Inappropriate Ventilation in Intubated Prehospital Patients on Arrival at the ED

In a study at a single emergency department, end-tidal CO₂ values revealed inappropriate ventilation in nearly half the patients.

Previous studies have raised concerns about excessive ventilation during resuscitation with a bag and mask, but does this also occur during intubation? In a prospective observational study, researchers in California assessed end-tidal carbon dioxide (ETCO₂) levels on arrival to the emergency department in 100 patients without cardiac arrest who received prehospital endotracheal intubation. Four patients with esophageal intubation were excluded.

Among the 96 patients (age range, 2 months to 92 years), presenting conditions were trauma (74 patients), medical (12), and burns (10). Overall, 61% of patients were transported by air. Median ETCO₂ was 32 mm Hg (range, 18–80 mm Hg). Nearly half the patients (48%) had abnormal ETCO₂ values, including …

Reviewing Author

Kristi L. Koenig, MD, FACEP

Disclosures

Editorial boardsKoenig & Schultz's Disaster Medicine: Comprehensive Principles and Practices

Kristi L. Koenig, MD, FACEP

Disclosures

Editorial boardsKoenig & Schultz's Disaster Medicine: Comprehensive Principles and Practices