An 8-year-old girl has polyuria, polydipsia, nausea, and abdominal pain x 2 days. Lethargic, Kussmaul breathing. Glucose 28 mmol/L, pH 7.15, HCO3 8,

Question

An 8-year-old girl has polyuria, polydipsia, nausea, and abdominal pain x 2 days. Lethargic, Kussmaul breathing. Glucose 28 mmol/L, pH 7.15, HCO3 8, ketones strongly positive. Most appropriate initial management?

Accepted Answer

IV NS bolus then continuous insulin infusion

Answer

IV dextrose 10% with insulin

Answer

Subcutaneous rapid insulin immediately

Answer

Oral rehydration and oral hypoglycaemics

Answer

IV sodium bicarbonate infusion

Paediatric DKA — MCCQE Part 1 MCQ

An 8-year-old girl has polyuria, polydipsia, nausea, and abdominal pain x 2 days. Lethargic, Kussmaul breathing. Glucose 28 mmol/L, pH 7.15, HCO3 8, ketones strongly positive. Most appropriate initial management?