Joseph Gladstone

A 16-year-old known type 1 diabetic is brought to the emergency department by ambulance, drowsy and confused after abdominal pain and vomiting at a party. Conduct a primary survey, take a collateral history, order urgent investigations, and initiate resuscitation and management.

1. 1Conduct a structured DRSABCDE primary survey
2. 2Take a focused collateral history from the mother and paramedics
3. 3Screen for and exclude hypoglycaemia, shock and other causes of reduced consciousness
4. 4Order urgent point-of-care and laboratory investigations
5. 5State the working diagnosis with relevant differentials and severity
6. 6Initiate fluid, insulin and electrolyte management
7. 7Arrange ICU admission, monitoring and explanation to the family