Initial evaluation and treatment of DKA in the emergency department

Slides:



Advertisements
Similar presentations
Diabetic Ketoacidosis in Children
Advertisements

Management of Diabetic Ketoacidosis in the PICU
Diagnosis and Management of Hyperglycemic Crises
Case Presentation Andreas Crede EM Registrar. Case 12 year old male 1/12 fatigue Severe LOW 3/7 increasing SOB 1/7 confusion + lethargy.
Electrolyte and Metabolic Disturbances AHMED GHALI MD.
Canadian Diabetes Association Clinical Practice Guidelines Hyperglycemic Emergencies in Adults Chapter 15 Jeannette Goguen, Jeremy Gilbert.
 Lactic acidosis is a physiological condition characterized by low pH in body tissues and blood accompanied by the buildup of lactate  Considered a.
Prepared by: Tristan Villanueva Arcibal BSN-RN Presented on: July 16, 2013 A CASE PRESENTATION OF A PATIENT WITH DIABETIC KETOACIDOCIS (DKA)
FY1 Teaching Nov 30th 2011 Dr Jack Bond ST5 Nephrology
SEPSIS KILLS program Adult Inpatients
Diabetic keto-acidosis (DKA) DKA or Hyperglycemia coma is defined when blood sugar mg/dl Is primarily seen in I.D.DM - can be seen in NIDDM. DKA.
Severe Sepsis Initial recognition and resuscitation
Sepsis.
Clinical Case 3. A 14 year old girl was brought to her GP’s office, complaining of: – weight loss, – dry mouth, – lethargy, – easy fatigability – and.
 Unexpected deterioration of sick patient  Hypoxaemia on sats monitoring  Reduced conscious level  Exacerbation of COPD  Monitoring of ventilated.
Copyright 2008 Society of Critical Care Medicine Management of Life- Threatening Electrolyte and Metabolic Disturbances.
MEDICATIONS. Medications Epinephrine Volume expanders Sodium bicarbonate Naloxone Dopamine.
Case 6 A 54 year old obese person come in emergency with altered consciousness level and increase respiratory rate (tachypnia) for last 4 hours. He is.
Diabetic Ketoacidosis DKA)
What Type of Shock is This?
ACUTE COMPLICATIONS. 18 years old diabetic patient was found to be in coma What questions need to be asked ? Differentiating hypo from hyperglycemia ?
Terry White, MBA, BSN SEPSIS. SIRS Systemic Inflammatory Response System SIRS is a widespread inflammatory response to a variety of severe clinical injuries.
DIABETES MELLITIUS Cells and Molecules Clinical Application Presented 9/6/02 By M. Grant Ervin MD,MHPE,FACEP.
DIABETIC KETOACIDOSIS By, Dr. ASWIN ASOK CHERIYAN Chair Person – Dr. JAYAMOHAN A.S.
Copyright 2008 Society of Critical Care Medicine
NYU Medical Grand Rounds Clinical Vignette Justin Simmons, M.D. Class of /27/2012 U NITED S TATES D EPARTMENT OF V ETERANS A FFAIRS.
Management of diabetic ketoacidosis (DKA) Prof. M.Alhummayyd.
Acute Diabetes Case B By: Abdullah Osman Christine Tanzil Ayse Togac.
Hyperglycemic Emergencies Dr. Miada Mahmoud Rady Ems/474 Endocrinal Emergencies Lecture 3.
INVESTIGATIONS AND DIFFERENTIALS OF HYPERGLYCAEMIC EMERGENCIES DR ILERHUNMWUWA P.N.
Sepsis. 54 year old man with a past history of smoking and diabetes presents to the emergency department with a one week history of progressive unwellness.
INVESTIGATIONS AND DIFFERENTIALS OF HYPERGLYCAEMIC EMERGENCIES
 Hypoglycemia  Physical Signs  –Sweating  –Tremulousness  –Tachycardia  –Respiratory Distress  –Abdominal Pain  –Vomiting.
DIABETIC KETOACIDOSIS Emergency pediatric – PICU division H. Adam Malik Hospital – Medical School University of Sumatera Utara 1.
Management of Diabetic Ketoacidosis
Management of Adult Diabetic Ketoacidosis Adapted from the WHO IMAI District Clinician Manual Vol. 1 Dr. Linda Hawker, June 2014.
بنام خدا.
Delirium Mini-Lecture June 2013.
Evaluation and Treatment of Children with Bronchiolitis in the Emergency Department Suspected bronchiolitis: Otherwise healthy child < 24 months of age.
ACUTE COMPLICATIONS.
Diabetes Ketoacidosis
MANAGEMENT OF DIABETIC KETOACIDOSIS IN CHILDREN
ACUTE COMPLICATIONS.
Chronic heart failure.
Acute Iron Overdose in the Setting of Active Labor with Fetal Umbilical Cord Serum Iron Concentration William Eggleston, Pharm.D.1 and Christine M. Stork,
SEPSIS – What is Sepsis? <insert date>
Protocol for the management of adult patients with DKA
Evaluation and Treatment of Children with Bronchiolitis in the Emergency Department Suspected bronchiolitis: Otherwise healthy child < 24 months of age.
Endocrine Emergencies & Management
Competency Title : Observations and The Deteriorating Patient for HCAs Competency Lead : Vikki Crickmore, Sister, Critical Care Outreach Team September.
Protocol for management of adult patients with DKA or HHS
Protocol for the management of adult patients with HHS
Protocol for the management of pediatric patients (250 mg/dl, venous pH
Paul Szczybor PA-C DFAAPA Lifebridge Critical Care
An 18-year-old Hispanic woman with a 10 year history of type one DM and reactive airway disease presented to the hospital emergency department with a 5-day.
Scenario 8.1 Eclampsia.
Protocol for the management of adult patients with HHS
Management of Adult Patients with Hyperosmolar Hyperglycemic Syndrome
Q1.
2018 Clinical Practice Guidelines Hyperglycemic Emergencies in Adults
Michael D. Menchine, MD, MPH, David L. Schriger, MD, MPH, Tyler W
Protocol for the management of adult patients with DKA
Heavy Lies the Helmet Episode #30 Case Studies.
Paediatric monitoring and response chart. Hospital:. Name:. Age:
Serial measurements of serum glucose, anion gap, serum carbon dioxide, and serum triglycerides throughout the patient's hospital stay. Serial measurements.
Endocrine Emergencies
Paediatric monitoring and response chart. Name. UR Number. Age:
Protocol for the management of pediatric patients (250 mg/dl, venous pH
Protocol for the management of adult patients with HHS
Protocol for the management of adult patients with DKA
Presentation transcript:

Initial evaluation and treatment of DKA in the emergency department Initial evaluation and treatment of DKA in the emergency department. *Laboratory studies: complete blood count, basic metabolic panel, venous blood gas, urinalysis, urine pregnancy test if female and childbearing age. Initial evaluation and treatment of DKA in the emergency department. *Laboratory studies: complete blood count, basic metabolic panel, venous blood gas, urinalysis, urine pregnancy test if female and childbearing age. If critically ill or clinically indicated: complete metabolic panel, serum osmolality, phosphate, lactate, cardiac markers, urine drug screen, blood alcohol level, chest X-ray, or other imaging studies. Calculate effective serum osmolality and corrected serum sodium. Signs of critical illness include 1) altered mental status: 2) signs of hypoperfusion; 3) significant derangement in heart rate, blood pressure, respiratory rate, temperature, or oxygen saturation; or 4) signs of severe acidosis such as marked Kussmaul respirations. BMP, basic metabolic panel; BP, blood pressure; ECG, electrocardiogram; HR, heart rate; hyperK, hyperkalemia; IVF, IV fluids; IVP, IV push; NS, normal saline; O2, oxygen; O2 sat, oxygen saturation; pt, patient; RR, respiratory rate; SC, subcutaneous; temp, temperature; VBG, venous blood glucose. Candace D. McNaughton et al. Clin Diabetes 2011;29:51-59 ©2011 by American Diabetes Association