mrcem2-0086
A 45 year old female patient has been brought to the emergency department with multiple injuries following a fall while hiking in the mountains. You observe significant injuries to the face. There is also bruising to the chest wall and a fracture dislocation to the ankle. The patient has undergone rapid sequence induction with Propofol and Suxamethonium. A chest X-ray shows multiple rib fractures but no pneumothorax or visible pulmonary contusion. You notice that the patient’s end tidal CO2 has steadily increased since being intubated from 4.5 KPa to 7.4 KPa. You observe esophageal temperature is 39.3ºC. What is the likely cause of these readings?