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Treatment For Dka And Hhs

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Hyperglycemic crises: Hyperglycemic hyperosmolar nonketotic coma (HHNK) versus DKA. See DKA video here: https://youtu.be/r2tXTjb7EqU This video and similar images/videos are available for instant download licensing here https://www.alilamedicalmedia.com/-/g... Voice by: Penelope Hammet Alila Medical Media. All rights reserved. All images/videos by Alila Medical Media are for information purposes ONLY and are NOT intended to replace professional medical advice, diagnosis or treatment. Always seek the advice of a qualified healthcare provider with any questions you may have regarding a medical condition. Support us on Patreon and get FREE downloads and other great rewards: patreon.com/AlilaMedicalMedia Hyperosmolar hyperglycemic state, or HHS, is another ACUTE and life-threatening complication of diabetes mellitus. It develops slower than DKA, typically in the course of several days, but has a much higher mortality rate. Like DKA, HHS is triggered when diabetic patients suffer from ADDITIONAL physiologic stress such as infections, other illness, INadequate diabetic treatment or certain drugs. Similar to DKA, the RISE in COUNTER-regulatory hormones is the major culprit. These hormones

Hyperosmolar Hyperglycemic Statetreatment & Management

Standard Care for Dehydration and Altered Mental Status Diagnosis and management guidelines for hyperglycemic crises are available from the American Diabetes Association. [ 6 , 10 , 24 ] The main goals in the treatment of hyperosmolar hyperglycemic state (HHS) are as follows: To vigorously rehydrate the patient while maintaining electrolyte homeostasis To monitor and assist cardiovascular, pulmonary, renal, and central nervous system (CNS) function In an emergency situation, whenever possible, contact the receiving facility while en route to ensure preparation for a comatose, dehydrated, or hyperglycemic patient. When appropriate, notify the facility of a possible cerebrovascular accident or myocardial infarction (MI). Initiation of insulin therapy in the emergency department (ED) through a subcutaneous insulin pump may be an alternative to intravenous (IV) insulin infusion. [ 25 ] Airway management is the top priority. In comatose patients in whom airway protection is of concern, endotracheal intubation may be indicated. Rapid and aggressive intravascular volume replacement is always indicated as the first line of therapy for patients with HHS. Isotonic sodium chloride solution i Continue reading >>

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  1. chitownmom

    That is really good that you can see the pattern. Be sure to write everything down for the doctor. Maybe you can talk to your daughter so that she can be sure the sit down if she experiences this at school.
    Good Luck!
    ChiTownMom Just A Mom Doing Her Best For Her Child

  2. sarahandbray

    My 4.5 year old daughter has had 3 or 4 small seizures and was in status epilepticus last July for 45 minutes....the entire morning before that episode, she was flushed and nauseous...wouldn't eat at all (which is very unlike her) and threw up about 20 minutes before her first seizure that day. I also pulled her shirt up that day and she had a red rash all over her for a few minutes that then went away and a low-grade fever. She tends to get very tired as well before a seizure.
    So far, (7 months), she's been seizure free on 500mg of Keppra 2X day.
    Good luck.
    Sarah

  3. Sara Z.

    YES!!! Those are my daughter's symptoms, though she is older (11). She was just diagnosed last week with complex partial seizures. I've been wanting to ask if anyone else has the constant nausea? She has been nauseous for over a month now . . . kind of like a morning sickness feeling 24/7. She has no appetite and only eats when I put food in front of her. She doesn't want to think about food, and often feels like she is going to throw up, but she never does. Now, of course, she is on Keppra, so I don't know if the meds are adding to her nausea. She has not had any more seizures since on Keppra, but she still has the constant nausea and sick feeling. Oh, by the way, my daughter's cheeks get really flushed too. Good luck to you . . . is the Keppra helping?

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Visit us (http://www.khanacademy.org/science/he...) for health and medicine content or (http://www.khanacademy.org/test-prep/...) for MCAT related content. These videos do not provide medical advice and are for informational purposes only. The videos are not intended to be a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of a qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read or seen in any Khan Academy video. Created by Matthew McPheeters. Watch the next lesson: https://www.khanacademy.org/test-prep... Missed the previous lesson? https://www.khanacademy.org/test-prep... NCLEX-RN on Khan Academy: A collection of questions from content covered on the NCLEX-RN. These questions are available under a Creative Commons Attribution-NonCommercial-ShareAlike 3.0 United States License (available at http://creativecommons.org/licenses/b...). About Khan Academy: Khan Academy offers practice exercises, instructional videos, and a personalized learning dashboard that empower learners to study at their own pace in a

Hyperosmolar Hyperglycemic State

Author: Dipa Avichal, DO; Chief Editor: George T Griffing, MD more... Hyperosmolar hyperglycemic state (HHS) isone of two serious metabolic derangements that occurs in patients with diabetes mellitus (DM). [ 1 ] It is alife-threatening emergency that, although less common than its counterpart, diabetic ketoacidosis (DKA), has a much higher mortality rate, reaching up to 5-10%. (See Epidemiology.) HHS was previously termed hyperosmolar hyperglycemic nonketotic coma (HHNC); however, the terminology was changed because coma is found in fewer than 20% of patients with HHS. [ 2 ] HHS is most commonly seen in patients with type 2DM who have some concomitant illness that leads to reduced fluid intake, as seen, for example, in elderly institutionalizedpersons with decreased thirst perception andreduced ability to drink water. [ 3 ] Infection is the most common preceding illness, but many other conditions, such as stroke or myocardial infarction, can cause this state. [ 3 ] Once HHS has developed, it may be difficult to identify or differentiate it from the antecedent illness. (See Etiology.) HHS is characterized by hyperglycemia, hyperosmolarity, and dehydration without significant ketoac Continue reading >>

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  1. blueniamh

    Hey all,
    This is sort of a spin off from the fat-shaming thread, but I didn't want thread hijack with a 'hey...help me fix my diet' post . I've been off my diet for few weeks for various reasons, but I need to go back on it and I think it needs minor tweaking. I was low carbing for the purposes of getting into ketosis, but also keeping my diet low fat (and overall watching the calories)...which was getting kinda tricky if I'm going to be honest.
    I've been reading the debate back and forth about different styles of diet in the other thread and well...I'm confused, mainly about the role of ketosis. My understanding of ketosis comes from a introductory subject on nutrition that I took many years back and is something like this: The brain (and some other part of the body which I can't remember) essentially need carbohydrates for fuel. In the absence of enough carbohydrate, the body breaks down fat cells into ketones as a substitute fuel for the brain. The source of fat for this process can either come from the diet or from stored body fat.
    My main internal theory for keeping my diet both low in fat and low in carbs was that I would go into ketosis and because I wasn't eating very much dietary fat that my body would have to use stored fat to produce ketones thus getting bonus fat loss on top of maintaining a calorie deficit I guess. Some of the studies being put forth were that ketosis did not increase the amount of fat burned (ok...that's if I understood correctly, which might be iffy)...the one point of consensus seemed to be that ketogenic diets increase satiety (...and I was sitting there thinking 'well, if it's just a matter of controlling my appetite I'd really like to eat some lf flavoured yoghurt' ).
    What I'm essentially trying to work out is: if I have a diet that is low fat and maintains a certain number of calories...is that the same as having a diet that is low fat, maintains the same number of calories, but is also ketogenic (low carbs) in terms of weight loss or would I burn more fat under the second scenario? I feel like I'm missing something.
    Thanks.

  2. Spacey47

    no diet of the same calorie level has any more benefit than any other it's about
    Energy in and out.
    If a certain diet helps you stick to a calorie deficit over another then consider it
    diet wise there is no metabolic advantage
    Imo humans evolved to eat the natural foodstuffs that grow on our planet get your calories from a balanced mixed diet
    and exercise...this is sustainable long term

  3. liv001

    You really would have to try this out on your body
    One thing is for sure a flavoured yogurt is not going to be your friend if you want to be in ketosis. They are flavoured with a loud of sugar and ketosis and sugar is not going to work
    I can answer this from an Atkins perspective (since Atkins is my kind of diet)
    The brain need glucose. In absence of enough carbs the body will break down protein to make the glucose.
    body needs energy - it usually gets a lot of energy from carbs. In absence of carbs it will break down fat through ketosis
    There is nothing wrong with eating fat. Not eating fat will not make ketosis change.
    You have to eat something and if you do not eat fat or carb you will have to eat protein. It may not be good to put your body through high amounts of protein - also it is believed the body can break down excess protein to create sugar and if that happens you may as well be eating carbs
    so you need to find your balance.
    Lost of stuff you can read about there about low carbing (I like to check the diet doctor's web site regularly, follow some of Jimmy Moore's podcasts - join a support group - because that helps)

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A lecture on the recognition, pathogenesis, and management of diabetic ketoacidosis and the hyperosmolar hyperglycemic state. Use of the VA and Stanford name/logos is only to indicate my academic affiliation, and neither implies endorsement nor ownership of the included material.

Treatment Of Diabetic Ketoacidosis (dka)/hyperglycemic Hyperosmolar State (hhs): Novel Advances In The Management Of Hyperglycemic Crises (uk Versus Usa)

Treatment of Diabetic Ketoacidosis (DKA)/Hyperglycemic Hyperosmolar State (HHS): Novel Advances in the Management of Hyperglycemic Crises (UK Versus USA) Current Diabetes Reports 2017, 17 (5): 33 PURPOSE OF REVIEW: Diabetic ketoacidosis (DKA) and hyperglycemic hyperosmolar state (HHS) are diabetic emergencies that cause high morbidity and mortality. Their treatment differs in the UK and USA. This review delineates the differences in diagnosis and treatment between the two countries. RECENT FINDINGS: Large-scale studies to determine optimal management of DKA and HHS are lacking. The diagnosis of DKA is based on disease severity in the USA, which differs from the UK. The diagnosis of HHS in the USA is based on total rather than effective osmolality. Unlike the USA, the UK has separate guidelines for DKA and HHS. Treatment of DKA and HHS also differs with respect to timing of fluid and insulin initiation. There is considerable overlap but important differences between the UK and USA guidelines for the management of DKA and HHS. Further research needs to be done to delineate a unifying diagnostic and treatment protocol. Continue reading >>

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  1. mandrex

    what is the best time of day to use ketostix, any advice

  2. DeniseTra

    don't use them. They tend to test dehydration mainly. If you are eating at the correct level, you will be in Ketosis.
    Ditto to Mrs REJ's recommendation on the Atkins site. I love it.

  3. jesskripp

    I use the ketosis strips on and off when I need a little boost of reasurance. I think the best time to test is in the morn. when you first wake up I noticed if I tested everday the results would vary. So maybe you should try testing once a week. They strips are kinda pricey but they last awhile. Hope this helps!
    "Life's a journey NOT a destination"

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