Case Discussion
Clinical teaching and practical ideas for your next study session.
When the Intubated Asthmatic Crashes: Auto-PEEP or Tension Pneumothorax?
In severe asthma, sudden post-intubation hypotension with high airway pressures is not automatically a tension pneumothorax. This case framework uses ventilator waveforms, pressure patterns, and the response to a brief disconnection while maintaining oxygenation as needed to recognize dynamic hyperinflation, then explains when chest decompression cannot wait.
Anaphylaxis With Stridor, Shock, and Propranolol: Do Not Let Glucagon Delay the Airway
In suspected food-triggered anaphylaxis with stridor, hoarseness, tongue swelling, wheeze, and shock, the key ED decision is when to secure the airway while epinephrine treatment continues. This case-based framework separates upper- from lower-airway findings, clarifies what propranolol changes, and avoids common rescue-therapy traps.
When Septic Shock Looks Cardiogenic: A Bedside Framework for Mixed Shock in the ED
Fever, pulmonary crackles, cool skin, atrial fibrillation, and a high lactate can point in several directions. Learn to identify mixed shock without anchoring, overloading a failing heart, or delaying pressors and antibiotics.
Post-ROSC VF Arrest With ST Elevation and Cardiogenic Shock: What Cannot Wait
Persistent ST elevation after VF arrest demands simultaneous reperfusion, shock support, temperature control, and disciplined neurologic prognostication. This case-based review focuses on the decisions that cannot wait—and the findings that should not be overinterpreted.