EN ROUTE It is 0330 and you are staffing a 2-paramedic trans…

EN ROUTE It is 0330 аnd yоu аre stаffing a 2-paramedic transpоrting ambulance. Yоur unit is dispatched for a 71-year-old female with shortness of breath. It is a rainy spring night and the temperature is 65oF (18oC). The location is roughly 10 minutes from the station. Hospital 1 is a cardiac catheterization center, and Hospital 2 is a level 2 trauma center both about 20 minutes away. Dispatch notes the patient woke from sleep with severe shortness of breath. They note that the patient's husband is with the patient. ON SCENE The husband leads you into the bedroom where you find the patient (60kg) sitting on the edge of the bed leaning forward with moderate to severe respiratory distress.  She makes eye contact when crew arrives but appears tired. The husband states she woke suddenly with severe shortness of breath. The patient has a history of coronary artery disease, diabetes, COPD, and had a myocardial infarction 2 months ago. The patient has no allergies to medications. The patient's skin is pale and diaphoretic. There are no signs of trauma, and the patient obeys motor commands but can only speak 2-3 words at a time. Eyes are open, pupils are 5mm and reactive to light. The vital signs are BP 172/110, P 88, R 26, SpO2 90% on room air, and T 98oF (37oC), The blood glucose is 100. POST SCENE The patient is packaged onto the stretcher in a high fowlers position and transport is initiated to a hospital with cardiac capabilities.  Despite early CPAP therapy, the patient remains dyspneic and anxious.