Throughout the day, PJ is still having trouble syncing with the ventilator, even with control of pain and sedation within goals with as needed boluses of fentanyl (no matter what you chose in question #12).  The team wants to paralyze PJ, to get him to synchronize with the ventilator and improve oxygenation.  The team orders a vecuronium infusion.  What is your response to the team’s choice of paralytic?

Which of the following continuous infusion neuromuscular blocking agents should be avoided if the patient is on steroids? 

The team asks you how they should monitor the level of paralysis provided by the paralytic.  You respond:

Listed are several rapid sequence intubation (RSI) medications and potential effects or limitations to use.  Which of the following RSI drugs is matched correctly with its potential unique side effect?

What is the hallmark feature of septic shock?

Which paralytic agent would be best for intubating PJ? 

No matter what you recommend in question #9, the team decides to use rocuronium.  What dose do you recommend?

The team decides to cover for pneumonia in PJ by adding vancomycin and piperacillin-tazobactam.  With regards to vancomycin, how would you approach dosing initially?

Which of the following was an outcome of the ProMISe trial?

After 3 days on the paralytic, the team feels that PJ’s ARDS is improving.  His calculated PaO2/FiO2 ratio has increased to 410, and the team decides to stop the paralytic infusion.  What adjustments do you want to make to the patient’s regimen?