A 44 year old man was found unconscious at home. He was brought in to the ED by ambulance. On arrival GCS =3 with fixed and dilated pupils. Temperature 25.9, hypotensive.Bloods show:

pH 6.9

pCO2 58 (35-45 mmHg)

HCO3 7 (22-26 mmol/l)

BE -24

Sodium 132 (137-145 mmol/l)

Potassium 7.2 (3.5-5 mmol/l)

Cl 95 (99-111 mmol/l)

Urea 10.6 (3-8 mmol/l)

Creatinine 267 (<130 umol/l)

CK 1835

Lactate 26 (<2 mmol/l)

Bilirubin 71 (<21 umol/l)

ALP 152 (35-110 U/L)

GGT 88 (<51 U/L)

ALT 8791 (<56 U/L)

Describe the abnormalities Interpret your findings and give reasonable differential diagnosis What are your immediate life threats? How would you proceed?