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Deaths Due to Asphyxiant Gases
Published in Sudhir K. Gupta, Forensic Pathology of Asphyxial Deaths, 2022
Carbon dioxide (CO2) is an odorless, colorless, and non-flammable gas. It is a normal constituent of air, i.e., 300 ppm or approximately 0.04% of atmospheric air. It is present in the atmosphere in gaseous form. It is transported in the form of liquefied compressed gas, and used in solid form as dry ice.1
Measuring and monitoring vital signs
Published in Nicola Neale, Joanne Sale, Developing Practical Nursing Skills, 2022
The major function of the respiratory system is to supply the body with oxygen and remove carbon dioxide. When the RR is measured, it is the act of ventilation that is observed. One respiration consists of one inspiration (breathing in) and one expiration (breathing out). Respiratory rate measurement is an important aspect of the person’s assessment. Churpek et al. (2016) state that this is the most accurate predictor of deterioration in a person. Deterioration of respiratory effort leads to low levels of oxygen in the blood and raised levels of carbon dioxide. Chapter 14 provides further detail about respiratory assessment.
Gas Exchange in the Lungs
Published in Peter Kam, Ian Power, Michael J. Cousins, Philip J. Siddal, Principles of Physiology for the Anaesthetist, 2020
Peter Kam, Ian Power, Michael J. Cousins, Philip J. Siddal
Each minute, 5 L of venous blood containing 15 mL of oxygen per 100 mL (750 mL oxygen) pass through the pulmonary capillaries, where 250 mL of oxygen are gained by oxygenation. Thus, arterial blood carries 1000 mL of oxygen to tissues each minute, where 250 mL are consumed (this can increase with tissue metabolism), leaving 750 mL of oxygen in the blood of the venous return. From the carbon dioxide dissociation curve, the carbon dioxide content of arterial blood is 48 mL per 100 mL of blood. Thus, in the cardiac output of 5 L/min, 2400 mL of carbon dioxide are carried to the tissues in arterial blood, where 200 mL are added; the venous blood carbon dioxide content is 52 mL per 100 mL of blood. Venous blood therefore carries 2600 mL of carbon dioxide to the lungs per minute, where 200 mL are expired, leaving 2400 mL of carbon dioxide in the arterial blood per minute.
Supraventricular tachycardia after respiratory syncytial virus infection in a newborn
Published in Baylor University Medical Center Proceedings, 2022
Seda Aydoğan, Nurdan Dinlen Fettah, Ali Ulaş Tuğcu, Ece Koyuncu, Tamer Yoldaş, Ayşegül Zenciroğlu
A 3760 g G1P1Y1 male baby born to a 24-year-old mother by vaginal delivery at 40 weeks of gestation was admitted at 17 days of age. He had a cough that began 4 days before hospital admission. His body weight was 4000 g, his axillary body temperature was 36°C, and his arterial oxygen saturation was 94% on room air. In the cardiovascular system examination, S1-S2 was rhythmical, no murmur was heard, the heart rate was 136 beats/min, and arterial blood pressure was 68–39 mm Hg. In the respiratory system examination, the respiratory rate was 64 breaths/min, bilateral thin crepitant rales were present, and intercostal retractions were present. Laboratory findings included a white blood cell count of 6400/mm3, hemoglobin of 14.9 g/dL, platelet count of 411.000/mm3, and C-reactive protein of <3 mg/L. The patient’s biochemical values were normal. For arterial blood gases, the partial pressure of oxygen was 62 mm Hg and the partial pressure of carbon dioxide was 45 mm Hg. No increase in aeration and cardiomegaly was detected on the chest x-ray. A nasopharyngeal swab sample was taken from the patient at the time of admission, and a viral panel study was performed. RSV was positive based on a polymerase chain reaction test. Our patient was not given β-agonist treatment or any antibiotics; only supportive treatment was applied.
Prehospital Manual Ventilation: An NAEMSP Position Statement and Resource Document
Published in Prehospital Emergency Care, 2022
John W. Lyng, Francis X. Guyette, Michael Levy, Nichole Bosson
Capnography provides the best currently available method to detect manual ventilations. The depicted amplitude of the capnograph waveform may be a reasonable surrogate for exhaled tidal volume, but two factors can influence this relationship: 1) inadequate perfusion, in which case the exhaled carbon dioxide level may be low; and 2) incomplete mask seal, such that exhaled air leaks around the mask, circumventing the ETCO2 sensor. Several systematic reviews concluded that ventilation could be improved with direct feedback including use of capnography (91, 92). Vithalani et al. performed a retrospective review of manual ventilation and found that EMS clinicians failed to recognize cases of ineffective ventilation; 8.4% of attempts to provide manual ventilation were not recognized as ineffective by EMS clinicians but were identified as ineffective during review of capnography waveforms (93).
Prehospital End-tidal Carbon Dioxide Predicts Mortality in Trauma Patients
Published in Prehospital Emergency Care, 2018
Kelsey Childress, Kelly Arnold, Christopher Hunter, George Ralls, Linda Papa, Salvatore Silvestri
Exhaled carbon dioxide can be measured quickly, accurately, and non-invasively using capnography. EtCO2 measurements have multiple applications in both prehospital and hospital settings, including verifying correct endotracheal tube placement, intraoperative monitoring, and detecting return of spontaneous circulation following cardiac arrest.3,5,7,9 EtCO2 has been shown to have a strong correlation with arterial PCO2 in the emergency department.10 In the prehospital setting, capnography is more reliable than pulse oximetry as it provides continuous monitoring and produces fewer false alerts.11 EtCO2 levels are associated with poor outcomes when measured intraoperatively in trauma surgery4,6,9,12,13 and, recently, Deakin et al.4 showed that decreased EtCO2 levels correlate with mortality in intubated prehospital patients suffering from blunt traumatic injury. Interestingly, several studies have also shown that EtCO2 levels are inversely correlated with serum lactate levels in sepsis,14 metabolic disturbances,15 and shock,16 suggesting a broader association with hypoperfusion.