Emergency physicians (EPs) intubate patients on a daily basis. Due to prolonged lengths of stay for many of these patients, the EP must manage the ventilator during the crucial early hours of critical illness.
Despite the marked increase in critically ill patients, emergency medicine residents receive very little training in mechanical ventilation (MV).1
In addition, recent literature has demonstrated some common themes regarding MV in the ED.2,3
Use of higher than recommended tidal volumes
Infrequent use of lung protective ventilation strategies
Infrequent monitoring of plateau pressures
Take Home Points
Pay attention to tidal volume
Monitor and maintain plateau pressures < 30 cm H2O
References
Wilcox SR, et al. Emergency medicine residents' knowledge of mechanical ventilation. J Emerg Med 2015;48:481-91.
Allison MG, Scott MG, Hu K, et al. High initial tidal volumes in emergency department patients at risk for acute respiratory distress syndrome. J Crit Care 2015;30:341-3.
Fuller BM, et al. Mechanical ventilation and acute respiratory distress syndrome in the emergency department: a multicenter, observational, prospective, cross-sectional study. Chest 2015. [Epub ahead of print]
