A 40-year-old gentleman with no known comorbidities presented with acute onset of abdominal pain lasting for 5 days. On evaluation in the Emergency Department, he was found to be tachycardic with a heart rate of 140/minute, tachypneic with a respiratory rate of 40/minute saturating 85% on room air, and a blood pressure of 100/60 mm Hg. Systemic examination revealed abdominal tenderness in the epigastric region. A blood gas analysis revealed lactate of 4 mmol/L. He was started on oxygen supprt through face mask and administered a stat dose of fentanyl for analgesia. Following initial resuscitation, he showed some respite in terms of improvement in pain score and a decrease in the heart rate to around 130/min. A contrast CT abdomen with pelvis was performed, which showed a bulky edematous pancreas suggestive of acute pancreatitis. He was transferred to the ICU for further care. In view of ARDS, he was commenced on high-flow nasal cannula (HFNC) and patient-controlled analgesia with fentanyl. Over the next 24 hours, despite HFNC, he had worsening respiratory distress needing to be intubated with modified rapid sequence induction. Post-intubation, in view of a poor PaO2/FiO2 ratio, he was kept deeply sedated and paralyzed to facilitate proning. After a session of proning, he improved and, over the next 48 hours, was weaned off paralysis and sedation. However, on day 4 of ICU admission, he developed ICU delirium. He was commenced on a dexmedetomidine infusion, which improved his condition. He was weaned off the ventilator and extubated successfully on day 6 of admission. Fentanyl PCA was provided for analgesia, and he was transferred to the wards the next day.