In this episode, Dr. Mohammed Hagahmed discusses the critical management of a patient presenting with suspected pulmonary embolism (PE) and right ventricular failure in the emergency department (ED). Highlighting the importance of optimizing resuscitation before intubation, he emphasizes strategies to address hypotension, optimize preload, and improve myocardial contractility while avoiding systemic hypotension. Dr. Hagahmed shares practical insights on medication choices, ventilatory settings, and the significance of careful patient monitoring, aiming to equip healthcare providers with essential knowledge for managing such high-risk cases effectively.