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Vent control

Flow starvation

The patient’s inspiratory demand exceeds the delivered flow; the pressure trace may show a concave or scooped inspiratory segment.

Adjust flow or rise timeMode-specific ventilator controls.Also assess resistanceBronchospasm or ETT resistance may increase demand.

Flow-starvation pattern

Flow-starvation pattern

The pressure curve is pulled downward during inspiration and improves after flow/rise-time adjustment.

Original Airway of the Month teaching diagrams redrawn from standard ventilator scalar and loop conventions. Interpretation is anchored to the AARC 2024 Patient–Ventilator Assessment guideline, the peer-reviewed Basics of Ventilator Waveforms review, the 2026 SYNAPsE asynchrony consensus, and the University of Pennsylvania Ventilator Overview and Troubleshooting tip sheet. Waveforms are pattern-recognition aids, not diagnoses; display colors, labels, and orientation vary by ventilator brand.

Fix ideas

  • Increase inspiratory flow in volume control or adjust rise time in pressure-targeted modes.
  • Assess respiratory drive, acidosis, pain, bronchospasm, ETT resistance, and synchrony.
  • Recheck VT, PIP/Pplat, and patient comfort after the adjustment.

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]