A 14-year-old with DKA has pH 6.92, potassium 4.8 mmol/L, preserved perfusion and compensatory hyperventilation. Insulin and isotonic fluids are

Question

A 14-year-old with DKA has pH 6.92, potassium 4.8 mmol/L, preserved perfusion and compensatory hyperventilation. Insulin and isotonic fluids are running. Which acid-base intervention is indicated?

Accepted Answer

Continue DKA treatment without bicarbonate; closely monitor potassium and neurologic status

Answer

Intubate and normalize PaCO2 because Kussmaul breathing perpetuates acidemia

Answer

Stop insulin until pH rises above 7.1 to avoid worsening extracellular acidosis

Answer

Give bicarbonate because every pH below 7.0 requires immediate buffer therapy

Answer

Change to hypotonic fluid because hyperchloremia is the primary cause of admission acidemia

Paediatric diabetic ketoacidosis with cerebral injury — RCPSC EM MCQ

A 14-year-old with DKA has pH 6.92, potassium 4.8 mmol/L, preserved perfusion and compensatory hyperventilation. Insulin and isotonic fluids are running. Which acid-base intervention is indicated?