Date Published

July 5, 2024

Updated For

ALS PCS Version 5.3



  • AHA Guidelines recommends using quantitative waveform capnography with an advanced airway in patients during CPR – Let's review WHY
    • Waveform capnography allows providers to monitor CPR quality, optimize chest compressions
      • Monitoring of CPR quality results in a higher likelihood of ROSC
    • Also allows for detection of ROSC (return of spontaneous circulation) during chest compressions

Evaluating The Effectiveness of Chest Compressions and Identification of ROSC

  • Target chest compressions to an ETCO2 value of at least 10 mmHg, and ideally 20 mmHg or greater, as a marker of CPR quality
    • If ETCO2 value <10 mmHg during CPR with an advanced airway,  re-assess chest compression quality 
  • When ROSC occurs there will be a significant increase in the ETCO2 (35-45 mmHg or higher) which indicated a drastic improvement in blood flow


  • Waveform capnography is a tool that can assist with cardiac arrest management
    • Allows providers to monitor CPR quality and optimize chest compressions 
      • Goal ETC02 is >20mmHg
      • If ETC02 is <10mmHg, try to determine if there is anything that can be optimized
    • Allows for the early detection of ROSC


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