EtCO2 can be useful, as you can call an arrest if the patient isn't making any. I also find it very useful to
measure the potassium as soon as possible. There was an excellent paper a few years ago that allowed
rescuers to differentiate those who would survive in a mass casualty situation after an avalanche by a
potassium estimation - all those with a potassium above the normal range died. I call arrests with a high
potassium too. I know ALS says you should treat it.
> Good thread Julian - as far as I am aware, the ETCO2 is actually a very
> useful
> prognostic indicator post arrest - if low then they are unlikely to
> survive to
> hospital discharge, if high then there is a good chance. You can
> probably
> quote the figures more readily. This may be useful in that it may help
> us
> decide which of the ROSC's to palliate and which to pull all the stops
> out
> for.
>
> PLEASE can we limit this thread to Julian's topic and not diversify
> back to
> evidence base behind ALS/Teaching/Short courses once again. Even though
> I have
> a professed interest in this, I think we have done that topic to death
> (sic)
> and it became quite tedious when it raised its head again recently.
>
> Andy
>
> >===== Original Message From Accident and Emergency Academic List
> <[log in to unmask]> =====
> >That's if chest compressions make any difference anyway?? No evidence
> >for that is there?
> >Best guide to outcome community>15mins not in VT/VF crap outcome. In
> >VF/VT slightly better
> >Seriously though most departments probably have difficulty finding the
> >ETCO2 probe for the patient needing ITU, as its still probably in ITU
> >Andy Webster
> >
> >-----Original Message-----
> >From: Accident and Emergency Academic List
> >[mailto:[log in to unmask]] On Behalf Of Julian Humphrey
> >Sent: 19 February 2003 23:33
> >To: Andrew Webster
> >Subject: End Tidal Carbon Dioxide monitoring in CPR
> >
> >Dear Colleagues
> >
> >Having read the article about end tidal CO2 monitoring in the recent
> ALS
> >Newsletter and completing my CTR on the subject. I would be interested
> >to hear whether, colleagues are routinely using end tidal CO2
> monitoring
> >in the management of patients in cardiac arrest. Is anyone currently
> >doing any research on this in UK?
> >
> >There is good quality evidence in the literature to suggest that it can
> >provide non invasive information on the quality of chest compressions,
> >and predict the return of spontaneous circulation before a pulse is
> >palable, and may be a be a guide to outcome. This is in addition to
> >confirming the correct placement of the ET tube.
> >
> >
> >Julian Humphrey
> >SpR in A&E Medicine
> >Yorkshire
>
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>
Best wishes,
Rowley Cottingham
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http://www.emergencyunit.com
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