Keiran Bellis

Much has been written recently regarding the need for increased utilisation of end-tidal Carbon Dioxide (ETCO2) monitoring in both peri-arrest and post arrest situation in addition to the cardiac arrest scenario.  Whilst it has been demonstrated that ETCO2 is key in terms of ensuring correct endotracheal tube placement in cardiac arrest Sinclair and Sartin (2015) has highlighted that ETCO2 monitoring has significant benefits when further utilised in the wider context of cardiac arrest to potentially improve patient outcomes.  The Use of ETCO2 monitoring allows the clinician a greater insight into the true current condition of the patient when compared with oxygen saturation monitoring (SPO2) as it has been noted that if a patient was to hold their breath, to simulate apnoea, capnography would show a marked reduction in exhaled Carbon dioxide (CO2) whilst SPO2 readings would continue to show ‘normal’ saturation levels for a number of minutes. 

This Paper will further highlight the benefits of ETCO2 use in the pre and out of hospital environment in many more situations aside from just the cardiac arrest situation.  Furthermore, this paper will propose its use in patients where acidosis and carbon retention are key factors such as Chronic Obstructive Airways Disease (COPD) and Diabetic Ketoacidosis (DKA), Asthma and Congestive Heart Failure (CHF) to name but a few. This paper will then go on to provide a robust justification and argument why the monitoring of ETCO2 is necessary and of patient benefit both in the pre and in hospital environment and additionally will also support the clinician in providing the optimal quality of care within the pre hospital environment.