A 23-year-old man presents to the emergency department with abdominal pain, vomiting, Kussmaul respirations and fruity breath odour. Capillary glucose...

Question

A 23-year-old man presents to the emergency department with abdominal pain, vomiting, Kussmaul respirations and fruity breath odour. Capillary glucose is 26 mmol/L, venous pH 7.12, and serum ketones are elevated. What is the most appropriate initial fluid therapy for his diabetic ketoacidosis?

Accepted Answer

0.9% sodium chloride bolus 15-20 mL/kg over the first hour

Answer

5% dextrose in water at 250 mL/hour

Answer

Half-normal saline (0.45% NaCl) at maintenance rate

Answer

Balanced crystalloid avoided because of lactate content

Answer

No fluids until insulin has been started

ca-mccqe1 MCQ (SBA): Diabetic ketoacidosis (fluid management)

A 23-year-old man presents to the emergency department with abdominal pain, vomiting, Kussmaul respirations and fruity breath odour. Capillary glucose is 26 mmol/L, venous pH 7.12, and serum ketones are elevated. What is the most appropriate initial fluid therapy for his diabetic ketoacidosis?