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Pediatric diabetic ketoacidosis

Educational use only. Not clinically reviewed

9-year-old girl for calm pediatric diabetic ketoacidosis recognition, qualified escalation, serial safety reassessment, and active-risk handoff. About 8 simulated minutes.

What you will practise

  • Connect the supplied illness trajectory, hydration, breathing, mentation, glucose, ketones, and acid-base findings.
  • Recognize the supplied pediatric diabetic ketoacidosis pattern and its no-current-shock boundary.
  • Activate experienced pediatric DKA, nursing, laboratory, fluid, insulin, electrolyte, and monitoring ownership.
  • Review neurological status, circulation, electrolytes, glucose, ketones, acid-base response, intake, output, and precipitating causes in parallel.
  • After elapsed qualified care, review the fixed whole-child and biochemical response without declaring DKA resolved.
  • Hand off neurological, circulatory, glucose, ketone, acid-base, electrolyte, intake, output, precipitant, and ownership work.

Review and sources

Not clinically reviewed. No clinician has signed this scenario.

  • Glaser N, Fritsch M, Priyambada L, et al. ISPAD Clinical Practice Consensus Guidelines 2022: Diabetic ketoacidosis and hyperglycemic hyperosmolar state. Pediatric Diabetes. 2022;23(7):835-856. doi:10.1111/pedi.13406.
  • National Institute for Health and Care Excellence. Diabetes (type 1 and type 2) in children and young people: diagnosis and management. NICE guideline NG18. Published 2015; overall last updated 2023; DKA fluid evidence reviewed 2020; shock-bolus wording amended 2022; minor DKA-checking update 2026. Section 1.4.
  • British Society for Paediatric Endocrinology and Diabetes. Guideline for the Management of Children and Young People under the age of 18 years with Diabetic Ketoacidosis. 2021. Version 3.
  • Kuppermann N, Ghetti S, Schunk JE, et al. Clinical Trial of Fluid Infusion Rates for Pediatric Diabetic Ketoacidosis. New England Journal of Medicine. 2018;378:2275-2287. doi:10.1056/NEJMoa1716816.

Every scenario in this module

Open Sim Lab is an educational simulator, not for clinical use. It is not a clinical decision-support tool, not a dosing calculator, and is not validated for any decision affecting a real patient.