All patients in stupor or coma should undergo blood chemistry studies, including blood gases. The anion gap and serum osmolality must be calculated in all patients. An indwelling catheter to monitor urine content and volume is essential. Electrocardiogram monitoring is indicated in all significant metabolic acidosis, especially for evaluation of intracellular potassium effect and arrhythmias. Repeated arterial monitoring of blood gases and electrolytes is essential with the use of flow sheets. Sodium lactate and Ringer's solution should never be given in an emergency care area. Large doses of insulin (100+ units intravenously) are not necessary or indicated in diabetic ketoacidosis and may be contraindicated and dangerous especially in HHNKC. Intravenous or intramuscular regular insulin after urine tests for glucose and ketones alone should not be given. Urine dilution of serum ketones is useless, and serum dilution may be grossly misleading and contraindicated: arterial studies are much more reliable.
所有处于木僵或昏迷状态的患者都应进行血液化学检查，包括血气分析。所有患者都必须计算阴离子间隙和血清渗透压。留置导尿管以监测尿液成分和尿量至关重要。所有严重代谢性酸中毒患者均需进行心电图监测，尤其是用于评估细胞内钾效应和心律失常。使用流程图对血气和电解质进行重复动脉监测至关重要。在急救区域绝对不应给予乳酸钠和林格氏液。大剂量胰岛素（静脉注射100单位以上）在糖尿病酮症酸中毒中并非必要或适用，尤其在高渗高血糖非酮症昏迷（HHNKC）中可能禁忌且危险。仅在尿液检测出葡萄糖和酮体后不应给予静脉或肌肉注射正规胰岛素。尿液稀释血清酮体并无用处，血清稀释可能会产生严重误导且禁忌：动脉检查更为可靠。
