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Final clinical long case 43

Created: 27/7/2012
A 24-year-old drug addict presents, complaining of ascending limb weakness, with a GCS of 14, having injected cocaine a few days earlier. You are asked to see him on the medical ward.

Electrolytes: Na+ normal; K+ 7.9 mM
Arterial blood gases: Combined metabolic and respiratory acidosis
ECG: Hyperkalaemia
Chest X-ray: Right lower zone infection/ aspiration, left lower lobe collapse.

1. What is the differential diagnosis?
2. How would you intubate this patient?
3. Discuss your further management of this patient.

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