1st best test - cony

[ArchivalUser]

in DKA

ABG
HCO3
finger glucose
art/PH

[ArchivalUser]

finger glucose

[ArchivalUser]

do you mean best 1st test for diagnosis?

if you already know it is DKA, you dont have to do finger glucose again.
ABG wont help too much. it is useful at the beginning of the treatment. after that, you never do it again. you follow up with anion gap to monitor the treatment progress
HCO3 along does not help either, you have to know Na and Cl concentrations also
art pH is probably the 1st best test you want to do since it is a brief version of ABG and tells you the most important index, ie, pH. you dont have to know PCO2 or PO2. that is why ABG is not the best 1st test

[ArchivalUser]

yes

[ArchivalUser]

1. finger stick 2.bmp(anion gap) 3. UA ketones. 4. ABG is last for stat blood w/u because its invasive. You need it but invasive stuff is almost always last on every new case algorithm step,blood work, xray, equipment procedures...etc but I'm sure you guys already know that.

In general this is how I remember algorithms for each case.

1. stable or unstable
2. PE-general or focused or very focused
3. ABC first in ER
4. stable/stabilized-finish PE
5. blood w/u stuff first in dx.--->cheap then expensive
6. Procedures--->non-invasive then invasive
7. Don't do harm/kill patient
8. consultation only after w/u dx is confirmed(in any case)
9. treatment(your discretion)--->before or after w/u dx.
10.Educate, advise...etc most cases only when 5 minute window pops up(some exceptions).
11. Final Diagnoses (Heard that this gives you know points, you can write in anything-but don't).
12. If you think u were reasonable with care and finish early: Score=high to very high marks.
13. If you have little clue on what your doing & case ends early: Score=mediocre to poor marks.

Just ranting, but though I would give you my algorithm. Please correct me if this is not a preferred way to address cases.

[ArchivalUser]

ABG should be done together with other 1st labs cos you need to know pH to confirm acidosis. once it is confirmed, you start to treat and close the gap.

[ArchivalUser]

thanks.

[ArchivalUser]

HC03 tells you the severity of the DKA.

[ArchivalUser]

HCO3 tells you the severity indirectly, pH tells you directly severity of acidosis. then you stop checking pH afterwards. instead you continue to check HCO3, which indirectly tells the severity of acidosis. it is not the only index to monitor and adjust your treatment plan.