Problem: Thirty minutes after her arrival into the ICU Mabel again complains of severe chest pain. Her assessment is as follows, Diaphoretic , HR- 169 bpm, RR - 32 bpm , Dyspneic and orthopnea, BP 105/69, SpO2 = 80%, ECG: St- segment elevation, inverted T waves, and Presence of Q waves in Leads I, AvL, and V1 through V6. ABG: pH 7.25, PaCO2 = 54 mm Hg, PaO2= 53 mmHg, SaO2 = 84%, FiO2= 100% NRBM. Breath sounds bilateral breath sounds with scattered crackles. Patient is coming in and out of consciousness.