Background and significance: It is estimated that 4800 children living in the USA are currently supported by mechanical ventilation at home. Despite advances in technology, the mortality rate of 21% remains high. Previous studies identified knowledge gap in the responses to emergencies in the home. Therefore, a training module focusing on the response to these emergencies is needed. Purpose /aims of the study: Children’s Hospital of Los Angeles (CHLA) approached regional home clinicians and formed an advisory panel to develop a training content for home mechanical ventilation (HMV) emergency management. Methods: We surveyed 28 HMV clinicians in So. California asking them to recall HMV emergencies in the home settings. We gathered this advisory panel for a focus group via the modified Delfi method to develop the training content of responses to HMV emergencies. Results: Ninety-two HMV emergency scenarios were recalled with 412 years of clinical experience on home HMV management. Data were categorized into 15 emergency situations. The expert panel deliberated on 1) the emergent situation 2) the immediate response 3) the possible causes and 4) pearls- the collective sharing of experiences on these encounters. Conclusion: A training didactic tool for in-home caregivers and nurses of HMV children was developed. We hope that providing focused education, based on real world experience and wisdom, will help reduce accidental deaths in children on HMV