An EMS unit receives a call to evaluate an ill person. On
arrival, the crew finds a man in a third-floor bedroom of a big
home. His complaint is shortness of breath, and he's noted to be
a very large patient, lying on a very large bed. He's unable to
move out of the bedroom, stating his size does not allow him to
move through the doorway. He has bathroom access through a
doorway that has been crudely widened by carving out one side of
the door frame. He says he has no known medical problems but
adds that he hasn't seen a physician in about 30 years. A family
member is in the house with the patient and verifies his
history. On physical exam, the patient is found warm and
diaphoretic. His respirations are labored at 40/min, pulse at
56/min, pulse oximetry reading is 82%. He's placed on 100%
oxygen via non-rebreather mask, and his pulse oximetry reading
increases to 90%. The crew asks him if he usually rests flat on
the bed. He states that a family member had suggested he lie
flat, but that position seems to hav