Management of respiratory distress in unstable mechanically ventilated patients*

ETT: endotracheal tube; CNS: central nervous system.

* This algorithm applies to patients who are in severe respiratory distress or are hemodynamically unstable. It does not apply to patients with mild to moderate distress who are stable or patients who need advanced cardiac life support.

¶ For this evaluation, we take a brief history and perform a rapid chest, cardiovascular, abdominal, and neurologic examination. We also perform focused bedside ultrasound examination, although that expertise for the latter is not universally available.