Arab Board EM Final Written Practice Questions - Arab Board Emergency Medicine Final Written Examination Exam

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A 24-year-old woman with severe diabetic ketoacidosis (pH 6.88, pCO2 12 mmHg, HCO3 2 mEq/L, blood glucose 620 mg/dL) develops acute respiratory fatigue and requires emergency endotracheal intubation. Which physiological consideration is most critical during rapid sequence intubation (RSI) in this patient?

Minimize the duration of apnea and set mechanical ventilation to match her severe compensatory hyperventilation Administer high-dose opioids to blunt the sympathetic response and deliberately induce hypoventilation Set the post-intubation ventilator to standard resting minute ventilation (tidal volume 6 mL/kg, rate 12/min) Administer sodium bicarbonate bolus after induction to eliminate the need for hyperventilation

Correct Answer:

Minimize the duration of apnea and set mechanical ventilation to match her severe compensatory hyperventilation

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