What is the role of capnography in prehospital airway management?

• A. Measures blood pressure.
• B. Only used after intubation to check oxygen saturation.
• C. Real-time confirmation of tracheal intubation and ongoing ventilation monitoring, aiding detection of tube dislodgement or misplacement.
• D. Not useful in prehospital settings.

Answer: (C)

Capnography monitors the amount of CO2 in exhaled air in real time, giving a continuous readout of ventilation and perfusion. In the prehospital setting this is gold for confirming that the endotracheal tube is actually in the trachea, because a proper airway will produce a consistent end-tidal CO2 waveform and a normal ETCO2 range. If the tube slips out, becomes dislodged, or is in the esophagus, the CO2 waveform can disappear or change abruptly, signaling the need for immediate correction. Beyond placement, capnography tracks how well ventilation is proceeding during bagging or mechanical ventilation and can reveal problems such as airway obstruction, disconnection, or changes in perfusion that affect CO2 delivery. It’s not used to measure blood pressure or oxygen saturation; those are assessed with other monitors, like pulse oximetry for oxygenation. In practice, capnography provides both quick confirmation of correct placement and ongoing ventilation monitoring, making it a central tool in safe prehospital airway management.