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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
22 maj 2020 · This is a subcutaneous (SubQ) insulin protocol that replaces insulin drip needs for mild to moderate DKA. Procedures are adapted for COVID-related considerations of minimizing risk to staff while optimizing patient safety and health.
INADEQUATE RESUSCITATION CAN BE FATAL. DISABILITY. Measure GCS / AVPU 1 hourly OR every . 30 minutes in severe DKA / under 2s . Use PEWS or equivalent local chart alongside the Serial Data Sheet in the ICP . Assess for evidence of cerebral oedema – see box. FLUID DEFICIT AND MAINTENANCE.
Add Dextrose (D51⁄2NS or D5NS*) to IVF @ 150 – 250 mL/h to maintain serum glucose 150 – 200 mg/dL and continue insulin at same rate. Titrate insulin to a minimum 0.1 Units/kg/hr and glucose goal between 150 – 200 mg/dL until ketosis and anion gap resolves.
Hold infusion follow Hypoglycemia Protocol and notify Physician. Administer insulin at 1 unit/hour and notify physician. If patient was previously on 1 unit/hour or less, multiply infusion rate by 0.5 and notify physician.
This is a subcutaneous (SC) insulin protocol that replaces the IV insulin infusion needs for mild to moderate DKA, adapted to minimize the risks to staff exposure, use of PPE, while optimizing patient safety. When patient’s DKA resolves, this protocol will be discontinued.
1 wrz 2020 · Proper management of DKA requires hospitalization for aggressive intravenous fluids, insulin therapy, electrolyte replacement as well as identification and treatment of the underlying...
