DKA Summary

Fluids + insulin + K⁺

Diagnosis

  • Glucose >11, ketones ≥3, pH <7.3 or HCO₃ <15

Fluids (0.9% NaCl)

  • 1 L STAT (over 1 h)
  • 1 L over 2 h × 2
  • 1 L over 4 h × 2
  • 1 L over 6 h

Insulin

  • Fixed-rate 0.1 U/kg/h
  • Continue long-acting basal

K⁺

  • K⁺ <3.5: hold insulin, urgent senior
  • 3.5–5.5: 40 mmol/L KCl per bag
  • >5.5: no added K⁺

Resolution

  • Ketones <0.3, HCO₃ >18, pH >7.3, eating
  • Switch to SC insulin
WardRound

WardRound

Clinical Decisions in Seconds