Immediate actions
- Bag with 100% O₂/PEEP if unstable and appropriate.
- Check tube depth, chest rise, waveform EtCO₂, and breath sounds.
- Suction the tube; look for kink, bite, mucus, blood, or mainstem.
Rescue pathway
Hypoxia after intubation
DOPES plus immediate oxygenation.
Tube / circuitDepth, cuff, circuit, oxygen source, waveform.ObstructionSecretions, blood, mucus, bronchospasm, kink/bite.Lung problemPneumothorax, shunt/ARDS, edema, aspiration.Stacking / auto-PEEPObstructive physiology or dyssynchrony.
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 · ARDS ventilation reference