A 10 year old girl presents to your ED with a 1 day history of generalised abdominal pain and nausea. On examination she looks unwell and has generalised abdominal tenderness and guarding.

Vitals:

BP 88/50

Temp  34.5

PR 120/min

Wt 68kg

Her blood results are as follows:

pH  7.20  (7.36-7.44)

pCO2  44  (36-44mmHg)

HCO3  17   (24+/-2  mmol/l)

Na  137  (136-144 mmol/l)

K  4.2  (3.3-5 mmol/l)

Cl  103  (98-108 mmol/l)

Urea  10.5  (4-8 mmol/l)

Creat  90  (30-70 umol/l)

Lactate 9.6  (<2)

Glucose  12.8  (4-6 mmol/l)

Question 1 – Describe and interpret these blood tests

Further blood tests showed:

Bilirubin   17  (<16umol/l)

ALP  282  (85-390 U/L)

GGT  233  (<21  U/L)

ALT  95  (<31 U/L)

Lipase  2414  (13-60 U/L)

Question 2 – Describe and interpret these results

Question 3 – What are your immediate goals of treatment?