Immediate Plasma Potassium Levels in Treating Diabetic Ketoacidosis

In Reply. —Dr Alonso is concerned that our recommendation 1 to use a blood-gas analyzer to measure stat potassium levels is not necessary since these values should be routinely available from the hospital laboratory in a short period of time. I certainly agree with this point in theory. Unfortunately, in many institutions this does not routinely happen for many reasons, including inadequate staffing, outmoded equipment, and the volume of stat specimens that can overwhelm the capability of the laboratory. For example, our laboratory in an urban municipal hospital receives approximately 300 stat samples per 24 hours. The average turn-around time is approximately 90 minutes. Although the use of plasma for stat specimens is under consideration in our laboratory, serum has been preferable because of technical problems with plasma. Many articles on diabetic ketoacidosis discuss what to do when initial potassium values are not available. 2-6 For example, a recent article