Think
- VT too high for lung size/mechanics.
- Excessive plateau/driving pressure.
- Consider reducing VT/pressure and reassessing oxygenation/ventilation strategy with RT/ICU/local protocol.
Vent control
Overdistension / bird-beak branch
The pressure-volume loop can show excessive pressure for little added volume near end inspiration.
See overdistension loopBird-beak pattern.Check PBW/VTVT based on predicted body weight.Safety parametersAlarms, pressure limits, trigger, I:E.
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