Diabetic Ketoacidosis: Rapid Identification, Treatment, And Education Can Improve Survival Rates.
The rescue squad arrives at the emergency department (ED) with Chad Smith, 72 years old, who was found unconscious on the basement floor of his home. En route to the hospital, Mr. Smith's respirations became very shallow. An endotracheal tube was inserted, and its placement was confirmed by end-tidal CO2 detection. Since arriving at the ED, he has remained comatose and is not assisting the ventilator. His vital signs are blood pressure, 80/48 mmHg; heart rate, 112 beats per minute; and temperature, 91.8°F. He has a sinus tachycardia without ectopy. The glucometer indicates a finger stick blood sugar (FSBS) reading of “panic high.” Mr. Smith is among the 5.9% of people in the United States with diabetes. 1 A significant percentage of them will experience diabetic ketoacidosis (DKA), a state of hyperglycemia, hyperketonemia, and metabolic acidosis. 2,3 DKA typically affects those with type 1 diabetes, although patients with type 2 diabetes who suffer from hyperglycemic hyperosmolar nonketotic syndrome also experience DKA, and with increasing incidence. 4,5 In January 2002, the American Diabetic Association (ADA) reported that there are approximately 100,000 hospitalizations for Continue reading >>