29 year old male call you with a complaint of "feeling run down" while at work. You're outside of his office and can see him. He does not appear to be in any significant distress. What do you do first?

You enter the room and find the patient sitting in a chair A&Ox4. Patient says he has just been feeling more run down the past few days but today he felt totally exhausted to the point of falling asleep at his desk and doesn't feel like he can safely get himself home. Patient complains of no other symptoms and denies recent fevers, coughs, headaches, changes in taste or smell, and travel. What is your next move?

Patient states he is a type 1 diabetic and has had some minor problems regulating his sugar recently. Takes insulin via pump and has a CGM (continuous glucose monitor). Patient denies all other history. Patient states he does not want to go to the hospital if he does not have to. BP of 134/88. RR 18. Pulse of 92. BGL of 98 mg/dL. Temp 99.1. What now?

Upon investigation, patient's SPO2 is 45%.

On 25 LPM patient is still stating at 76%. Cataldo is at least 7 minutes out. Patient still is only complaining of fatigue.