to guide effective compressions which is absolutely not just an advanced skill.
thanks, this was really helpful
Helpful thank you! I'm in PA school and we didn't learn much about this and the squiggly lines are confusing me on my ER rotation.
Top presentation Sam ... Kev from Wales 🏴 UK RETIRED OPERATING DEPARTMENT PRACTITIONER
Brother I gotta say you guys are like super heroes an i don’t think anybody can fully express our appreciation for what y’all do 🙏 with that being said what advice can you give people that are squeamish to blood an stuff like that ? I’ve seen plenty of my own blood but could you address a video maybe how people like me can over come that squeamishness if that’s a word ? Thank you for everything you do !
Amazing video
Thanks sir for great information
Thank you! Please do ekg reading next!
Very good
Hey Sam, been wondering if you will ever do a review of the Combat Medical IFAK or any of their other gear, I find that their products are both great for the tactical and civilian setting by trying to make them more user-friendly when it comes to all their products.
Mabuhay from
MANILA PHILIPPINES
MAY 2022 !
Good to see Pi in the house.
I’m about to have capnography as part of autonomic testing, so I wanted to know a bit more about it. No doubt at the test I will be busy trying not to faint and won’t be able to see the screen anyway, but I like to know stuff.
First to comment... Great work. Do you have any codes for the Emma?
Would there be any use for this device for providing rescue breaths? Or would it just register your own values? I'm not sure for bystander CPR if using a BVM is allowed if the bystander is trained in using it. I've did quite some resuscitations since here you can register to be alerted to help in providing CPR.
Get some.
I wouldn't call it the *most* versatile vital sign though. That place goes to pulse oximetry. First of all, you can evaluate both B and C, you can use it on everyone, it doesn't require any other material (unlike the mask or tubing with capnography) or preparation and with a plethysmography you can get an idea of the vascular condition and volume status (deep dicrotic point, undulating plethysmography curve).
The problem is that it stops working the second the patient shunts and only tells you hemoglobin saturation without further information on cellular metabolism.
@@PrepMedic Of course it has its limitations, quite a few actually, but in regards to mere amount and diversity of information in comparison to difficulty of use, the pulse oxy still comes out on top imo.
The easiest way to estimate actual oxygen distribution in the body is arguably respiratory frequency (which is automatically measured by capno as well, but can just as much be measured clinically), since it pretty accurately reflects blood pH. Needless to say, this also has its artifacts (pain→↑; opioids→↓), but this is true for all clinical and apparative findings.
Oftentimes one can get around the bad signal in shock by using an ear clip, which can, should the need arise, be put pretty much anywhere it fits (e.g. cheeks, tongue).
Any idea where we can get one?
What is a etc02 of 1 mean please
Hey guys this week we're looking at the acid base buffer system *MUSIC EXPLODES SWAT TEAM FORCING ENTRY ASSAULT RIFLES DRAWN*
You’re going to love acid-base, or else…..
great video, i did not know most of that. what would you recommend i read to learn more? we have the tools on our ambulance rig, but we hardly use them. i think its because most of us don't know its true value now that i have watched this.
If the etco2 is above 45 wouldn’t that mean there more alkalotic and under 35 is acidotic?
Metabolically, potentially but not respiratory. You can have a respiratory Alkalosis that is actively buffering and metabolic acidosis and visa versa. Think of CO2 as an acid, if you have a lot (over 45) it’s a respiratory acidosis and if you have a little (under 35) you have respiratory alkalosis. The numbers are representative of an actual amount, it isn’t read like you would read a PH where the smaller the number the more acidic.
@@PrepMedic makes a lot more sense now, thank you for that explanation!
Yea, because its so damn expensive.
I have a few questions. 1 is, is the reason we can use etco2 to see if someone is in shock because pulse oximeters may not be as accurate?
A pulse ox only measures how saturated a person's hemoglobin is with a gas, can be oxygen, could be Carbon Monoxide, or any other gas that has an affinity to hemoglobin. If a person is in shock, their cells are not getting perfused, meaning the cells are not receiving the oxygen that is attached to the hemoglobin, and when cells are well perfused, meaning a person has adequate blood pressure, the cells use the oxygen, which is then converted to energy and one of the end products of that is Carbon Dioxide, which is then exhaled in the lungs. If the cells are not being perfused (ie. shock) they do not receive adequate oxygen, thus the carbon dioxide level being exhaled is much lower, which will result in a lower end tidal reading.
@@bettysmith4527 thankyou, so the pulse oximeter in shock wouldn’t pick up much ir any saturated hemoglobin with a gas when someone’s in shock?
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My favorite were the martian Lego’s.