Diabetic Ketoacidosis
Not yet clinically reviewed
This protocol was migrated from the earlier Pharmapedia and Ward Guide apps for educational use. Follow your hospital's own policies and consult seniors when in doubt.
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