Sudden Death Flashcards
A 28 year old known type 1 diabetic is admitted with a 4 day history of polyuria, polydipsia, tiredness, nausea and vomiting. A capillary blood glucose returns at 18.2mmol/L and capillary ketones are 3.6mmol/L.
What is the most appropriate investigation to confirm the most likely diagnosis?
Venous blood gases- low PH or bicarbonate would confirm a diagnosis of DKA
Potential ECG changes in a person with DKA?
Hypokalaemia- can lead to small T waves present in ECG and prolonged PR interval
An 18 year old male presents to the emergency department with nausea and abdominal pain.
On physical examination, he has dry mucous membranes and reduced skin turgor.
Vital signs are: heart rate 110 bpm, respiratory rate 24/min, blood pressure 80/60 mmHg, temperature 38’C, and oxygen saturations 99% on room air.
Urine dipstick shows 3+ ketones. Blood show a sodium of 150 mmol/L, potassium of 5.8 mmol/L, bicarbonate of 17 mmol/L, and chloride of 101 mmol/L.
Given the most likely diagnosis, which of the following is the most appropriate first step in the management?
500ml bolus intravenous 0.9% sodium chloride stat
