Medic 11 · 15 min · ground
Match MV, then 6 mL/kg · Pplat ≤30 · ΔP ≤14 · SpO₂ 92–96 · Match pre-intubation MV; do not park at 40
Load card puts the starting breath on the box. Connect starts the clock. End whenever you want.
24-year-old woman, new DKA, Kussmaul, pH 6.92, HCO3 4, K 3.1 after 2 L. Tired, GCS slipping, tubed before you arrived.
Handoff
They bagged her at 12. That is not enough. If you 'protect' her with 6 mL/kg and a rate of 14 she will get more acidotic and arrest. Match her pre-intubation minute ventilation.
Match pre-intubation MV — then wean to 6 mL/kg
Rate 24–30. 7–8 mL/kg only until pH ≥ 7.20, then 6.
Don't cause autoPEEP chasing rate
Young lungs can take rate. Watch the flow return to zero.
Arrive without a deeper acidosis
This is a ventilation problem more than an oxygen problem.
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