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Vent control

Increase expiratory time

Reduce the amount of gas delivered per minute and shorten inspiration so exhalation can finish.

I:E calculatorEstimate expiratory time.Treat obstructionAsthma/COPD setup.

Common adjustments

  • Lower RR.
  • Shorten inspiratory time; in volume control, increasing inspiratory flow shortens Ti.
  • Reduce VT when appropriate.
  • Use a square flow pattern when it helps shorten Ti in volume control.
  • Treat bronchospasm and clear tube/circuit obstruction.

Reassess

  • Flow returns to zero before the next breath.
  • Blood pressure, EtCO₂, gas exchange, delivered VT, and patient-ventilator synchrony.

Evidence and use limits

Last reviewed: 2026-07-17. Designed for: emergency medicine learners, clinicians, EMS, RT, and airway educators.

This is an educational cognitive aid, not a bedside order set. Confirm medications, ventilator changes, pediatric dosing, procedures, and escalation decisions against the patient’s physiology, the ventilator in use, and local ED/ICU/anesthesia/pharmacy/RT/EMS/pediatric policy.

Full references · Editorial policy · AARC 2024 ventilator assessment · ATS/ESICM/SCCM lung-protective ventilation · ATS 2024 ARDS 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]