MICU intern's survival guide diabetic ketoacidosis: Difference between revisions
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Created page with "{{CMG}} {{Diabetic ketoacidosis}} ==Overview== {{WH}} {{WS}}" |
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{{Diabetic ketoacidosis}} | {{Diabetic ketoacidosis}} | ||
==Overview== | ==Overview== | ||
==Step 1: Confirm the diagnosis of Diabetic ketoacidosis== | |||
===History=== | |||
* [[Polydipsia]] | |||
* [[Polyuria]] | |||
* [[Confusion]] | |||
* [[Vomiting]] | |||
* [[Weakness]] | |||
* [[Abdominal pain]] | |||
* [[Weight loss]] | |||
===Physical examination=== | |||
* Assess for [[dehydration]]. | |||
* [[Kussmaul's breathing]] (deep sighing respiration) | |||
* [[Ketone breath]] | |||
* [[Lethargy]] | |||
* [[Drowsiness]] | |||
===Initial Laboratory works=== | |||
* [[Blood glucose]] > 200mg/dL | |||
* [[Acidosis]] pH < 7.3 | |||
* [[Ketone]] in blood and urine | |||
* Blood electrolytes and [[urea]] | |||
==Step 2: Call senior staff== | |||
==Step 3: Initial management== | |||
===Management if the patient is in shock=== | |||
* Attention to ABC. | |||
* Airway +/- NG tube | |||
* Breathing 100% oxygen | |||
* Circulation (10 ml/kg of .9% NS, replete until circulation restored, maximum 3 doses) | |||
===Management if dehydration > 5%, and patient acidotic=== | |||
===Management if dehydration < 5%, and patient non-acidotic=== | |||
==Step 4: Management== | |||
==References== | |||
{{Reflist|2}} | |||
{{WH}} {{WS}} | {{WH}} {{WS}} | ||
Latest revision as of 16:51, 28 December 2012
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
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Overview
Step 1: Confirm the diagnosis of Diabetic ketoacidosis
History
Physical examination
- Assess for dehydration.
- Kussmaul's breathing (deep sighing respiration)
- Ketone breath
- Lethargy
- Drowsiness
Initial Laboratory works
- Blood glucose > 200mg/dL
- Acidosis pH < 7.3
- Ketone in blood and urine
- Blood electrolytes and urea
Step 2: Call senior staff
Step 3: Initial management
Management if the patient is in shock
- Attention to ABC.
- Airway +/- NG tube
- Breathing 100% oxygen
- Circulation (10 ml/kg of .9% NS, replete until circulation restored, maximum 3 doses)