"57 yo, male, in sitting position c/o coughing and spitting up copious amounts of thick yellow secretions. Pt is looking gray. mother states he had surgery a month ago. coughed up blood and a piece of metal two days ago. Pt appears weak."
well Im not saying he's healthy.
but this isn't really so bad..... because.... He's sitting, that's good. he's coughing, that's good, looks grey, (but sitting) not so bad, the surgery was a month ago, not bad, the coughing up of a piece of metal was 2 days ago ( if it even really happened at all, senior citizen's story is not always reliable ), that's not bad...
what the pt really needs is a doctor. so if he survived the last 48 hours after the metal cough, he can do 10 more minutes on the way to the hospital.