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Situation category
Post-intubation deterioration
Tube-in/patient-worse differential and immediate rescue.
No EtCO2 Waveform After IntubationNo waveform EtCO2 after intubation is a crisis until proven otherwise. Assume the tube or the circulation is the problem and act immediately.Hypoxia After IntubationTube-in, patient-worse hypoxia demands immediate oxygenation while the team searches for displacement, obstruction, pneumothorax/patient factors, equipment failure, and stacked breaths.Hypotension After IntubationPost-intubation hypotension is often physiology plus medications plus positive pressure. Treat it as an airway-adjacent shock problem.High Airway Pressure After IntubationHigh pressure is not a diagnosis. The key move is to classify resistance, compliance, equipment, tube, and patient-ventilator interaction.DOPES Algorithm for Post-Intubation DeteriorationDOPES is a simple shared mental model for tube-in/patient-worse deterioration. It should trigger oxygenation and a systematic search for reversible causes.