Case 1

A 16 year old boy with no past history is referred to the ED by his GP. He has been feeling generally unwell for a few weeks complaining of frequent urination and being thirsty all the time. He has lost about 3kg in weight. Today he has started vomiting and his mother noticed that he is very pale and lethargic.

On arrival to the ED you notice a sweet smell on his breath.

His observations are as follows.

 Temp 37

RR 30

HR 120

120/70

98% RA

Question 1

What is the most likely diagnosis?

Question 2

What bedside test do you do to confirm this diagnosis?

 Question 3

What are your treatment priorities?