Knowledge and Confidence of Iraqi Pediatric Residents in Management of Diabetic Ketoacidosis in Children

Abstract

Background: Diabetic ketoacidosis (DKA) is a leading cause of mortality in children with type1 diabetes mellitus. Pediatric residents in Iraqi hospitals are usually the front liners in managingpediatric emergencies. Therefore, it is important to make sure they are practicing at the highestpossible standards to ensure patients’ safety. Objectives: this study evaluates the knowledge ofIraqi pediatric residents regarding DKA recognition and management and sheds the light on theareas that need further improvement. Methods: An online survey was conducted. A survey link toan online questionnaire using Survey Monkey was sent to residents at different levels between firstand fourth year of training (R1-R4) in general pediatrics. Results: About 60.9% of respondentsspent more than 6 months in pediatric emergency training. The majority of residents had treatedmore than 10 children presented with DKA, with the highest percentage (81.8 %) found amongR4s residents. Only 27.8% of residents recognized the diagnostic criteria of DKA. Three quartersof the participants could correctly calculate IV fluid infusion rate for maintenance by accountingfor the deficits and subtracting the boluses before calculating the corrections over 48 hours. 68.3%of respondents would not routinely attach DKA patients to a cardiac monitor unless the patient’scondition is unstable. 69.6% of survey respondents feel confident in treating children with DKA.Most participants (91.3%) think that there is a need for more DKA training/education sessions.Conclusions: Most of the respondents have a reasonable level of knowledge on how to manageDKA in children in Iraqi children’s hospitals. Some gaps in knowledge were identified and needto be highlighted in near future. Educational sessions for the residents about DKA management inchildren are deemed necessary.