SCOTTISH PEAD DKA FLUID CALCULATOR

Diabetic ketoacidosis including fluid calculation sheet

Warning: This guideline is 270 day(s) past its review date.

Objectives

Standardisation of the management of diabetic ketoacidosis in children, including an algorithm for intravenous fluid administration. 

Scope

Children with known or newly diagnosed diabetes mellitus. 

Audience

Medical and nursing staff that encounter this patient group. 

Overview

Biochemical assessment and monitoring

Fluids for DKA - use with DKA IV Fluid Calculation Sheet (below)

Weigh the child and compare with previous known weights and centile charts - access the electronic medical record for existing patients.

1. Treat shock with 10ml/kg N Saline. May repeat once before discussing with a consultant.
   
   
2. Calculate fluid deficit - see A, B, C and D on calculation sheet
   
   
3. Determine maintenance fluid volume per kg from age:
   0-2 years 160ml per kg
   3-5 years 140ml per kg
   6-9 years 120ml per kg
   10-14 years 100ml per kg
   >14.9 years 60ml per kg
   (NB Maintenance calculation is for 48 hours)
   
   
4. Calculate hourly fluid rate (for 48h)
   

   Hourly Rate (ml) =

   [48h MAINTENANCE (C x E) + DEFICIT (D x 1000)] - Volume used to treat shock 48