Bronchoscopy can be used to resolve respiratory nobivac 1-hcp failure caused by tenacious mucus plugs.However, emergent bronchoscopy to resolve mucus plugging is not always available in small rural hospitals around the country.We present a case in which increasing the positive end-expiratory pressure settings on the willy wonka book week costume ventilator resulted in immediate improvement in patient oxygenation and imaging findings during a respiratory emergency caused by mucus plugging.