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Vent control

Plateau pressure

Plateau pressure estimates alveolar pressure after an inspiratory hold when flow is zero.

Pplat not elevatedResistance branch.Pplat elevatedCompliance/alveolar pressure branch.Bird-beak / high VT concernOverdistension branch.

Plateau measurement

Plateau measurement

Use an inspiratory hold only when passive/synchronous enough for valid interpretation.

How to measure

  • Ask RT to perform an inspiratory hold when the patient is passive or synchronous.
  • Flow should be zero during the hold.
  • Read plateau after pressure equilibrates.

Pitfalls

  • Plateau is unreliable if the patient is coughing, actively inhaling/exhaling, or dyssynchronous.
  • Treating a high peak pressure without checking plateau can send you down the wrong branch.

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.

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