Follow up | Right Decisions

Please update your RDS mobile app to version 4.7.1

We are pleased to advise that deep linking capability, enabling users to directly download individual mobile toolkits, has now been released on the RDS mobile app. When you install the update, you will see that each toolkit has a small QR code icon the header area beside the search icon – see screenshot below. Clicking on this icon will open up a window with a full-size QR code and the alternative of a short URL for sharing with users. Instructions are provided.

You may need to actively install the update to install RDS app version 4.7.1 to see this improvement. Installing this update is also strongly recommended to get the full benefits of the new contingency arrangements – specifically, that if the RDS website should fail, you will still be able to download new mobile app toolkits.

To check your current RDS version, click on the three dots bottom right of the RDS app screen. This takes you to a “More” page where you will see the version number. To install latest updates:

On iPhones – go to the Apple store, click on your profile icon top right, scroll down to see the apps waiting to be updated and update the RDS app.

On Android phones – these can vary, but try going to the Google Play store, click on your profile icon top right, click on “Manage apps and device”, select and update the RDS app.

Please get in touch with ann.wales3@nhs.scot with any questions.

12 weeks after start of treatment

Check - Serum U&E’s, Calcium, Phosphate, Alkaline Phosphatase, PTH.
Ensure dietetic review carried out.
Expect improvement in biochemistry and motor milestones.
Reduce Vitamin D dose to maintenance (as multivitamins or combined with Calcium (see combination products).
Expect improvements in x-ray appearance.
Discharge to GP on Vitamin D supplement – to continue until at least the age of 5yrs, preferably until the child stops growing.

Consider alternative diagnoses and referral to Metabolic Bone Clinic or Endocrine Clinic.

Remember

• In young infants and older adolescents, the classic findings of rickets (x-ray changes and bony deformities) may be absent despite profound Vitamin D deficiency.
Other siblings and parents, especially mother, may also be Vitamin D deficient and vitamin D supplementation (400 units/600 units) may be beneficial for the whole family.
Iron deficiency anaemia often accompanies Vitamin D deficiency.