Question

A patient in the ICU at CMCH, Vellore has metabolic acidosis and the lactate concentration is > 3mmol/L. Advise treatment for this patient who is already diabetic and is taking glyciphage/glucophage medication. The blood pH of the patient is 6.8. Provide remedial measures?

Answer 1

Answer:

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Explanation:

Electrocardiographic monitoring demonstrated a narrow-complex sinus tachycardia. A repeat fingerstick glucose upon arrival to the ED was 364 mg/dL. The patient became increasingly combative, attempting to bite and spit at the ED staff. He was placed in 4-point soft restraints, had a respiratory protection mask placed over his mouth, and was medicated with intravenous lorazepam 2 mg, dolasetron 12.5 mg, morphine sulfate 4 mg, and hydration with 0.9% saline. Within 45 minutes, the patient was no longer combative, and the physical restraints were removed.