DKA outside of ED or PICU
Question:
In the last year, we’ve established a Moderate Care Unit to care for patients with mild-moderate DKA on our general pediatrics floor. Do any other sites have any experience with managing DKA and/or an insulin drip outside of the ED or PICU? If so, what does your process look like? And how do you think it has improved your care for patients with diabetes?
Name: Ashley Garrity, MPH
Clinic: C.S Mott Children’s Hospital, University of Michigan
Adult or Pediatric Population: Both
Date: 7/13/2023
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Hi Ashley – our medical acute care floor manages our DKA patients on insulin drips. We would be happy to chat with you about this:)
cbyer-mendoza@rchsd.org
Hi Ashley,
We have a Diabetes Care Unit (DCU) with nurses specifically trained and certified to manage DKA on the hospital floor. These Certified Diabetes Nurses (CDNs) are NOT CDCES, but they do bedside teaching for new-onset diabetes under the supervision of the inpatient CDCES. There are some exclusions on who can be managed outside of the PICU (e.g., age <5, pH <7, bicarb <5, altered mental status on GCS eval must be managed in PICU). We have found that this improves care for patients with diabetes, helps to facilitate timely education, and decreases the length of stay. It also allows family-centered rounds to take place with the entire diabetes care team (MD, NP, fellow, CDCES, RD, SW, bedside nurse, childlife specialist, +/- psychologist). To learn more, please email our inpatient CPT lead, Dr. Siripoom McKay (siripoom@bcm.edu)