We’ve started pre-oxygenating for 5 minutes before induction, placing a 22 g IV, and logging BP/ETCO2 every 5 minutes on 25–35 minute spays, and hypotension dips have disappeared for us. Are you seeing similar improvements with capnography on quick cases, or is Doppler-only monitoring working fine in your setup?
@OP Same here — “5 minutes” of pre-oxygenation plus capno on 25–35 min spays cut our dips because we catch that early ETCO2 creep and drop iso sooner; , Doppler-only was missing those 60–90 sec breath-holds. Concrete step: set a high ETCO2 alarm at 50 and give a couple gentle breaths if it trends up in the first 10 minutes; ACVAA backs routine capnography even for short cases: https://acvaa.org/wp-content/uploads/2021/06/MonitoringGuidelines2019.pdf. Are you running sidestream or mainstream?
@OP Adding 2 gentle recruitment breaths post-intubation steadied ETCO2; Doppler’s fine, but capno catches small circuit leaks.
On 25–35 min spays, capno paid for itself for us by flagging rebreathing on the Mapleson F — if inspired CO2 creeps >2 mmHg, we bump FGF to about [redacted]/kg/min and the “, rising ETCO2” settles without touching iso… Bonus: during the 5 minutes of pre-oxygenation it tells me if my mask seal is trash, which avoids a rocky start; we still keep Doppler for MAP. Are you on circle or non-rebreathing, @julian_bennett92?