LR vs Normal saline

A 22 yo male presents septic to the ED 2 hours ago. He has been out of insulin for a few days now because he has been playing fortnite and after making a bunch of in-app purchases, he optimized his avatar and went on a crazy battle royale spree.  His battle royale spree ended when he was found by EMS surrounded by vomit at home.

His blood pressure on arrival is 85/60, and he is tachycardic at 110. ABG shows pH of 7.25, pCO2 of 26 mmHg and lactate of 3.5. You want to give the patient fluids, what would you like to give?

A) 2 more liters of normal saline

B) D5 to raise his glucose level

C) Lactated Ringers

D) Free water


Blake Briggs