Forgot to mention that regardless of the calculated amount of fluid the maximum total fluid to be given over any 24 hour period should not exceed 1.5 to 2 X maintenance fluids.
@cheelomwiinga9326
4 жыл бұрын
noted
@hesbonkenneth305
2 жыл бұрын
Thank you Daktari, kindly share the slides 🙊, My name is Ken a medical student at University of Nairobi.
@hesbonkenneth305
2 жыл бұрын
I’ve been this attentive in a physical class
@tedsonmwanza8781
2 жыл бұрын
Brilliant, practical. Thank you Dr
@hesbonkenneth305
2 жыл бұрын
This is amazing Daktari, can request fir the slides, wooow you should be my lecturer, very clear and wonderful
@SA-Academy2021
11 ай бұрын
Thank you Dr Mwaba😊
@cheelomwiinga9326
4 жыл бұрын
Awesome lecture. Thank you
@osbornehagatea8273
3 жыл бұрын
superb explanation maam..!!
@chabotasimweemba8878
4 жыл бұрын
Great lecture indeed, just a clarity on maintenance fluid, in the lecture you giving 100ml/kg 1st 10kgs then 50ml/kg for next 10kgs and rest 25ml/kg instead of 20ml/kg as usual. Any reason for using 25mls instead of 20mls. Thank you
@chisambomwaba5186
4 жыл бұрын
Holliday-segar 4-2-1 rule
@elizabethm3310
4 жыл бұрын
Thank you for the clear lecture Dr. Mwaba. Just wanted to find out to what extent these principles can be extrapolated to adults.
@chisambomwaba5186
4 жыл бұрын
By and large same principals. For example adults get 6iu insulin per hour - if you assume an adult weighs 60kg and give 0.1 iu/ kg/hour). Fluid therapy specifics may be different but the general principles are the same
@lungilechimya4325
2 жыл бұрын
thank you for this lecture its incredibly helpful. Just a clarification, we were taught that you start the insulin infusion only after the administering the first 10ml/kg/hr of fluid. Is this a hard and fast rule?
@abrahamshiliya6789
4 жыл бұрын
How do you administer insulin therapy if you do not have an infusion pump.. Can you approximate using "drops per minute" if you give the calculated dose of insulin in 50ml Normal saline? If so, what's your target dops per minute? Thank you.
@chisambomwaba5186
4 жыл бұрын
Yes Please use the old fashioned drops per minute. The drops would depend on the type of giving set that you are using( usually indicated how many drops per ml will be delivered) and how the insulin is mixed up. Once you know these two factors then just do some mathematics to figure out the drops per minute.
@bito-7616
4 жыл бұрын
On insulin administration, do have to start do a loading dose of 0.1IU/kg followed by the maintenance dose of 0.1IU/Kg/hr via infusion pump?
@chisambomwaba5186
4 жыл бұрын
No evidence to support giving a bolus of insulin. May actually increase chance if cerebral eodema. Start your fluids then after an hour start insulin infusion
@kasondesakala1221
4 жыл бұрын
How is the subcut insulin dose calculated?
@vishalsinha2048
4 жыл бұрын
Thank you! If we used 40 IU of insulin to control the DKa, how do we transition to sub cut insulin which the patient is expected to continue after discharge?
@chisambomwaba5186
4 жыл бұрын
2 methods: 1st: direct transition to 2/3 given am and then 1/3 given PM. The morning dose consists of 2/3 Lenten and 1/3 soluble. The initial subcut dose given 30 minutes before discontinuing insulin infusion. Monitor patient response and titrate to reach target dose before discharge. Method 2: before starting the above method first transition patient to 6 hourly subcut insulin . Titrate dose to get good control then change to the twice daily insulin as outlined above. Monitor and titrate to ensure target sugars are achieve before discharge achieve
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