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A 24 year old male presents to the emergency department with shortness of breath and wheezing. He reports that he has a history of asthma and has been hospitalized multiple times and previously has been admitted to the ICU. His initial vital signs are T: 37.4, HR: 115, BP: 134/76, RR: 28, SpO2: 92%. The patient is given albuterol, ipratropium, steroids, and magnesium. He shows minimum improvement and starts to display signs of fatigue and lethargy. The patient is given ketamine and rocuronium and subsequently intubated and connected to a ventilator. Within one minute, the patient’s BP droops to 90/52. The patient has equal bilateral chest rise and breath sounds on auscultation and the trachea appears midline.