DKA / HHS bedside calculator

Reference aid only. Verify every rate against the official protocol and facility double-check policy before acting.

Lab values

Sodium

mEq/L

Chloride

mEq/L

Bicarbonate (HCO₃)

mEq/L

Serum glucose

mg/dL

BUN

mg/dL

Ethanol, if any

mg/dL

Potassium (K⁺)

mEq/L

β-hydroxybutyrate

mmol/L

Urine ketones

mg/dL

Urine output, last hour

mL/hr

Converted to mL/kg/hr using weight.

Patient has a known history of diabetes

Use the measured Na, Cl and HCO₃ from the lab panel. Don't use the calculated anion gap from the iSTAT Chem-8.

Diagnostic criteria check

This shows which protocol criteria the entered values meet. The diagnosis itself is made by the provider.

Hydration status

Severe hypovolemia Mild dehydration Cardiogenic shock

Risk factors

Kidney disease, heart failure, or weight under 60 kg

Sodium, glucose, K⁺, pH and urine output come from the Labs tab. Corrected Na is sorted as low (<135), normal (135–145) or high (>145); the printed algorithm doesn't state cutoffs, so confirm these match your lab's reference range.

IV fluids

Potassium

Bicarbonate

Hourly titration

Current infusion rate

units/hr

Current BG

mg/dL

Previous BG

mg/dL

BG has already reached ≤250 during this infusion

Has at least 1 hour passed since the last rate increase?

Yes, or no prior increase No

Rates assume 1 unit/mL concentration and are rounded to 0.1 unit/hr. When no changes are made for 4 consecutive hourly checks, BG checks may go to every 2 hours.

Starting the infusion

Maintenance fluids are ordered

Resolution inputs

Uses current and previous BG from the Insulin drip tab, and pH, HCO₃, β-hydroxybutyrate, anion gap, osmolality and urine output from the Labs tab.

Previous anion gap

Patient is back to baseline mental status