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Peri-intubation hypotension risk — ABEM Board MCQ

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HardProcedures and resuscitationPeri-intubation hypotension riskABEM Board

A 64-year-old man with septic shock is undergoing intubation as triage level 1. Before induction his BP is 78/40 mm Hg on norepinephrine, lactate is 7 mmol/L, and ultrasound shows a collapsible IVC. Which of the following is the most likely diagnosis?

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Correct answer: D — High risk of peri-intubation cardiovascular collapse

Shock, vasopressor need, high lactate, and preload responsiveness predict peri-intubation collapse; resuscitation and hemodynamic planning should precede induction where possible.

Reference: ACEP Clinical Policy: Endotracheal Intubation; ABEM EM Model