June 12, 2015

A 25 year-old female is suddenly rolled back in a wheelchair into your resuscitation area. As you walk into the room, you see a pale, ashen lady with a diffuse red rash holding an emesis basin between her legs filled with a mixture of sputum and blood. You glance up to the monitor as your nurse places a second peripheral IV, and you see an oxygen saturation of 88%, RR of 28, BP of 105/92, HR of 122, and temperature of 99.1. She continues to cough and is barely able to speak due to increased work of breathing. You immediately call for intubation equipment and medications. The intubation goes well with ketamine and rocuronium, despite blood pooling in the oropharynx. The post intubation chest xray demonstrates diffuse infiltrates.