Endocrinologist Manages Patient’s DKA But Results in Coma

Case Overview

This case involves a sixteen-year-old male patient who was being treated for diabetic ketoacidosis. He presented to the emergency room with complaints of a sore throat and vomiting. After an initial evaluation, the patient was found to have a blood glucose level of greater than 650. The patient was started on an insulin drip and admitted to the ICU for close observation of his blood glucose, serum electrolytes, and blood gasses. The patient was permitted to have ice chips for complaints of thirst but reportedly drank over 250ml of water against the advice of the physician on his case. Less than two hours after his transfer to the ICU, the patient began to vomit and suffer from aspiration and the floor nurse immediately came to his aid to lift the head of the bed. While the nurse was using suction to clear the residual mucus, the patient became unresponsive and a code was called. CPR was instituted and the patient was placed on a ventilator but his pupils were fixed and dilated after the resuscitation efforts.