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Management of Diabetic Ketoacidosis in Hospitalized Patients
The management of diabetic ketoacidosis (DKA) in hospitalized patients is a time-sensitive process that aims to correct dehydration and electrolyte imbalances, reverse the ketoacidosis, and identify and treat the underlying cause.Fluid resuscitation is the cornerstone of treatment, typically done with normal saline (0.9% sodium chloride) at a rate of 1-2 liters per hour. Once the patient is clinically stable, fluids can be switched to half-normal saline (0.45% sodium chloride) or dextrose 5% in water.Electrolyte replacement is also essential, with the most important electrolytes to replace being sodium, potassium, and phosphate. Sodium is replaced with normal saline or half-normal saline, potassium with potassium chloride, and phosphate with potassium phosphate or sodium phosphate.Insulin therapy is used to reverse the ketoacidosis, typically initiated with a bolus dose of regular insulin, followed by a continuous infusion of regular insulin. The dose of insulin is adjusted based on the patient's blood glucose levels.
About the Speaker
Dr. Yogesh Rathod
Director & Consultant Critical Care Physician Aadhar Superspeciality Pvt. Ltd and Aadhar Critical Care
Dr. Yogesh Bhimrao Rathod is a consultant critical care physician with over 10 years of experience. He is currently the director and chairman of Aadhar Superspeciality Pvt. Ltd. and Aadhar Critical Care, both located in Solapur, Maharashtra, India.Dr. Rathod has a wealth of experience in all aspects of critical care, including critical care nephrology, cardiology, neurology, and gastroenterology. He is also proficient in anesthesiology, anesthesia procedures, pain management, interventionist intensive care, internal medicine, bronchoscopy, and thoracoscopy
Upcoming Case Discussions
Treatment of Renal Disease in ANCA Vasculitis
The treatment of renal disease in ANCA-associated vasculitis (AAV) typically involves a combination of immunosuppressive therapies to control inflammation and prevent further kidney damage. First-line treatment often includes high-dose corticosteroids and cyclophosphamide or rituximab, both of which help to induce remission by targeting the underlying immune system dysfunction. In cases of kidney failure or rapidly progressive glomerulonephritis, plasmapheresis may be used to remove circulating autoantibodies. Once remission is achieved, maintenance therapy with lower doses of immunosuppressants, such as azathioprine or mycophenolate mofetil, is used to prevent relapses and preserve kidney function.
Management of Pediatric Type 1 Diabetes
Pediatric type 1 diabetes management focuses on maintaining glycemic control while supporting normal growth. Insulin therapy, via multiple daily injections or pumps, is essential, with doses adjusted based on blood glucose monitoring or continuous glucose monitoring (CGM). Nutrition plans emphasizing carbohydrate counting and balanced meals are crucial, alongside adjustments for physical activity to prevent glucose fluctuations. Education for families on recognizing hypo- and hyperglycemia symptoms and managing sick days is vital. Regular follow-ups with a pediatric endocrinologist help monitor HbA1c levels, growth, and complications. Psychosocial support is key for ensuring adherence and addressing emotional challenges.
Rising Cardiac Arrests in Young Entrepreneurs
The increasing cases of cardiac arrests among young entrepreneurs are becoming a serious health concern. Intense stress, long working hours, unhealthy eating habits, and lack of physical activity are major contributors to heart-related issues in this group. This often leads to neglecting personal health, resulting in irregular sleep patterns and chronic fatigue. Additionally, skipping regular medical check-ups can leave underlying heart conditions undetected. Emphasizing stress management, healthy lifestyle choices, and routine health screenings is crucial to reducing this growing risk
Medical Management of Endometriosis
Medical management of endometriosis typically involves the use of hormonal therapies such as birth control pills, progestins, or GnRH agonists to reduce estrogen levels and suppress the growth of endometrial tissue. Pain management with NSAIDs, as well as targeted treatments like aromatase inhibitors or the use of intrauterine devices (IUDs), can help alleviate symptoms. In some cases, additional treatments like surgery may be considered for severe cases or when fertility is a concern.
Analytical Skills in Problem Solving
Today’s session on analytical tools and techniques in healthcare can provide valuable insights into how data-driven approaches enhance decision-making and problem-solving. Sharing personal or professional experiences where analytical skills were effectively used to address challenges can offer practical understanding and inspire learners. These skills are crucial in healthcare for accurate patient diagnosis, effective treatment planning, and efficient resource allocation. By applying analytical methods, healthcare professionals can improve patient outcomes, streamline operations, and make informed, evidence-based decisions that contribute to overall healthcare efficiency and quality.