Skip to airway content Airway of the MonthRead the patient. Rescue the airway. Run the room.

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.

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.

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]