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Vent control

Oxygenation knobs

Use FiO₂ and PEEP deliberately, then reassess oxygenation and hemodynamics.

Adult vent calculatorPBW-based VT and a patient-specific starting framework.If SpO₂ is fallingOpen hypoxia rescue.If BP is fallingPositive pressure and PEEP may worsen preload or RV function.

Use

  • Use high FiO₂ for immediate rescue when needed, then titrate promptly to the patient’s oxygenation target and avoid unnecessary hyperoxemia.
  • PEEP should be individualized to oxygenation, recruitability, blood pressure, and RV physiology.

ARDS guardrails

  • For moderate-to-severe ARDS, a higher-PEEP strategy may be appropriate with ICU/RT guidance.
  • Avoid prolonged recruitment maneuvers; reassess blood pressure and right-ventricular tolerance after PEEP changes.

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]