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Royal College of Anaesthetists - Educational Campaign on Capnography During CPR

No Trace = Wrong Place


The Royal College of Anaesthetists (RCoA) and the Difficult Airway Society (DAS) have initiated a campaign 'No Trace = Wrong Place' during CPR.  If there is no capnography waveform during CPR, the endotracheal tube is not in the trachea unless ruled out by other means. This campaign was initiated at the request of UK Coroners to promote awareness of the unrecognized esophageal intubation during CPR.  RCoA and DAS have collaborated to create the video resource Capnography: No Trace = Wrong Place.  Presented by Professor Tim Cook, the video shares the important message that during cardiac arrest, if a capnograhy trace is completely flat, osophageal intubation should be assumed until proven otherwise.  There is also a Power Point presentation by Professor Cook on this subject. and search for Mr. Peter Saint and Mrs. Sharon Grierson 

The RCOA and DAS advises to download the Power Point slide for departmental educational purposes. 

Colorimetric devices may not be sensitive enough to measure low concentrations of exhaled carbon dioxide.  Limitations of this device must be understood (

Continuous waveform capnography is therefore recommended during CPR.