Diabetic Ketoacidosis

Feature: Excessive urination, Excessive thirst, Kusmaul breathing, Fruity smell, Confusion, Abdominal pain, Vomiting.Investigation: RBS level more 350, Urine for ketone, ABGs, Electrolytes

Management

• Admit patient
• Pass N/G tube or IV line
• Fluid replacement- INF N/S, 1st Liter in 30 mints, Then 2nd in 1 hour, 3rd in 2hrs, 4th liter in 4 hrs, Switch to D/saline when RBS level less than 250
• Insulin therapy: Inj Humolin-R 0.1unit/kg, followed by 5units/hour as continues infusion in N/S
• Regular monitoring of RBS hourly and Electrolytes 2 hourly
• If k level is less than 2.5 then add 2-amp KCl in each 500ml N/S after 1st N/S infusion
• When patient stable RBS-250 stop IV insulin, give 4units S/C
• Inj Ceftriaxone (Oxidil) 1gm IV BD