Pregnancy. Respiratory failure.

33-year-old G2P1 pregnant at 33 weeks, comes in with shortness of breath. She has had a cough for about 3 weeks and her legs have been swollen for a few months.

Goals and Objectives

Educational Goal:

• To manage respiratory failure and cardiogenic shock in a pregnant patient.

Objectives (Medical and CRM):

Medical:

• Recognize a critically ill pregnant patient in respiratory distress and shock.
• Work through the differential diagnosis of dyspnea in pregnancy.
• Manage cardiogenic shock in pregnancy.
• Facilitate safe intubation with considerations for a pregnant patient.

CRM:

• Effectively lead a team through the management of a pregnant patient in shock.
• Utilize ED resources (cardiac-monitoring, bedside U/S, pCXR) to guide management.
• Prevent fixation error in a pregnant patient with dyspnea by keeping the differential wide.
• Call consultants early for a pregnant patient in shock.