Patient presentation: an unresponsive patient, helmeted driver of a motorcycle struck by another vehicle at a high rate of speed then struck and run over by an additional vehicle, was assessed with a glasgow coma scale (gcs) score of 3, indicative of severe consciousness impairment.Medical interventions: rapid sequence intubation (rsi) was performed to establish airway patency.The endotracheal tube (ett) was ventilated with an adult sunmed (af2140mbp) manual resuscitator with a manometer, positive end-expiratory pressure (peep) valve set at 5 cmh2o, heat and moisture exchange filter (hmfe), in-line end-tidal co2 (etco2) sensor and connected to a 15 l/min oxygen source.Fic02 elevation issue: while using the sunmed manual resuscitator, the patient's fraction of inspired co2 (fico2) levels increased until the clinical team placed the patient on a ventilator.This increase began at 14:38.36 (figure 1) and peaked at 20 mmhg at 14:42.13 (figure 2).Fico2 levels fluctuated between 10 and 20 mmhg (figure 3) until the patient was transitioned to a ventilator at 14:49.51.The elevation in fico2 resolved once the ventilator was initiated (figure 4).Product problem: suspicions arise that the manual resuscitator may be the source of the abnormal fic02 elevation.The fic02 increase poses a risk of hypercapnia, which can significantly impact the patient's bodily functions, physical well-being, and potentially lead to life-threatening consequences.Furthermore, this inconsistency raises concerns regarding adherence to performance specifications and user expectations.Patient outcome: the patients outcome is unknown, as care was handed over to another provider.
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