RR – 30-40
SpO2 – 91% in air
HR – 130
BP – 100/40
CRT – 4 secs
Drowsy but rousable, can talk appropriately.
BM reads HI.
Blood ketones 6.
Significant metabolic acidosis on venous blood gas.
WHY WE SIMULATED
Cerebral oedema is a serious complication of DKA and requires awareness of the presenting features and judicious fluid administration to minimise the chances of an iatrogenic component to the condition.
It is appropriate to speak up if you have concerns regarding a clinical situation whatever your grade/job title.
Try to verbalise your thinking as this helps keep the team focussed and ensures everyone is working towards the same priorities.
Importance of cautious fluid administration to prevent cerebral oedema.
Considered wide range of diagnoses for teenager with reduced conscious level.
Followed local protocol for the treatment of DKA.
Recognised that “specialist” suggesting inappropriate fluid resuscitation and ensured only appropriate fluids administered.