A 33-year-old man is brought to ED 4 hours after a suicide attempt involving ingestion of an unknown substance.
His observations are HR 105, BP 142/79, RR 30, oxygen saturation 94% on 6 L high-mask oxygen, and GCS E2 V3 M4.
Urgent blood gas and blood results are shown below.
| Parameter |
Result |
| pH |
7.02 |
| pCO2 |
20 mmHg |
| pO2 |
85 mmHg |
| HCO3 |
8 mmol/L |
| Lactate |
8.2 mmol/L |
| Glucose |
8 mmol/L |
| Urea |
24 mmol/L |
| Creatinine |
210 micromol/L |
| Measured osmolality |
299 mOsm/kg |
| Na |
142 mmol/L |
| K |
4.0 mmol/L |
| Cl |
106 mmol/L |
| Ca |
1.9 mmol/L |
| Mg |
0.8 mmol/L |
Describe the acid-base disturbance.
(Marked out of 2.0)
/ 2
Name three other abnormalities on the gas or blood tests, then state the likely diagnosis and why.
(Marked out of 5.0)
/ 5
List two further investigations you would request and give a rationale for each.
(Marked out of 4.0)
/ 4
He has a generalised tonic-clonic seizure lasting 5 minutes. Describe six steps in management.
(Marked out of 6.0)
/ 6
Total Score: 0 / 17
Percentage: 0%
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