Yes! There's no fooling you. Always the ABCs first. While the patient was initially alert and reportedly had a reassuring exam for the ED, he has since clearly declined quite rapidly. He needs to be intubated for airway protection, and this decline in the context of his impressive SDH also further indicates that operative intervention is very much going to be needed.
In terms of his bilateral SDH, the SDH on the right side is causing the most trouble with the compression and subfalcine herniation (= midline shift). Given its sheer extent, burr holes would likely be inadequate for evacuation of this hematoma. A craniotomy is likely to be needed, and you can help weigh in on this.
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