Ok, the Fool is on call in the PICU tonight (Early AM right now…) and I have new found respect for the Tetrology of Fallot. This 3 1/2m baby desated to the 40s, then down as low as 19! Tried all the standard stuff. Oxygen, Morphine, IV Fluids, and nothin! Tried Ketamine. Zip! Finally, as the textbooks say, tried the alpha agonist, phenylephrine and There you go! O2 sats as high as the 90s! Good thing too, now the baby is on a phenylephrine drip and so far so good, but I was getting damn nervous with a kid’s O2 sat in the 20s! So, read up on Tetrology for your Peds exams or USMLE everyone! It’s worth it! – Fool