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Rescue pathway

Ventilator pivots by physiology

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

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.

Evidence and use limits

Last reviewed: 2026-07-23. 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: Clinical review pending: 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 cognitive-aid guide only; not a bedside order set or substitute for local protocol, medical direction, or clinical judgment. Website contact: kybrown@kumc.edu