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**Sadly sweeps up the broken glass the movers left on the entryway floor.** "Awww dammit, I cut my pinky finger and bled all over the floor........." **Tosses the used sledge hammer into the rusty old garbage bin in the corner of the room.** "Holy crap, sorry didn't realize it would be such a loud bang!!" **Uses a small can of purple paint to cover the red scrapes on the door frame...** "oh, so that's what mauve looks like......" **Brings in a Karaoke machine** "Let's see what the old crab ass is gonna do now"

The vending machine company has received word of this defective machine and is now here and is removing the machine from the premises with a profuse set of apologies and refunds to all who got pieces of crap for their quarters.

64/40 (MAP 48) isn't going to cut it. Start a second 500mL fluid fluid challenge and switch to a NRB for the time being. What do you have available to you for pressors Chris? What's the patients heart history? Specifically do they have any history of valve incompetence/replacement? Here's hoping the receiving hospital has ECMO available. They might need it to buy enough time to give this patient a shot at surviving this episode.

Best guess? You don't know either. What about the COA/COG? That's find you want to keep the scenario moving forward. But it can't really move if people don't know what other people are talking about. And honestly? Right now, I'm more curious what the abbreviations really stand for than I am in the scenario.

HIPPA...