Integrated Multidisciplinary Management of Pediatric Diabetic Ketoacidosis: Nursing, Emergency Medical Services, Social Work, and Safety Systems Across the Care Continuum
Abstract
Background: Diabetic ketoacidosis (DKA) is a life-threatening metabolic emergency characterized by hyperglycemia, ketosis, and metabolic acidosis. Pediatric patients are particularly vulnerable due to limited physiological reserves and higher risk of cerebral edema.
Aim: To provide an integrated, multidisciplinary approach for managing pediatric DKA across emergency, nursing, social work, and safety systems, emphasizing evidence-based protocols and interprofessional collaboration.
Methods: This review synthesizes current guidelines and literature on pediatric DKA, detailing pathophysiology, epidemiology, diagnostic criteria, and treatment strategies. It highlights the roles of emergency medical services, nursing care, and psychosocial interventions in optimizing outcomes.
Results: DKA incidence remains significant, with up to 30% of children presenting in DKA at initial diabetes diagnosis. Mortality rates are low in high-resource settings (0.15–0.31%) but cerebral edema accounts for most fatalities. Effective management requires early recognition, controlled fluid resuscitation, continuous insulin infusion, proactive electrolyte replacement, and vigilant neurological monitoring. Multidisciplinary coordination reduces complications and recurrence risk, particularly in adolescents where psychosocial factors often drive repeated episodes.
Conclusion: Pediatric DKA demands rapid, protocol-driven care integrated with education and prevention strategies. Interprofessional teamwork and structured communication are essential to minimize morbidity and mortality.
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Copyright (c) 2025 Khaled Lafi Abdulkarim Al-Mutairi, Fahad Bunaydir Shulaywih Almutairi, Mjaed Metaib Atek Almutairi, Fatimah Mohammed Salh Alamri, Najmah Abdullah Aldandan, Abdulaziz Mohammed Aqdi, Abdullah Madsus Alanazi, Bader Abdulhamid Mohammed Alharbi, Mohammed Faris Alqahtani, Fahad Abdul Aziz Alsaedi, Zamzam Ali Sahli
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