Ventilating Head Injury
The use of quantitative end-tidal capnometry to avoid inadvertent severe hyperventilation in patients with head injury after paramedic rapid sequence intubation.
Davis DP, Dunford JV, Ochs M, Park K, Hoyt DB.J Trauma. 2004 Apr;56(4):808-14
In this study of 291 intubated head injured patients, 144 had ETCO2 monitoring. The patients with ETCO2 monitoring had lower incidence of inadvertant severe hyperventilation (5.6%) than those without ETCO2 monitoring (13.4%). Patients in both groups with severe hyperventilation had significantly higher mortality (56%) than those without (30%).
“The use of ETCO2 monitoring to guide ventilation for patients with severe head injury undergoing paramedic RSI appears to prevent excessive hyperventilation.”
Bottom Line for EMS: Monitor ETCO2 to prevent hyperventilation in intubated head injured patients.