Question

A 24-year-old woman with type 1 diabetes presents with abdominal pain, vomiting and drowsiness. She has Kussmaul respirations and ketotic breath. Capillary blood glucose is 28 mmol/L and bedside ketones are 5.5 mmol/L. Arterial pH is 7.1. What is the most appropriate initial fluid management?

Accepted Answer

Give a 1 litre bolus of 0.9% sodium chloride over 1 hour

Answer

Give a rapid bolus of 1 litre 5% dextrose

Answer

Start fixed-rate intravenous insulin before any fluids

Answer

Restrict fluids and give subcutaneous insulin

Answer

Give 20 mmol potassium chloride before fluids

Practice question

A 24-year-old woman with type 1 diabetes presents with abdominal pain, vomiting and drowsiness. She has Kussmaul respirations and ketotic breath. Capillary blood glucose is 28 mmol/L and bedside ketones are 5.5 mmol/L. Arterial pH is 7.1. What is the most appropriate initial fluid management?