You are called to a residence for a 60 year old male complaining of difficulty breathing. You arrive on scene and notice a two store apartment building, Pt's, apartment is on top floor with 20 steep steps up to the door. you make your way up the step and notice that the steps are in poor condition and doubt that you will be able to use your stair chair due to the condition of the steps. In the house you find you patient in the back bedroom, down a narrow hallway. you start your assessment on this patient. you find your patient has a decreased mental status, his color is gray, excessive sweating, you also find JVD, Peripheral and Pulmonary edema, lung sounds are wheezing and course crackles in all fields. You pt patient on the monitor you notice a wide complex tachycardia at a rate of 230/ min. his pulse is faint, pulse ox reading is 61% on 3 liters of o2. his family states he has refused to be treated in the past. his weight is approx 350 lbs., His vitals are B/P 90/50, Pulse of 230, respers of 60
what is you next step in care for this patient?