CTAS 1. A 10-year-old with new diabetes has vomiting and Kussmaul respirations. Glucose is 31 mmol/L, pH 7.08, bicarbonate 7 mmol/L, potassium 4.9

Question

CTAS 1. A 10-year-old with new diabetes has vomiting and Kussmaul respirations. Glucose is 31 mmol/L, pH 7.08, bicarbonate 7 mmol/L, potassium 4.9 mmol/L, and corrected sodium is 132 mmol/L. GCS is 14. What is the most appropriate next step?

Accepted Answer

Isotonic IV fluids, insulin after initial fluids, close neuro monitoring

Answer

Half-normal saline at maintenance

Answer

Insulin bolus before fluids

Answer

Rapid bicarbonate bolus

Answer

Discharge after subcutaneous insulin

Paediatric DKA — RCPSC EM MCQ

CTAS 1. A 10-year-old with new diabetes has vomiting and Kussmaul respirations. Glucose is 31 mmol/L, pH 7.08, bicarbonate 7 mmol/L, potassium 4.9 mmol/L, and corrected sodium is 132 mmol/L. GCS is 14. What is the most appropriate next step?