Peds H- Hyperglycemia and Hypoglycemia

Introduction * In pediatric patients, have a low threshold to check blood sugar* Undiagnosed diabetics commonly identified in ED during first episode of DKA* HYPOglycemia is very common in multiple conditions, especially in ill children Hyperglycemia * DKA is different in kids* They get cerebral edema* Increased intracranial pressure with rapid fluid administration* Common symptoms* Headache* Altered mental status* Neurologic deficits* Cushings triad* Hypertension* Bradycardia* Irregular breathing* Treatment = mannitol Hypoglycemia * Multiple causes* Sepsis* Inborn errors of metabolism* Endocrine disorders* Replace glucose using “Rule of 50s”* Dextrose % x Volume = 50* Neonates: 5ml/kg of D10* Pediatrics: 2ml/kg of D25* Teens/Adults: 1ml/kg of D50* 1 “amp” of D50 = 25g of sugar = 50ml Additional Reading * Rule of 50s (PEMBlog)* Pediatric DKA (EM Cases)