Kiwiology Posted March 18, 2012 Share Posted March 18, 2012 Sigh! *puts suxamethonium back in hip pouch, sorry bro not today my friend! Mum has DKA Sounds like baby is just dehydrated, change diaper and see if oral fluids or milk (have a look in the fridge for some) is tolerated Link to comment Share on other sites More sharing options...
Lytefall Posted March 18, 2012 Share Posted March 18, 2012 In addition to the bolus and ongoing supportive care and vitals also prepare for potential complications of prolonged DKA. As far as my scope of practice goes unless anything else pops up its transport and pre-alert receiving facility Sent from my iPhone using Tapatalk Link to comment Share on other sites More sharing options...
cwilliams17 Posted March 18, 2012 Share Posted March 18, 2012 (edited) Hello, Ok...Kiwi and Lytefall, Her mouth is dry and her lips are cracked and smell of acetone. Some think emesis is suctioned from her mouth. She tolerates a LMA (...or EGD of choice...) and is easy to ventilated. Her lungs are clear and her stas perk up to 93%. A large IV is inserted and a bolus is started. Her blood glucose level is 38 mmol/dL. Her mother states that she has been a diabetic since she was young a needs insulin. She also has been battling a cold for the last week. The police bring the infant to you to assess. The infant is lethargic, with flacid muscle tone. His mouth is dry and the soilded diaper is dry. The skin tents when pinched and a quick bracial pulse check shows a rapid, regular rate of 150. He is breathing 50 time a minute. Cookie.... A second ambulance is on the way as Fire First responders. Cheers!!! Fix the sugar problem you wouldn't need to put in an advanced airway. Edited March 18, 2012 by cwilliams17 Link to comment Share on other sites More sharing options...
Kiwiology Posted March 19, 2012 Share Posted March 19, 2012 Fix the sugar problem you wouldn't need to put in an advanced airway. Potentially yes, but in the mean time ... Oh and I don't really consider the LMA an "advanced" airway, its so bloody simple you can teach a firefighter volunteer Technician to put one in and maintain competency. Link to comment Share on other sites More sharing options...
cwilliams17 Posted March 19, 2012 Share Posted March 19, 2012 Potentially yes, but in the mean time ... Oh and I don't really consider the LMA an "advanced" airway, its so bloody simple you can teach a firefighter volunteer Technician to put one in and maintain competency. in the meantime, a competent provider should be able to start a line and give d50 in the time your volunteer technician can stick the LMA in there. If you are worried about her airway use BVM Give the d50, if you still have problems with airway then use your airway devices. Link to comment Share on other sites More sharing options...
Kiwiology Posted March 19, 2012 Share Posted March 19, 2012 (edited) in the meantime, a competent provider should be able to start a line and give d50 Well you just proved you're not competent. Giving somebody with DKA who has a blood sugar of 38 mmol/l dextrose is bad glycolojuju Oh, and D50 went out of fashion with MAST pants and long spine boards; 10% glucose is where its at increasingly worldwide Edited March 19, 2012 by kiwimedic Link to comment Share on other sites More sharing options...
cwilliams17 Posted March 19, 2012 Share Posted March 19, 2012 I take that back. I failed to read how the glucose level was presented. I don't use the mmol/dl, sorry. Well you just proved you're not competent. Giving somebody with DKA who has a blood sugar of 38 mmol/l dextrose is bad glycolojuju Oh, and D50 went out of fashion with MAST pants and long spine boards; 10% glucose is where its at increasingly worldwide no need to be an ass. I work and volunteer with agencies in two states that use D50. Sorry I don't live or work where they use 10% glucose. Link to comment Share on other sites More sharing options...
Kiwiology Posted March 19, 2012 Share Posted March 19, 2012 (edited) Right, but you think it's a good idea to give somebody D50 when they have a BGL of 38 mmol/l? Your use of the term "sugar problem" leads me to wonder if you understand the pathogenesis of DKA and why D50 (or 10% glucose) is not appropriate in this situation? Edited March 19, 2012 by kiwimedic Link to comment Share on other sites More sharing options...
cwilliams17 Posted March 19, 2012 Share Posted March 19, 2012 Right, but you think it's a good idea to give somebody D50 when they have a BGL of 38 mmol/l? Your use of the term "sugar problem" leads me to wonder if you understand the pathogenesis of DKA and why D50 (or 10% glucose) is not appropriate in this situation? Once again, no need to be an ass. No I don't think it's a good idea to give a patient D50 with a glucose level of 684 mg/dl. 1 Link to comment Share on other sites More sharing options...
Kiwiology Posted March 19, 2012 Share Posted March 19, 2012 Once again, no need to be an ass. No I don't think it's a good idea to give a patient D50 with a glucose level of 684 mg/dl. I'm not being an ass, you said it was quicker to stick in a drip and infuse some sugar than to put in an LMA in this patient So naturally my next question is why suggest it if you don't think it's a good idea? Link to comment Share on other sites More sharing options...
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