Heradstveit and Heltne reported the PQRST mnemonic for proper monitoring of end-tidal carbon dioxide (capnography) during the resuscitation after a cardiac arrest. A number of factors can cause inaccurate readings and these must be avoided. The authors are from Haukeland University Hospital and the University of Bergen in Norway.
Patient selection: resuscitation after a cardiac arrest
Letter
Expansion
Meaning
P
position of tube
capnography can confirm correct tracheal tube placement, especially during transport
Q
quality of CPR
ETCO2 may decline due to poor chest compressions; resuscitators should be rotated so that the quality of compressions is maintained
R
ROSC
return of spontaneous circulation may be heralded by a sudden increase in ETPCO2
S
strategy
ETCO2 levels need to be interpreted in light of history and exam fiindings
T
termination of resuscitation
persistently low or a fall in ETCO2 may indicate a futile resuscitation
Causes of a low ETCO2 may include:
(1) pulmonary embolism
(2) internal hemorrhage
(3) tension pneumothorax
(4) epinephrine therapy
(5) failed resuscitation
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