You are called to a nursing home to find a 72-year-old female complaining of an infected wound in her leg. she is warm to touch, breathing rapidly, and is very lethargic. you get her into your ambulance and note she has a temperature of 103.1 degrees. she has an etco2 of 29mmhg with a blocked waveform and an spo2 of 93% on room air.

In a patient with a history of infected wound associated with fever, as well as difficulty of breathing; septic shock can be considered albeit the blood pressure and the heart rate should be taken. This is a case of an infected wound involving the skin that may have hematogenously seeded to the lungs and caused pneumonia. Since the normal flora of the skin is comprised of Staphylococcus aureus, then the same etiologic agent will affect the lungs and cause Staphylococcal pneumonia, which is very toxic for the patient. Pneumonia is backed by the end-tidal CO2 of 29 mmhG as well as the oxygen saturation of 93% (normal is above 95%) in room air.