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Contributor: Aaron Lessen, MD Educational Pearls: End tidal CO2 is accurate to 1-4 mmHg in intubated patient but use with those on positive pressure ventilation like BiPAP is unclear Study looked at patients on BiPAP for COPD or CHF and found end tidal CO2 measurements were significantly underestimated when compared to VBG levels End tidal CO2 measurements for those on positive pressure ventilation appears to be inaccurate References Uzunay H, Selvi F, Bedel C, Karakoyun OF. Comparison of ETCO2 Value and Blood Gas PCO2 Value of Patients Receiving Non-invasive Mechanical Ventilation Treatment in Emergency Department [published online ahead of print, 2021 Apr 27]. SN Compr Clin Med. 2021;1-5. doi:10.1007/s42399-021-00935-y Casati A, Gallioli G, Scandroglio M, Passaretta R, Borghi B, Torri G. Accuracy of end-tidal carbon dioxide monitoring using the NBP-75 microstream capnometer. A study in intubated ventilated and spontaneously breathing nonintubated patients. Eur J Anaesthesiol. 2000;17(10):622-626. doi:10.1046/j.1365-2346.2000.00731.x Summarized by John Spartz, MS4 | Edited by Erik Verzemnieks, MD The Emergency Medical Minute is excited to announce that we are now offering AMA PRA Category 1 credits™ via online course modules. To access these and for more information, visit our website at https://emergencymedicalminute.org/cme-courses/ and create an account. Donate to EMM today! Diversity and Inclusion Award