The patient, a 51-year-old woman with acute respiratory failure secondary to an acute exacerbation of chronic obstructive bronchitis, was brought to the emergency department (ED) by emergency medical services.

In the ED, she was intubated and placed on mechanical ventilation.

On admission, it soon became apparent that she had suffered severe, irreversible hypoxic encephalopathy.

On day 5, she was weaned from the ventilator and extubated; however, significant neurological function was never regained.

She became febrile and dyspneic. Antibiotics were started to provide comfort and relief of her pneumonia. She expired on day 10.

5A1955Z Respiratory ventilation, greater than 96 consecutive hours

0BH17EZ Insertion of endotracheal airway into trachea, via natural or artificial opening

Comments: The patient was intubated in the ED and maintained on mechanical ventilation until day 5, more than 96 hours.