UMEM Educational Pearls

Improving Compliance with Lung-Protective Ventilation

  • Approximately 250,000 ED patients are intubated and receive mechanical ventilation each year in the United States.
  • While emergency physicians understand the importance of providing lung-protective ventilation, current studies demonstrate that more than 40% of ED patients are placed on initial tidal volumes > 8 ml/kg of predicted body weight (PBW).
  • In many cases, this may be due to the inaccurate estimation of patient height when determining PBW.
  • In a recent single-center study, Tallman and colleagues evaluated a quality improvement intiative, whereby respiratory therapists were provided with a tape measure and an EHR BPA that reminded them to measure the patient's height for PBW.
  • In this study, these simple, low-cost interventions significantly increased compliance with lung-protective ventilation.
  • Take Home Pearl: Be sure to measure your intubated patient to accurately determine PBW and set the correct tidal volume.


Tallman CMI, et al. Impact of provding a tape measure on the provision of lung-protective ventilation. West J Emerg Med. 2021; 22:389-93.