DKA or hyperosmolar

Discussion in 'USMLE STEP 2 CS' started by Gibbs., Jul 26, 2008.

  1. Gibbs.

    Gibbs. Guest

    So if you have a patient with either DKA or hyperosmolar you start with fluids

    You give 0.9% and you can even give 1 liter per hour
    you can give 5-10 units of insulin rigth of way
    then you give insulin drip so the glucose goes down 50-75 mg/dl per hour
    also you give 10 meq of K bicarbonate or K cloride
    and then you give 0.45% SOLUTION
    when the glucose reach 250-300 you give dextrose 50% if the sodium is 150 you can change the solution to a D5%

    WHEN do we change from 0.9% to 0.45% solution?

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