The Role of EtCO2 in Termination of Resuscitation

EtCO2 may not always determine when to terminate resuscitation Out-of-hospital cardiac arrest (OHCA) is a common occurrence; it's estimated that approximately 300,000 people per year are treated for OHCA in the United States, with a survival rate of 9.6%.1 EMS systems used to transport all cardiac arrest patients to hospitals, regardless of return of spontaneous circulation (ROSC). However, evidence now suggests that appropriate management of OHCA includes the termination of resuscitation (TOR) in certain settings, given that the overall outcome for many patients is grim. A 2016 study conducted in Paris, France, indicated that OHCA patients had a survival rate of 0% if the following three criteria were met by the patient: 1) The patient didn't arrest in front of rescuers; 2) The patient had a non-shockable rhythm; and 3) The patient didn't respond to two rounds of epinephrine.2 Cardiopulmonary resuscitation (CPR) has evolved substantially since it was first publicly described in 1960. High-quality CPR is critical to the achievement of ROSC.3 Advances in research have addressed many issues in the application of CPR, including: 1) the avoidance of over-ventilation; 2) rate of chest compression; 3) use of "compressions-only" CPR early in the course of patient management; 4) depth of compressions; and 5) employment of waveform capnography during the management of the case. EtCO2 measurement is widely used to determine the effectiveness of resu...
Source: JEMS Patient Care - Category: Emergency Medicine Authors: Tags: Patient Care Cardiac & Resuscitation Source Type: news