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The ability to safely and effectively manage the airway is among the most fundamental and challenging aspects of out-of-hospital (OOH) emergency medical treatment. Commonly used devices to facilitate OOH airway management encompass a spectrum from basic means, such as the bag-valve mask (BVM), to more advanced and invasive means, such as the esophageal-tracheal combitube, laryngeal mask airway (LMA), laryngeal tube airway (LT), endotracheal tube (ET), and, ultimately, emergency surgical airways. End-tidal carbon dioxide (PetCO2) monitoring has emerged as the technology that can best confirm endotracheal or endobronchial location of an endotracheal tube. The threshold for detection of exhaled CO2 is significantly lower for capnometry and capnography as opposed to colorimetric devices. The use of capnography for OOH airway management enhances patient safety and can prevent the problem of unrecognized misplaced intubation (UMI) and should be a mandatory component of OOH airway management.
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