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Cerebral oedema in paediatric DKA — RCPSC EM MCQ

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HardPaediatric emergenciesCerebral oedema in paediatric DKARCPSC EM

A 10-year-old with DKA becomes increasingly irritable 5 hours after starting treatment. Headache worsens, HR drops from 132 to 86/min, BP rises, and oxygen saturation remains normal. Glucose is falling and sodium has not risen as expected. What is the most appropriate next step?

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Correct answer: D — Give hypertonic saline or mannitol immediately and involve ICU

Give hypertonic saline or mannitol immediately and involve ICU is correct: the clues indicate Cerebral oedema in paediatric DKA and this option addresses the immediate ED priority. The distractors delay care, target a less likely problem, or are unsafe in this physiology.

Reference: PALS; Canadian paediatric DKA practice