60 yo for parathyroidect.

150 kg down from 250 last 6 mos
usual morbid obese co-morbidities and meds
"allergic" to Aleve
Chronic afib

Fent, prop, Sux with NIM intubation. Appropriate vent settings with expected vital signs. Nothing out of the ordinary. Two grams ancef infusing.

Bair hugger, prep, drape uneventful.

Surgeon gowning and gloving when compliance precipitously dives. Paw from 23 to 50 with eTv from 700 to 95. Sats OK but CO2 climbing. Reasonable surgeon told to hold on a minute. No wheeze on auscultation. Tube is at about 21, and is not mainstemmed.

HR 103, bp 70/30 sat 97 co2 55

Simple 2-3 word answers only, no questions. You have all you need. Uncommon but not unheard of event...Go.