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TREATMENT FOR DIABETES KETO-ACIDOSIS

Posted May 07 2009 9:22pm

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

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