The doctor who had the right intentions at least

You really don’t like to hang around. Live fast, die young is your philosophy, which is great for your maritally unsatisfied partner if you were a racing driver who has taken out life insurance. It is less good for a doctor. You give a rapid acting insulin analogue stat, mindful this is an emergency and therefore needs rapid treatment. However, this rapidly created hypoglycemia of 0.5 mmo/L, especially at that dose. This was treated with an intravenous glucose infusion.  However, everyone was now confused as to whether or not to continue insulin in a recently hypoglycemic patient in DKA. You call the medical SpR, who gives you a lollipop and asks you to sit in the doctors mess for a few minutes.

Score: 4/10 – The initial management was just about OK, but the choice of insulin wasn’t right. You need soluble insulin on a VRIII. That was a pretty intense dose of rapid acting Novorapid stat, which caused a severe hypoglycemia. The ABG was also unnecessary pain for no gain, and there should not have been potassium in the first bag. But hey, the patient is probably just about alive. You get what you pay for, and the NHS barely pay you anything.