Current Utilization of Continuous End-Tidal Carbon Dioxide Monitoring in Pediatric Emergency Departments

Objective: End-tidal carbon dioxide (ETCO₂) monitoring has numerous clinical applications in the emergency setting. This study was designed to explore the current availability and utilization patterns for continuous ETCO₂ monitoring in pediatric emergency departments.

Methods: A Web-based survey was distributed to directors of all accredited pediatric emergency medicine fellowship programs in the United States and Canada.

Results: Eighty-one percent of directors completed this survey. Eighty-eight percent had access to ETCO₂ monitoring for intubated patients and 53% for nonintubated patients. Seventy-nine percent of respondents used ETCO₂ monitoring "always" or "often" for endotracheal tube confirmation. Only 20% of respondents used ETCO₂ monitoring "always" or "often" for moderate sedation, 16% for trauma, and 6% for acid-base disturbances. One hundred percent of respondents who used ETCO₂ monitoring felt that it was easy to use. The most common reason for not using ETCO₂ monitoring was lack of equipment (65%).

Conclusions: ETCO₂ monitoring is widely available, yet underutilized, for spontaneously breathing patients in pediatric emergency departments.