UMEM Educational Pearls

Title: Tips for the Resuscitationist - "PQRST"

Posted: 1/6/2015 by Mike Winters, MD
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"PQRST" - Capnography in Cardiac Arrest

Resuscitation of the patient in cardiac arrest can be stressful, chaotic, and variable depending on the setting.
Capnography is a valuable tool in the management of patients in cardiac arrest.
Heradstveit, et al. published a pneumonic for the use of capnography during cardiac arrest:
- P - Position of the tube
  - The sensivity and specificity of capnography for endotracheal tube confirmation is superior to auscultation and capnometry.
- Q - Quality of CPR
  - Early detection of poor-quality compressions.
- R - ROSC
  - A sudden increase in end-tidal CO2 can indicate ROSC without interrupting CPR for pulse checks.
- S - Strategy
  - May assist clinicians in determining underlying etiology of cardiac arrest.
- T - Termination
  - An end-tidal CO2 value < 10 mm Hg after 20 min of resuscitation has been shown to be very accurate in predicting death.

Heradstveit BE, Heltne JK. PQRST - A unique aide-memoire for capnography interpretation during cardiac arrest. Resuscitation 2014; 85:1619-20.