"Does your sick patient require intubation? Protecting their airway requires more than skill with the mechanics of intubation, it requires understanding the physiology of critically ill patients and how it intersects with intubation and mechanical ventilation. The HOV mnemonic -Hypotension -Oxygenation (hypoxia) -Ventilation (pH) is a simple way to organize key concepts & skills you need when intubating a critically ill patient. Review these slides and then ask yourself next time you intubate a sick patient, "are you driving in the HOV lane?"