A 2 year old child was brought to you with history of drowsiness followed by unconsciousness and seizure. In the ER you find that the blood sugar is 25 mg/dl. You gave 5 ml/kg Dextrose but the child didn't respond. A subsequent blood glucose showed that the sugar level has risen to 130 mg/dl. Which of the following may be detrimental in this situation?
This is a case of post ictal state following a hypoglycaemic fits. Giving more glucose will just worsen the cerebral oedema. The dexamethasone if given will help to relieve the cerebral oedema. Levetiracetam is an antiepileptic and doesn't cause any harm in this scenario. Inhaled O2 can be given case of seizures. Ref: Oxford Handbook of Clinical specialities, Edition 8, Page - 187
Inhaled O2
2.5 ml/kg 10% dextrose
Levetiracetam
Dexamethasone