In this follow-up episode, Bruce and the team continue discussing ventilation and airway management. This episode goes into greater depth on how ETCO2 can be used to manage an array of patients effectively and how a thorough understanding and monitoring of end-tidal during a resuscitation attempt can help ensure a patient remains neurologically intact, assuming ROSC is achieved. Bruce covers case studies on this topic, and the team has the opportunity to look at the “oscillations” in end-tidal and how they provide vital information on the efficacy of CPR and PPVs. This episode provides unique insight and information on the delivery of effective ventilations and how to best use the tools in our toolbox to ensure our patients receive the highest possible level of care. This episode highlights the central theme of part 1: that airway management should not be lightly handed over to the least experienced provider; instead, thorough training should be provided to all members of a crew to ensure all are competent and understand the weight and importance of the delivery of effective ventilations to not only the management of the patient while they are in crisis, but to their longevity following the incident.
Below are graphics and their descriptions provided by Bruce to help understand concepts discussed in the course.
This example shows “Oscillations, 30:2 Ventilations. This patient is intubated (Patent Airway). Tidal Volume is excellent, and compressions look high quality. You can see it all play out. Also, notice that in the 30:2, the first end-tidal waveform is shortened. That is because we are trying to give two really fast breaths, so we interrupt the first breath out with an immediate 2nd breath in, giving it a shortened waveform. This is trained at TVFR to give your two breaths and then look for a shortened waveform, and the 2nd breath has the compressions. Appreciate how consistently our variables work together, and the end-tidal is not wavering or all over the place.”
– Bruce Opsal