Ruh Roh: Interpretation vs Clinical Correlation. PART 1

EMS responds to the report of a 50 year old patient suffering from weakness, altered mental status, and generalized "body pain." The patient is minimally alert. There are no signs of apparent trauma. History is significant for DM and kidney disease. After loading the patient onto the stretcher, vital signs reveal:
BP: 80/P
P: 60
R: 20/min
Blood glucose: 40 mg/dL

Providers administer 25g of IV dextrose and initiate fluid therapy. A 12 lead ECG is obtained: 

12 LEAD ECG


12 LEAD ECG FINDINGS
The rhythm reveals a bizarre and wide QRS complex. The rhythm is slightly irregular and no P waves are discernable. The rhythm appears to be ventricular in origin.

EMS TREATMENT AND TRANSPORT RELATED QUESTIONS
1. What is the most appropriate destination for this patient? Should this patient be transported to a cath capable facility? Should the patient's instability necessitate transport to the closest hospital?
2. What are your treatment priorities?
3. What is the most probable cause of the ECG findings?