Non Ketotic Hyperosmolar coma

Clinical Features:

• 1)Excessive thirst
• 2)Dry mouth
• 3)Increased urination
• 4)Warm, dry skin
• 5)Fever
• 6)Drowsiness, confusion
• 7)Hallucinations
• 8)Vision loss
• 9)Convulsions
• 10)Coma

INVESTIGATION:

• 1)RBS
• 2)serum electrolyte
• 3)urine for ketine bodies
• 4)ABG

Rx:

• Fluids:Hypotonic saline 0.45% initially then 0.9% saline when osmolarity normal .
  
• Insulin: initially ½ loading dose- 5-10 units I/V and then 2-4 unit per hour ...I/M or I/V given until blood glucose 11.1 mmol/l
• Treatment of underlying cause