• Trainee will demonstrate competence in the initial evaluation and management of patients with diabetic ketoacidosis, including the pediatric population

Objectives

Trainee will be able to:

• Describe the pathophysiology of DKA

• List criteria for diagnosing DKA

• List common presenting signs and symptoms of patients in DKA

• List diagnostic tests commonly indicated in the work-up of patients with DKA

  • Fingerstick glucose

  • CBC with differential

  • BMP / Mg / Phos

  • VBG

  • Serum ketones

  • UA

  • Infectious work-up (as indicated)

• Name common electrolyte abnormalities and approach to treatment

  • Sodium

  • Potassium

  • Serum

  • Total-body

  • Magnesium

  • Phosphate

• Name common acid-base abnormalities and approach to treatment

• Name and describe three pillars of DKA management

  • Volume repletion

  • Insulin therapy / glucose management

  • Electrolyte management

• Describe appropriate initial fluid resuscitation for:

  • Pediatric patients

  • Adult patients

• Describe appropriate insulin therapy:

  • Timing / conditions for initiation

  • Type / route / dose of insulin

• Describe appropriate electrolyte repletion:

  • Thresholds for repletion

  • Route / dose of therapy

• Name the tests used for continued monitoring and appropriate intervals for testing

  • Glucose

  • Electrolytes

  • pH

  • Anion Gap

• Describe the appropriate disposition for patients with DKA