Diabetic emergencies: Ketoacidosis
Diabetic ketoacidosis (DKA) results from severe insulin deficiency and leads to the disordered metabolism of proteins, carbohydrates, and fats
By DeWayne Miller
Our flight crew was dispatched to a small local hospital for a 58 year old male with an altered level of consciousness and elevated blood sugar.
His son had found him unresponsive on the couch and called EMS for help.
While en route to the local hospital a bedside glucose was checked reporting "high." His respiratory rate was 36 and his heart rate was in the 150s. He was slow to respond, but woke to verbal commands and was orientated to person only.
At the hospital, another bedside glucose returned "high" and he received 10 units of insulin IV. A foley catheter was inserted draining 1400 ml of urine immediately.
The flight crew arrived to find our patient’s LOC without change. Pupils were equal at 3 mm, and sluggish in response to light. Mucous membranes were dry. He had a respiratory rate of 36 breaths per minute and shallow. His lung sounds were clear and equal bilateral. An incision at his right shoulder from a surgery one week ago appeared well healed with no redness or signs of infection.
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