Common causes
- Bronchospasm/asthma/COPD.
- Secretions, mucus plug, blood, or ETT obstruction.
- Tube kink, patient biting, small ETT, circuit/tubing resistance.
Vent control
High resistance branch
PIP high with normal/lower plateau: look for resistance between ventilator and alveoli.
Obstruction waveformScooped/prolonged expiratory limb.Secretions / mucus / bloodSuction and tube patency.Tube / circuit kink or biteCheck tube, bite block, tubing.If oxygenation failingOpen hypoxia rescue.
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