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?

Next Next
Back