A case-based, step-by-step walkthrough of the first minutes of mechanical ventilation in the emergency department. This session focuses on the transition from effective BVM ventilation to safe ventilator setup, early waveform interpretation, and immediate troubleshooting during the highest-risk phase of care.

Learning Objectives

By the end of this session, participants will be able to:

1. Review and apply core principles of mechanical ventilation, including oxygenation, ventilation, and lung protection, and describe how these guide initial ventilator setup in emergency settings.

2. Demonstrate effective bag-valve-mask (BVM) technique, including seal optimization, ventilation timing, use of PEEP, and strategies to avoid air trapping.

3. Perform a structured, stepwise ventilator setup for emergent intubation, including mode selection (PRVC, VC, PC), initial parameter selection, and correct assembly and connection of the ventilator circuit.

4. Interpret essential ventilator waveforms (pressure, flow, and volume) to assess patient ventilator interaction and recognize early signs of obstruction, poor compliance, auto-PEEP, or dyssynchrony.

5. Identify and troubleshoot common early ventilator alarms using a systematic bedside approach.

Apply a case-based approach to transitioning from BVM to intubation to ventilator support, integrating assessment, waveform interpretation, and real-time adjustments in a rural or resource-limited ED environment.

Rapid-Fire Troubleshooting, Physiology, and Complex Vent Scenarios

A case based, high-yield troubleshooting session built around rapid cases that reflect what actually happens on shift. This webinar focuses on waveform interpretation, resistance versus compliance problems, safe minute ventilation adjustments, and decisive intervention during deterioration.

Learning Objectives

By the end of this session, participants will be able to:

1. Identify and troubleshoot common post-intubation ventilation problems, including mucus plugging, endotracheal tube kink or obstruction, cuff leak, right mainstem intubation, high-resistance states, and pneumothorax.

2. Interpret abnormal ventilator waveforms to distinguish between resistance and compliance problems, and select appropriate interventions.

3. Calculate current and desired minute ventilation using structured formulas to guide safe adjustment of tidal volume and respiratory rate in conditions such as opioid overdose, metabolic acidosis, and neurologic injury requiring targeted PaCO₂.

4. Apply physiologic principles to guide ventilator changes in complex acid-base disorders, including intentional hypoventilation in metabolic alkalosis and controlled hyperventilation strategies for elevated intracranial pressure.

5. Recognize clinical deterioration on the ventilator and intervene appropriately, including when to shorten inspiratory time, when to reduce respiratory rate to prevent auto-PEEP, and when to disconnect and manually decompress the chest.

Use a systematic, case-based reasoning approach to rapidly interpret ventilator feedback, respond to alarms, and make safe, effective bedside adjustments during emergent scenarios typical of rural and community ED practice.

A cased-based session covering pediatric ventilation fundamentals plus structured non-invasive respiratory support. This webinar focuses on safe initial setup, common pediatric pitfalls, and clear escalation frameworks for HFNC, BiPAP, and intubation in both adult and pediatric patients.

Learning Objectives

By the end of this session, participants will be able to:

1. Describe key physiologic differences between pediatric and adult patients and explain how these differences influence ventilator setup.

2. Select appropriate initial ventilator settings for infants and children, with a focus on pressure control ventilation, short inspiratory times, and age-appropriate respiratory rates.

3. Recognize and troubleshoot common pediatric ventilation problems.

4. Initiate and titrate High-Flow Nasal Cannula (HFNC) in both pediatric and adult patients, adjusting flow and FiO₂ based on work of breathing, oxygenation goals, and patterns of response.

5. Set up and optimize BiPAP, choosing appropriate IPAP, EPAP, and delta pressure for conditions such as SCAPE, COPD exacerbation, pneumonia, and mixed respiratory failure.

6. Identify early signs of non-invasive ventilation failure and determine when escalation to intubation is required.

Apply a structured escalation framework (HFNC to BiPAP to Intubation) using case-based reasoning and live ventilator demonstration to guide real-time decision-making in emergency and resource-limited settings.