If unstable
- Disconnect from the ventilator briefly to allow exhalation while oxygenating appropriately.
- Bag slowly and reassess BP, breath stacking, and wheeze/resistance.
- Call RT/ICU/anesthesia backup early.
Vent control
Auto-PEEP hemodynamics
Air trapping can reduce venous return and cause hypotension/PEA physiology.
Open hypotension pathwayShock after intubation.Tension / auto-PEEP branchTwo pressure problems that kill.
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