MRCP2-0573

MRCP2-0573

A 36-year-old man is brought to the emergency department after being a bystander at a house fire. He had called the fire and ambulance services and performed CPR on an unconscious resident until the ambulance arrived. While the emergency services were dealing with the fire and the resident, the man started feeling light-headed and was brought to the hospital as a precaution.

Upon review, the patient’s condition has deteriorated, and he is confused and unable to provide any history. He has a low heart rate, low blood pressure, and reduced consciousness. An urgent arterial blood gas is taken, and the patient develops convulsions while awaiting the results.

pH 7.11
PaO2 100 mmHg
SaO2 96% on room air
PaCo2 28 mmHg
Bicarbonate 7 mmol/L
Chloride 105 mmol/L
Lactate 8 mmol/L
Carboxyhaemoglobin 0.7%
Na+ 138 mmol/l
K+ 4.5 mmol/l

What is the most appropriate management for this patient?