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Neonatal Resus

PUT OUT A NEONATAL CRASH CALL 

CRH – will result in at least a Neonatal SpR, SHO +/- a neonatal nurse.

HRI – may not generate a response. Consider a crash bleep to anaesthetics

CALL NEONATAL CONSULTANT (WILL ONLY GIVE ADVICE AS AT CRH)

CALL THE ED CONSULTANT

***Remember Grab Box***

Unless within the first few hours of life using the APLS algorithm is equally if not more appropriate

Paediatric Hypoglycaemia

Paediatric Hypoglycaemia (BM <2.6) is a relatively common presentation in the Emergency Department. However, if we don’t do the BM it’s easy to miss.

Hypoglycaemia in paediatric diabetic patients is managed separately – see here

Hypoglycaemia in neonates (<72 hours of life) also has specific management – see here (Flowcharts A + B)

Hypoglycaemia is generally caused by disruption in one of the following:

  • Carbohydrate intake
  • Carbohydrate absorption
  • Gluconeogenesis
  • Glycogenolysis

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DKA in Kids

Diabetic Ketoacidosis – remember in paediatrics this may be the 1st presentation of diabetes.

  • Fluid – are more considered than adults due to the risk of cerebral oedema
  • Insulin – WAIT – need 1hr of fluid first
  • Paeds – involve them early
  • USE the BSPED DKA Management flow charts, calculators and full guidelines for when electrolytes won’t play ball which are all linked below.

DKA Management Calculator (recommended by paediatrics)- HERE

DKA Management Flow Chart – HERE

Full CHT DKA Guideline – HERE

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Diabetic Hyperglycaemia (Kids)

Diabetic children sometimes attend ED with hyperglycaemia, but not in DKA (what should we do?)

Paeds have produced some advice to follow:

  1. Ketones over 0.6?
    • <0.6: Encourage fluids & food, may need an insulin correction
    • >0.6: ask Question 2
  2. Are there clinical features of DKA?
    • NO: Encourage fluids & food, decide Insulin correction, will need to be monitored
    • YES: Will need Paeds admission