Rule of thumb
- Treat oxygenation and perfusion while diagnosing.
- If unstable, bag the patient and simplify the system.
- Reassess tube, circuit, monitor, meds, ventilator, and patient physiology.
Rescue pathway
What is failing?
Start from what you can see in real time.
SpO₂ fallingOxygenation problem.BP/MAP fallingShock problem.No/low EtCO₂Tube, circulation, or equipment.Vent alarm / high pressureResistance, compliance, circuit, or dyssynchrony.Abnormal vital signsBradycardia, tachycardia, fever, low EtCO₂.Physiology pivotARDS, asthma/COPD, DKA, shock/RV, neuro.
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