REFLECTIONS ON PREHOSPITAL CARE
EtCO2: the key to effective prehospital ventilation
1 Surrey Ambulance Service NHS Trust, The Horseshoe, Bolters Lane, Banstead, SM7 2AS, UK
2 Durban Institute of Technology, Durban, South Africa
Correspondence to:
Correspondence to:
Corresponding author: R Owen
Surrey Ambulance Service NHS Trust, The Horseshoe, Bolters Lane, Banstead, SM7 2AS, UK; robert.owen@surrey-ambulance.nhs.uk
Accepted 10 March 2006
Keywords: end-tidal carbon dioxide; intubation; ventilation
| The first 150 words of the full text of this article appear below. |
An advanced life support (ALS) unit staffed by two paramedics and two students was dispatched to a road traffic accident in South Africa. On arrival the team noted an adult male who had fallen from a minibus travelling at speed. The patient was noted to be in extremis:
- A. Airway was partially obstructed by blood/vomit, although the patient was lying in a lateral position
- B. Respiration was shallow at 6 breaths min–1 and oxygen saturation via pulse oximetry was 100% on high-flow oxygen
- C. Heart rate was 100 bpm and blood pressure 160/100 mm Hg
- D. Eyes – 1; verbal – 1; motor – 3
- E. Isolated head injury with no other obvious injuries
Treatment priorities where dictated by the need to secure/protect the airway, concerns over hypoventilation,1 and prolonged hospital transfer time. The decision was made to attempt to reduce secondary hypoxic brain injury through endotracheal intubation.2 Due to
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