Diabetic Ketoacidosis

First Things First (assess & treat for the following)

• Shock present?
• Airway protection intact?
• Other diagnoses present (ACS, sepsis, pancreatitis, etc.)?
• Establish cause:
  • Infection (>30%): pneumonia, UTI, cellulitis, fungal sinusitis, perirectal abscess, necrotizing fasciitis
  • Insulin issues (20-35%): missed doses, pump malfunction, undertreatment
  • Interfering medications: thiazides, -blockers, glucocorticoids, protease inhibitors
  • Glucose containing IV fluids, total parenteral nutrition (TPN)
  • Dietary non-compliance