Act
- Bag slowly; allow full exhalation.
- Lower RR and shorten inspiratory time/increase inspiratory flow as appropriate.
- Treat bronchospasm and dyssynchrony.
- Consider brief disconnect if crashing and air trapping is suspected.
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Airway of the MonthReview the case. Understand the airway. Build the skill.
Airway of the MonthReview the case. Understand the airway. Build the skill.
Troubleshooting review
Hypoxia: stacking / auto-PEEP
Air trapping can worsen oxygenation and cause hypotension.
See auto-PEEP waveformFlow not returning to baseline.Ventilator timing referenceEstimate expiratory time.If MAP fallsAuto-PEEP shock.
Evidence and use limits
Last reviewed: 2026-07-23. Designed for: emergency medicine learners, clinicians, EMS, RT, and airway educators.
This is an educational clinical reference, 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: Kyle Brown MD; Andrew Pirotte, MD; Reba Hodge, MD; Amanda Vanderwerf, PharmD, BCEMP; Morgan Kimball, PharmD, BCEMP; Joshua Mohess
Clinical review: EM faculty Reviewed: local ED, ICU, EMS, anesthesia, pharmacy, and pediatric protocol review recommended before bedside teaching rollout.
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 clinical-reference guide only; not a bedside order set or substitute for local protocol, medical direction, or clinical judgment.
Website contact: kybrown@kumc.edu