A 68 year old female is brought to ED by ambulance. her husband found her this morning confused and called the ambulance. He had last seen her last night before bed when she was well.

PMH – HTN, NIDDM

She takes propranolol, metformin, gliclazide, SGLT 2 inhibitor for diabetes

In ED the patient was obtunded GCS 11

BP 90/60             HR  110/min                  RR 25/min                     T  32 degree Celsius

Her blood gas:

pH  6.738

pCO2  30.8

HCO3  3.9                 BE  -36.5

Hb  168 g/l

Na  140 mmol/l          K  4.9  mmol/l                Cl  114  mmol/l

Glu  34  mmol/l          Lactate  3.6  mmol/l

Creat  143  umol/l

Describe the blood gas and interpret.

Any other tests you would do?