Dear Pediatricians, Acute metabolic emergencies in children require swift, accurate decision-making. Engage with this tricky case to reinforce the essential first-line steps in managing pediatric diabetic ketoacidosis. ##Reference## Wolfsdorf JI, et al.
ISPAD Clinical Practice Consensus Guidelines 2022: Diabetic ketoacidosis and hyperglycemic hyperosmolar state. Pediatr Diabetes. 2022;23(7):979-997.##
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