POST SCENE During trаnspоrt the pаtient is plаced оn high flоw oxygen and is given a fluid bolus. The patient becomes harder to arouse and his respiratory rate begins to drop. The vital signs are BP 78/54, HR 146, RR 12, SpO2 90% on 15 LPM via a NRB. Capillary refill is 5 seconds. ON SCENE The patient (20 kg) is found laying on the couch in the living room. There is an anxious appearing teenager pacing the room. The patient does not open his eyes when the crew enters the room and appears to be sleeping. The sitter reports the patient has had a cough and fever the last 2 days and has been home from school. The sitter reports not being able to wake the child up to eat and called 9-1-1. The patient has no prior medical history and takes no medications. There are no allergies. The patient’s skin is warm to the touch and dry. The patient moans, grabs at the medics hand, and flutters their eyes when stimulated. The pupils are 4mm and reactive. Breath sounds are diminished bilaterally with scattered rhonchi in the right lower lobe. The vital signs are BP 80/54, HR 142, RR 38, SpO2 92% on room air. The blood glucose is 132 mg/dL. EN ROUTE The paramedic is dispatched to a residence for a 6-year-old patient with altered mental status. Babysitter is on scene with the patient. The time of the call is 1315. The response time is 12 minutes. The paramedic is partnered with an EMT, a BLS fire department engine crew is dispatched to the scene. The weather is clear in the area and the temperature is 77 F (25 C). A local community hospital is 15 minutes away, and a comprehensive medical facility is about 25 minutes away.