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.
Bottom Line Recommendations: Diabetic Ketoacidosis
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
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
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
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
This document outlines the references used and team involved in the development of the diabetic ketoacidosis PedsPac.
Evidence Repository: Diabetic Ketoacidosis
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/
Recommandations De Base Acidocétose Diabétique
Dr. Sarah Reid and Dr. Karen Gripp
Dr. Sarah Reid and Dr. Karen Gripp
Acidocétose Diabétique Pédiatrique – Algorithme
Dr. Sarah Reid and Dr. Karen Gripp
Dr. Sarah Reid and Dr. Karen Gripp
Carte de Poche d'Acidose Diabetique
Dr. Sarah Reid and Dr. Karen Gripp
Dr. Sarah Reid and Dr. Karen Gripp
Feuille Dordonnances Pr-Rdiges pour d'Acidose Diabetique
Dr. Sarah Reid and Dr. Karen Gripp
Dr. Sarah Reid and Dr. Karen Gripp
Équipe De Développement Acidocétose diabétique
Bottom Line Recommendations: Diabetic Ketoacidosis
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
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
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
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
Dr. Sarah Reid and Dr. Karen Gripp
Dr. Sarah Reid and Dr. Karen Gripp
Acidocétose Diabétique Pédiatrique – Algorithme
Dr. Sarah Reid and Dr. Karen Gripp
Dr. Sarah Reid and Dr. Karen Gripp
Carte de Poche d'Acidose Diabetique
Dr. Sarah Reid and Dr. Karen Gripp
Dr. Sarah Reid and Dr. Karen Gripp
Feuille Dordonnances Pr-Rdiges pour d'Acidose Diabetique
Dr. Sarah Reid and Dr. Karen Gripp
Dr. Sarah Reid and Dr. Karen Gripp
Équipe De Développement Acidocétose diabétique
Diabetic Ketoacidosis Development Team
This document outlines the references used and team involved in the development of the diabetic ketoacidosis PedsPac.
Evidence Repository: Diabetic Ketoacidosis
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/