Diabetic Ketoacidosis – remember in paediatrics this may be the 1st presentation of diabetes.
- Fluid – are more considered that adults due to the risk of cerebral oedema
- Insulin – WAIT – need 1hr of fluid first
- Paeds – involve them early
Diabetic Ketoacidosis – remember in paediatrics this may be the 1st presentation of diabetes.
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 is generally caused by disruption in one of the following:
Parents who have experienced a sudden and unexpected death of a baby or child often feel anxious when they have another baby. CONI is a programme working with local public healthcare providers to facilitate a service for bereaved parents to help with the anxieties around another baby.
In our trust we don’t have paediatric critical care beds. However, in our region we use EMBRACE (a paediatric critical care transport team), who can transfer critically ill children to specialist centers (in or out of region).
RCPCH have released a GREAT series of podcasts on paediatric sepsis. It is from a paediatric slant, but is applicable to the ED and well worth a listen [For Docs and Nurses]
Is a rare complication of I.V. Phenytoin, which presents with a triad of: Pain, Oedema & Discolouration, typically in the hand.
In our case a child presented in status epilepticus, having received rectal diazepam from the ambulance crew, then 0.1mg/kg lorazepam in the ED, followed by 20mg/kg I.V. Phenytoin over 30 min, via a 24g cannula in back of the hand.
After intubation the patients thumb, index and middle fingers were all noted to be purple. Radial pulse was weak however, we saw good flow on ultrasound doppler in the ED. The patient had no cardiovascular Hx or FHx.
To maintain or restore patency of the ductus arteriosus
Only to be used in infants who are ventilated or where ventilation is immediately available
DO NOT DELAY IN STARTING Alprostadil if: there is clinical
suspicion of duct dependent CHD while waiting for paediatric cardiology opinion OR echocardiogram, even when in-house echo facilities are present.
PDF: Alprostidil
Have you ever wanted an infant to PU faster?
Gentle suprapubic cutaneous stimulation with gauze soaked in cold fluid (the Quick-Wee method) led to a clinically and statistically significant increase in voiding and successful urine collection within five minutes for infants aged 1-12 months
An ideal job to be given to parents/carers
Occasionally children (<18 yrs) unfortunately will either die in ED or be brought in dead, this is obviously a terrible time for the child’s family and for staff. Despite this there are several important things we must do. Read more