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Diabetic Ketoacidosis (DKA)
Pre-reading
Emergency Medicine Cases Podcast : Paediatric DKA

Diabetic Ketoacidosis Guideline
File Size: 491 kb
File Type: pdf
Download File

Workbook Questions

Diabetic Ketoacidosis
 
Case 1
A 20kg, 6-year-old girl presents to the Emergency department with a 2-day history of lethargy and abdominal pain. She had 3 vomits this morning and is unable to keep anything down. On further questioning you discover she has had increased thirst and bed wetting, which is new over the last 2 weeks. The nurse at triage does a BSL and it reads high.


  1. What do you expect this girl will look like in the bed and what are the likely abnormalities in her observations?
 
 You decide to place an IV line and take a venous gas, the results are below:
  • pH 7.15
  • pO2 100
  • pCO2 26
  • HCO3 18
  • Na+ 132
  • K+ 5.0
  • BSL 36 mmol/L
  • Ketones 6.2
 
  1. Can you interpret the gas above?

Her observations are as follows : HR 130, RR 42, Sats 99% RA, Temp 36.4, CRT < 2 secs

  1. What are your immediate management priorities?
  2. You decide not to give a fluid bolus but estimate 5% dehydration, using the table below calculate her fluid replacement
Picture
  1. An hour after starting the Iv fluids her BSL is 32 and Ketones are 6.1, what is the next step in your management? How would you prescribe this?
  2. You continue to check hourly blood gases and ketones and 2 hours later the BSL is 11 and the Ketones are 3.6, how would your change your existing management?
  3. What are the complications of DKA and the treatment of DKA to look out for?
Copyright © 2015
  • Home
  • Guidelines
    • AAA Rupture
    • Acute Coronary Syndrome
    • Anaphylaxis
    • Aortic Dissection
    • Appendicitis
    • Asthma
    • Backpain
    • Bowel Obstruction
    • Bronchiectasis
    • Burns
    • Chest Pain >
      • ADP Chest Pain Pathway
    • Cholecystitis
    • Confusion
    • COPD
    • Diverticulitis
    • DKA
    • DVT
    • Eating Disorders
    • Febrile Neutropaenia
    • Fractures >
      • Bier's block procedure form
      • Fractured neck of Femur
    • Funnel Web Spider Bite
    • Headache
    • Influenza Like illness
    • Meningitis
    • Obstetrics >
      • Hypertensive disorders in pregnancy
      • Normal Birth
      • PPH
      • Preterm labour
      • Still birth
      • Trauma in pregnancy
    • Pancreatitis
    • Paracetamol OD
    • Pathology Ordering
    • Peri-anal abscess
    • Pertussis
    • Pneumonia
    • Pneumothorax
    • Podiatry
    • Procedural Sedation >
      • Procedural Sedation
    • Pulmonary Embolus
    • PV Bleeding in Early pregnancy >
      • EPAU - Early Pregnancy Assessment Unit
    • Redback Spider Bite
    • Ring cutter use
    • Seizure
    • Septic Arthritis
    • Use of Restraints
    • Stroke / TIA
    • Sepsis
    • Smoking cessation
    • Snake Bite
    • Syncope >
      • Telemetry guideline
    • TIA
    • Tonometer use
    • Antidotes
    • Dagibatran reversal guidelines
    • Funnel Web Spider Bite
    • Redback Spider Bite
    • Paracetamol OD
    • Snake Bite
    • Warfarin Reversal Guidelines
    • Trauma >
      • C-spine injury
      • Head Injury
      • Imaging Guidelines
      • Trauma in pregnancy
      • Sutures
    • Abdominal Pain
    • Allergy / Anaphylaxis
    • Antimicrobial Guidelines
    • Asthma & Wheeze
    • Behavioural Disturbance
    • Boils - Staph decolonisation treatment
    • Bronchiolitis
    • Buckle fractures
    • Burns
    • Cervical Spine Guideline
    • Chest Pain (Paediatric)
    • Child Protection
    • Constipation
    • Croup
    • DKA
    • Drowning
    • Eating Disorders
    • Fever
    • Fluids in Kids
    • Foreign Bodies
    • Gastroenteritis
    • Headache
    • Head Injury
    • High Flow Nasal Cannula Oxygen
    • Hypoglycaemia
    • Jaundiced Neonate
    • Limping in children
    • Malaria
    • Meningitis
    • Oncology Emergencies
    • Otitis Externa
    • Otitis Media
    • Paediatric Fracture Clinic Referral
    • Paracetamol Poisoning
    • Petechial Rash
    • Pneumonia (CAP)
    • Seizures / Status Epilepticus
    • Sepsis Guideline
    • Tetanus Prophylaxis
    • Torticollis
    • UTI NICE Guideline
    • Trauma in children >
      • LCCH Paeds Trauma Guidelines
      • C Spine Injury LCCH Guideline
      • LCCH Massive Transfusion
    • RCH Melbourne Guidelines
  • Parent Handouts
    • Accidental Poisoning
    • Abdominal Pain
    • Ankle Sprain
    • Arrhythmia
    • Asthma
    • Bronchiolitis
    • Chest Infections
    • Cast Care
    • Cellulitis
    • Constipation
    • Croup
    • DKA
    • Epistaxis
    • Eye Foreign Body
    • Febrile Convulsion
    • Fever
    • Fracture- Buckle
    • Fracture- Clavicle
    • Fracture- Elbow
    • Fracture- Finger/Toe
    • Fracture- Foot
    • Gatroenteritis
    • Glue- Lacerations
    • Head Injury
    • Jaundice
    • Otitis Externa
    • Parechovirus
    • Periorbital and Orbital cellulitis
    • Pulled Elbow
    • Seizures
    • Tonsillitis
    • Urticaria
    • Viral Illness
    • Wound Care
  • ACE the ACEM
  • Blog