Common causes
- ARDS or pulmonary edema.
- Pneumothorax, pleural effusion, abdominal distension, chest-wall limitation.
- Mainstem intubation or excessive VT/pressure.
Vent control
Low compliance / high alveolar pressure branch
PIP high and plateau high: think lung/chest compliance or overdistension.
Lung problem pathwayARDS/shunt/pulmonary edema/pneumothorax.Overdistension / high VTBird-beak loop branch.If BP fallsTension/PEEP/RV/shock pathway.
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