Before intubation
- Teach the room DOPES before high-risk intubations.
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Post-intubation rescue
DOPES Algorithm for Post-Intubation Deterioration
DOPES is a simple shared mental model for tube-in/patient-worse deterioration. It should trigger oxygenation and a systematic search for reversible causes.
DOPESpost-intubationhypoxiatroubleshooting
Clinical-use limit: Educational resource and cognitive-aid guide only; not a bedside order set or substitute for local protocol, medical direction, or clinical judgment.
During intubation
- D - displacement. O - obstruction. P - pneumothorax/patient. E - equipment. S - stacked breaths.
- Bag with 100% oxygen/PEEP when appropriate while roles check each category.
After intubation
- Fix the cause, reset equipment/ventilator, and debrief the failure mode.
Common pitfalls
- Using DOPES as a memory word without assigning roles.
- Forgetting auto-PEEP/stacked breaths.