Metformin associated lactic acidosis
Our story starts in a small village nearby Brno, where the married couple Melitovi are going to have dinner. The husband (45 y/o) has been vomiting the last few days and doesn’t have much appetite. His wife worries about him. When Mr. Melita wants to get up from the chair, he suddenly feels nauseous. He is breathing deeply, he is agitated, confused and his head is spinning. Mrs. Melitová doesn’t hesitate and immediately calls the ambulance. The ambulance crew gathers some information about the patient and finds out that he has type 2 DM and is treated with metfromin. Mr Melita is transported to the emergency department. You are the doctor at the emergency department, what should be your next step?