Background: Penetrating neck injuries require prompt recognition, diagnosis and management of critical airways. This case demonstrates an emergent situation that a "medical negligence" was avoided with the aid of end-tidal carbon dioxide (ETCO) waveform.
Case Summary: We report a case of malposition of the endotracheal tube into the right hemithoracic cavity for cervical knife trauma, resulting in pneumothorax. Tube placement was not confirmed during emergency airway management, and the patient was directly transferred to the emergency operation room. Assisted by ETCO and imaging examinations, the anesthetist timely noticed the absence of ETCO waveform and resolved this urgent situation before anesthesia induction.
Conclusion: This case emphasizes the necessity of ETCO waveform and/or X-ray confirmation of endotracheal intubation even in emergent situations.
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http://dx.doi.org/10.12998/wjcc.v9.i34.10733 | DOI Listing |
Turk J Anaesthesiol Reanim
December 2024
Sri Ramachandra Institute of Higher Education and Research, Department of Anaesthesiology and Pain Medicine, Chennai, Tamilnadu, India.
Objective: Successful endotracheal intubation is a key step in advanced airway management. The gold standard confirmation for successful endotracheal intubation is end-tidal carbon dioxide (etCO) monitoring, although recent studies suggest that ultrasound can also be used. In this study, we explored the time-sensitive early recognition of successful endotracheal intubation by comparing ultrasound and etCO monitoring.
View Article and Find Full Text PDFRespir Med
January 2025
Sydney Medical School, The University of Sydney, Edward Ford Building (A27), Camperdown, NSW, 2006, Australia; Research Operations, Nepean Hospital, Nepean Blue Mountains Local Health District, Kingswood, NSW, 2747, Australia. Electronic address:
Background And Objective: Accurate severity assessment in acute asthma is vital to guide patient management and disposition. End-tidal carbon dioxide (EtCO) has been proposed as a real-time measure for this purpose. This study aimed to systematically review literature on EtCO measurement in assessing the severity of acute asthma exacerbations.
View Article and Find Full Text PDFIntensive Care Med Exp
November 2024
Department of Anesthesiology, Vanderbilt University Medical Center, 1211 Medical Center Drive, Nashville, TN, 37232, USA.
Background: Enhancing venous return during cardiopulmonary resuscitation (CPR) can lead to better hemodynamics and improved outcome after cardiac arrest (CA). Peripheral Intravenous Analysis (PIVA) provides feedback on venous flow changes and may indicate an increase in venous return and cardiac output during CPR. We hypothesize PIVA can serve as an early indicator of increased venous return, preceding end-tidal CO (etCO) increase, before the return of spontaneous circulation (ROSC) in a rat model of CA and CPR.
View Article and Find Full Text PDFJ Oral Maxillofac Surg
October 2024
Associate Professor, Department of Oral and Maxillofacial Surgery, University of Illinois Chicago College of Dentistry, Chicago, IL.
Background: End-tidal carbon dioxide (EtCO) is an invaluable anesthesia measure due to minimal delay in monitoring ventilation. Oral and Maxillofacial Surgery (OMS) presents special challenges because oral exhalations are not sampled effectively via nasal cannula normally used to avoid interfering with procedures.
Purpose: The purpose of the study was to compare EtCO waveforms obtained in subjects using nasal monitoring and combined nasal and oral monitoring under simulated ventilatory conditions.
Int J Emerg Med
April 2024
Division of Medical Toxicology, Department of Emergency Medicine, Icahn School of Medicine at Mount Sinai, 10029, New York, NY, United States of America.
Background: Capnography is a quantitative and reliable method of determining the ventilatory status of patients. We describe the test characteristics of capnography obtained during Emergency Department triage for screening acidemia.
Results: We performed an observational, pilot study of adult patients presenting to Emergency Department (ED) triage.
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