Paediatric emergencies: Oxford handbook

Question 1

Neonatal hypoglycaemia: Def, RF, Mx

Answer 1

Def: <2.6mmo
RF: lUGR, marcosomia, hypoxia, septic, poor feeding
Mx: asymptomatic and finger-prick glucose <2.6mmol/L give additional oral/nasogastric milk and repeat until glucose >3mmol/L
If fitting, twitchy, lower GCS, floppy, or apnoeic and glucose <2.6mmol/L

Question 2

Mx of symptomatic neonat hypoglycaemia

Answer 2

If symptomatic ( fitting, twitchy, lower GCS, floppy, or apnoeic) and glucose <2.6mmol/L:
-IV access and give 2mL/kg 10% dextrose, follow by infusion 10% dextrose
-repeat sugar 10m after bolus
If no IV access
-buccal GlucoGel or IM glucagon (200mcg/kg)
If glucose still low after 2nd bolus dextrose oer 12.5% may be required which needs central access. Also IV hydrocortisone