Illinois — Targeted Issue
Pediatric Quality Improvement Modules: Head Trauma, Seizures, and Diabetic Ketoacidosis
Sept. 1, 2007 - Aug. 31, 2010


Loyola University Chicago
Principal Investigator(s)
Award Amount


HRSA Region


EMSC Region


HPP Region



Great Lakes


Name Roles Agency Mailing Address Office Phone Email
Mark Cichon, DO
  • Principal Investigator
Loyola University Chicago


Title Published Description Format Availability
Pediatric Hyperglycemia and Diabetic Ketoacidosis (DKA) 2012 DKA management in pediatric patients is complex, time sensitive, and requires a multidisciplinary approach. Key best ED DKA management practices highlighted by this study include establishing specific DKA guidelines and ensuring access to a pediatric endocrinologist. To increase the knowledge base and comfort level of prehospital and ED providers managing pediatric DKA patients, the Illinois EMSC team developed this PowerPoint educational module. PowerPoint Available Online
Pediatric Mild Traumatic Head Injury 2010 Targeting all health care providers who care for children, this course contains 10 narrated chapters along with appendices that contain additional resources. Key areas of focus include recommendations for appropriate triage/management of mild traumatic head injuries, guidelines for neuroimaging, child maltreatment screening, patient education, and head injury prevention strategies. Online learning Available Online


Title Published Author Abstract Publication PMID
Current Variability of Clinical Practice Management of Pediatric Diabetic Ketoacidosis in Illinois Pediatric Emergency Departments 2012 Barrios, Ellen K. MD*; Hageman, Joseph MD†; Lyons, Evelyn RN, MPH‡; Janies, Kathryn BA§; Leonard, Daniel MS§; Duck, Stephen MD∥; Fuchs, Susan MD† This study aimed to investigate the management of pediatric patients with diabetic ketoacidosis (DKA) presenting to emergency departments (EDs) participating in the Illinois Emergency Medical Services for Children (EMSC) Facility Recognition program.

In 2010, Illinois EMSC conducted a survey (including case scenarios) and medical record review regarding management of pediatric patients with DKA. Data were submitted by 116 EDs.

Results: Survey response rate was 94%. Only 34% of EDs had a documented DKA guideline/policy; 37% reported that they did not have hospital adult or pediatric endocrinology services. Case scenarios identified a high percentage of respondents given an intravenous (IV) isotonic sodium chloride solution of 10 to 20 mL/kg during the first hour. However 17% to 21% would use an alternative choice such as administering initial IV solution of 0.45 sodium chloride, initiating an insulin drip before fluids, or waiting for more laboratory results before giving fluids or insulin. A total of 532 medical record reviews were submitted. In 87% of records, patients received an initial IV isotonic sodium chloride solution within the first hour. In 74%, patients received IV insulin infusion/drip (0.1 U/kg/h) after the initial fluid bolus. Of the patients, 51% were transferred to another facility; 22% were admitted to an intensive care unit.

Conclusions: Best ED practice management of pediatric DKA includes establishing a specific guideline/protocol and ensuring access to a pediatric endocrinologist. Both were identified as improvement areas in this project. Illinois EMSC has developed an educational module and provided direct feedback to all participating EDs, to improve their management of pediatric patients with DKA.
Pediatric Emergency Care 0