A 63 year old male presents to the ED with his wife after she noticed progressive change in behavior and yellowing of his skin over the last 2 days. The wife reports the patient has been havin abdominal pain. In the ED the patient's vitals are: T: 100.6 degrees, HR 140, RR: 22, SpO2%: 97%, BP: 85/45 mm Hg. The patient is in mild distress and appears ill. The patient is altered and has diffuse jaundice. What is the most appropriate management for this patient?