ABSTRACT
I. INTRODUCTION The second item in the ABCs of resuscitation-breathing-encompasses both oxygenation and ventilation. After the airway is secured, the prehospital care provider must ensure that patients are adequately oxygenated and appropriately ventilated. While not as inherently exciting as achieving a difficult intubation in the field, the securing and ongoing monitoring of oxygenation and ventilation comprise the vital ‘‘follow-through’’ to initial airway management. Given the limitations inherent to the use of traditional auscultation in their practice environment, prehospital care providers have learned to employ other means of assessing respiratory performance. Some of these surrogate measures (see Table 1) are low-tech yet effective: observation of patient color, endotracheal tube fogging, or chest rise and resistance associated with bag-valve-mask ventilation. Other measures employed to follow patients’ oxygenation and ventilation are even more effective, if somewhat more technical. This chapter will address the prehospital monitoring of oxygenation and ventilation, with emphasis on pulse oximetry and carbon dioxide monitoring, and will also discuss prehospital mechanical ventilation.
