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