Skip to airway content Airway of the MonthReview the case. Understand the airway. Build the skill.

Troubleshooting review

Ventilator pivots by physiology

Move this from one-size-fits-all settings to disease-specific priorities.

Educational review boundary: This page summarizes common patterns and published management options. It does not analyze an individual patient or generate a treatment directive. Verify the current source, local protocol, and clinical context.
ARDS / hypoxemiaOxygenation knobs and pressure cost.Asthma/COPDAuto-PEEP / stacking waveform.DKA / acidosisMinute ventilation calculator.Shock / RV failureHemodynamic pivot.Vent control hubModes, parameters, pressure, alarms.

ARDS / severe hypoxemia

  • PBW-based low VT; reassess plateau/driving pressure when feasible.
  • FiO₂ and PEEP strategy with RT/ICU.

Asthma/COPD

  • Long expiratory time, lower RR, avoid stacking, watch auto-PEEP.

DKA / severe acidosis

  • Avoid prolonged apnea and post-intubation under-ventilation; match high minute ventilation thoughtfully.

Shock / RV failure

  • Avoid excessive PEEP/intrathoracic pressure; consider RV physiology and preload/perfusion.

Clinical review / use limits

Authored by: Airway of the Month education team. Last reviewed: July 2026. Audience: EM learners, faculty, EMS, RT, simulation educators, and airway teams.

Resources · Editorial policy · ACEP intubation policy · AARC 2024 ventilator assessment guideline · ATS 2024 ARDS guideline 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 clinical-reference guide only; not a bedside order set or substitute for local protocol, medical direction, or clinical judgment. Website contact: [email protected]