The outcomes of implementing clinical guidelines to manage pediatric diabetic ketoacidosis in emergency department

Abstract

Background

Type 1 diabetes is the most common endocrine health condition among youth. Healthcare professionals must consider evidence-based guidelines in managing children and adolescents with diabetic ketoacidosis (DKA). The current study aims to assess the outcomes of implementing clinical guidelines by the American Diabetes Association to manage DKA among pediatrics in an emergency department in Palestine.

Methods

A prospective cohort study was conducted among 60 children (<12 years old) with type 1 diabetes mellitus with DKA throughout February to May 2021. The children were assessed on arrival and during the next 6 h for implementing the recommended guidelines of DKA management (e.g., fluids and insulin therapy). The assessment included measurement of vital signs (blood pressure, heart rate, respiratory rate, O₂ saturation), PH, HCO3-, and random blood glucose (RBG). A repeated-measure ANOVA was used to detect the difference between outcome measures during the follow-up period.

Results

After implementing the recommended guidelines of DKA management, all vital signs improved significantly in the follow-up period (p < 0.05). Also, PH, HCO₃-, and random blood glucose (RBG) were significantly enhanced in the follow-up period (p < 0.05) among children with DKA.

Conclusion

The study demonstrated that the recommended DKA management guidelines effectively managed children with DKA in emergency departments. Healthcare professionals should adhere to the guidelines when treating children with DKA.