Hyperosmolar Hyperglycemic State (HHS) – The Management in the Emergency Department

Abstract

Introduction: The hyperosmolar hyperglycemic state (HHS) poses a direct threat to the health and life of the patient. It is most common in patients with type 2 diabetes, and it is associated with high mortality. For this reason, HHS requires a quick diagnosis and implementation of the correct treatment. Mortality due to HHS ranges from 5% to 16%. It is about ten times higher than in diabetic ketoacidosis. This is due to the underlying cause of hyperglycemia, the severity of dehydration, and often the advanced age and comorbidities. The aim: The study aimed to develop the correct management strategy for the medical staff in the Emergency Department (ED) for a patient with the suspected HHS. Material and methods: The research material was obtained from the analysis of the patient’s medical records during his stay in the ED and from the emergency medical card and the order of the EMS team to dispatch to this 62-year-old patient due to the deterioration of verbal and logical contact and unassessed glucose values. The study used an individual case study method. Results: Combating hyperglycemia, replenishing water deficit, correcting electrolyte disturbances, as well as diagnostics and initial therapy of comorbidities are the priorities in providing medical care to a patient with suspected HHS. Conclusions: The medical staff in the ED followed guidelines on HHS management.