Indication: Diabetic ketoacidosis — hyperglycaemia + ketonuria/ketonaemia + metabolic acidosis. Typically presents with profound depression, dehydration, vomiting, and Kussmaul respiration.

What this protocol does:
• NaCl 0.9% maintenance fluid (NOT LRS — lactate complicates DKA management). Start with rehydration bolus separately; the protocol's 50 mL/h is the maintenance rate.
• Regular insulin CRI 0.05 IU/kg/hr — the most frequent medication interval in any system protocol (q1h dosing rows seeded for 24 h). Adjust the rate (not the dose) based on hourly glucose readings.
• Glucose monitoring q2h — protocol's highest-frequency monitoring task

Watch points:
• Drop in glucose > 75 mg/dL/hr is too fast — risk of cerebral oedema; halve the rate.
• Once glucose < 250 mg/dL, switch the maintenance fluid to include dextrose (NaCl + 2.5–5% dextrose) so the CRI can keep resolving the ketoacidosis without inducing hypoglycaemia.
• Hypokalaemia is the most common life-threatening electrolyte derangement during DKA treatment — supplement KCl in the fluids per the standard sliding scale once urine is being produced.
Escalate if: refractory acidosis, persistent hypokalaemia, neurological signs, or no improvement in 12 h.