A young girl who is known to have T1DM (type 1 diabetes mellitus) presented with drowsiness and deep breathing. Her sugar level 20. Her BP 120/80mmHg and her mucous membranes are dry. What would be the next appropriate step?

The key is E ABG. [Likely diagnosis is DKA where ABG is done to demonstrate acidosis. While

definitions vary, mild DKA can be categorized by a pH level of 7.25-7.3 and a serum bicarbonate level

between 15-18 mEq/L; moderate DKA can be categorized by a pH between 7.0-7.24 and a serum

bicarbonate level of 10 to less than 15 mEq/L; and severe DKA has a pH less than 7.0 and bicarbonate

less than 10 mEq/L. In mild DKA, anion gap is greater than 10 and in moderate or severe DKA the anion

gap is greater than 12. These figures differentiate DKA from HHS (hyperosmolar hyperglycemic state)

where blood glucose is greater than 600 mg/dL but pH is greater than 7.3 and serum bicarbonate

greater than 15 mEq/L.].