Author: Susan Uí Bhroin / Editor: Sarah Edwards / Codes: PhC4, PhP2, PhP3, SLO3 / Published: 06/07/2021

Just after midnight an ambulance arrives with a 26-year-old female patient. A takeaway owner had called the emergency services after she became unresponsive in his restaurant.

Her vitals are as follows:

• BP 90/40
• Heart rate 140
• Temperature 36.5C
• Respiratory Rate 22
• SpO2 85% on 100% O2 via non-rebreather mask
• GCS 10 (E4, V2, M4)

From the end of the bed you notice she is profoundly cyanosed despite receiving 100% O2.

Your FY2 successfully obtains an ABG and she reads the following results to you as you secure IV access:

• pH 7.28
• PO2 42kPa
• pCO2 3.5kPa
• HCO3 13
• Lactate 9.7

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