Breathing

Standard resuscitation room monitoring

This include the following:

  • SpO2
  • 3-lead ECG monitoring
  • Non-invasive blood pressure every 3-5 minutes
  • End–tidal carbon dioxide (ETCO2) monitoring in the ventilated patient

The ETCO2 is a guide to the trend of arterial partial pressure of CO2 (PaCO2), while not being the same numerically due to V/Q mismatches. The aim is normocarbia, as hypo- and hypercapnia are linked to increased mortality. [3]

Controlled ventilation gives indirect control of other homeostatic mechanisms undertaken by a conscious and physiologically ‘normal’ body.

For example:

  • Changes in PaCO2 affect cerebral blood flow
  • Positive End-Expiratory Pressure (PEEP) can dramatically improve gas exchange

While hypoxia is well known to cause increased mortality, there is increasing evidence that prolonged periods of hyperoxia is also harmful, and independently associated with decreased survival to hospital discharge. Target oxygen saturations post-ROSC are 94-98%. [4]

BEWARE of the risk of precipitating vomiting if ventilating without a definitive airway.