Double Triggering? Look for Reverse Triggering First

When two breaths occur in succession without allowing full expiration, it is termed double triggering. In this example, the first breath is machine-triggered, indicated by the absence of a pressure drop prior to inspiration. This is immediately followed by a patient-triggered breath, and the pattern continues consistently. The predictable relationship—where the ventilator-delivered breath initiates a subsequent patient effort—indicates reverse triggering, meaning the machine-triggered breath activates the diaphragm and leads to a reflex patient-triggered breath.