9. DIABETIC KETOACIDOSIS (DKA)
• Diabetic ketoacidosis (DKA) is the state of
uncontrolled catabolism associated with
insulin deficiency, resulting in hyperglycaemia
(RBS >11mmol/L), osmotic diuresis, and
dehydration and ketonaemia (>3mmol/L)
Acidaemia (blood pH <7.3), significant
ketonuria (2+or more or standard urinalysis).
• It is the commonest endocrine emergency
usually encountered in previously diagnosed
diabetics.
23. Treatment
• General resuscitation: A, B, C.
• Airway: Ensure that airway is patent.
• If comatose, insert an airway.
• If comatose and has recently vomited, insert a
NGT, aspirate and leave on open drainage.
• Breathing: Give 100% oxygen where indicated.
Bag and mask ventilation if apnoeic.
24. Treatment
• Circulation: Insert two large bore IV cannulae
and take blood samples.
• If shocked (Tachycardia with poor capillary
refill time or hypotension) give 20 ml/kg 0.9
saline as quickly as possible, and repeat if
necessary up to a max of 60mls/kg.
