HHS

Question 1

Anamnesis ODAART

Answer 1

Onset
Duration (penurunan kesadaran)
Age >60 thn
Aggravating (mual muntah lemas kejang)
Riwayat
Treatment (tiazid, furosmide, digitalis, steroid)

Question 2

ABC

Answer 2

kussmaul, bau aseton, hipotensi postural, bisa hipertensi juga, takikardi tp denyut lemah, tanda dehidrasi, kejang

Question 3

Px penunjang

Answer 3

HHS glukosa plasma ≥600mg/dL
AGD pH >7.3, serum bicarbonat >15, anion gap <12
Serum keton
Serum osmolaritas ≥320mOsm/kg
Elektrolit

Question 4

Tatalaksana SALE INNISFREE

Answer 4

SAL ine 1L/jam target sistol >90, urin>0.5 lihat serum Na
kalo high, 0.45% NaCl
kalo low, 0.9% NaCl
sampe serum glucose 300mg/dL
E lektrolit 40mEq sampe kalium ≥3.3mEq/L (kalo udah 5, gausah, kalo belum 5 tapi udah 3.3, kasi 30mEq sampe 4.5)
INSulin REEpid acting bolus IV/SC 0.18 unit/kgBB dan 0.09 unit/kgBB/jam IV drip, cek serum glucose tiap jam kalo stabil TURUNNYA 50-70 STEADY PER JAM cek elektrolit BUN creatinin tiap 2-4jam

NORMAL SEMUA
ganti ke D5 DILARUTKAN 0.45% NaCl turunkan insulin 0.05-0.1 unit/kg/jam, maintain SG 250-300, plasma osmo ≤315 mOsm/kg

Question 5

Tertangani. Lalu?

Answer 5

Cek neuro (hemiparesis reversible)