EKG on arrival👇🏼. CT angiography of the chest negative for pulmonary embolism. What is the diagnosis?

Turn them back! The free radicals are running rampant 🤣

Lactate is just but piece of the puzzle

Agree. A single lactate level may not be as useful. However, if you are attempting to maximize perfusion with vasoactive agents, IV fluids etc.. but the lactate level is rising, this may be a sign that something is not being addressed - infection, tamponade, blood loss etc.

Would also consider DDAVP especially in renal insufficiency to help with platelet dysfunction