A multidisciplinary team led by Jacques-Brett Burgess, MD; Pediatric Hospitalist at Munson Medical Center (MMC), has been studying the treatment of Pediatric Diabetic Ketoacidosis (DKA) in the hospital setting for several years by reviewing patient charts and VOICE reports, as well as discussing with colleagues practicing at children’s hospitals.
Their research uncovered several opportunities:
- Insulin doses and IV fluid boluses were often higher than recommended best practice
- IV bolus doses of insulin were given, which is not recommended in current practice
In response to these findings, the team has implemented new Pediatric Diabetic Ketoacidosis (DKA) PowerPlans for MMC and our MHC community hospitals* to guide the treatment of children with diabetic ketoacidosis up to 21 years of age. The new Cerner PowerPlans include:
- Standardized treatment approach to manage pediatric DKA using a two-bag infusion method, which can be used in all MHC EDs and at MMC; a detailed Reference Text is included in these PowerPlans.
- Established telehealth consults at Munson Medical Center with Helen DeVos Children’s Hospital ICU
- For non-Cerner hospitals, we will be adapting a paper version of the DKA PowerPlan
*The MMC DKA PowerPlan differs from the DKA PowerPlan for the community hospitals due to differences in the availability of compounded fluids.
What does this mean for our patients?
- Providers at our community hospitals can initiate treatment for their DKA patients ≤21 years by following the MHC Pediatric DKA protocol
- ED providers are also asked to consult with the on-call MMC pediatric hospitalist for all pediatric DKA patients
“We believe that in implementing this new Pediatric DKA protocol, it will improve care for some of our most vulnerable patients,” said Dr. Burgess. “This a new way to treat pediatric diabetes, which has already shown to be successful in the short time since the Pediatric DKA protocol was implemented. Next, we are looking to develop an adult DKA PowerPlan.”