Euglycaemic ketoacidosis on the antenatal ward — emergency management station

A 29-year-old G3P2 with type 1 diabetes for 18 years is an inpatient at 33+1 weeks, admitted 48 hours ago with preterm prelabour rupture of membranes. She received betamethasone on admission. Overnight she has become nauseated and has vomited twice. At 05:40 the midwife escalates: the woman is breathing deeply, feels 'awful', and the CTG has become tachycardic with reduced variability. Capillary glucose 8.9 mmol/L. You are the registrar. The consultant is 20 minutes away and has been called. An anaesthetic registrar and a midwife are with you.