Here is a quick guide to dosing of fluids and insulin in pediatric dka. Infants have a slightly different management strategy that is not covered here.
insulin drip: 0.05 -0.1 units/kg/hr
Fluids: Start off with a 10-30 mL/kg bolus of NS (I’d recommend the lower end)
K <5.5
INSTRUCTIONS FOR IVF:
BAG 1: 75meq Na-acetate/75 meq NaCL with 20 meq KCl/20 meq KPhos
BAG 2: D10 75meq Na-acetate/75 meq NaCL with 20 meq KCl/20 meq KPhos
Maintenance rate=M=***
BGM >350: Bag 1 100%M
BGM 250-350: Bag 1 50%M + Bag 2 50%M
BGM < 250: Bag 2 100%M
Adultish child with K >5.5
INSTRUCTIONS FOR IVF:
BAG 1: 75meq Na-acetate/75 meq NaCL
BAG 2: D10 75meq Na-acetate/75 meq NaCL
Maintenance rate=M=***
BGM >350: Bag 1 100%M
BGM 250-350: Bag 1 50%M + Bag 2 50%M
BGM < 250: Bag 2 100%M