ARDS + Airway Emergencies

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from 10/3/24 CCMF meeting

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A 55-year-old male with a history of COPD is intubated for respiratory failure secondary to pneumonia. An hour into ventilation, his oxygen saturation drops from 98% to 82%, his heart rate increases, and he becomes hypotensive. What do you do and why?
You are receiving sign out in a rural ED. The prior team tells you about a boarding patient, pending transfer to an ICU, in room 3. The patient is a 68-year-old male with a history of CHF and ARDS is intubated for acute hypoxic respiratory failure in the ED. He has been boarding for over 24 hours. Over the course of the shift, oxygen saturations are slowly declining. You are unable to contact the receiving ICU. What can you do to determine the cause of this patient’s gradual decline in respiratory status?
A patient is brought to CCT via EMS, intubated in the field. VS notable for temperature of 102, BP 90/60, saturating 92% on MV. Portable CXR shows diffuse bilateral patchy opacities. Initial labs notable for a P/F ratio of 110. You suspect the patient is in ARDS, secondary to pneumonia. The ICU is at capacity, and you expect it will be at least a few hours before the patient leaves the ED. How do you manage the patient?