25 years old female is brought to ED by SJA with c/o nausea and vomiting and intermittent tachycardia of upto 180 . She admitted ingesting at least 30 tablets of slow K ( potassium chloride) 3 hours ago with intent to kill herself.

There was no other co ingestion. On arrival to ED her GCS was 15. Her HR was 85, BP 130/70, afebrile, sats 98 RA. Her ECG showed sinus tachycardia, hyperacute T waves, prolonged PR interval. Her VBG results were as followed.

PH                          7.29

PCO2                     40

HCO3                     21

Na                          132

K                             8.0

Cl                            98

lactate                     3.9

BSL                          7

Questions:

1. What are the main metabolic abnormalities on this VBG?
2. What are the 3 most important consideration in this patients management?
3. How will you initially treat this patient in ED.?