An infant with respiratory distress was intubated. The fastest and accurate method to confirm intubation:
Ans. a. Capnography (Ref: Morgan 4/590-593)Capnography is the surest confirmatory sign of correct intubationQ.So, the fastest and accurate method to confirm intubation in the above mentioned infant is capnography.CapnographyCapnography is the continuous measurement of end tidal carbon dioxide (ETCO2) and its waveform.Normal: 32 to 42 mmHgQ(3 to 4 mmHg less than arterial pCO2, which is 35 to 45 mmHg)Principle: Infrared light is absorbed by carbon dioxideQUses of CapnographyIt is the surest confirmatory sign of correct lntubationQ (esophageal intubation will yield ETCO2=0)Intraoperative displacement of endotracheal tubeQ (ETCO2 will become zero)Diagnosis of malignant hyperthermiaQ (ETCO2 may rise to more than 100 mm Hg)For detecting obstructions and disconnections of endotracheal tubes (ETCO2 will fall)Diagnosing pulmonary embolism by air, fat or thrombus (sudden fall of ETCO2 occurs. It may become zero if embolus is large enough to block total pulmonary circulation)Exhausted sodalime or defective valves of closed circuit will show high ETCO2 values.To control level of hypocapnia during hyperventilation in neurosurgery.Indicator of cardiac output. In cardiac arrest ETCO2 is zero.
Capnography
Clinically by auscultation
Chest radiography
Airway pressure measurement
Breathing Systems