Subjective History (CIAMPEDS)
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C hief complaint
I mmunizations / isolation
A llergies
M edications
P ast history / parents perception
E vents surrounding illness
D iapers/diet
S ymptoms associated
Hypernatremic dehydration
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, eg Diarrhoea with hypertonic soup fluid replacement
- Appear less clinically sick than actual fluid loss
- Causes cerebral shrinkage (ICH, seizure, coma, death)
- Rapid correction can cause cerebral edema
- Needs slow fluid restoration over 48hr (8mEq/L / 24hr)
Appearance assessment (TICLS)
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T one
I nteractiveness
C onsolability
L ook/gaze
S peech/cry
Pediatric DKA
Hyperglycemia & dehydration
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N/S bolus 10ml/kg over 30min (+ 2nd bolus)
2 bag system N/S+40KCL & D10+40KCL 1-2hr later
BGL q30-60min
VS & NVS q1hr
Electrolytes, BGL, ketones, venous gas q2-4hr
DKA flowsheet
Monitor for headache/behaviour/abnormal resp
NPO until rehydrated & Gluc stable
U/O & U/A - ketones
Give this one a try later!
C hief complaint
I mmunizations / isolation
A llergies
M edications
P ast history / parents perception
E vents surrounding illness
D iapers/diet
S ymptoms associated
Hypernatremic dehydration
Give this one a try later!
, eg Diarrhoea with hypertonic soup fluid replacement
- Appear less clinically sick than actual fluid loss
- Causes cerebral shrinkage (ICH, seizure, coma, death)
- Rapid correction can cause cerebral edema
- Needs slow fluid restoration over 48hr (8mEq/L / 24hr)
Appearance assessment (TICLS)
Give this one a try later!
T one
I nteractiveness
C onsolability
L ook/gaze
S peech/cry
Pediatric DKA
Hyperglycemia & dehydration
Give this one a try later!
N/S bolus 10ml/kg over 30min (+ 2nd bolus)
2 bag system N/S+40KCL & D10+40KCL 1-2hr later
BGL q30-60min
VS & NVS q1hr
Electrolytes, BGL, ketones, venous gas q2-4hr
DKA flowsheet
Monitor for headache/behaviour/abnormal resp
NPO until rehydrated & Gluc stable
U/O & U/A - ketones
