Author: Farouk Omer / Editor: Amie King / Codes: / Published: 11/06/2026
A 45-year-old man presents with a three-day history of abdominal pain, repeated episodes of vomiting (more than six episodes) and progressively worsening shortness of breath.
His past medical history includes type 1 diabetes mellitus.
On arrival, he appears dehydrated and tachypnoeic. His observations are: blood pressure 93/50 mmHg, heart rate 97BPM temperature 37.1 C, and oxygen saturation 98% on room air. Capillary blood glucose is 23 mmol/L.
Venous blood gas analysis shows a pH of 7.12, a bicarbonate concentration of 8 mmol/L and a ketone level of 3.5 mmol/L. Serum biochemistry demonstrates a sodium concentration of 135 mmol/L, potassium 4.7 mmol/L, and urea 8.9 mmol/L.
An ECG shows normal sinus rhythm.
