Diabetic Ketoacidosis (DKA) Clinical Pathway — Emergency Department, ICU and Inpatient
Diabetic Ketoacidosis (DKA) Clinical Pathway — Emergency Department, ICU and Inpatient
Goals of Therapy
| Correct Dehydration | Conservative fluid resuscitation starting with 10 mL/kg bolus of normal saline Careful reassessment to avoid contributing to risk of cerebral edema |
|---|---|
| Correct Ketoacidosis | Start insulin after the initial hour of fluid resuscitation Do not use insulin bolus, it increases the risk for cerebral edema |
| Normalize Blood Sugar | Aim to drop glucose by 50-100 mg/dL per hr |
| Avoid Complications | Anticipate and evaluate for cerebral edema Assess mental status and neurologic exam frequently during treatment |
| Treat Precipitating Event | Evaluate for underlying cause (infection, trauma, ingestion) |
Metrics
Cohort: Child's with diagnosis of diabetes mellitus, types I, II and DKA