Take bloods:

  • for Blood gas (bicarb, base deficit), lactate, glucose, FBC, U&E, Ca++, Mg++, PO4, clotting, CRP, blood cultures, whole blood
    (EDTA) for PCR, X-match.
  • Take throat swab.
  • If limited blood volume, prioritise blood gas, lactate, glucose, electrolytes, FBC, clotting.

Close monitoring for signs of:

  • Raised ICP
  • Shock
  • Perform LP if no contraindication

Do not delay antibiotics

Repeated review: Children with MD can deteriorate rapidly.
Deterioration detected? - recommence from Recognition and initial actions