So what we'll do is we'll just jump straight into case number two for today. We have a 63-year-old male with a history of hypertension, hyperlipidemia, COPD, hepatic cirrhosis, and peripheral arterial disease. And he begins to experience severe respiratory distress at home. His wife calls EMS, who comes out to their house. He's unable to speak in full sentences and can't provide a history. The patient's wife reported to EMS that over the past few days, he's had a productive cough and progressive shortness of breath and fatigue. EMS places him on a non-rebreather mask during transport, and the patient is saturated 93%. They bring him to the hospital. On arrival to the hospital, the patient is tachypneic and looks tired. However, he can follow some simple commands and provide one-word responses. He has diffuse, ronchorous breath sounds with wheezing bilaterally. He's also hypertensive to 195 over 84 and tachycardic to 121. His abdomen is round but soft, non-tender, and he has pitting edema in both of his lower extremities. The patient is quickly placed on BiPAP, and nebulizer treatments are initiated. A chest X-ray shows diffuse bilateral coalescent opacities, and point-of-care ultrasound shows B-lines throughout the lungs with a hyperdynamic and tachycardic heart. His IVC is large but collapsible. He gets corticosteroids, furosemide, nitroglycerin for his initial treatment, and his lab work results. The team notes that he has a leukocytosis, an INR of 1.6, creatinine of 2.23, and a mild hyponatremia. Now, I suspect most of you probably already saw the agenda for today, but hint, hint. But which of the following conditions is most consistent with this presentation? So take a look at your response system. Refresh the page if you haven't already, and you should be able to see the question on your device. And for those who maybe lost the tab or whatever, it's polev.com slash critical care one. We'll give it a couple more seconds. All right, we'll keep going. Second question for you is, which of the following is not a strategy for treating severe ARDS? Oh, I'm liking the answers to this question. 100%, almost. Almost, so close. All right, the ICU team is consulted, and the patient is quickly admitted to the medical ICU. And with that, we'll hear some updates in the care of ARDS patients from Dr. Javier Amador-Castaneda and Dr. Bushra Amina.

respiratory distress

ARDS

emergency medical services

BiPAP therapy

medical ICU