If capnography is unavailable in flight, which indicators form the basis of airway assessment?

• A. Capnography waveform
• B. Rely on clinical assessment, chest rise, breath sounds, SpO2, and patient effort
• C. Pulse pressure monitoring
• D. End-tidal CO2 targets

Answer: (B)

When capnography isn’t available in flight, you base airway assessment on observable signs of ventilation and oxygenation: how the chest moves with each breath, what you hear on breath sounds, the patient’s level of effort breathing, and the oxygen saturation. Chest rise shows that air is entering the lungs and being vented; breath sounds help you detect obstructions, secretions, or poor air entry; how hard the patient is working to breathe indicates airway patency and the presence of airway obstruction or fatigue; SpO2 tells you whether oxygenation is adequate, though it can lag behind ventilation and be influenced by supplemental oxygen. Without capnography, you miss the direct CO2 measure and waveform that confirm ventilation efficiency, so you rely on these clinical cues to gauge airway status. Pulse pressure monitoring reflects hemodynamics rather than airway status, and end-tidal CO2 targets aren’t usable without CO2 data, so they aren’t appropriate indicators in this scenario.