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Sustained life-like waveform capnography after human cadaveric tracheal intubation
  1. Cliff Reid1,
  2. Anthony Lewis1,
  3. Karel Habig1,
  4. Brian Burns1,
  5. Frank Billson2,
  6. Sven Kunkel2,
  7. Wesley Fisk3
  1. 1Department of Ambulance Service New South Wales, Greater Sydney Area Helicopter Emergency Medical Service, Bankstown, New South Wales, Australia
  2. 2Sydney Hospital Macquarie Street, Sydney, New South Wales, Australia
  3. 3Department of Ray Last Anatomy Laboratory, University of Adelaide, Adelaide, New South Wales, Australia
  1. Correspondence to Dr Cliff Reid, Greater Sydney Area Helicopter Emergency Medical Service, Ambulance Service New South Wales, 670 Drover Road, Bankstown Airport NSW 2200, Australia; reidcg{at}me.com

Abstract

Introduction Fresh frozen cadavers are effective training models for airway management. We hypothesised that residual carbon dioxide (CO2) in cadaveric lung would be detectable using standard clinical monitoring systems, facilitating detection of tracheal tube placement and further enhancing the fidelity of clinical simulation using a cadaveric model.

Methods The tracheas of two fresh frozen unembalmed cadavers were intubated via direct laryngoscopy. Each tracheal tube was connected to a self-inflating bag and a sidestream CO2 detector. The capnograph display was observed and recorded in high-definition video. The cadavers were hand-ventilated with room air until the capnometer reached zero or the waveform approached baseline.

Results A clear capnographic waveform was produced in both cadavers on the first postintubation expiration, simulating the appearances found in the clinical setting. In cadaver one, a consistent capnographic waveform was produced lasting over 100 s. Maximal end-tidal CO2 was 8.5 kPa (65 mm Hg). In cadaver two, a consistent capnographic waveform was produced lasting over 50 s. Maximal end-tidal CO2 was 5.9 kPa (45 mm Hg).

Conclusions We believe this to be the first work to describe and quantify detectable end-tidal capnography in human cadavers. We have demonstrated that tracheal intubation of fresh frozen cadavers can be confirmed by life-like waveform capnography. This requires further validation in a larger sample size.

  • Resuscitation, Training
  • Airway

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