Yes, we're back with another episode of Best Case Ever, the mini podcast series as part of EM cases.

My name is Dr. Rajiv Tavanathan, and here with me today is Dr. Peter Reardon.

He's a fifth-year resident in the emergency medicine program here at the University of Ottawa,

and he's completing a fellowship in intensive care with an interest in both airway management and thrombosis medicine. So as a result, he's had some exposure to some interesting critical care cases. And full disclosure, Pete also happens to be a co-resident of mine and it's just an all-around great guy. So welcome Pete to the show. Thanks so much for having me, Rijiv. No problem. You're here to tell us about your best case

ever. Why don't you hit me with what you got? Yeah, so this case happened to me while

rotating through the ICU as a fellow. And I was doing my pre-rounds in the morning and the senior

resident comes running up. And this is a guy who does not get rattled about anything. So

immediately he has my full attention. And he tells me that

he gets a stat consult from the emergency. And there's a young patient there who has had a seizure,

has a very high lactate, and is acedemic. And he needs an ICU fellow or staff stat.

That's a really bad prognostic sign when the Emerge Doc is requesting for the staff right

away.

Yeah, this is like the moment where, you know, I don't need my coffee anymore because my heart rate's

gone up 30, 40 beats.

Okay, so you run down to emerge.

Yeah, so we're walking down and talking about potential differential. I mean,

you know, sometimes it's not uncommon for seizures to have acedemia transiently and lactates that

come and go. And so we're talking about that and the physiology and, you know, potential for other

causes. But we walk into the recess bay and immediately recognize

that this is not that straightforward. And so there's three or four nurses working on the patient,

there's chest compressions ongoing, and the emergent doc turns to us and starts to tell us

more about the case. And apparently in the interval, the patient has arrested three times, has been intubated,

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