Urgent care required
Advanced paediatric life support management.
Discuss/transfer to NICU/PICU.
- 100% maintenance fluids: enteral feeds if tolerated or isotonic i.v. fluids e.g. 0.9% sodium chloride with 5% glucose
- Do not restrict fluids unless there is evidence of increased ADH secretion (SIADH) or raised intracranial pressure (RICP)
- Monitor fluid administration, urine output, electrolytes and blood glucose.
- Consideration of imaging.
- Perform/repeat LP when contraindication no longer present.
- Liaise with neurosurgical/PID unit if complications.
Repeat LP after starting treatment if:
- Persistent or re-emergent fever
- New clinical findings (esp. neurological)
- Deteriorating clinical condition
Continue monitoring, repeated review and escalation of care.
Has a specific pathogen been identified?
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