He was initially suspected of lower respiratory tract infection and diabetic ketoacidosis on clinical examination and treated with intravenous fluids, antibiotics, and insulin infusion. The point of care ultrasound (POCUS), as part of the primary survey, showed right atrium (RA)-right ventricle (RV) dilation and a D-shaped left ventricle, which was highly suspicious of pulmonary embolism and was later confirmed with computed tomography pulmonary angiogram (CTPA). Here, INS is linked to pulmonary embolism.