Carbon dioxide monitoring in emergency medicine training programs.
OBJECTIVE
Although the measurement of carbon dioxide (CO2) in breath is the standard of care for verification of endotracheal tube placement in all anesthesia practice and in the prehospital setting, there is currently no uniform consensus on the status of CO2 monitoring in emergency medicine. We conducted this survey to delineate practice patterns of CO2 monitoring in academic emergency medicine training programs and to describe the preference for type of CO2 monitoring device.


METHODS
We surveyed the availability, presence, and types of CO2 monitoring in all general emergency medicine (GEM) residency programs and all pediatric emergency medicine (PEM) fellowship programs. A two-question survey was used, and data were collected from March 1998 to June 1998. The clinicians surveyed were asked whether their emergency department (ED) used CO2 monitoring for detection of endotracheal tube placement and, if so, what type of CO2 monitoring devices was used. Types of CO2 monitoring devices were categorized as colorimetric, capnometric, capnographic, or combinations of these.


RESULTS
Of the 168 programs surveyed, all GEM and PEM programs responded, and the survey results showed that 136 of 168 (81%) used some form of CO2 monitoring, and 32 of 168 (19%) did not use CO2 monitoring. The majority of programs (115/168, 68%) used a single device. Colorimetric devices were used most frequently (76/168, 45%), and capnometry was used the least (9/168, 5%). PEM programs had a significant preference for quantitative CO2 monitoring, whereas GEM programs had a significant preference for qualitative CO2 monitoring.


CONCLUSIONS
Although the majority of academic emergency medicine training programs used CO2 monitoring, 19% did not. Colorimetric devices were the most frequently used CO2 monitoring technology.
Division of Emergency and Transport Medicine, Department of Pediatrics, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA. vwang@chla.usc.edu
Vincent J
VJ
Wang
Baruch
B
Krauss
D002245:Carbon Dioxide / Q000032:analysis*; D004635:Emergency Medicine / Q000193:education*; D006801:Humans; D007396:Internship and Residency; D007442:Intubation, Intratracheal; D008991:Monitoring, Physiologic / Q000379:methods*; D010372:Pediatrics / Q000193:education*; D010818:Practice Patterns, Physicians'; D011795:Surveys and Questionnaires; D014481:United States
D002245:Carbon Dioxide