Deep Dive MW R4

EM Clerkship

Zack Olson, MD ; Mike Estephan, MD ; Maddie Watts, MD

Education, Science, Life Sciences, Courses, Health & Fitness, Medicine

5 • 795 Ratings

🗓️ 15 November 2022

⏱️ 25 minutes

🔗️ Recording | iTunes | RSS

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Summary

Diabetic Ketoacidosis – hyperglycemia, ketosis, and anion gap metabolic acidosis Don’t forget about euglycemic DKA (especially in setting of SGLT2 inhibitor) or mimics such as alcoholic ketoacidosis Treatment of the ketoacidosis Insulin (usually a drip or bolus + drip) – only once K>3.5 Volume Resuscitation (NS initially, change to LR) Bicarb drip (poor evidence, only […]

Transcript

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0:00.0	Hey everyone. My name is Mike Estefan, and I thank you for joining me today on this month's
0:05.8	deep dive episode on the EM Clerkship podcast. This month, we're going to be talking about
0:12.9	diabetic ketoacidosis, or DCA, for short. Before we begin, just a quick word from our sponsors at Pearson Rabbit's Insurance.
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0:39.7	explain what types are good, what's bad, what to look out for, and put it in a language that,
0:46.1	you know, somebody like me with no prior experience could understand. And that is something that I
0:51.7	really liked about working with Pearson Rabbits.
0:55.0	They will make the process as easy and straightforward for you as possible.
1:00.0	Please check out PearsonRavits at www.personRavits.com
1:05.0	and schedule a consultation with them today.
1:08.0	Now, back to our episode.
1:10.0	We're going to start by talking about the definition
1:12.7	of diabetic ketoacidosis and how we diagnose this in the ED. After that, the bulk of this
1:20.0	episode is going to be talking about the management of DCA. So, the definition of DCA is literally in the name.
1:29.9	Diabetic, meaning hyperglycemia.
1:32.8	Keto, meaning ketosis, the presence of ketone bodies in the blood.
1:38.2	And acidosis, a low bicarb.
1:41.8	Now, this can get a little tricky. It's not exactly 100% of the time straightforward.
1:48.5	For example, there is an entity called eoglycemic DCAA. It's basically DCAA, but you have a normal or only
1:57.1	slightly elevated blood glucose. And where we see this often is in patients taking
	...

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