What is the most appropriate treatment for DKA?
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What is the most appropriate treatment for DKA?
Treatment usually involves: Fluid replacement. You’ll receive fluids — either by mouth or through a vein — until you’re rehydrated. The fluids will replace those you’ve lost through excessive urination, as well as help dilute the excess sugar in your blood.
How is DKA ICU treated?
TREATMENT OPTIONS IN THE ED OR ICU The treatment of acute DKA includes restoration of fluid deficits in the first 24 to 36 h, electrolyte replacement and insulin therapy, which is administered slowly to decreased plasma glucose[23,24].
How is DKA EMS treated?
The most important prehospital treatment is to begin isotonic IV fluids. In the ED, the current standard of care for patients in DKA is to receive about 20 cc/kg bolus (1—1.5 L) of normal saline and then 500 cc/hr. for four hours. Thus, EMS providers should aim for this as the patient’s initial therapy.
What is the two bag method DKA?
Background: The “two-bag method” of management of diabetic ketoacidosis (DKA) allows for titration of dextrose delivery by adjusting the infusions of two i.v. fluid bags of varying dextrose concentrations while keeping fluid, electrolyte, and insulin infusion rates constant.
Why is bicarbonate not used in DKA?
Acidosis in DKA is due to the overproduction of β-hydroxybutyric acid and acetoacetic acid. At physiological pH, these 2 ketoacids dissociate completely, and the excess hydrogen ions bind the bicarbonate, resulting in decreased serum bicarbonate levels.
Should you intubate a DKA patient?
(Avoid) Intubating the DKA Patient Furthermore, these patients with profound metabolic acidosis are at risk of circulatory collapse peri-intubation as periods of apnea during intubation will cause their pCO2 levels to rise rapidly, worsening the acidosis.
How can you tell the difference between Somogyi and dawn phenomenon?
If the blood sugar level is low at 2 a.m. to 3 a.m., suspect the Somogyi effect. If the blood sugar level is normal or high at 2 a.m. to 3 a.m., it’s likely the dawn phenomenon.
What is the DKA protocol?
Key DKA management points Start intravenous fluids before insulin therapy. Potassium level should be >3.3 mEq/L before the initiation of insulin therapy (supplement potassium intravenously if needed). Administer priming insulin bolus at 0.1 U/kg and initiate continuous insulin infusion at 0.1 U/kg/h.
