Mohamed Dahir Abdi

2. • Hypoglycemia is a condition in which your blood sugar (glucose) level
is lower than the standard range. Glucose is your body's main energy
source. Hypoglycemia is often related to diabetes treatment.

3. Symptoms
• If blood sugar levels become too low, hypoglycemia signs and symptoms can include:
üLooking pale
üShakiness
üSweating
üHeadache
üHunger or nausea
üAn irregular or fast heartbeat
üFatigue
üIrritability or anxiety
üDifficulty concentrating
üDizziness or lightheadedness
üTingling or numbness of the lips, tongue or cheek

4. Treat Hypoglycemia
Immediately give If the child can drink, give the 50 ml of 10% glucose bolus orally.
If the child is alert but not drinking, give the 50 ml by NG tube.
If the child is lethargic, unconscious, or convulsing, give 5 ml/kg body weight of sterile
10% glucose by IV, followed by 50 ml of 10% glucose or sucrose by NG tube

5. The table below shows how to reconstitute 50 ml
of 10% glucose from available solutions..
Mixture of Gives
12.5 ml of 40% dextrose + 37.5 ml of
Distilled water
50 ml of
10% Dextrose
7.5 ml of 40% dextrose + 42.5 ml of 5%
dextrose
10 ml of 50% dextrose + 40 ml Distilled
water
6 ml of 50% dextrose + 44 ml of 5%
dextrose

6. • Start feeding F-75 half an hour after giving glucose and give it every half-
hour during the first 2 hours.
• For a hypoglycemic child, the amount to give every half-hour is ¼ of the
2-hourly amount shown on your F-75 Reference Card.
• Take another blood sample after 2 hours
• The Better is to Prevent it.

7. Manage Hypothermia
• Hypothermia is low body temperature.
• rectal temperature is below 35.5 0C or
The axiliary temperature is below 35 0C.
• Both hypothermia and hypoglycemia are signs that the child has a
serious systemic infection.

8. Maintain temperature (prevent hypothermia)
The following measures are important for all severely malnourished children:
• Cover the child, including his head.
• Stop draughts in the room. Move the child away from windows.
• Maintain room temperature of 28 and 32 0C (82.4-89.6 0 F) if possible.
• Keep the child covered at night.
• Warm your hands before touching the child.
• Avoid leaving the child uncovered while being examined, weighed, ..
• Promptly change wet clothes or bedding.
• Dry the child thoroughly after bathing.
If it is not possible to warm the room, let the child sleep with skin to skin contact to
the mother or caretaker, and cover them with a blanket.

9. What is ReSoMal?
vORS
üStandard WHO ORS
üHigh sodium,
ü low sugar, and
üless potassium
q less sodium,
q more sugar, and
q more potassium
q Can be prepared from standard ORS and some
additional ingredients.
• Water 2 liters
• WHO-ORS one 1 liter packet
• sugar 50 g
• mineral mix solution* 40 ml or one leveled scoop
CMV
vReSoMal?

10. Treat Dehydration
How often to give ReSoMal Amount to give
Every 30 minutes for first 2 hours 5 ml/kg body weight
Every hour for up to 10 hours 5 - 10 ml/kg*

11. Manage a severely malnourished child with
shock
• What is shock?
• Shock is a generalized hypo perfusion of tissues.
• It is caused by diarrhea with severe dehydration, hemorrhage, burns,
or sepsis.
lethargic or unconscious and has cold hands plus either:
• slow capillary refill (longer than 3 seconds), or
• weak ,fast or absent radial or femoral pulses and
• absence of signs of heart failure in an edematous child

12. Treatment
ü Give oxygen
ü Give sterile 10% glucose 5 ml/kg by IV
ü Give IV fluids
ü Keep the child warm.
Giving IV fluids
IV fluid at 15ml/kg over 1 hour and if no improved we can repeat again the same as
- Riger lacteting 15ml/kg
-Dextros

13. MANAGEMENT OF ABDOMINAL
DISTENSION
is a condition in which the abdomen is swollen or distended. It can be
caused by a variety of factors, including gas, bloating, and constipation.
The following measures should be taken:
• Give Gentamicin IV once daily plus Ampicillin IV every 6 hours
• Revice Iv antibiotics Ceftriaxone 1gm IV and Also Ciproflaxcine 200mg

14. - Stop all other drugs that may be causing toxicity (such as metronidazole
and Also other Medication)
• Give a single IM injection of magnesium sulphate (2ml of 50% solution).
• Pass an NG-tube and aspirate the contents of the stomach, then “irrigate”
the stomach with 50ml of isotonic clear fluid and repeat
• Put 5 ml/kg of sugar-water (10% sucrose solution) into the stomach and
leave it there for one hour.

15. - We can Read Managing Heart failure ?
- How to manage heart Filure?
Insha Allah Next Class