Sandbox
| Mild DKA | Moderate DKA | Severe DKA | HHS | |
| Plasma glucose | >250 mg/dL | >250 mg/dL | >250 mg/dL | >600 mg/dL |
| Arterial pH | 7.25-7.30 | 7.00 to <7.24 | <7.00 | >7.30 |
| Serum bicarbonate (mEq/l) | 15-18 | 10 to <15 | <10 | >18 |
| Urine ketone | Positive | Positive | Positive | Small |
| Serum ketone | Positive | Positive | Positive | Small |
| Effective serum osmolality | Variable | Variable | Variable | >320 mOsm/kg |
| Anion gap | >10 | >12 | >12 | Variable |
| Mental status | Alert | Alert/drowsy | Stupor/coma | Stupor/coma |
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table HIT
| Score = 2 | Score = 1 | Score = 0 | |
|---|---|---|---|
| Thrombocytopenia Compare the highest platelet count within the sequence of declining platelet counts with the lowest count to determine the % of platelet fall. (Select only 1 option) |
♦ > 50% platelet fall AND nadir of ≥ 20 AND no surgery within preceding 3 days | ♦ > 50% platelet fall BUT surgery within preceding 3 days OR ♦ any combination of platelet fall and nadir that does not fit criteria for score 2 or score 0 (eg. 30-50% platelet fall or nadir 10-19) |
♦ < 30% platelet fall any platelet fall with nadir < 10 |
| Timing (of platelet count fall or thrombosis) Day 0 = first day of most recent heparin exposure (Select only 1 option) |
♦ platelet fall day 5-10 after start of heparin ♦ platelet fall within 1 day of start of heparin AND exposure to heparin within past 5-30 days |
♦ consistent with platelet fall days 5-10 but not clear (eg. missing counts) ♦ platelet fall within 1 day of start of heparin AND exposure to heaprin in past 31-100 days ♦ platelet fall after day 10 |
♦ platelet fall ≤ day 4 without exposure to heaprin in pas 100 days |
| Thrombosis (or other clinical sequelae) (Select only 1 option) |
♦ confirmed new thrombosis (venous or arterial) skin necrosis at injection site ♦ anaphylactoid reaction to IV heparin bolus ♦ adrenal hemorrhage |
♦ recurrent venous thrombosis in a patient receiving therapeutic anticoagulants ♦ suspected thrombosis (awaiting confirmation with imaging) ♦ erythematous skin lesions at he heparin onjection sites |
♦ thrombosis suspected |
| Other causes for thrombocytopenia (Select only 1 option) |
♦ no alternative explanation for platelet fall is evident | Possible other cause is evident: ♦ sepsis without proven microbial source ♦ thrombocytopenia associated with initiation of ventilator ♦ other |
Probable other cause present: ♦ within 72 h of surgery ♦ confirmed bacteremia/fungemia ♦ chemotherapy or radiation within past 20 days ♦ DIC due to non-HIT cause ♦ posttransfusion purpura (PTP) ♦ platelet count < 20 AND given a drug implicated in causing D-ITP ♦ non-necrotizing skin lesions at LMWH injection site ♦ other |