A 70-year-old male with a history of congestive heart failur…
A 70-year-old male with a history of congestive heart failure, hypertension, and coronary artery disease presents with acute severe dyspnea. He is experiencing worsening symptoms over the course of the night, including fatigue and worsening dyspnea while lying flat (orthopnea). His current medications include beta blockers, ACE inhibitors, and diuretics.Phase: On SceneThe patient is sitting upright in tripod, visibly distressed, and speaking two words at a time. Vital signs:Blood pressure: 190/88 mmHgHeart rate: 110 bpmRespiratory rate: 28 breaths/min, with accessory muscle useSpO₂: 86% on room airAuscultation reveals bilateral crackles in all lung fields.What finding would indicate immediate need for CPAP?