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Airway Intubation Confirmation and End-Tidal CO2 Detector

Clinical Indications: Last update 02/2009

    The End-Tidal CO2 detector shall be used with any Endotracheal Tube or Blind Insertion
    Airway Device use.
    It is strongly recommended that continuous Capnography be used in place of or in addition
    to the use of an End-Tidal CO2 detector.


    1. Attach End-Tidal CO2 detector to the Blind Insertion Airway Device or the Endotracheal Tube.

    2. Note initial ETCO2. ETCO2 detection should be used on all Cardiac, Respiratory, AMS or patients where airway control or assistance is needed. ETCO2 will be documented on each patient.

    3. The CO2 detector shall remain in place with the airway and monitored throughout the
    prehospital care and transport unless continuous Capnography is used. Any loss of ETCO2
    detection is to be documented and monitored as procedures are done to
    verify or correct the airway problem.

    4. Tube placement should be verified frequently and always with each patient move, change in BVM compliance, defib, change in patient status and prior to be turned over to a hospital in front of person taking over airway note End-Tidal CO2 detector reading.

    5. To confirm airway:
    - Visual tube passing the vocal cords
    - Mark tube at the gums or teeth (avgerage 21-23)
    - Good Bag compliance
    - No epigastric sounds
    - Good lung sounds
    - Sao2 above 90%
    - ETCO2 reading
    - Good wave form
    - Improvement in patient color

    5. Document the procedure and the results on/with the Patient Care Report (PCR) as well as on
    the Airway Evaluation Form.

Competency Based Skill Requirements:

    -Maintain knowledge of the indications, contraindications, technique, and possible
    complications of the procedure. Assessment of this knowledge may be accomplished via
    quality assurance mechanisms, classroom demonstrations, skills stations, or other
    mechanisms as deemed appropriate by the local EMS System.

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