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
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