PSYCH 2B03 Lecture Notes - Lecture 3: Glomerulonephritis, Blood Gas Test, Glucose
13 Aug 2020
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Diabetic ketoacidosis: take the history off this patient (5 mins) Sally 9 year old girl presents to a&e. Passing lots of urine: rush to the toilet, wet the bed last night (secondary eneuresis) Nobody else in the family has been ill recently. Birth svd 38+4 weeks, no complications antenatally or after delivery. Medications and allergies- insulin basal bolus with long acting given at night and 3 short acting insulin injections before meals and nkda. Lives at home with mum, dad and brother. Jwh, jm, ajs: what would your immediate management be? (4 mins, abc, resuscitate the patient, make sure the airway is secure, 100% oxygen. If in shock give 10ml/kg bolus of normal saline (0. 9% saline). Insulin infusion (0. 05-0. 1 u/kg per h) is started after 1 hr. Insulin: do not give a bolus, monitor blood glucose regularly (hourly, aim for a reduction of 2mmol/h as rapid reduction is dangerous.
