I work mostly in an Adult Intensive Care Unit now. The other night we had a pt brought to us in severe DKA with Kussmaul breathing, profuse vomiting, altered LOC, and BGL in the 1000s mg/Dl. The intensivist ordered 6 liters LR over a 1-2 hours and insulin. I asked him why LR and he told me that it is like a cheap bi-carb drip that is ready to go for EMS. The lactose gets converted to bi-carb in the liver. He also stated the glucose level is more an annoyance; the real problem is the imbalance. Anyone ever heard of this?