A 27 years old man,previously healthy ,brought by his brother to ED unresponsive ,He was seen last normal last night . No other information is available . On examination , his Vital signs : HR: 130 ,BP: 88/ 50 ,RR: 30 breath per min ,SpO2: 80% % in 100% oxygen, T:39.6 C, blood sugar : 7 mmol/l . He