17th July 2020

A 58-year-old man presents to the emergency department with severe abdominal pain

A 58-year-old man presents to the emergency department with severe abdominal pain. He has a past medical history of Type 2 diabetes mellitus and atrial fibrillation. He is not allergic to any drugs.

His observations on admission are:

• Respiratory rate: 23/min
• Pulse: 113 bpm
• BP: 134/98 mmHg
• SpO₂: 97%

An ABG has been done and shows the following:

• pH: 7.24 (7.35 – 7.45)
• pO₂: 11.1 (10 – 14)
• pCO₂: 3.2 (4.5 – 6.0)
• HCO₃: 14 (22 – 28)
• Lactate: 6.4 (<2)

What is the best initial treatment for this patient?

Select the SINGLE most appropriate option from the list below. Select ONE option only.