Ventilator Troubleshooting Summary
High PIP, nl Pplat:
 - DDx: Tubing problem, Bronchospasm, Secretions
 - Next Steps: Check for kinks, Nebs, Suction
High PIP, high Pplat:
 - DDx: Mainstem intubation, PTX, Alveolar filling, Obesity/Distention
 - Next Steps: BS, CXR, Bowel reg, Para, etc.
Auto-PEEP:
 - DDx: Obstructive lung disease, Insufficient expiratory time
 - Next Steps: ↓ RR, ↓ I:E ratio, ↑ IFR, PEEP = 2/3 auto-PEEP, Bronchodilators/Steroids
Hypoxemia:
 - DDx: Vent issue, PTX, Alveolar filling, PE
 - Next Steps: Bag, BS, CXR, CTPE
Fighting the vent:
 - DDx: Pain, Dynamic hyperinflation, Ischemia, Distention, Undersedation
 - Next Steps: Treat underlying cause, ↑ Sedation

Dr. Nicky Singh @nickysinghmd via MGH IM Residents @mghmedres

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