27th February 2024

A 80 year old woman is admitted to hospital with 4 hours of worsening breathlessness and a productive cough.

A 80 year old woman is admitted to hospital with 4 hours of worsening breathlessness and a productive cough. Her observations are as follows: HR 90, BP 100/85, RR 17 and sats 93% on RA. She has a past medical history of hypertension, CKD and valvular heart disease. She is a long-term smoker.
A CXR is obtained:

Select the single, most appropriate definitive management.