Getting Worse

Nursing home lethargic patient with fever of 103, rhonchi, tachypnea. SAT 72% on room air. The nonrebreather got the SAT up to 100%. I had the patient on capnography and it was in the high 30's when all of a sudden it shot up to the 50's. His respiratory rate was also went up to the 50's. His SAT only went down to 96%, and he soon looked like he was having a harder time breathing. We were just pulling into the ER. At triage, they put him in the less severe wing. I told them the nurse was getting worse, but I think he already had it in his mind -- nursing home pneumonia. It took a little while for me to find a nurse in the wing we went to. I gave the report, but he's getting visibly worse, I said. Twenty minutes later he was intubated. I later read, in sepsis, you can expect a high respiratory rate and a high C02. I am still learning the capnography, but I was impressed with the sudden leap in C02 seeming to flag the oncoming change in condition.