Question

A 24-year-old woman presents with polyuria, polydipsia and weight loss. Capillary glucose is 21 mmol/L, venous pH 7.20, bicarbonate 14 mmol/L, ketones 4.5 mmol/L. Which initial fluid management strategy in the emergency department is most appropriate?

Accepted Answer

1-2 L isotonic saline bolus over the first hour

Answer

500 mL 5% dextrose bolus over 30 minutes

Answer

Immediate insulin bolus before fluids

Answer

Restrict fluids to avoid cerebral oedema

Answer

Start half-normal saline at 50 mL/h

Practice question

A 24-year-old woman presents with polyuria, polydipsia and weight loss. Capillary glucose is 21 mmol/L, venous pH 7.20, bicarbonate 14 mmol/L, ketones 4.5 mmol/L. Which initial fluid management strategy in the emergency department is most appropriate?