18 year old man was brought to ED with an overdose of unknown medication. He was intoxicated and very agitated. He needed 4 security guards to restrain him so a medical officer can put a cannula and administer midazolam.

Blood gas was taken from the cannula before midazolam administration and it showed the following:

PH = 7.19

PO2 = 52    mmol/L

PCO2 = 28   mmol/L

HCO3 =  19   mmol/L

Na = 141  mmol/L

K = 3.6 mmol/L

Cl = 104 mmol/L

lactate = 17.4  mmol/L

Cr = 51   nmol/L

BSL = 6.2  mmol/L

Questions:

1. Interpret these blood gases
2. What are the potential causes?
3. how will you manage this case?