<prompt> Endtidal CO2 is increased to maximum level inPul. embolismMalignant hyperthermiaExtubationBlockage of secretion  <response>: The unanticipated doubling or tripling of end tidal CO2 is the earliest most sensitive indicator of malignant hyperthermia. The earliest signs seen during anesthesia are masseter muscle rigidity MMR, tachycardia, hypercarbia. 