Paediatric DKA Severity Assessment (ISPAD)
Classifies paediatric DKA severity per ISPAD 2022 guidelines. Guides IV fluid rate, bicarbonate use, and PICU referral. Cerebral oedema prevention is key.
Score interpretation
→ IV access; calculate fluid deficit (max 5%); rehydrate over 48h; fixed-rate insulin 0.05-0.1 units/kg/h; glucose monitoring 1-2h; may tolerate oral fluids if well
→ IV rehydration over 48h; insulin infusion; 2-hourly neuro obs; no sodium bicarbonate (risk of cerebral oedema); K+ replacement; monitor for cerebral oedema (headache, bradycardia, hypertension)
→ PICU admission or PICU input; immediate 10ml/kg 0.9% NaCl bolus if shocked; cerebral oedema protocol (hypertonic saline 2.7% 2.5-5ml/kg or mannitol 0.5g/kg); intubation if GCS <=8; endocrinology urgently
Interpretation bands for the Paediatric DKA Severity. Apply clinical judgement and local guidance.
References
Related
Curated clinical cross-links plus same-class fallbacks.
- Dexamethasone (Paediatric) · Corticosteroid — Croup / Bacterial Meningitis / Post-Extubation Stridor / Cerebral Oedema
- Insulin (IV Infusion — ICU Glucose Control) · Insulin — ICU Glucose Management
- Insulin (Soluble / Actrapid) · Insulin
- Insulin Glargine · Long-Acting Insulin Analogue (Basal)
- Insulin Aspart · Rapid-Acting Insulin Analogue (Bolus)
- Insulin Detemir · Long-acting Insulin Analogue
Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.