Which point in the waveform is an ETCO2 measured?

Which point in the waveform is an ETCO2 measured?

The amount of carbon dioxide exhaled at the end of each breath (EtCO2) is measured through a sensor located between the patient’s airway and ventilator and is then numerically and graphically displayed as a waveform.

How do you read ETCO2?

The amount of CO2 at the end of exhalation, or end-tidal CO2 (ETCO2) is normally 35-45 mm HG. The height of the capnography waveform accompanies this number on the monitor, as well as the respiratory rate.

What is the normal ETCO2?

End-tidal CO2 (EtCO2) monitoring is a noninvasive technique which measures the partial pressure or maximal concentration of carbon dioxide (CO2) at the end of an exhaled breath, which is expressed as a percentage of CO2 or mmHg. The normal values are 5% to 6% CO2, which is equivalent to 35-45 mmHg.

What are the four phases of capnography?


  • Phase I: Respiratory Baseline.
  • Phase II: Expiratory Upstroke.
  • Phase III: Expiratory Plateau.
  • ETCO2: Peak EtCO2 level.
  • Phase IV: Inspiratory Downstroke.
  • Why does hyperventilation cause low ETCO2?

    Increased work of breathing from pulmonary edema may lead to fatigue and respiratory failure. This would cause a rise in ETCO2, but the waveform will remain upright. Hyperventilation causes excess CO2 to be exhaled, which would present with a crisp waveform and low ETCO2, or hypocapnea.

    What does a shark fin ETCO2 waveform indicate?

    A rectangular waveform indicates that difficulty breathing is from another cause that will not be helped by albuterol. The more pronounced the shark fin and the higher the ETCO2, the greater the risk of respiratory failure and arrest is.

    How high can ETCO2 go?

    Oxygenation should be titrated to achieve SPO2 of 92%, and ventilation should be titrated to achieve ETCO2 between 35 and 45 mm Hg. Capnography is the most reliable method to confirm correct advanced airway placement, and provides documentable proof.

    What does elevated ETCO2 mean?

    ETCO2 is the amount of carbon dioxide (CO2) in exhaled air, which assesses ventilation. So a high ETCO2 is a good sign of good ventilation, while low ETCO2 is bad sign that represents hypoventilation.

    What causes low ETCO2?

    Low ETCO2 with other signs of shock indicates poor systemic perfusion, which can be caused by hypovolemia, sepsis or dysrhythmias. Cardiac arrest is the ultimate shock state; there is no circulation or metabolism and no CO2 production unless effective chest compressions are performed.

    What should ETCO2 be during CPR?

    Teams should aim for EtCO2 at least >10 mm Hg and ideally >20 mm Hg. Where do these numbers come from? These values are approximately 1/4 the normal EtCO2 (35-45 mm Hg), and ideal CPR will provide at least 1/4 of cardiac output. This is an example of capnography during CPR.

    What happens to ETCO2 When you hyperventilate?

    Hyperventilating patients who eliminate excess of CO2 would have an ETCO2 reading below 30 mmHg. In a patient whose panic attack is worsening, ETCO2 would decrease as their respiratory rate increases. Likewise, a decrease in respiratory rate and rise in ETCO2 suggests that the patient’s panic attack is improving.

    What is the normal range for ETCO2?

    Normal ETCO2 is 38 mm Hg at sea level, although for clinical purposes, an acceptable ETCO2 range is between 35 and 45 mm Hg.6 The amount of exhaled CO2 detected decreases quickly in segment D-E (phase IV), which represents inhalation.

    How is ETCO2 measured?

    Providers measure the value of ETCO2 in each exhaled breath with a very thin tube inserted into the breathing circuit or the patients oxygen mask or nasal prongs. The waveform (capnogram) that you then see on the capnography monitor provides a real time recording of the patient’s respiratory rate, pattern and depth of breathing, and of course the value of CO2 exhaled.

    What is the purpose of ETCO2 monitoring?

    EtCO2 monitoring is essential during many types of medical procedures ranging from routine respiratory observation to open heart surgery, as well as any time general anesthesia must be administered.

    What is a high ETCO2?

    A high eco2 occurs when the lungs have failed to remove enough carbon dioxide from the blood, due to a disease such as COPD (chronic obstructive pulmonary disease). It can also occur when air with a high level of carbon dioxide has been breathed in.