84 year old, female patient from the emergency department. Past medical history of chronic obstructive pulmonary disease, congestive heart failure, hypertension, diabetes mellitus, atrial fibrillation. Past surgical history of coronary artery bypass grafts x 4, right total knee replacement, left total hip replacement. History of VRE (Vancomycin-resistant Enterococcus) and MRSA (Methicillin-resistant Staphylococcus aureus). Will need peripherally inserted central catheter, chest x-ray, type and cross match for 2 units of packed red blood cells, immediately.