VAP Prevention

Minimize duration of mechanical ventilation through daily sedation breaks and spontaneous breathing trials in eligible patients, and the use of noninvasive ventilation in some to prevent intubation

Hand hygiene

Maintain the head of bed at 30-45 degrees whenever possible

Use endotracheal tubes with subglotic suction (Evac) with cuff inflated to at least 20cm H20.

Discontinue H2 blockers and PPIs in patients that are no longer high risk (e.g. tolerating enteral nutrition)

Regular oral care

Orotracheal intubation preferred to nasotracheal

Use orogastric tubes instead of nasogastric tubes and initiate enteral nutrition early

Early mobilization