Question

A 23-year-old man with type 1 diabetes presents with abdominal pain, polyuria and vomiting. His capillary glucose is 22 mmol/L, venous pH 7.18, bicarbonate 12 mmol/L and serum ketones are elevated. What is the key first-line fluid management in the ED?

Accepted Answer

Normal saline 1-2 L in the first 1-2 hours

Answer

5% dextrose in water at 250 mL/h

Answer

Half-normal saline with potassium 20 mmol/L starting at 50 mL/h

Answer

No fluids until insulin infusion started

Answer

Colloid bolus 500 mL then restrict fluids

Practice question

A 23-year-old man with type 1 diabetes presents with abdominal pain, polyuria and vomiting. His capillary glucose is 22 mmol/L, venous pH 7.18, bicarbonate 12 mmol/L and serum ketones are elevated. What is the key first-line fluid management in the ED?