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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.
*The BCCH DKA Medical Protocol can also be downloaded in fillable PDF format from our website: www.bcchildrens.ca/endocrinology-diabetes-site/documents/dkaprtfill.pdf
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.
DIABETIC KETOACIDOSIS – INITIAL MANAGEMENT GUIDE. DIAGNOSIS OF DKA BLOOD GLUCOSE(BG) > 11*- (glucose may be normal in a known diabetic) + ACIDOSIS - pH <7.3 or HCO3-<15mmol/l + KETONAEMIA – Bld Ketones> 3mmol/l.
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.
Document in special instructions section of the IV insulin order form that the patient is on DKA protocol. Use any soluble insulin eg: Actrapid, Humulin R. Concentration should be 50 units of insulin in 49.5mL 0.9% sodium chloride through a syringe driver. Step 4 - Continuation of intravenous insulin Long acting (basal) subcutaneous insulin can be
