•4) Increased emphasis of restoration of
circulating volume and treatment of shock ( previously
the emphasis was of caution with fluids and early use of ionotropes). This is now replaced with measured
fluid administration to ensure adequate circulating volumes before ionotropres.
-In
mild , Moderate or severe DKA those who
need IV fluids – ALL
should have 10mls/kg bolus over 60 mins(
subtracted from fluids calculated)- (not
done previously)
-Those
in shock – APLS definition – Tachycardia( poor pulse volume) and increased
central CRT with decreased conscious level- initial
20mls/Kg bolus ( previously
10mls/Kg) and repeated boluses of 10mls/kg up
to total 40mls/Kg (previously
not allowed)…Not subtracted from rest of
calculated fluid deficit (
was previously deducted
//////////////////
No comments:
Post a Comment