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Diabetic ketoacidosis is a complication of new or existing pediatric diabetes and may be complicated by cerebral injury. Due to this risk, it is treated differently than adult DKA. Health care providers must follow a published pediatric-specific protocol when treating pediatric DKA. Early communication with the diabetes specialist at your pediatric referral site is a key element of the management of these patients. Key highlights include dehydration is a key component of DKA pathophysiology; all patients with DKA should receive a 20 ml/kg IV bolus of normal saline or Ringer's lactate over 20 minutes at the initiation of treatment, which can be repeated if the patient remains hypoperfused; ongoing fluids in DKA should be weight-based and account for the significant fluid deficit, with an increased maximum of 500 ml/hr; and every patient in DKA is at risk of cerebral injury before and during treatment, especially if DKA is more severe. Assess every patient with DKA for signs of cerebral injury and follow the TREKK DKA algorithm. In June 2023, TREKK’s DKA resources have been updated to reflect the 2022 International Society for Pediatric and Adolescent Diabetes (ISPAD) guidelines.

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Key Resources 

Bottom Line Recommendations: Diabetic Ketoacidosis  (2023)

Bottom Line Recommendations: Diabetic Ketoacidosis

Download

Dr. Sarah Reid and Dr. Karen Gripp

Dr. Sarah Reid and Dr. Karen Gripp

Bottom line recommendations for the treatment and management of diabetic ketoacidosis (DKA).

Algorithm: Diabetic Ketoacidosis  (2023)

Algorithm: Diabetic Ketoacidosis

Download

Dr. Sarah Reid, Dr. Karen Gripp and Dr. Sarah Lawrence

Dr. Sarah Reid, Dr. Karen Gripp and Dr. Sarah Lawrence

An algorithm for recognizing and managing pediatric diabetic ketoacidosis

Pocket Card: Diabetic Ketoacidosis  (2023)

Pocket Card: Diabetic Ketoacidosis

Download

Dr. Sarah Reid, Dr. Karen Gripp and Dr. Sarah Lawrence

Dr. Sarah Reid, Dr. Karen Gripp and Dr. Sarah Lawrence

A pocket guide to red flags for pediatric diabetic ketoacidosis

Order Set: Diabetic Ketoacidosis  (2023)

Order Set: Diabetic Ketoacidosis

Download

Dr. Sarah Reid, Dr. Karen Gripp and Dr. Sarah Lawrence

Dr. Sarah Reid, Dr. Karen Gripp and Dr. Sarah Lawrence

This order set is for management of pediatric diabetic ketoacidosis in the ED. This document is adaptable to your hospitals form policy. 

Diabetic Ketoacidosis Development Team  (2023)

Diabetic Ketoacidosis Development Team

Download

This document outlines the references used and team involved in the development of the diabetic ketoacidosis PedsPac. 

Evidence Repository: Diabetic Ketoacidosis  (2022)

Evidence Repository: Diabetic Ketoacidosis

Download

Dr. Sarah Reid and Dr. Karen Gripp

Dr. Sarah Reid and Dr. Karen Gripp

Evidence repositories are collections of best available resources and evidence (clinical guidelines, peer reviewed literature, systematic reviews, etc.), collated by our knowledge synthesis team and content advisors. This evidence repository is not intended to be an exhaustive list of resources for a topic, but rather a curated list of current, evidence-based resources, based on expert consensus of relevance and usability for a general emergency department setting. We search databases (Cochrane Library, PubMed, TRIP Database) and web search engines (Google, Google Scholar) to locate evidence. Additionally, hospital websites are browsed for guidance documents, such as clinical practice guidelines (CPG) for healthcare professionals. 

 

Every effort is made to identify resources that are open access (i.e. publicly available, free of charge, not requiring a subscription). 

 

More information about the creation of our evidence repositories can be found at https://pubmed.ncbi.nlm.nih.gov/28537762/

 

VIDEO: DKA in Kids  (2020)

VIDEO: DKA in Kids

Visit

Recommandations De Base Acidocétose Diabétique  (2023)

Recommandations De Base Acidocétose Diabétique

Download

Dr. Sarah Reid and Dr. Karen Gripp

Dr. Sarah Reid and Dr. Karen Gripp

Acidocétose Diabétique Pédiatrique – Algorithme  (2023)

Acidocétose Diabétique Pédiatrique – Algorithme

Download

Dr. Sarah Reid and Dr. Karen Gripp

Dr. Sarah Reid and Dr. Karen Gripp

Carte de Poche d'Acidose Diabetique  (2023)

Carte de Poche d'Acidose Diabetique

Download

Dr. Sarah Reid and Dr. Karen Gripp

Dr. Sarah Reid and Dr. Karen Gripp

Feuille Dordonnances Pr-Rdiges pour d'Acidose Diabetique  (2023)

Feuille Dordonnances Pr-Rdiges pour d'Acidose Diabetique

Download

Dr. Sarah Reid and Dr. Karen Gripp

Dr. Sarah Reid and Dr. Karen Gripp

Équipe De Développement Acidocétose diabétique  (2023)

Équipe De Développement Acidocétose diabétique

Download

Bottom Line Recommendations: Diabetic Ketoacidosis  (2023)

Bottom Line Recommendations: Diabetic Ketoacidosis

Download

Dr. Sarah Reid and Dr. Karen Gripp

Dr. Sarah Reid and Dr. Karen Gripp

Bottom line recommendations for the treatment and management of diabetic ketoacidosis (DKA).

Algorithm: Diabetic Ketoacidosis  (2023)

Algorithm: Diabetic Ketoacidosis

Download

Dr. Sarah Reid, Dr. Karen Gripp and Dr. Sarah Lawrence

Dr. Sarah Reid, Dr. Karen Gripp and Dr. Sarah Lawrence

An algorithm for recognizing and managing pediatric diabetic ketoacidosis

Pocket Card: Diabetic Ketoacidosis  (2023)

Pocket Card: Diabetic Ketoacidosis

Download

Dr. Sarah Reid, Dr. Karen Gripp and Dr. Sarah Lawrence

Dr. Sarah Reid, Dr. Karen Gripp and Dr. Sarah Lawrence

A pocket guide to red flags for pediatric diabetic ketoacidosis

Order Set: Diabetic Ketoacidosis  (2023)

Order Set: Diabetic Ketoacidosis

Download

Dr. Sarah Reid, Dr. Karen Gripp and Dr. Sarah Lawrence

Dr. Sarah Reid, Dr. Karen Gripp and Dr. Sarah Lawrence

This order set is for management of pediatric diabetic ketoacidosis in the ED. This document is adaptable to your hospitals form policy. 

Recommandations De Base Acidocétose Diabétique  (2023)

Recommandations De Base Acidocétose Diabétique

Download

Dr. Sarah Reid and Dr. Karen Gripp

Dr. Sarah Reid and Dr. Karen Gripp

Acidocétose Diabétique Pédiatrique – Algorithme  (2023)

Acidocétose Diabétique Pédiatrique – Algorithme

Download

Dr. Sarah Reid and Dr. Karen Gripp

Dr. Sarah Reid and Dr. Karen Gripp

Carte de Poche d'Acidose Diabetique  (2023)

Carte de Poche d'Acidose Diabetique

Download

Dr. Sarah Reid and Dr. Karen Gripp

Dr. Sarah Reid and Dr. Karen Gripp

Feuille Dordonnances Pr-Rdiges pour d'Acidose Diabetique  (2023)

Feuille Dordonnances Pr-Rdiges pour d'Acidose Diabetique

Download

Dr. Sarah Reid and Dr. Karen Gripp

Dr. Sarah Reid and Dr. Karen Gripp

Équipe De Développement Acidocétose diabétique  (2023)

Équipe De Développement Acidocétose diabétique

Download

Diabetic Ketoacidosis Development Team  (2023)

Diabetic Ketoacidosis Development Team

Download

This document outlines the references used and team involved in the development of the diabetic ketoacidosis PedsPac. 

Evidence Repository: Diabetic Ketoacidosis  (2022)

Evidence Repository: Diabetic Ketoacidosis

Download

Dr. Sarah Reid and Dr. Karen Gripp

Dr. Sarah Reid and Dr. Karen Gripp

Evidence repositories are collections of best available resources and evidence (clinical guidelines, peer reviewed literature, systematic reviews, etc.), collated by our knowledge synthesis team and content advisors. This evidence repository is not intended to be an exhaustive list of resources for a topic, but rather a curated list of current, evidence-based resources, based on expert consensus of relevance and usability for a general emergency department setting. We search databases (Cochrane Library, PubMed, TRIP Database) and web search engines (Google, Google Scholar) to locate evidence. Additionally, hospital websites are browsed for guidance documents, such as clinical practice guidelines (CPG) for healthcare professionals. 

 

Every effort is made to identify resources that are open access (i.e. publicly available, free of charge, not requiring a subscription). 

 

More information about the creation of our evidence repositories can be found at https://pubmed.ncbi.nlm.nih.gov/28537762/

 

VIDEO: DKA in Kids  (2020)

VIDEO: DKA in Kids

Visit