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PAEDIATRIC ALTERED
CONSCIOUS LEVEL GUIDELINE |
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Round three
2. Observations
Observations
2a) Children with a reduced conscious level should have the following observations recorded at presentation:
heart rate
respiratory rate
oxygen saturation level
blood pressure
temperature
|
Position |
Comment |
|
ED |
Fits with all life support guidelines |
|
Agreed |
Neither agree nor disagree |
Disagreed |
|
100% |
0% |
0% |
2b) Children with a reduced conscious level should have the following observations recorded at least every hour until the observations and clinical state are stable:
heart rate
respiratory rate
oxygen saturation level
blood pressure
|
Position |
Comment |
|
paed |
Continuos monitoring would be the best. If not available, depending on the condition of the child, the observations need to be recorded every 30 minutes or even every 15 minutes. Continuos monitoring of blood pressure is not practical in all situations, since it will need an art line, so it could be checked every 10-15 minutes. |
|
paed |
I would add temperature to that list until stable |
|
Paed ED |
Not convinced that having O2 sats are needed if they have been normal |
|
Agreed |
Neither agree nor disagree |
Disagreed |
|
84% |
8% |
8% |
2c) Children with a reduced conscious level should have the following monitored continuously from presentation until the monitoring and clinical state are stable:
heart rate
oxygen saturation level
continuous cardiac monitoring (ECG leads monitoring rhythm)
|
Position |
Comment |
|
Paed |
They should have continuous monitoring until better – not until stable. |
|
Neuro s |
I’m not sure that continuous monitoring is essential if first two or three intermittent readings are normal- this could put a strain on limited resources in some departments |
|
renal |
Would tend to agree more strongly for heart rate and oxygen sat but can’t see the same justification for continuous ECG monitoring. |
|
Paed ED |
Heart rate/continuous cardiac monitoring are essentially the same aren’t they? Not convinced that having O2 sats are needed if they have been normal |
|
Neuro |
Feel less strongly about rhythm monitoring |
|
Agreed |
Neither agree nor disagree |
Disagreed |
|
91% |
9% |
0% |