Category: speciality

DKA – Adult

Things to remember

  • Give 0.9%NaCl
  • Actrapid “Fixed Rate” 0.1unit/kg/hr
  • Basal Insulin e.g. Levemir, Lantus, Semglee, Abasaglar, Toujeo, Tresiba,
    please continue this at usual dose and times
  • Potassium – if below 5.5 will need KCl infusion (see guide)
  • BM <14 – Start 10% Dextrose 125ml/hr
  • BEWARE SGLT-2 inhibitors chance of Euglycaemic DKA

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Rash/Derm Guide

Guide Taken from the Primary Care Dermatology Society(PCDS) other good sourse is DermnetNZ.

A relatively easy way to find out what you’re looking at!

Rash – Apearance
Rash – Site
Lesions
Skin Conditions (DermnetNZ – a bit clunckier)

Lower Limb DVT

Signs and Symps

No single feature is diagnostic:

  • Single limb oedema – Most specific
  • Leg pain – 50% but is nonspecific
  • Calf pain on dorsiflexion of the foot (Homan’s sign)
  • Tenderness of deep veins – 75% of patients
  • Warmth AND/OR erythema (although blanching is possible)
  • A palpable, indurated, cordlike, tender subcutaneous venous segment

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Methaemoglobinaemia

Q: Why are Smurf’s Blue? 

A: Methaemoglobin (MetHb) of course!

MetHb is produced by oxidisation of the Iron in Haemoglobin (Hb) from Fe2+ to Fe3+

Fe3+ prevents Hb carrying oxygen (thus produces symptoms of hypoxia)

Often due to chemical ingestion, but may also be genetic

Treated with Methyl Blue & supportive measures

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