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Ask Dr. Muneeb Ali Your Own Question
Dr. Muneeb Ali
Dr. Muneeb Ali, Doctor (MD/DO)
Category: Health
Satisfied Customers: 6037
Experience:  MBBS, MD, ECFMG certified. 11 year experience in dealing with cases related to all fields of medicine
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Dka patient with 93 sats what to do, Breathing labour...skin

Customer Question

Dka patient with 93 sats what to do
JA: What are all the symptoms you're experiencing (e.g. loss of appetite, fever, rash)?
Customer: Breathing labour...skin pale....vomiting....going to toilet alot
JA: How long have you been dealing with the skin issue? Have you noticed any major changes in your overall skin or nails recently?
Customer: Sweating alot
JA: Anything else in your medical history you think the doctor should know?
Customer: 35 breaths per minute Hearth rate 110
Submitted: 2 months ago.
Category: Health
Customer: replied 2 months ago.
Hello
Expert:  Dr. Muneeb Ali replied 2 months ago.

Hi,

Welcome to JA and thanks for this question. Im sorry to hear about the patient in question. DKA is a MEDICAL EMERGENCY and needs for the patient to be evaluated and treated IMMEDIATELY in the ER. The fact that the breathing is laboured and the skin is pale means that the person has a low BP. The high heart rate and the rapid breathing rate are also indications that the acidosis in the blood is getting worse. This patient needs a lot of fluid in order to get better and immediate administration of insulin to control the acidosis. The low saturation would improve once the breathing rate comes back down and this would be supplemented in the meantime by oxygen.

My recommendation is to IMMEDIATELY take this patient to the ER where he will be administered IV fluids in the form of saline, IV insulin and oxygen in the beginning. He needs to undergo a lot of tests as well.

Hi,

Welcome to JA and thanks for this question. Im sorry to hear about your EKG reports in the past. I think the 24 hour EKG test showed 2 runs of SVT or VT, is that what it showed? Because SVE or VE are not common abbreviations. VE can be considered to be ventricular ectopic beats but again this is not a common abbreviation, ectopic beats are referred to as PVCs and supraventriculatr ectopic beats are referred to as PACs. So i think you may have had two runs of SVT which is supraventricular tachycardia, now having two runs of SVT can be considered as normal depending on what type of SVT occurred because the machine can sometimes also classify simple tachycardia (rise in heart rate) as SVT and if your doctors said that it was normal then i would consider the result as being normal and not consider the two runs as being significant.

During a 24 hour EKG, in order for a run of SVT to be significant it has to last for moe than 20-30 secs and possibly cause symptoms and has to be reccurrent but in your case i think you did not have SVT but rather simple tachycardia which the machine interpreted as SVT. Machine based reports for EKG's are NEVER reliable and that is why doctors always look at EKGs themselves in order to make a final diagnosis.

So in my opinion no further testing is necessary especially if the 24 hour EKG was considered as being normal, the two runs which the machine showed would not be considered as significant in this scenario. Take him to the ER NOW

Do you have any more questions?

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Expert:  Dr. Muneeb Ali replied 2 months ago.

Hi,

Welcome to JA and thanks for this question. Im sorry to hear about the patient in question. DKA is a MEDICAL EMERGENCY and needs for the patient to be evaluated and treated IMMEDIATELY in the ER. The fact that the breathing is laboured and the skin is pale means that the person has a low BP. The high heart rate and the rapid breathing rate are also indications that the acidosis in the blood is getting worse. This patient needs a lot of fluid in order to get better and immediate administration of insulin to control the acidosis. The low saturation would improve once the breathing rate comes back down and this would be supplemented in the meantime by oxygen.

My recommendation is to IMMEDIATELY take this patient to the ER where he will be administered IV fluids in the form of saline, IV insulin and oxygen in the beginning. He needs to undergo a lot of tests as well.

Do you have any more questions?

Please leave a POSITIVE rating by clicking on the stars above, until you do i am not compensated for my time. You can continue to ask follow-up questions even after the POSITIVE rating. You can also ask questions from me directly by going on the link below,

http://www.justanswer.com/medical/expert-dr-muneeb-ali/

Expert:  Dr. Muneeb Ali replied 2 months ago.

The latter part of the previous answer was for another patient, please ignore it. But you DO need to take this patient to the ER and if you are the patient yopurself, this has to be managed immediately. The respiratory rate is VERY HIGH and this indicates the severity of the condition. An ER visit is MANDATORY here.

Do you have any more questions?

Please leave a POSITIVE rating by clicking on the stars above, until you do i am not compensated for my time. You can continue to ask follow-up questions even after the POSITIVE rating. You can also ask questions from me directly by going on the link below,

http://www.justanswer.com/medical/expert-dr-muneeb-ali/