This case involves a 46-year-old male who presented to the emergency room after experiencing a severe episode of respiratory distress at a local store. Upon arriving at the ER, the patient decompensated further into total respiratory arrest at which point CPR was initiated. The emergency room physicians were unable to intubate the patient and also unable to gain IV line access due to an extremely low blood pressure. After multiple failed attempts at obtaining airway access via endotracheal means, a cricothyroidotomy approach was utilized. Adequate levels of oxygenation were never able to be reached via this ventilation method and it was at this point that anesthesiology was called. The anesthesiologist was able to successfully intubate the patient on the second try but ultimately the patient did not recover from the long term oxygen deprivation and died shortly after successful airway placement.