28th May 2025

An 18-year-old man is brought in by ambulance to the emergency department with his partner.

An 18-year-old man is brought in by ambulance to the emergency department with his partner. His mother explains that has been unwell for three days with cough, loss of appetite and abdominal pain. She has noticed he has lost a lot of weight in the past few months. His sister has coeliac disease. On examination, he looks acutely unwell with tachycardia, tachypnoea, and some generalised abdominal tenderness. 

Venous blood gas shows pH 7.21, pCO2 5.4, pO2 4, HCO3- 11, Lactate 4, K+ 5.9, Glucose 28

Blood ketones are 6

What is the immediate management for this patient?
Select the SINGLE most appropriate option from the list below. Select ONE option only.