Peds

Pediatric DKA / metabolic acidosis

Before / During / After / Pitfalls

Before

• Intubation is dangerous; preserve compensation if possible and involve pediatric critical care early.
• Use measured/length-based weight and peds DKA protocol.
• Plan minute ventilation and avoid prolonged apnea.

During

• Immediate ventilation after tube; careful EtCO2/pH follow-up.
• Avoid hypotension/hypoxia.
• Use peds equipment/meds from weight-based references.

After

• Frequent gas/electrolyte/neuro reassessment.
• Watch cerebral edema risk.
• Continue DKA protocol; tube is supportive, not definitive therapy.

Pitfalls

• Under-ventilation after paralysis.
• No peds critical care involvement.
• Using adult assumptions for tube size/vent RR.