Medicine Guy
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When do u plan to treat acidosis in a patient with diabetic keto acidosis
and his blood gas picture shows acidosis
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| meg
Forum Guru
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In DKA , we just start with Normal Saline and Insulin. Acidosis will take care by itself. The metabolism will shift from ketoacid synthesis to glucose utilisation. We dont need to give Bicarb.
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| Medicine Guy
Forum Junior
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what about potassium 
anyway.... is there any ph value at which one should think of supplementing with sodabicarb.
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| zaki
Forum Guru
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give bicarb when ph is <7 or some say <6.9
any way all DKA pt are K+ depleted and needs k supplementation after 1 L of fluid if initial values are normal or high and /or when diuresis is started and ecg show no sign of hyperkalemic toxicity to the heart
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Maverick
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| meg
Forum Guru
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giving insulin corrects the hyperkalemia.
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| cool
Forum Newbie
Topics: 4
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when acidosis will be corrected k itself will go in side cell, and it will be ok , then u need to give k by drip.
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| alishalah
Forum Newbie
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Hydration with normal saline & insuline will be fair enough to start with, & acidosis will correct by itself, however if pH <7.1, NaHCO3 can be given
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| pathfinder1000
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pH is >7.1 the acidosis will take care of itself as u give N saline and Insulin/K. But if pH is 6.9-7.1 then give 1 ampoule (44meq) of bicarb ; if pH <6.9 then give 2 ampoules (88meq).
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| scorpion
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hi..
first we must start with normal saline with regular insulin (this is the treatment of choice) in all patients....
sodium bicarbonate is given when ph<7...
potassium is shifted from cells due to asidosis so serum potassium is usually normal or high ....
when asidosis improves and serum potassium returns into cells it will be low ..
so we must infuse potassium when asidosis is corrected , this occurs within 2 - 3 hours after beginning therapy , or sooner if initial serum potassium is inappropriately low.
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