A 12-year-old boy arrives as ESI 2 with polyuria, vomiting, and abdominal pain. BP 94/58, HR 132, RR 32 with Kussmaul breathing. Glucose is 520

Question

A 12-year-old boy arrives as ESI 2 with polyuria, vomiting, and abdominal pain. BP 94/58, HR 132, RR 32 with Kussmaul breathing. Glucose is 520 mg/dL, pH 7.08, bicarbonate 7 mEq/L, potassium 4.8 mEq/L. Which of the following is the most appropriate next step in management?

Accepted Answer

Start isotonic fluids, potassium-aware replacement, and IV insulin after initial fluids

Answer

Give long-acting insulin and discharge

Answer

Restrict fluids to prevent cerebral edema

Answer

Give sodium bicarbonate immediately

Answer

Administer glucagon

Pediatric diabetic ketoacidosis — ABEM Board MCQ

A 12-year-old boy arrives as ESI 2 with polyuria, vomiting, and abdominal pain. BP 94/58, HR 132, RR 32 with Kussmaul breathing. Glucose is 520 mg/dL, pH 7.08, bicarbonate 7 mEq/L, potassium 4.8 mEq/L. Which of the following is the most appropriate next step in management?