A 35 year old female with a back ground of type 1 diabetes presents to ED after an anaphylactic reaction to nuts.  The patient has received 2 x 500mcg imi adrenalin and salbutamol nebs.  A VBG is done:

pH 7.50                                   Na 137 mmol/l

pCO2 15 mmHg                      K 2.9 mmol/l

HCO3 13 mmol/l                     Cl 103 mmol/l

B/E -6.8                                   Glucose 23 mmol/l

Lactate 8.3                              Ketones 1.2

1. Describe and interpret the VBG
2. The patient continues to show signs of anaphylaxis – how would you further manage this patient?