Paediatric DKA Recognition and Initial Fluid Management

Paediatrics

Diabetic ketoacidosis (DKA) is a life-threatening complication of diabetes in children that requires prompt recognition and careful initial management. Clinical features such as polyuria, polydipsia, vomiting, abdominal pain, dehydration, Kussmaul breathing and altered sensorium should raise suspicion. Diagnosis involves assessing blood glucose, ketones, venous pH and bicarbonate levels. Initial management focuses on evaluating circulatory status, restoring fluid balance with appropriate isotonic fluids and closely monitoring neurological status, electrolytes and glucose levels. Understanding fluid selection, administration, insulin timing and cerebral injury risk is essential for safe treatment. Timely intervention and structured monitoring help improve outcomes. Please participate in the survey and share your opinion on paediatric DKA recognition and initial fluid management.

In your opinion, which clinical feature is most useful for recognising DKA early in children?

• Kussmaul breathing
• Persistent vomiting
• Abdominal pain
• Altered sensorium

Do you think children with DKA should receive initial fluid therapy before starting insulin infusion?

• Strongly agree
• Agree
• Disagree
• Not sure