A 30 year old man is brought to your ED after being found confused at a party. He has a history of anxiety and depression and is on medication.

Temp  39.5

BP 100/60

RR  30/min

PR 130/min

O2 sats 95 RA

His blood gas shows:

pH 7.04

pCO2  65 mmHg

HCO3  8 mmol/l

BE  -15

Lactate  10

K  8.5 mmol/l

Na  155 mmol/l

Cl  115 mmol/l

Hb  143 g/l

Describe and interpret the blood tests

List the causes

Describe the treatment priorities