A type 1 diabetic who comes to the emergency room for dyspnea and general malaise. The blood test showed blood glucose 450 mg/dl, Na 142 mEq/l, K 4 mEq/l, pH 7.15, bicarbonate 12 mmol/l. Which treatment would NOT be indicated?
Easy question since the treatment of diabetic ketoacidosis is a very repeated topic in the MIR. Bicarbonate is indicated at pH < 7.
Fast IV saline.
Serum glucose 5% iv when blood glucose is less than 250 mg/dl.
Rapid human insulin iv.
Potassium chloride 100 mEq / day diluted in sera.
Sodium bicarbonate 1M 100 cc iv in 30 minutes.
Bicarbonate is indicated at pH < 7.