A 25 year old male well known to your ED for Cannabis hyperemesis syndrome, presents after numerous syncopal episodes during the day. He has an episode of loss of consciousness in ED while monitored and is found to be in Torsades de Pointes.

A VBG is done

pH 7.50                                              Na 128 mmol/l

PCO2 48mmHg                                K 1.5mmol/l

HCO3 38mmol/l                                Cl 90 mmol/l

Lactate 1.5 mmol/l                            Cr 100 umol/l

BSL 5.6

1. Describe and interpret the VBG
2. Discuss the management of Torsades de Pointe