The Variable Practice of Attending Style in the ICU

The patient we have today is a 76 year old gentleman who has a past medical history of diabetes and hypertension. So he came into the intensive care unit with septic shock and acute respiratory failure from a community acquired pneumonia. He's on high flow nasal cannula, 50 liter, 60%. And he's been on mid range nor epinephrine since about the time he's been in your ICU. Right after shift change, you're paged to his room because the nurse noticed his heart rate abruptly jumped right up to 155.