DKA…some insights into it’s management

A VBG is adequate for the diagnosis and ongoing management of patients with DKA. ABGs offer no added benefit and are associated with increased pain and complications. Patients with DKA may present with a weak or absent nitroprusside assay reaction on urinalysis for ketones as this test only checks for acetoacetate (the minor ketone body […]

Paediatric DKA Calculator

Remember that glucose should be considered the sixth vital sign and any “sick” appearing child should have a point of care glucose done!

Hyperglycemic Hyperosmolar Syndrome

HHS is defined by hyperglycemia and hyperosmolarity due to volume depletion with resultant altered mental status Profound hypokalemia is common as a result of osmotic diuresis. Replete aggressively Hypokalemia = hypomagnesemia. Replete both of these electrolytes simultaneously Fluid repletion is the key point in management but careful repletion is vital as patients may not tolerate […]

Top 10 Posts of 2017

Mistakes that Kill during Cardiopulmonary Resuscitation Too Slow or Too Fast Chest Compressions Too Shallow or Too Deep Chest Compressions Too Many or Too Slow Breaths Leaning on the Chest Too Many Interruptions Giving Up Too Soon Too Slow Adaptation     Oxygen Bubble Bottles or Bacteria Swimming Pools? Humidified oxygen is widely administered in hospitals […]

Top 10 Posts of 2016

  10. All Shock Explained 9. Priapism Non-ischemic (high-flow) Ischemic (low-flow) Physical Exam Typically painless, not fully tumescent Painful, fully tumescent with corpus cavernosa rigidity without involvement of corpus spongiosum and glans penis Aetiology High-flow priapism is extremely rare and most commonly associated with antecedent trauma including blunt trauma, or resulting from needle injury of […]

Blood gas measurements in DKA

Guidelines recommend checking an ABG or VBG in all patients with DKA.  This practice is not evidence-based and should be abandoned. ABG or VBG provides little information about whether or not the patient has DKA (beyond what is already known from the serum chemistries). Rather than pH, serum bicarbonate may be used to gauge the severity of […]

Emergency Medicine Kenya Foundation