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Diabetic ketoacidosis (DKA) is a frequent and potentially life-threatening complication of type 1 diabetes. Though preventable and despite advances in monitoring technologies, insulin therapeutics and insulin delivery systems, the rates of both community and hospital acquired DKA remain largely unchanged. Although mortality today is relatively
Starting the Insulin Drip . If patient is in DKA: Weight of patient in KG __________ X 0.1 units= __________ units/hour . Directions. Check blood glucose every hour and adjust according to the table provided below. Multiply current infusion rate by number provided in table. The result is your new insulin drip rate.
6 sie 2021 · Every hospital will have a DKA protocol, which can generally be followed. However, it's still useful to understand the broad strokes of how insulin is utilized in DKA, as described below. (#1) insulin infusion: getting started. Unless the patient is hypokalemic (K <3.3 mM), insulin should be started immediately.
Transition to adult critical care insulin drip protocol, weaning insulin drip to off as able. h. Discuss conversion to home insulin therapy with rounding Physician.
Start D10W or D10NS @ 150 - 250 mL/h and/or consider reducing insulin rate by 1⁄2. Keep Serum glucose between 150 – 200 mg/dL. If cannot maintain glucose > 150 mg/dL despite D10 and diet then titrate insulin down to a minimum of 0.5 unit/hr.
Start soluble insulin infusion at 0.05 - 0.1 units/kg/hr Expect K+ levels to fall with insulin infusion Monitor 1 -2hrly Glu/Ketones and Lab U&E If < 3.0mmol - may require central access HYPOKALAEMIA CAN BE FATAL IN DKA INITIAL ASSESSMENT AIRWAY Assess patency – if not self-maintaining, or AVPU score = ‘V’ or less
(Updated 09/2017 4) The Insulin Drip [To be done simultaneously with Section 3 “Initial Fluid Management”] A) Immediately order an insulin drip infusion at 0.1 units/kg/hr, start after NS bolus and f/u POC glucose done. i) Do NOT give an initial IV or subcutaneous insulin bolus
