Emergency MedicineEndocrinology
Diabetic Ketoacidosis (DKA)
Diagnosis and management of DKA in adults following JBDS guidelines with fluid resuscitation, fixed-rate insulin infusion, and monitoring.
Source: JBDS 2013 / Joint British Diabetes Societies; NICE NG17
Used in: Diabetes & DKA
Step 1 of ~7
action
Confirm DKA Diagnosis
DKA diagnostic criteria (all three):
1. Blood ketones ≥3.0 mmol/L (or urine ketones ++ or more)
2. Blood glucose >11 mmol/L (or known diabetic)
3. Bicarbonate <15 mmol/L and/or venous pH <7.3
NOTE: Euglycaemic DKA possible (glucose <11) — especially in SGLT2 inhibitor users. Check ketones in any unwell diabetic.
Obtain: VBG, blood glucose, blood ketones, FBC, U&E, LFTs, blood cultures if febrile, ECG, CXR, urine dip (precipitant), pregnancy test if female.
Related
Curated clinical cross-links plus same-class fallbacks.
Drugs
- Insulin (IV Infusion — ICU Glucose Control) · Insulin — ICU Glucose Management
- Enalapril with hydrochlorothiazide · ACE inhibitor + thiazide diuretic (fixed-dose)
- Amiloride with Bumetanide · Potassium-Sparing Diuretic + Loop Diuretic (Fixed-Dose Combination)
- Amlodipine with Valsartan · Calcium-Channel Blocker + ARB (Fixed-Dose Combination Antihypertensive)
- Potassium chloride with calcium chloride and sodium chloride · Crystalloid IV fluid
- Potassium chloride with calcium chloride sodium chloride and sodium lactate · Balanced crystalloid IV fluid
Pathways
- Difficult Airway Algorithm (DAS) · DAS 2015; Royal College of Anaesthetists
- Major Haemorrhage Protocol · NICE NG24; UK MHP guidelines
- New-Onset Atrial Fibrillation · ESC 2020 AF Guidelines; NICE NG196
- Hypertensive Emergency · ESC/ESH 2018 Hypertension Guidelines; NICE NG136
- Bradycardia Management · Resuscitation Council UK ABCDE; ESC 2021 Pacing Guidelines
- Ventricular Tachycardia / Fibrillation · Resuscitation Council UK ACLS; ESC 2022 Ventricular Arrhythmia Guidelines
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