A 27 year old man is brought to your ED by ambulance after taking an overdose of a commonly used medication. He is tachypnoeic with a normal mental state and blood pressure.

His ABG (RA) shows:

pH    7.498   (7.36-7.44)

pCO2   30   (35-44 mmHg)

pO2  77.6

BE  0.4

HCO3  23.3   (24 +/- 2 mmol/l)

Na    139 mmol/l   (137 -145 mmol/l)

K     3.6   (4 – 6 mmol/l)

Cl  108  (99-111 mmol/l)

Glucose  6.6  (4 -6 mmol/l)

Lactate  1.5  (<2  mmol/l)

Questions:

1. Describe the abnormalities

2. What is the likely ingestant?

3. What are the important management issues?

4. What are the indications for haemodialysis?

Thanks to Artur for this one!!