Core Blood and Urine Tests

Children with a reduced conscious level should have a capillary glucose tested within 15 minutes of presentation. [1]

In all cases, Blood gas: pH, pCO₂, bicarbonate and lactate may provide useful information in cases of shock, sepsis, trauma, respiratory distress, or suspected acid-base imbalance.

Sepsis-specific cases: Urinalysis, full blood count: haemoglobin, white cell count and differential, and platelet count; blood culture (meningococcal pcr depending on clinical presentation), CRP.

Metabolic-specific cases:

• Venous/arterial blood gas
• Glucose: rapid capillary estimation should be confirmed with laboratory analysis of a venous sample [11]
• Urine ketones – obtained on a urine dipstick
• Liver function tests: aspartate/alanine transaminase, alkaline phosphatase, albumin or protein
• Serum ammonia (telephone laboratory and send within 30 minutes for analysis)
• Urea and electrolytes: sodium, potassium and creatinine give information regarding hydration, suspected metabolic and endocrine derangements, and kidney function
• See further investigations for hypoglycaemia)

Overdose cases: Plasma, serum and urine to be saved for later analysis of specific agents e.g. opiates, tricyclics.