What is the correct procedure if a patient begins to fight the ventilator at emergence?
Fighting the ventilator is a common occurrence when patients come out of anesthesia. As patients emerge from anesthesia and start to breathe on their own, the endotracheal tube and the ventilator’s controlled breaths irritate the patient. Fighting the ventilator is non-productive and may have safety implications because it limits tidal volumes and also increases airway pressures. This may be detrimental to the lungs. When this occurs, the clinician should respond as they normally would at the end of the case. Most likely this would entail turning off the ventilator. The QED-100 may remain active. However, the clinician should be encouraged to place the patient on synchronous intermittent mandatory ventilation (SIMV) or pressure support (PS), if available. This will allow the machine to help augment spontaneous breaths with greater tidal volumes or possibly even “kick-in” breaths if the patient is not making an effort to breathe after the ventilator is taken out of control mode. If neit
