Department of Emergency Medicine

UMEM Educational Pearls

Category: Critical Care

Title: The Crashing Vented Patient

Posted: 2/24/2009 by Mike Winters, MD (Updated: 4/20/2024)
Click here to contact Mike Winters, MD

The Crashing Intubated ED Patient

  • For intubated ED patients who develop respiratory distress and are hemodynamically unstable, perform the following:
    • Immediately disconnect from the ventilator
    • Manually ventilate with 100% FiO2
    • Exclude tension pneumothorax (decompress)
    • Exclude auto-PEEP (allow for lung deflation)
    • Check ET tube for kinks, twisting, or obstruction
    • Check for air leak (check pilot balloon and listen for air coming from mouth/nose during manual ventilation)
    • Check the ventilator circuit

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