Case of the Month

A 61-year-old woman with a long-standing history of rheumatoid arthritis presented to an outside hospital complaining of several hours of worsening dysphagia. She was having difficulty swallowing her secretions on the day prior to admission and started choking after attempting to take her daily medication. There was no respiratory distress upon initial presentation. She developed stridor and began to desaturate in the ED, requiring bedside intubation.