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13th August 2024
A 56-year-old man is referred to you with a reduced conscious level. He is known to suffer from type 2 diabetes
A 56-year-old man is referred to you with a reduced conscious level. He is known to suffer from type 2 diabetes and had consulted his GP in the days preceding admission with vomiting and diarrhoea. His heart rate is 135 bpm and blood pressure is 95/40 mmHg. On examination his mucous membranes are dry, and his GCS is 9 (E2V2M5).
An arterial blood gas demonstrates:
| pH | 7.29 | (7.35-7.45) |
| pO₂ | 35.6 | (10-12) |
| FiO₂ | 60% | |
| pCO₂ | 5.1 | (4.5-6) |
| Na⁺ | 159 | (135-145) |
| K⁺ | 5.4 | (3.5-5.5) |
| HCO₃⁻ | 19.1 | (22-26) |
| Lac | 4.4 | (0-2) |
| Glu | 56 | (4-7.8) |
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