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
Table2: Components of the Glasgow Coma Score (older children and adults)

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