The Shift Change · Case 004 · November 3, 2026
The Cough That Wasn't Flu
Three weeks of cough in the middle of flu season. A negative rapid flu test, two rounds of antibiotics, and now she is septic on high-flow oxygen. She is also on a biologic for rheumatoid arthritis. What is your first order, and who needs a mask?
The Shift Change · Case 003 · October 20, 2026
The Belly Under Pressure
A man with alcohol-related pancreatitis is in the ICU on an insulin drip for triglycerides of 1380. The triglycerides are falling fast. So why is his belly getting tighter, and his urine slowing down?
The Shift Change · Case 002 · October 13, 2026
The Straining Bleed
Post-op day three after a craniotomy. He strains on the toilet. Thirty minutes later: GCS 5, decorticate posturing, Cushing's triad, and 99% on 2 liters. Intubate first, or scan first?
The Shift Change · Case 001 · October 9, 2026
The Post-Intubation Crash
Intubated for a COPD flare with pneumonia. First pass, clean tube. Five minutes later his MAP is 49. What do you do in the next 60 seconds?
Educational content only, not medical advice. Cases are drawn from clinical experience; details are changed so no patient can be identified. Medications are named without doses; follow your facility's protocols and your local medical direction.