Understanding Pediatric Diabetic Ketoacidosis

About this episode

This episode discusses pediatric diabetic ketoacidosis and its management in prehospital settings.

Mike Brown sits down with Dr. Sarah Fabiano and Mike Ellis as they distill pediatric diabetic ketoacidosis into a clear prehospital approach. Using a “sour blood stew” recipe metaphor, they explain how zero units of insulin produces ketones, osmotic diuresis, dehydration, and electrolyte shifts. Key takeaways for EMS: prioritize perfusion with IV fluids (lactated Ringer’s preferred), monitor rhythm, obtain potassium before giving insulin, use a two bag insulin/dextrose strategy to close the anion gap safely, and avoid intubation unless absolutely necessary as spontaneous ventilation supports the physiologic need for higher alveolar tidal volumes. This podcast is brought to you by Medical Shipment: https://medicalshipment.com/

People in this episode

Host: Mike Brown

Guests: Dr. Sarah Fabiano, Mike Ellis

Topics covered

• pediatric diabetic ketoacidosis
• prehospital care
• insulin management
• electrolyte shifts
• IV fluids

Keywords

• diabetic ketoacidosis
• pediatrics
• insulin
• IV fluids
• electrolyte shifts
• prehospital care

Sponsors

Medical Shipment

More episodes of EMS Today

• Pierce Foundation & Mental Wellness Summits for First Responders · June 8, 2026 · 46 min
• Peer Support, PTSD Care and Resilience · June 4, 2026 · 56 min
• Surviving a Near‑Fatal ER Stabbing · June 1, 2026 · 1h 10m
• Building a National EMS Memorial · May 23, 2026 · 44 min
• Prehospital Blood, POCUS, MIH, AI, and Body Cams · May 22, 2026 · 34 min
• CPR, Stop the Bleed and Community Action · May 21, 2026 · 32 min