A 19 year old known diabetic is brought to the ED having been found collapsed in bed. He was seen the previous day and had been complaining of a GI upset. His diabetes was normally fairly well controlled and he had not had a hospital admission for many years.

On arrival she has the following observations.

P-155
BP - 100/60
RR - 56
GCS E-2, V- 3, M-5
Apyrexial
ECG shows Sinus rhythm

ABGs are as follows (kPa)

FiO2 - 40%
pH - 6.760
pCO2 - 1.16
pO2 - 20.4
Hb - 13.9
K+ - 4.4
Na+ - 142
Ca - 1.35
Cl - 117
Glu - 36
Lac - 25
BXS - -30.4
HCO3 - 3.7