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Rescue pathway

Crisis map

Start here if the tube is in and the patient is worse.

What is failing?Choose the visible problem.SpO₂ fallingOpen hypoxia pathway.BP/MAP fallingOpen hypotension pathway.No/low EtCO₂Tube, circulation, or equipment.Vent alarm / high pressureResistance, compliance, circuit, dyssynchrony.Abnormal vital signsTranslate vitals into a failure bucket.

First four moves

  • Call for help and assign roles.
  • Disconnect from ventilator and bag with 100% O₂/PEEP if unstable and appropriate.
  • Verify tube position/depth and waveform EtCO₂.
  • Search DOPES: displacement, obstruction, pneumothorax/patient, equipment, stacked breaths.

Do not miss

  • Right mainstem, esophageal tube, tube obstruction, tension pneumothorax, auto-PEEP, medication-related hypotension, RV failure.

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.

This is an educational cognitive-aid scaffold, not a bedside order set. Verify medications, ventilator changes, pediatric dosing, and procedures against local ED, ICU, anesthesia, pharmacy, RT, EMS, and pediatric policies.

Resources · Editorial policy · ACEP intubation policy · ARDS ventilation reference