A 3-year-old child is brought to the emergency department af…
A 3-year-old child is brought to the emergency department after being found with an open bottle of an unknown household substance. The caregiver is unsure how much or what was ingested but reports the child had access for approximately 30 minutes. On arrival, the child is lethargic but arousable. Vital signs: HR 156, RR 34, BP 94/48, Temp 37.6, SpO2 98% on room air Physical exam: Diaphoretic, flushed skin, vomited once in triage, no focal neuro deficits Lab results: pH 7.29, CO2 22, HCO3 10, Anion gap 26, serum glucose 88, Lactate 1.6, serum osmolality normal, urinalysis positive for ketones Which of the following is the most appropriate next step in management?