Skip to airway content Airway of the MonthRead the patient. Rescue the airway. Run the room.

Rescue pathway

Crisis map

Start here if the tube is in and the patient is worse.

What is failing?Choose the visible problem.SpO₂ fallingOpen hypoxia pathway.BP/MAP fallingOpen hypotension pathway.No/low EtCO₂Tube, circulation, or equipment.Vent alarm / high pressureResistance, compliance, circuit, dyssynchrony.Abnormal vital signsTranslate vitals into a failure bucket.

First four moves

  • Call for help and assign roles.
  • Disconnect from ventilator and bag with 100% O₂/PEEP if unstable and appropriate.
  • Verify tube position/depth and waveform EtCO₂.
  • Search DOPES: displacement, obstruction, pneumothorax/patient, equipment, stacked breaths.

Do not miss

  • Right mainstem, esophageal tube, tube obstruction, tension pneumothorax, auto-PEEP, medication-related hypotension, RV failure.

Clinical review / use limits

Authored by: Airway of the Month education team. Last reviewed: July 2026. Audience: EM learners, faculty, EMS, RT, simulation educators, and airway teams.

This is an educational cognitive-aid scaffold, not a bedside order set. Verify medications, ventilator changes, pediatric dosing, and procedures against local ED, ICU, anesthesia, pharmacy, RT, EMS, and pediatric policies.

Resources · Editorial policy · ACEP intubation policy · AARC 2024 ventilator assessment guideline · ATS 2024 ARDS guideline update

About this resource
Created by: Andrew Pirotte, MD; Kyle Brown, MD; Reba Hodge, MD; Amanda Vanderwerf, PharmD, BCEMP; Morgan Kimball, PharmD, BCEMP; Joshua Mohess Clinical review: Emergency medicine faculty review completed. Medication content reviewed by Amanda Vanderwerf, PharmD, BCEMP, and Morgan Kimball, PharmD, BCEMP. Last reviewed: 2026-07-23 Next scheduled review: 2027-01-23 Designed for: EM residents, emergency physicians, EMS clinicians, airway educators, and simulation faculty Important: Educational resource and cognitive-aid guide only; not a bedside order set or substitute for local protocol, medical direction, or clinical judgment. Website contact: [email protected]