question
New CDI: 95 year old male, sats 78% when EMS arrived, sob, RR 20. Placed onto NRB and given duoneb. Arrived ER, sats dec again to 88% on ra via oxymask to maintain sats. No other documentation from ED physician re: use of accessory muscles, distress, cyanosis written. Diagnosed with pneumonia. BNP also > 9000 with a history of systolic and diastolic heart failure. Would a question toward acute respiratory failure or acute exacerbation of chf be reasonable or are there not really enough clinical indicators to support any of these two? Thank you