ARDS is one of the more complex syndromes we manage in critical care. More than just pulmonary edema, we are battling stiff lungs, refractory hypoxemia, rising pressures, and frequently making decisions that can either protect the lung or make things worse.In this episode, I’m joined by respiratory therapist Melody Bishop for a deep dive into ARDS ventilator management through the lens of physiology, evidence, and real bedside practice. We break down what’s actually happening in the lung, why some long-held practices have fallen out of favor, and how nurses and RTs can work together to make more precise, lung-protective decisions.If ARDS has ever felt like guesswork, this episode will help it make sense.Topics discussed in this episode:What ARDS looks like at the alveolar level and why surfactant loss changes everythingHow inflammation leads to stiff lungs, poor compliance, and refractory hypoxemiaWhy lung-protective ventilation is about avoiding harm, not chasing perfect numbersMoving beyond tidal volume: how driving pressure reframes vent managementHow RTs use compliance trends to judge whether lungs are improving or failingPEEP selection: why tables are a guide, not the final answerThe physiology behind proning and why it’s one of the few ARDS interventions that saves livesWhy recruitment maneuvers fell out of favor (and what works instead)What nurses should be watching on the ventilator to catch deterioration earlyConnect with Melody and download her free book:https://melodybishoprt.com/Mentioned in this episode:Rapid Response Academy Winter 2026 Cohorthttps://www.rapidresponseandrescue.com/rraCONNECT 📸 Connect on Instagram: https://www.instagram.com/therapidresponsern/ 📚 Check out my course: https://www.rapidresponseandrescue.com/learnmore 🧑‍💻Check out my website: https://www.rapidresponseandrescue.com/ 📬 Subscribe to my newsletter: https://www.rapidresponseandrescue.com/login 🎁 Affiliation and discounts: https://www.rapidresponseandrescue.com/therapidresponsern ✅ Earn CE’s for listening to podcasts through RNegade: https://rnegade.thinkific.com/?ref=d9d541 SAY THANKS 💜Leave a review on Apple Podcasts: https://podcasts.apple.com/ca/podcast/rapid-response-rn/id1535997752 💚Leave a rating on Spotify: https://open.spotify.com/show/55LQqeDg6XFeixvZLEp4xE ⏱️ To get the FREE Rapid Response RN Assessment Guide and the coupon code for $10 off the cost of the course, message Sarah on Instagram @TheRapidResponseRN and type the word PODCAST! This episode was produced by Podcast Boutique https://www.podcastboutique.com