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

Vent control

Cuff leak branch

Low exhaled VT with audible leak or poor seal.

Check tube positionCuff at cords / partial extubation.If SpO₂ fallingOpen hypoxia rescue.

Leak / cuff pattern

Leak / cuff pattern

Low exhaled volume may reflect cuff leak, circuit leak, or partial extubation.

Original Airway of the Month teaching diagrams redrawn from standard ventilator scalar and loop conventions. Interpretation is anchored to the AARC 2024 Patient–Ventilator Assessment guideline, the peer-reviewed Basics of Ventilator Waveforms review, the 2026 SYNAPsE asynchrony consensus, and the University of Pennsylvania Ventilator Overview and Troubleshooting tip sheet. Waveforms are pattern-recognition aids, not diagnoses; display colors, labels, and orientation vary by ventilator brand.

Check

  • Pilot balloon/cuff inflation and cuff pressure.
  • Audible leak at mouth/neck/trach site.
  • Tube size, cuff rupture, tube migration, or cuff above cords.

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]