Observations & monitoring

  • Hourly
    • Neurological & basic observations
      • NB: Half-hourly neurological observations should be employed in children under 2 years &/or those with severe DKA (increased risk of cerebral oedema)
    • Strict fluid balance
    • Capillary blood glucose & ketones
      • Urine ketones can be used if blood testing not available
  • Medical review, venous blood gases, U&Es & glucose
    • Check 2 hours after management commenced
    • Then at least 4 hourly
  • Medical staff should be informed immediately if:
    • Headache, change in CGS or behaviour
    • Slowing of pulse, changes in the ECG trace (especially T wave changes)
Fig 9: Young people with DKA should be monitored regularly during their treatment