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Mild DKAModerate DKA Severe DKA HHS
Plasma glucose >250 mg/dL >250 mg/dL >250 mg/dL >600 mg/dL
Arterial pH 7.25-7.30 7.00 to <7.24 <7.00 >7.30
Serum bicarbonate (mEq/l) 15-18 10 to <15 <10 >18
Urine ketone Positive Positive Positive Small
Serum ketone Positive Positive Positive Small
Effective serum osmolality Variable Variable Variable >320 mOsm/kg
Anion gap >10 >12 >12 Variable
Mental status Alert Alert/drowsy Stupor/coma Stupor/coma


 
 
 
 
 
 
123Mild DKAModerate DKASevere DKAHHS
Plasma glucose >250 mg/dL>250 mg/dL>250 mg/dL>600 mg/dL
Arterial pH 7.25-7.30 7.00 to <7.24 <7.00 >7.30
Serum bicarbonate (mEq/l) 15-18 10 to <15 <10>18
Urine ketone Positive Positive Positive Small
Serum ketone Positive Positive Positive Small
Effective serum osmolality Variable Variable Variable >320 mOsm/kg
Anion gap >10 >12 >12 Variable
Mental status Alert Alert/drowsy Stupor/coma Stupor/coma


table HIT

Score = 2 Score = 1 Score = 0
Thrombocytopenia
Compare the highest platelet count within the sequence of declining platelet counts with the lowest count to determine the % of platelet fall.
(Select only 1 option)
> 50% platelet fall AND nadir of ≥ 20 AND no surgery within preceding 3 days > 50% platelet fall BUT surgery within preceding 3 days OR
any combination of platelet fall and nadir that does not fit criteria for score 2 or score 0 (eg. 30-50% platelet fall or nadir 10-19)
< 30% platelet fall
any platelet fall with nadir < 10
Timing (of platelet count fall or thrombosis)
Day 0 = first day of most recent heparin exposure (Select only 1 option)
platelet fall day 5-10 after start of heparin
platelet fall within 1 day of start of heparin AND exposure to heparin within past 5-30 days
consistent with platelet fall days 5-10 but not clear (eg. missing counts)
platelet fall within 1 day of start of heparin AND exposure to heaprin in past 31-100 days
platelet fall after day 10
platelet fall ≤ day 4 without exposure to heaprin in pas 100 days
Thrombosis (or other clinical sequelae)
(Select only 1 option)
confirmed new thrombosis (venous or arterial)
skin necrosis at injection site
anaphylactoid reaction to IV heparin bolus
adrenal hemorrhage
recurrent venous thrombosis in a patient receiving therapeutic anticoagulants
suspected thrombosis (awaiting confirmation with imaging)
erythematous skin lesions at he heparin onjection sites
thrombosis suspected