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.