DKA – Adult

Last Updated on by FRCEM Intermediate

Treatment:

  • Use of normal saline (0.9% NaCl). The ABCD recommend 1L in the first hour, 2L in the next 2-4 hours and then 1L 4-6 hourly, with a reduced rate in those who are elderly or have cardiac disease.
  • Once the blood glucose is below 14 mmol/l then 10% dextrose should be added at 125 ml/hr in addition to the crystalloid fluid replacement ongoing.
  • Commence a fixed rate intravenous insulin infusion at 0.1 UNITS/kg
  • initiated when the potassium level is below 5.5mmol/L
  • Patients should receive low weight molecular heparin as per the hospital protocol.

DKA Complications

  • Hypoglycaemia
  • Hypokalaemia
  • Cerebral oedema
  • Acute respiratory distress syndrome
  • Hyperchloraemic metabolic acidosis

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