Consultations
Lucy Potts
ED or Paediatric Endocrinologist consultation
Likely Diabetic Ketoacidosis. Suspected first presentation of T1DM in child with relevant family history of autoimmune disease.
Progressive onset (1 month history of weight loss and polyuria) precipitated by concurrent urinary tract infection.
Continue close monitoring of airway, breathing, and vital signs, according to guidelines. Correct dehydration: start IV fluids, monitor and balance electrolytes as appropriate. Correct glycemia, reverse ketosis, correct acidosis: start IV insulin 1 hour after fluid bolus. Monitor neurological exam, BGL, and ketones hourly. Repeat VBG in 4 hours.
Identify underlying cause once stable: test for diabetes autoantibodies, confirm UTI, search for alternative/additional infective trigger (blood culture).
Patient requires PICU admission.
Other consultations
Not indicated.