There was a helpful JAMA Internal Medicine article on caring for transgender patients this past month. This will help us apply it in the ED.

Use of any LR in pediatric patients with DKA, as opposed to only NS, was associated with lower overall costs, similar length of stay, and markedly reduced incidence of cerebral edema in this retrospective study.

Neither the fluid rate (fast or slow) or type (NS vs 1/2NS) altered the risk of brain injury with decline in GCS <14 in children with DKA.

In patients with septic shock, those treated with hydrocortisone + fludrocortisone had a lower 90-day mortality compared to placebo (43% vs 49.1%, NNT 17). They also had significantly more vasopressor-free and organ-failure free days, in addition to having a shorter time to weaning from vasopressors and mechanical ventilation.

Haloperidol markedly reduced pain and nausea in ED patients with gastroparesis compared to usual care.  But be careful.  Haloperidol is not without side effects.

For pediatric DKA with altered mental status - treat first, CT later.

Discharge glucose level did not correlate with 7-day return to the ED.  It looks like there isn't a specific target glucose we need to attain prior to discharge.