Do now
- If unstable, disconnect from the ventilator and bag with 100% O₂/PEEP as clinically appropriate.
- Check tube depth, waveform EtCO₂, chest rise, suction catheter pass, circuit, and oxygen source.
- Call RT/ICU/anesthesia backup early.
Vent control
High pressure: immediate actions
When unstable, separate patient problem from ventilator/circuit problem quickly.
If SpO₂ fallingHypoxia rescue.If BP/MAP fallingHypotension rescue.If EtCO₂ absent/lowTube/circulation/equipment.If stable enoughPeak/plateau decision.
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