Full clinical assessment

1) Assessment of conscious level

• Assessed using the Glasgow Coma Score[32]
• If the child is comatose or has a reduced conscious level:
  • Consider transfer to PICU/HDU if available
  • Consider treatment for raised intracranial pressure (if clinical suspicion)
  • Seek anaesthetic and senior paediatric support

2) Full physical examination

• The presence of the following should be excluded:
  • Cerebral oedema
  • Infection
  • Ileus

3) Weigh the child

• If not possible due to the child’s clinical condition:
  • Most recent clinic weight
  • Estimated weight from centile charts