This patient is a 28 year old male who was brought to you by EMS after he was found lying unconscious in his apartment by his family. The only medical history known by EMS is the patient was recently admitted for severe pancreatitis and has an indwelling PICC line in his LUE. EMS found the patient to be pale, bradypnic with a GCS of 3, O2 sat 75%. EMS RSI’d the patient and placed him on PEEP 8, TV 10 mg/kg, FiO2 100%. The O2 sat was noted to decrease to the mid 50s immediately after intubation, and remained there. In the ED, the patient’s vitals are: BP 120/84 P 105 O2 sat 56% T 97.5F. The patient appears severely cyanotic, but has normal pulses and symmetric breath sounds.
The patient is a 56 y/o female who presents with sudden onset substernal chest pain associated with dyspnea and some diaphoresis. Vitals stable. An initial ECG was obtained.
Cardiology was emergently consulted, but there was some suspicion that the ECG changes noted were merely J-Point elevation. A bedside echocardiogram was subsequently performed: