Just Another Jonah Call

Just finished my 3 consecutive night shifts..tiring! And one of the nights was particularly jonah. Well, let the pictures tell the stories.A 66 year-old man with no known comorbids, with history of fever for a week, presented with severe SOB. The ABG showed severe metabolic acidosis - pH 7 with Bicarb of 4! The ECG:The typical ECG of "Tall tented T waves, widened QRS, small P". What's in your