Last Modified: 1:22pm 16/04/2021

6 to 12 hours

The aim within this time period is to:

Ensure that clinical and biochemical parameters are improving.
o Continue charting blood glucose hourly; sodium and calculated osmolality 2 hourly
o Take appropriate action (as outlined in time 60 minutes to 6 hours) above

Continue IV fluid replacement to achieve positive balance of 3-6 litres by 12 hours.
o Maintain an accurate fluid balance chart.

Assess for complications of treatment e.g. fluid overload, cerebral oedema, extra pontine myelinolysis (e.g. deteriorating conscious level).

Continue treatment of any underlying precipitant.
o If patient not improving seek senior advice

Avoid hypoglycaemia.
o Aim to keep blood glucose 10-15 mmol/L in first 24 hours
o If blood glucose falls below 14 mmol/L commence 5% or 10% glucose at 125 ml/hr AND
CONTINUE 0.9% sodium chloride solution

Ensure referral has been made to diabetes team.

JBDS Guidelines