RANT ALERT! OK, I just need to vent. Had a call about 3 AM at our SNF that was all to common. Toned out for a male PT age 94 with difficulty breathing. I had the ambulance, so respond, and walk in to find the patient with severe, rapid wheezing respirations. Ask the nurse what's been happening, and he tells me the PT has had an O2 sat in the 70s since that afternoon! So, they started him on oxygen...5 LPM via cannula. So, preped our O2 kit for 15 LPM by mask. Took his O2 sat...was about 75%. Put the O2 on him, and surprise surprise, it came up to the 80s before we got him on the gurney (and we were hustling) and was in the 90s by the time we got him in the rig. Dropped back down again during transport because we had to suction him several times, but they had him back up in the ER. BTW, he had a HX of pulmonary edema. I get so freakin' PO'd at this facility, because their response to any respiratory distress is 5 LPM (or less!) by cannula. I can't count the number of times we've come into that situation, and on every single one we've seen a marked improvement in the PT when we start them on 15 LPM by mask (shocking, I know). I also love the fact that he'd been in distress for a little over 12 hours before they decided it was an emergency, and woke us up. OK, got that off my chest. I'm just a little cranky this morning...calls at 11:30 PM, 3 AM and, oh yeah, our dispatch toning us out at 5 AM and saying "Sierra Madre Fire, disregard, accidental activation." just after I'd fallen back asleep. Thanks for listening.