First 30 seconds
- 1ABCDE
- 2IV access, bloods + VBG + ketones
- 3Fluid: 1 L 0.9% NaCl over 1 h (500 mL/15 min if SBP<90)
- 4Fixed-rate insulin 0.1 U/kg/h
Hyperglycaemia (>11 mmol/L) + ketonaemia (≥3) + acidosis (pH<7.3 or HCO₃<15).
A
Airway
- • Patent? Talking? Stridor?
- • Suction, jaw-thrust, adjuncts, definitive airway if needed
B
Breathing
- • RR, SpO₂, auscultate, percuss
- • O₂ to target sats, NIV / intubate as required
C
Circulation
- • HR, BP, cap refill, JVP
- • 2× large-bore IV, bloods, monitor, ECG
D
Disability
- • AVPU/GCS, pupils, glucose, temp
E
Exposure
- • Full exposure, skin, rash, bleeding, lines, infection source
