Y2 ENDOCRINE EMERGENCY MANAGEMENT

Question 1

management of acute hypocalcaemia?

Answer 1

calcium gluconate
- IV 10ml 10% over 10 mins (in 50ml saline or dextrose).
+ Infusion 10ml 10% in 100ml infusate at 50ml/hour.

Question 2

How do you confirm DKA?

Answer 2

venous blood gases, urine dip and blood glucose.

• capillary ketones >3mmol/L or ++ urinary ketones.
• pH <7.3 or HCO3 <15
• glucose >11mmol/L or known diabetes

Question 3

what IV fluids do you give in DKA?

Answer 3

1L saline over 1 hour (faster if hypotensive) WITHOUT POTASSIUM.
after first litre add potassium chloride to each litre depending on VBG.

Question 4

what fixed-rate insulin infusion should be given in DKA?

Answer 4

IV insulin infusion of 0.1 unit/kg/hour of rapid acting insulin.
MAX. RATE OF 15 UNITS/HOUR.

Question 5

what is the main danger in HHS?

Answer 5

dehydration and venous thromboembolism