A 19-year-old with type 1 diabetes is vomiting at a remote campsite. Glucose is 28 mmol/L, ketones 5.4 mmol/L, respiratory rate 32/min with deep

Question

A 19-year-old with type 1 diabetes is vomiting at a remote campsite. Glucose is 28 mmol/L, ketones 5.4 mmol/L, respiratory rate 32/min with deep breathing, pulse 132/min and systolic blood pressure 92 mmHg; retrieval time to hospital is 75 minutes. What is the most appropriate immediate action?

Accepted Answer

Urgent transfer with oxygen, cautious fluids and pre-alert for DKA

Answer

Give subcutaneous insulin boluses at scene until ketones fall

Answer

Delay transport while attempting oral rehydration

Answer

Treat as panic hyperventilation because SpO2 is normal

Answer

Convey without pre-alert because glucose is the main abnormality

DKA with shock in a remote setting — DipIMC MCQ

A 19-year-old with type 1 diabetes is vomiting at a remote campsite. Glucose is 28 mmol/L, ketones 5.4 mmol/L, respiratory rate 32/min with deep breathing, pulse 132/min and systolic blood pressure 92 mmHg; retrieval time to hospital is 75 minutes. What is the most appropriate immediate action?