Pitfalls

Anticipate, monitor and correct:

• Hypoglycaemia
• Acidosis
• Hypokalaemia
• Hypomagnesaemia
• Hypocalcaemia
• Anaemia
• Coagulopathy
• Raised ICP

A single retrospective study has suggested potential risk factors for death in the management of IMD to include [28]:

• The absence of specialist paediatric care in the emergency department
• Inadequate fluid resuscitation
• The absence of consultant supervision within the first 24 hours
• Failure to recognise disease severity, progression, or complications