La capnographie en préhospitalier : intérêts et limites

This paper reviews the CO2 expired monitoring applications in emergency medecine and especially in prehospital setting. The beneficial use of capnography in out hospital setting is prouved in the intubation process, in the cardiac arrest rescusitation and in the optimization of ventilation. The capnography is the gold standard to confirm the good placement of into tracheal intubation with a sensibility of 93% and a specificity of 97% all pathologies inclued. It is an independant alarm and makes it possible to detect earlier a hypoxemic incident like an accidental extubation, deconnexion, tracheal obstruction, or respirator failure. In the cardiac arrest management, the sensibility of the method decreases but the use of capnography stay to be recommended in association with another oesophageal detector. In this management, the CO2 expired monitoring shows a greatest interest in the outcome and the diagnosis. The capnometry makes it possible the optimization of ventilation in out hospital setting by an adaptation of respiratory preset inclued a strategy based on the clinical status.