TREATMENT FOR DIABETES KETO-ACIDOSIS

This contain the emergency ward management of diabetes ketoacidotic patient

• Fluids, N. saline 1 lit. first 1/2 hr

• 1 lit next hour

• 1 lit next 2 hrs

• Then 500 ml hrly total of 5l.Change to 5% dextrose. When blood sugar is 10-16 mmol. alternating with N saline
• Insulin: Sol. Insulin 20 units IV 10 units IM hrly till blood sugar is 13mmol.

• Then 10 units SC 4 hrly

• Potassium: add 1.gm (20mmol) to each L of fluid Beginning with second L of N saline Omit K if S.K is over 6 mmol.

• HCO3, 100mmol of NaHCO3 if pH is below 7.1 Ppt. In 1 to 1 1/2 hrs if pH is still less than 7.1

• General Management:

• Monitor pulse, BP, CVP urine output.

• NG suction

• Oxygen

• Catheterise bladder

• Monitor blood sugar, electrolytes, urea, pH

• HCO3 4 hrly

• Ppting treat , cause

• Mangement of unconcious state

• DIC