👤 By the CinnaEMS Content Team🕐 Updated 2026-09-27🏷️ Airway, Respiration & Ventilation🔖 Free to read, print, and share
Also known as: IV · IO · intraosseous · capnography · ETCO2 · advanced airway
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Use this quick-reference guide to recognise, treat and hand over Vascular Access & Capnography on the NREMT and on the call. Keep it handy during review and on exam day!
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📒 The 1-minute cheat sheet
📌 Lines
Infiltration → stop, remove
Overload → slow to KVO
IO: tibia or humerus
📌 Capnography
Normal 35–45 mmHg
Rise in CPR → ROSC
Shark fin → bronchospasm
📌 Tube
Waveform = in the airway
Worse → DOPE
📚 Vascular Access & Capnography — full study notes
The cheat sheet above is your quick recall card. These notes go deeper — what it is, what to do first, what changes the plan, and what to hand over.
For AEMT and paramedic candidates, access and airway confirmation are examined through their complications: what an infiltrated line, fluid overload or a misplaced tube looks like, and what the capnography waveform is telling you.
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Key points
Understand these first
Infiltration: cool, pale, swollen site with a slow drip — stop and remove.
Circulatory overload: crackles and distended neck veins — slow to a keep-open rate.
IO in the proximal tibia or humeral head; never in a fractured bone.
A continuous capnography waveform is the best confirmation of an advanced airway.
Normal end-tidal CO2 is 35–45 mmHg; a sudden rise during CPR suggests ROSC.
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Treatment priorities
What to do, in order
Never re-advance a needle into its catheter.
Uncontrolled bleeding without head injury: aim for a radial pulse, not a normal pressure.
Intubated and worsening: DOPE — displacement, obstruction, pneumothorax, equipment.
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Red flags — report now
Escalate immediately
Waveform lost after moving the patient
Right-only breath sounds (tube too deep)
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Patient teaching
What patients must know
Drip rate = volume × drop factor ÷ minutes.
❓ Vascular Access & Capnography: NREMT FAQs
What are the priority actions for Vascular Access & Capnography in the field?
Never re-advance a needle into its catheter. Uncontrolled bleeding without head injury: aim for a radial pulse, not a normal pressure. Intubated and worsening: DOPE — displacement, obstruction, pneumothorax, equipment.
What findings in Vascular Access & Capnography change your plan or your transport decision?
Waveform lost after moving the patient. Right-only breath sounds (tube too deep).
What do I need to know about Vascular Access & Capnography for the NREMT?
Infiltration: cool, pale, swollen site with a slow drip — stop and remove. Circulatory overload: crackles and distended neck veins — slow to a keep-open rate. IO in the proximal tibia or humeral head; never in a fractured bone. A continuous capnography waveform is the best confirmation of an advanced airway.
What should the crew communicate or document for Vascular Access & Capnography?
Drip rate = volume × drop factor ÷ minutes.
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Quick Tip
Infiltration: cool, pale, swollen site with a slow drip — stop and remove.