Call for Help

• SpO2 less than 88% on an FIO2 of 1.0 for more than 15 minutes
despite troubleshooting
• pH less than 7.25 for more than 2 blood gases
• pH less than 7.10
• PaO2 less than 40
• SpO2/FIO2 or PaO2/FIO2 ratio of less than 150 for 2 hours
• SpO2/FIO2 or PaO2/FIO2 ratio of less than 80
• High-priority alarms (red) you cannot resolve within 2 minute
• Manually ventilate until help arrives
• Low-priority alarms (yellow) you cannot resolve within 15 minutes
In collaboration with

© 2020 American Heart Association

KJ-1425
Basic Ventilator Management Algorithm
Management Goals:
SpO2 88-98%
Yes No VT - 6- 8 ml/Kg PBW
Other indications Oxygen via face
P/F or S/F >150? pH 7.25-7.42
for intubation? mask or HFNC
PIP <35
Pp lat :,;30

No F102 0.3 0.4 0.4 0.5 0.5 0.6 0.7

PEEP 6 6 8 8 10 10 10
Yes
Ventilator settings: F102 0.7 0.7 0.8 0.9 0.9 0.9 1
• M ode: VC or PRVC
• Tidal volume: 6 ml/kg PBW PEEP 12 14 14 14 16 18 18-24
• PEEP: 10 cmH2O
• RR: 25 bpm
• F10 : 1.0
2
Obtain an ABG and CXR
within 1 hour

Reassess every Contact ICU

3- 6 hours Escalation Team

No
Pplat / PIP PIP high: Consider suctioning
acceptable? Pp lat high: Consider lowering VT

Yes No
Yes Resolved?

<88%: Adjust PEEP according to

No
PEEP/F102 chart
SpO2 88%-98%?
>98%: Wean F10 2 and readjust PEEP In collaboration with
according to the PEEP/F102 chart

Yes No
pH <7.25 increase RR
pH 7.25-7.42?
pH >7.42 decrease RR

KJ-1425 4/20 © 2020 American Heart Association

In collaboration with