Volume 6, Issue 1, Pages 1 – 48 (2007)

Management of Suspected Avian (H5N1) Influenza in a Non-pandemic Setting

Abstract

Avian (H5N1) influenza has been responsible for millions of wild bird and poultry deaths throughout the world. Sporadic human cases with a high mortality have occurred, almost exclusively in association with very close contact with sick, dying or dead birds. Appropriate management of suspected cases requires their prompt recognition via attention to travel and bird-exposure history. The early isolation, diagnosis and treatment of suspected cases as well as prompt involvement of the health protection unit should enable patients to be optimally managed with minimum risk to health care staff.

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The Management of Diabetic Ketoacidosis

Abstract

This article reviews the management of diabetic ketoacidosis (DKA) in adults with a focus on the three basic principles of treatment: intravenous fluid therapy, intravenous insulin administration and potassium replacement. The recommendations are modelled on the national guidance for the management of DKA in children. We highlight the importance of being alert to signs of life-threatening complications of the condition such as cerebral oedema and adult respiratory distress syndrome (ARDS). We also discuss the use of near-patient testing of capillary beta-hydroxybutyrate (b-OHB) using a ketone meter as an aid to managing and preventing DKA.

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