A 61-year-old with HHS (glucose 1050 mg/dL, osmolality 340 mOsm/kg, minimal ketones) is lethargic. Initial fluid strategy?...

Question

A 61-year-old with HHS (glucose 1050 mg/dL, osmolality 340 mOsm/kg, minimal ketones) is lethargic. Initial fluid strategy?

Accepted Answer

Half-normal saline bolus first

Answer

D5W 500 mL bolus then insulin

Answer

Isotonic crystalloids 15-20 mL/kg in the first hour

Answer

Bicarbonate infusion

Answer

No fluids until electrolytes return

us-abem MCQ (SBA): HHS