Saved from iatrogenia twice!!

I get a call at 530 PM tonight from an ANA doc stating that, in fragmented English, a guy has a bad heart, intubated and they need help. I was thinking some old guy was having a heart attack or heart failure. To my surprise the guy was in his early 20s. At first glance his vitals were stable, so I knew I had time to quiz the ANA docs before intervening. (Story goes: he was playing volleyball when he suddenly passed out. He was brought to the spanish hospital down the street. All they did was intubate him and transfer. No labs no EGK no xrays). I asked what they (ANA) had done, and they said nothing. So I instructed them to examine the patient. I examined him after the duty doc was done and immediately noticed that the left side of his lung had no breath sounds. I asked him to listen again because he said the exam was initially normal. After a second listen he noticed there were no breath sounds on the left. So we moved the tube back 3 or 4 cm back. On re-examine breath sounds were normal bilaterally. Then we spent about 5 minutes discussing the differential, while the nurse obtained an EKG. All he could come up with was seizure, which is true. I told him most likely is arrhthymia. His EKG is above. In short, I think the guy has WPW - an unfortunate conduction pathway in his heart. Since our resources are limited, I went to find a cardiology textbook to look for alternative long term treatments, since we do not have first line treatment (ablation and other anti-arrhythmic medicines). When I came back, I noticed the labs were done. His pH was 7 and CO2 was 100!!!! normal is 7.4 and CO2 of 40. Of course no one looked at the labs!!! I told them to repeat it STAT while I tried to figure out what was going on. The ventilator was acting wierd. Tidal volume (measured breath the machine gives the patient) going from 0 to 1200 cc (it was set for 400). Repeat blood gas was still horrible. So I told the doc to get another machine while I manually bag the patient. Well, there was no resistance while trying to "bag" the patient, so I knew that the tube somehow came out. either I did not inflate the cuff enough or the cuff had a leak. In a very commanding tone, I tell everyone to grab me the intubation kit and get meds ready. I pull out the tube and lower the head of the bed and try to put a mask on his face to hand bag him. It was difficult because he was fighting me. I figure since he is fighting me, he can probably breath on his own. We repeat a blood gas and it improved dramatically, still slightly abnormal, but not nearly as bad. Guess I had to just relieve the obstruction in his throat. It was good learning for all. Still not exactly sure about long term treatment. I emailed a cardiology friend of mine with the options available to us to see what he would do.