CHANGES IN RESPIRATORY STATUS

1. Assess patient’s prior interventions.

2. Assess the following patient’s respiratory status:

- Rate
- Rhythm
- Depth
- Effort

3. Assess monitors:

- Oxygenation (SpO2)
- EtCO2 (with advanced airway or EMMA mounted on non-rebreather mask)
- Cardiac monitoring if available

4. Determine cause of ventilation issue and/or ventilator alarm using DOPE mnemonic.

Table 1. Trouble shooting - DOPE Algorithm

Recently published USAF EMS protocols

Figure 1. Normal Capnogram, Normal EtCO2: 35-45 mmHg
Figure 2. Endotracheal Tube in Esophagus

Possible causes:

- Missed intubation
- A normal capnogram is the best evidence that the ET tube is correctly positioned.
- With ET tube in the esophagus, little or no CO2 is present.

Figure 3. Obstruction in Airway or Breathing Circuit

Possible causes:

- Partially kinked or occluded artificial airway
- Presence of foreign body in the airway
- Obstruction in expiratory limb of breathing circuit
- Bronchospasm

Source: https://openairway.org/capnography