New DKA audit looking at adolescence care
An audit to explore the care of young people who fall between paediatric and adult care for diabetic ketoacidosis (DKA) has been launched.
Depending on the results gained from the questionnaire, it may lead to the development of a unified DKA guideline for adults and children to fill a void.
Leading specialist in the treatment of DKA Dr Ketan Dhatariya says the care of 16 to 18-year-olds presenting with DKA is “fraught with difficulty” and in response is urging diabetes inpatient teams to join the initiative.
The diabetes and endocrinology consultant, from the Elsie Bertram Diabetes Centre in the Norfolk and Norwich University Hospitals NHS Foundation Trust, has put together a questionnaire designed to be filled out by those ‘at the front door’.
This could be adult or paediatric junior doctors or nurses in A&E or the acute medical units who look after people with DKA within the first hour of initial presentation. It may also be filled out by the nursing staff if they are involved in their care.
Dr Dhatariya said: “The care of 16 to 18 year olds presenting with DKA is fraught with difficulty. Whilst they may have their outpatient care in the children and young persons department, if they are admitted to hospital, their care maybe delivered by a number of different teams – adult or paediatrics, who may or may not have a specialist interest in diabetes.
“The most commonly used guidelines in the UK are produced by the JBDS, but these specifically state they should only be used for those over 18 years old. The guidelines for those under 18 are produced by BSPED. However, it is unknown whether those who are 16-18 years old are treated appropriately.”
The project is a joint collaboration with adult and paediatric teams.
Dr Dhatariya added: “We want to get as many replies as possible to get an understanding of the current state of affairs for this potentially vulnerable group of individuals.
“Please pass this email on to whoever you think will be best to give this the right junior – it could be the senior nurse in adult A&E, acute medical unit or in the paediatric emergency area, or paediatric acute assessment unit. It could be the clinical lead for adult or paediatric diabetes to pass on to the juniors in the emergency areas.”