| Sub-title | |
| Authors | M Debono A G Abela C J Magri J Vassallo J Azzopardi N Calleja |
| Abstract | Aim: To analyse the management of patients admitted with DKA according to the existing protocol. Methods: Patients admitted with ‘DKA' between 14th August 2004 and 14th August 2005 were identified from the Admissions book at the A+E Department. Data was obtained from patients' medical records and analysed according to a preset proforma. Parameters measured, investigations taken, insulin regime, intravenous fluids and potassium supplements given were recorded. Results: From a total of 56 patients, 50 files were traced, of which 19 satisfied the criteria for the diagnosis of DKA. In the population studied the mean age was 35 years with a male predominance of 58%. 11 patients were Type 1 diabetics, 4 were Type 2 and another 4 were newly diagnosed Type 1 diabetics. Only 2 patients had their parameters checked regularly according to protocol. In the majority of patients fluids given in the first 22 hours coincided with the amount of fluids stated in the protocol whilst 47% of patients (n=9) were administered the stipulated amount of insulin via infusion pump. As regards potassium supplementation 89% of patients (n=17) were started on potassium replacement at a later stage resulting in a lower mean potassium level (3-4mmol/L) than the target of 4-5mmol/L. The mean duration of stay in hospital was 7 days. Conclusion: Various problems have been identified on analysis of audit results. These principally included errors with parameter monitoring, and dose of insulin and potassium supplementation. Deviations from the protocol resulted in increased length of stay in hospital. Consequently, an audit cycle is recommended after introduction of the new DKA guidelines. |
Published in: | |
| Journal | Malta Medical Journal |
| Volume | 18 Supplement |
| Page | |
| Date | 01/12/2006 |
| Link to journal | |
| Key words | audit, diabetes, guidelines, ketoacidosis |