MedBugs: SAQ #357

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Case: Neonatal hypoglycaemia with seizure

A 14-day-old boy presents to ED with drowsiness. His parents saw his eyes deviate to one side and some lip smacking. This lasted 2 minutes. They feel he might have had a seizure.

HR 165
RR 40
BP 80/40
SpO2 98% RA

T 36.3 wt 3kg BGL 'Lo'

1. List (3) tests you will order to specifically look for the cause of this neonate’s hypoglycaemia and what it might indicate. 6 marks

2. Other than IV or IO administration of glucose, what else could you prescribe as temporary measures? Detail the dose and route. 2 marks

A venous gas has been obtained after fluid resuscitation. pH 6.9 pCO2 25 pO2 53 Na 135 K 5.3 Cl 117 Glucose ... Lactate 10.1 iCa 1.25 Hb 89 Bicarbonate 10 Bilirubin 154

3. Please interpret the venous gas result. 4 marks

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Case: Neonatal hypoglycaemia with seizure

1. List (3) tests you will order to specifically look for the cause of this neonate’s hypoglycaemia and what it might indicate. 6 marks

2. Other than IV or IO administration of glucose, what else could you prescribe as temporary measures? Detail the dose and route. 2 marks

3. Please interpret the venous gas result. 4 marks

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