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previews",[218,229,234,239,246],{"type":219,"data":220},"video",{"readDurationInSeconds":221,"video":222},137,{"platform":223,"name":224,"url":225,"size":226},"YouTube","Using end tidal capnometry","https:\u002F\u002Fwww.youtube.com\u002Fwatch?v=PGMrju7olM4",{"width":227,"height":228},200,113,{"type":230,"data":231},"free_text",{"readDurationInSeconds":232,"text":233},12.266666666666666,"\u003Cp> \u003Cstyle type=\"text\u002Fcss\">\u003C!--td {border: 1px solid #ccc;}br {mso-data-placement:same-cell;}--> \u003C\u002Fstyle> End-tidal capnometry can be a useful surrogate for perfusion monitoring and is a crucial tool in your resuscitation tool kit. In this video, from our Resuscitation Essentials course, you'll discover how end-tidal capnometry can be used to help monitor your patients' wellbeing and what you need to consider in order to avoid misinterpretation of the results.\u003C\u002Fp>",{"type":230,"data":235},{"readDurationInSeconds":236,"title":237,"text":238},11.2,"Join our Resuscitation Essentials course today!","\u003Cp>Gain a deep understanding of end-tidal carbon dioxide monitoring for assessing ventilation and perfusion in your patients! With our \u003Cstrong>\u003Ca href=\"https:\u002F\u002Fwww.medmastery.com\u002Fcourse\u002Fresuscitation-essentials\">Resuscitation Essentials \u003C\u002Fa>\u003C\u002Fstrong>course, you'll master a step-by-step approach for managing patients who are near to, or experiencing, cardiac arrest in any environment. \u003C\u002Fp>",{"type":240,"data":241},"cta",{"readDurationInSeconds":242,"text":243,"buttonText":244,"buttonUrl":245},3.466666666666667,"Become a great clinician with our video courses and workshops","Start learning for free","https:\u002F\u002Fwww.medmastery.com\u002Fuser\u002Fregister",{"type":230,"data":247},{"readDurationInSeconds":248,"title":249,"text":250},74.13333333333333,"Transcript","\u003Ch3 dir=\"ltr\" id=\"docs-internal-guid-dde8a920-7fff-4ddb-72a8-a20ec74e935e\">\u003Cspan>End-tidal CO\u003Csub>2\u003C\u002Fsub> monitoring\u003C\u002Fspan>\u003C\u002Fh3>\u003Cp dir=\"ltr\">\u003Cspan>[0:00]\u003C\u002Fspan>\u003Cbr>\u003Cspan>Oxygen is metabolized throughout the body into carbon dioxide by oxidative phosphorylation. This carbon dioxide is circulated via the bloodstream into the lungs, where it's expired and can be measured. This can be done quantitatively with an end-tidal capnometer, or capnograph. These are devices which measure the presence of CO\u003Csub>2\u003C\u002Fsub> passing by a sensor, attached near the patient's airway or within the breathing circuit. A report of value is usually in millimeters of mercury. \u003C\u002Fspan>\u003C\u002Fp>\u003Ch3 dir=\"ltr\">\u003Cspan>Using capnography to confirm airway placement\u003C\u002Fspan>\u003C\u002Fh3>\u003Cp dir=\"ltr\">\u003Cspan>[0:31]\u003C\u002Fspan>\u003Cbr>\u003Cspan>This can be useful in several ways. For one, the presence of cyclical waveform confirms communication with the ventilatory system and can be used to confirm endotracheal tube placement. \u003C\u002Fspan>\u003C\u002Fp>\u003Ch3 dir=\"ltr\">\u003Cspan>End-tidal CO\u003Csub>2\u003C\u002Fsub> monitoring as a marker of perfusion\u003C\u002Fspan>\u003C\u002Fh3>\u003Cp dir=\"ltr\">\u003Cspan>[0:41]\u003C\u002Fspan>\u003Cbr>\u003Cspan>We also know that the rate of generation of carbon dioxide is relatively constant. Therefore, with the constant ventilatory rate, the only changing variable is the rate of circulation, so we can use changes in quantitative end-tidal capnometry as a surrogate for perfusion. More perfusion to the lungs will create a higher level of expired carbon dioxide and less perfusion will create less expired carbon dioxide. \u003C\u002Fspan>\u003C\u002Fp>\u003Ch3 dir=\"ltr\">\u003Cspan>Capnography during CPR and cardiac arrest\u003C\u002Fspan>\u003C\u002Fh3>\u003Cp dir=\"ltr\">\u003Cspan>[1:05]\u003C\u002Fspan>\u003Cbr>\u003Cspan>Very low levels of expired carbon dioxide suggest poor perfusion and obviate the need to interrupt compressions for a pulse check. Prolonged periods of cardiac arrest with very low end-tidal CO\u003Csub>2 \u003C\u002Fsub>suggest that a return of spontaneous circulation is unlikely. \u003C\u002Fspan>\u003C\u002Fp>\u003Ch3 dir=\"ltr\">\u003Cspan>Causes of low end-tidal CO\u003Csub>2\u003C\u002Fsub> readings\u003C\u002Fspan>\u003C\u002Fh3>\u003Cp dir=\"ltr\">\u003Cspan>[1:20]\u003C\u002Fspan>\u003Cbr>\u003Cspan>Of course, other factors may create a low reading as well, including obstructive lung disease, hyperventilation, or a large portion of dead space from another cause of poor perfusion like a pulmonary embolism. Administration of sodium bicarbonate will increase the amount of carbon dioxide expired, without reflecting an increase in perfusion. \u003C\u002Fspan>\u003C\u002Fp>\u003Ch3 dir=\"ltr\">\u003Cspan>Monitoring ventilation with capnography\u003C\u002Fspan>\u003C\u002Fh3>\u003Cp dir=\"ltr\">\u003Cspan>[1:40]\u003C\u002Fspan>\u003Cbr>\u003Cspan>In addition to its utility as a surrogate for perfusion monitoring, end-tidal CO\u003Csub>2\u003C\u002Fsub> may also serve as a reliable method to monitor ventilation for a variety of patients, including those at risk for airway obstruction or apnea.\u003C\u002Fspan>\u003C\u002Fp>",{"courses":252,"showAwardsBelow":48},[253],{"id":254,"isFreeCmeCourse":255,"title":256,"type":257,"specialization":258,"teachers":260,"cmeCredits":262,"teacherIllustration":263,"backgroundImage":264,"relativeUrl":265,"lastChanged":266,"created":267,"description":268,"relativeURL":265,"meta":269},5236,false,"Resuscitation Essentials","course",[259],"Emergency medicine and critical care",[261],"Christopher R. Tainter, MD",3,"https:\u002F\u002Fmedmastery-backend-prod-kjbeds.s3.eu-west-1.amazonaws.com\u002Fmedia\u002Fimages\u002F99f55eb1-6358-434e-bd05-101915d2de76","https:\u002F\u002Fmedmastery-backend-prod-kjbeds.s3.eu-west-1.amazonaws.com\u002Fmedia\u002Fimages\u002F99f55eee-ca2a-4d37-beeb-eafdef1a9482","\u002Fcourses\u002Fresuscitation-essentials","1763556352","1533061301","Resuscitation is all about making rapid, life-saving decisions in the face of uncertainty. Algorithms give structure, but can’t cover every possible scenario. 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Learn when injectable cholesterol medication helps and how PCSK9 inhibitors work.",{"alt":314,"title":290,"size":315,"location":316},"Two PCSK9 inhibitor autoinjector pens—an injectable cholesterol medication—shown on a light blue background.",{"width":292,"height":292},{"bucket":294,"key":317},"\u002F2026-05\u002FC121(3)_magazine image.png",{"id":319,"title":320,"relativeURL":321,"image":322,"professionLong":323,"profession":324,"weight":326},1563,"Franz Wiesbauer, MD MPH","\u002Fteachers\u002Ffranz-wiesbauer-md-mph","https:\u002F\u002Fmedmastery-backend-prod-kjbeds.s3.eu-west-1.amazonaws.com\u002Fmedia\u002Fimages\u002F9c43cef0-41ee-4005-9e4a-d8711c816401","Franz is the founder and CEO of Medmastery. He is an internist with a specialization in cardiology and a master’s in public health from Johns Hopkins University.",{"name":325},"Internist",4,"\u002Fmagazine\u002Fpcsk9-injectable-cholesterol-medication",279,"5m",{"created":331,"updated":332,"published":333},1779483663,1779495630,1779495631,{"id":335,"title":336,"text":337,"image":338,"author":344,"path":346,"readDuration":347,"readDurationFormatted":348,"internal":349},1351,"Starting statins as first-line therapy for hyperlipidemia","Starting statins: how to choose the right agent for your patient, match statin intensity to cardiovascular risk, and monitor effectively after initiation.",{"alt":339,"title":290,"size":340,"location":342},"Healthcare provider discussing starting statins with a patient and reviewing a medication bottle",{"width":341,"height":341},660,{"bucket":294,"key":343},"\u002F2026-05\u002FC121(2)_magazine image.png",{"id":319,"title":320,"relativeURL":321,"image":322,"professionLong":323,"profession":345,"weight":326},{"name":325},"\u002Fmagazine\u002Fstarting-statins-first-line-therapy",238,"4m",{"created":350,"updated":351,"published":352},1778960150,1779196374,1778961827,{"seo":354,"og":356},{"title":355,"description":213},"Using end-tidal capnometry | Medmastery",{"title":355,"description":213,"image":357},{"alt":290,"title":290,"size":358,"location":361},{"width":359,"height":360},620,329,{"bucket":294,"key":362},"\u002Fmigrated-images\u002FScreen Shot 2018-08-13 at 11.14.57 am.png",{"id":364,"created":365,"updated":366,"published":365},248,1534155422,1779397192]