It's super easy to screw up your DKA patient. Whether you are the treating physician or the transporting paramedic, you need to understand all the steps in DKA treatment. In DKA, proper timing of treatments and careful observation in a must. Let's break down this process step-by-step.
Insulin should probably not be your first treatment
Giving insulin as first line treatment in the DKA patient can seriously harm them. Why?
Insulin brings water into the cells. Your DKA patient is already likely very dehydrated. When glucose builds up in our blood, our kidneys want to waste it in an attempt to offload glucose and normalize BGL values. When the kidneys waste glucose, what follows? Water. Polyuria (production of abnormally large volumes of dilute urine) is a sign of increased blood glucose and glucose wasting by the kidneys. Polyuria = dehydration. Therefore, giving insulin as a first line treatment will further deplete intravascularly available f