Question

A 25-year-old woman with known type 1 diabetes presents with 1 day of polyuria, vomiting, and abdominal pain. Capillary glucose is 23 mmol/L. Venous blood gas shows pH 7.18 and bicarbonate 12 mmol/L. Serum ketones are elevated. Which is the most appropriate initial fluid choice?

Accepted Answer

0.9% saline bolus 15-20 mL/kg over the first hour

Answer

D5W 0.45% saline at maintenance rate

Answer

Ringer's lactate at 50 mL/hour

Answer

0.45% saline bolus 30 mL/kg

Answer

No fluids initially to avoid cerebral oedema

Practice question

A 25-year-old woman with known type 1 diabetes presents with 1 day of polyuria, vomiting, and abdominal pain. Capillary glucose is 23 mmol/L. Venous blood gas shows pH 7.18 and bicarbonate 12 mmol/L. Serum ketones are elevated. Which is the most appropriate initial fluid choice?