The unconscious child
Sepsis, hypovolaemia, trauma, anaphylaxis?
system o/es
airway
| Examination/investigations | Intervention |
|---|---|
| Protecting airway? Need adjuncts? Airway at risk? | Need to tube? Do you have the right people around? |
breathing
| Examination/investigations | Intervention |
|---|---|
| The usual CXR?? |
Oxygen! |
circulation
| Examination/investigations | Intervention |
|---|---|
| BP Urine output |
10ml/kg crystalloid bolus up to 40ml/kg |
| Femoral pulses in neonate | Consider the "cardiac baby" |
disability
| Examination/investigations | Intervention |
|---|---|
| GCS Pupils; tone; posture Glucose + Blood gas Ammonia? |
- as per Status epilepticus if suspicion present - hypoglycaemia present: 2 ml/kg of 10% dextrose bolus → infusion 10% glucose to maintain serum glucose 4-7mmol/L |
- Febrile Convulsion and seizures/Status epilepticus
- Diabetic ketoacidosis
- The hypoglycaemic child
- look for signs of metabolic syndromes - dysmorphism, hepatomegaly, failure to thrive
- CNS infection - Neonatal meningitis, HSV meningitis
- Raised ICP
exposure
| Examination/investigations | Intervention |
|---|---|
| GCS Pupils; tone; posture Glucose + Blood gas |
as per Status epilepticus if suspicion present |
generic interventions - no clear cause
Investigations
- CT, LP
- tox screen
- metabolic syndrome: urine organic/amino acids, plasma lactate
- EEG - non-convulsive status...
Intervention
- broad spectrum abx + aciclovir