Diabetic Ketoacidosis Flow-Chart.
Pilot March 2009
Name Label
Page 1
Date Time 08.00 09.00 10.00 11.00 12.00 13.00 14.00 15.00 16.00 17.00 18.00 19.00
Temperature
Pupil Scale
1 Q
Pulse
2 Q Respiratory Rate
3 Q BP
4 Q SpO2
GCS
5 Q L
Pupil Size
(mm) R
6 Q Headache (9)
Capillary Glucose
7 Q Capillary Ketone
Q
IV Sites
8
Equipment check
Insulin Rate u/kg/hr
Insulin Rate ml/hr
Total Insulin Infused (ml)
1. 0.9% NaCl
2. 0.45% NaCl + 5% Glucose
3. 0.45 % NaCl + 10% Glucose
4. 0.9% NaCl + 5% Glucose
5. 0.9% NaCl + 10% Glucose
6.
With Potassium; 40 mmol/l (9)
Oral/Enteral fluids
Total Intake
Oral/NG losses
Urine
Other
Total Output
Cumulative Fluid Balance
pH
pCO2
HCO3
ABE
Lab Glucose
Sodium
Potassium
Urea
Lab HCO3
Lactate
Anion Gap
Chloride
Corrected Sodium
Creatinine
Phosphate
Name Label
Page 2
Date Time 20.00 21.00 22.00 23.00 00.00 01.00 02.00 03.00 04.00 05.00 06.00 07.00
Temperature
Pupil Scale
1 Q
Pulse
2 Q Respiratory Rate
3 Q BP
4 Q SpO2
GCS
5 Q L
Pupil Size
(mm) R
6 Q Headache (9)
Capillary Glucose
7 Q Capillary Ketone
Q
IV Sites
8
Equipment check
Insulin Rate u/kg/hr
Insulin Rate ml/hr
Total Insulin Infused (ml)
1. 0.9% NaCl
2. 0.45% NaCl + 5% Glucose
3. 0.45 % NaCl + 10% Glucose
4. 0.9% NaCl + 5% Glucose
5. 0.9% NaCl + 10% Glucose
6.
With Potassium; 40 mmol/l (9)
Oral/Enteral fluids
Total Intake
Oral/NG losses
Urine
Other
Total Output
Cumulative Fluid Balance
pH
pCO2
HCO3
ABE
Lab Glucose
Sodium
Potassium
Urea
Lab HCO3
Lactate
Anion Gap
Chloride
Corrected Sodium
Creatinine
Phosphate