Question

A 23-year-old woman with type 1 diabetes presents with nausea, vomiting and abdominal pain over 24 hours following a viral illness. Capillary glucose is 24 mmol/L, pH 7.15, bicarbonate 10 mmol/L, ketones 5.5 mmol/L. What is the most appropriate immediate fluid management in the emergency department?

Accepted Answer

Bolus 10-20 mL/kg 0.9% sodium chloride then continue 0.9% sodium chloride at 4-6 mL/kg/h

Answer

Bolus 30 mL/kg 0.9% sodium chloride then start 0.9% sodium chloride at 10 mL/kg/h

Answer

Start 5% dextrose at 10 mL/kg/h

Answer

Start 0.45% sodium chloride at 10 mL/kg/h

Answer

Restrict fluids to avoid cerebral oedema

Practice question