40yo post-partum female presents to the ED c/o SOB ...

Submitted by Sarab Sodhi, MD

An 82-year-old woman is mechanically ventilated for acute respiratory failure following acute intracerebral hemorrhage. Her FiO2 has been 30% with an arterial blood gas showing adequate ventilation and oxygenation for the last 24 hours (7.43/37/89/25). Suddenly, the ventilator alarms for low exhaled tidal volume. On bedside evaluation, her SpO2 is 84%, respiratory rate 20 breaths per minute, HR 124 beats per minute and blood pressure 105/65 mm Hg. Her ventilator graphics before and after the alarm are depicted below. What mode of mechanical ventilation is she receiving and what triggered the alarm? 

Submitted by Emily Damuth, MD

A 65 yo male presents with foot pain

Submitted by Sydney Tabaac, MD

A 45 year-old male with no medical history presents with Right knee pain after a mechanical fall causing him to land onto his right knee. Exam reveals moderate swelling and tenderness. He is unable to extend the knee.

Submitted by Ozair Rizvi, MD