TL;DR

Capnography (ETCO2): Continuous end-tidal CO2 measurement for ETT confirmation, ventilation monitoring, and CPR quality. Normal: 35-45 mmHg.

By Valenke Exam Prep Team·Last updated 2026-06-02

Capnography (ETCO2)

NREMT PARAMEDIC

Definition

Continuous end-tidal CO2 measurement for ETT confirmation, ventilation monitoring, and CPR quality. Normal: 35-45 mmHg.

Practical Example

Field Scenario: An elderly woman found on the floor after a fall. Alert but confused, hip pain with external rotation and shortening of right leg. Suspect hip fracture: splint in position found, monitor for shock.

This scenario tests your ability to apply knowledge of capnography (etco2) under time pressure with incomplete information, exactly the type of decision-making the certification exam assesses.

Overview

Continuous end-tidal CO2 measurement for ETT confirmation, ventilation monitoring, and CPR quality. Normal: 35-45 mmHg. Waveform interpretation heavily tested on Paramedic exam.

In prehospital assessment, temperature reference range: adult 97.8-99.1 F (36.5-37.3 C), pediatric same range, rectal preferred under 2yo. Deviations from these norms guide treatment decisions in the field.

Safety Considerations

Field safety for capnography (etco2) includes scene assessment before patient contact. Ensure BSI (body substance isolation) precautions are in place. PPE selection depends on the mechanism and suspected pathogens. Gloves are the minimum; add mask and eye protection for splash risk, N95 for airborne pathogens.

Never approach a scene involving hazardous materials, violence, or structural instability without proper resources and clearance from incident command.

Exam Focus Areas

On the Nremt Paramedic exam(s), questions about capnography (etco2) typically test:

Correct medication selection, dosing, and route of administration
Assessment findings that differentiate between similar presentations
Appropriate transport decisions and hospital notification criteria

Step-by-Step Procedure

Protocol steps for capnography (etco2):

RSI sequence: preoxygenation then sedation (etomidate 0.3mg/kg or ketamine 2mg/kg) then paralytic (succinylcholine 1.5mg/kg or rocuronium 1mg/kg) then intubation then confirm placement with waveform capnography

Differential Diagnosis

When assessing capnography (etco2), use structured assessment tools to differentiate between possible causes:

Trauma Score: Components: GCS, Systolic BP, Respiratory rate. Scoring: Revised Trauma Score: coded values 0-4, sum correlates with survival probability.

Glasgow Coma Scale: Components: Eye opening (1-4), Verbal response (1-5), Motor response (1-6). Scoring: 3-15, 8 or less = severe, 9-12 = moderate, 13-15 = mild.

Why It Matters

Waveform interpretation heavily tested on Paramedic exam.

Practice This Topic

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Frequently Asked Questions

What protocol applies to capnography (etco2) in prehospital care?▼

For capnography (etco2): Pediatric weight-based dosing: Broselow tape for length-based weight estimation in emergencies

What medications are commonly associated with capnography (etco2)?▼

For capnography (etco2): adenosine: 6mg rapid IV push, then 12mg if needed, route IV rapid push with flush, for SVT (narrow complex tachycardia). epinephrine: 1:10,000 1mg IV/IO q3-5min (cardiac arrest), 1:1,000 0.3mg IM (anaphylaxis), route IV/IO, IM, ET, for Cardiac arrest, anaphylaxis, severe asthma.

What assessment tools help evaluate capnography (etco2)?▼

For capnography (etco2): Trauma Score: evaluates GCS, Systolic BP, Respiratory rate; scoring is Revised Trauma Score: coded values 0-4, sum correlates with survival probability. Glasgow Coma Scale: evaluates Eye opening (1-4), Verbal response (1-5), Motor response (1-6); scoring is 3-15, 8 or less = severe, 9-12 = moderate, 13-15 = mild.