Case set 05: educational synthesis

Educational work by a pre-medical student — not medical advice. Not a clinical protocol, prescription, or patient handout, and not for patient care. See DISCLAIMER.

Revised 27 October 2026. This summary follows the corrected case bank. It supplies no separate medication, device or escalation instructions.

• Scenario 1: Early low-output physiology. No automatic decision to withhold diuresis or lower PEEP follows from RV dysfunction alone.
• Scenario 2: Aortic repair and agitation. The earlier claim that beta-blockade should be avoided because heart rate is not the main driver is withdrawn. No replacement antihypertensive regimen is prescribed.
• Scenario 3: Chronic LVAD low-flow alarms. A low-flow alarm does not justify empiric speed, fluid or transfusion changes outside specialist assessment.
• Scenario 4: VV-ECMO with hypoxemia. A normal post-membrane value does not prove that all circuit-related causes are absent or make transfusion/paralysis automatic.
• Scenario 5: Explicitly chosen comfort-focused care. Comfort-only goals are explicitly supplied here and are not inferred from DNR/DNI. Sedative combinations are not automatically appropriate; choices require proportionate symptom-focused assessment by the treating team.

Reflection

For each scenario, separate observed fictional facts from hypotheses; identify missing data; explain one alternative mechanism; and cite a source with its population and limits. Do not treat a successful exercise as clinical competency or institutional approval.