Sharpening PUMA's teeth: improving guidance for capnography to confirm tracheal intubation in cardiopulmonary resuscitation.

Panel (a) shows an example from that reference where end-tidal carbon dioxide (ETCO2) is initially < 1 kPa for a sustained (>7 breath) period, but rises with improved cardiopulmonary resuscitation (CPR) quality and treatment (the patient may still die despite this). Keywords: blood gases; cardiac arrest; difficult intubation; hypoxia; lung ventilation EN blood gases cardiac arrest difficult intubation hypoxia lung ventilation 937 942 6 07/06/23 20230801 NES 230801 The principle that using waveform capnography is essential to confirm correct tracheal tube placement dates from the 1980s [[1]], and its mandatory use has been repeated in successive minimum monitoring guidelines [[2]]. Some cases of unrecognised oesophageal intubation highlighted the need to extend this principle to cardiopulmonary resuscitation (CPR), where it had been wrongly assumed that cardiac arrest would invariably result in a flat waveform making capnography useless, but this is not the case. [Extracted from the article]