The podcast is outstanding and should be listened to again and again.
In this post, I link to and excerpt from EMCrit 314 Shadowboxing [Review of a case of a patient with both respiratory failure and circulatory failure], by .
All that follows is from the above resource.
Initial Presentation at Main ED:
The patient presented to the resuscitation room as a medical alert after a transfer from the freestanding ED for further evaluation and management. However, in transport, vital signs had changed. He was arriving of hypoxia again (SpO2 81%) despite non-rebreather at 15 lpm with 100 FiO2, hypotension (SBP 80s), tachypnea (RR 40s-60s) and tachycardia (HR, irregular, 120s-140s).
On arrival, the patient was hypoxic at 81% on the EMS pulse oximeter. He was in atrial fibrillation with a rapid ventricular response but he was able to inform the team that normally his rate is well-controlled and he only occasionally feels it when the HR is elevated.