A 77 year old female presents to your ED with 3 days of feeling unwell with diarrhoea and vomiting.

Her blood results:

pH 6.91

pCO2  28  (35-45 mmHg)

HCO3  6  (22-26  mmol/l)

BE  -25

Na  137  (137-145)

K 7.5  (3.5-5  mmol/l)

Chloride  89  (99-111)

Lactate  26

Describe and interpret the blood gas.

What other investigations would you consider?

How would you treat this patient?