Case

A 56 yo homeless man is found poorly responsive and brought via EMS to ED.  No old records.  

VS: T 99.4R HR 122 RR 24 BP 110/48 and So2 of 94% RA

What problems can you identify from the labs and how do you work this up? 

Solution

Problems:

1. Hyponatremia 
2. Hyperkalemia
3. Bicarb < 5 
4. Elevated renal function 
5. Elevated LFT (Alk phos, GGT, AST/ALT and elevated Bilirubin)