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Riding the Waves: End-Tidal CO2 Monitoring
End-Tidal CO2 monitoring has a variety of uses in the Emergency Department. Whether used diagnostically or for monitoring of a patient’s physiology, clinicians must possess an understanding of the information that you can gather from EtCO2 waveform tracings. Knowing how to interpret the waveforms makes EtCO2 much more than a number, allowing the clinician to gain insight into minute to minute changes in a patients physiological state.
Grand Rounds Recap 6.7.23
This week Dr. Diaz starts off with a challenging case of massive upper GI bleed managed with balloon tamponade. We then moved into a case follow-up with profound electrical storm and recurrent ventricular arrhythmias secondary to a STEMI. Following this, we took a deep dive into waveform capnography regarding normal physiology and alterations with lung pathology with Dr. Wilson. Next, we had an exciting CPC showdown where Dr. Bryant successfully diagnosed Dr. Haffner’s case of valproic acid toxicity presenting with hyperammonemic encephalopathy. We closed with Dr. Wosiski-Kuhn outlining the difficulty of intubation in a patient with DKA and severe metabolic acidosis.
EtCO2 vs. Standard Triage Vitals in Predicting In-Hospital Mortality and ICU Admission
Boarding of admitted patients in the ED and subsequent overcrowding of ED’s continues to plague hospitals in the United States and Internationally. The Covid-19 pandemic exacerbated an already growing problem regarding capacity management and patient flow. In this current climate, the Emergency Physician’s responsibilities continue to shift toward the front-end of the process, mainly patients waiting to be seen in the lobby. As such, identifying sick patients in a timely manner and utilizing additional resources to predict patients at risk of clinical deterioration will be paramount moving forward.