This is the fourth case in a series looking at critical care medicine. A 59-year old man in your ICU was just extubated 30 minutes ago. He is four days post blunt polytrauma and has ongoing agitation but no other requirement for intubation. Since extubation, he has required several sedatives and has now developed stridor at rest.
Tag: airway edema
Burn with CO/CN Toxicity
A 33 year-old female is dragged out of a burning house and presents to the ED unresponsive. She has soot on her face, singed eyebrows, and burns to her entire chest, the front of her right arm, and part of her right leg. She is hypotensive and tachycardic with a GCS of 3. The team should proceed to intubate and fluid resuscitate. After this, the team will receive a critical VBG result that reveals profound metabolic acidosis, carboxyhemoglobin of 25 and a lactate of 11. If the potential for cyanide toxicity is recognized and treated, the case will end. If it is not, the patient will proceed to VT arrest.
EM Sim Cases 