A 70s M is bib ems for sob. He has a history of chf and htn. His hha called ems because he c.o. sob. On arrival, his VS are hr 90, rr 22, bp 160 / 70, t 99.0, O2 sat is 90 on the ems nrb. He is in moderate respiratory distress, and he is very obese and osa in appearance. Lung sounds are clear, heart sounds are normal, no S3, you can’t see any veins in the neck due to obesity. He has mild bilateral edema. He has an extensive area of cellulitis in his RLQ abdominal wall.
He is lethargic, but if you poke him hard enough, he will open his eyes and respond. However, he is unable to provide any history.
vbg = 7.13 / 140 / 110
What do we do next?