Acutely Ill Child

Acute abdomen
Diabetic ketoacidosis / Diabetes mellitus
Poisoning / intoxication

  • List toxic agents that can cause altered level of consciousness and describe their mechanisms of action
  • Describe common toxidromes
  • Explain the effect of hyperglycemia on fluid, electrolyte and acid-base status
  • Describe the basic principles of pharmacology used in the management of diabetic ketoacidosis
  • Describe the pathophysiology of glucose homeostasis and the consequences of hyperglycemia
  • Describe how the physiology of the cardiopulmonary systems impacts the vital signs in different age groups
  • Describe the anatomic differences between the pediatric and adult airway
  • Recognize that a primary respiratory event can lead to cardiac arrest in the pediatric population
  • Define shock and describe the pathophysiology of four broad categories of shock: hypovolemic, distributive, cardiogenic and neurogenic
  • Recognize that body surface area and degree of burn injury impact fluid management in the pediatric population
  • Recognize that acute illness may lead to multisystem organ dysfunction

Overview & Foundational Knowledge

Brayer AF & Humiston SG. Invasive meningococcal disease in childhood.  Pediatrics in Review, 2011; 32(4): 152-160.

Review of meningococcal disease. Clinical features, treatment guidelines and complications.

The medical assessment of bruising in suspected child maltreatment cases: A clinical perspective.

Canadian Pediatric Society Practice Guideline (2013). Good tables, differential diagnoses.

Avner JR.  Altered States of Consciousness. Pediatrics in Review 2006; 27 (9): 331-338. 

Approach to altered level of consciousness. Common causes, differential diagnosis, table on herniation syndromes and management.

Yager P & Noviski N. Shock. Pediatrics in Review 2010; 31(8): 311-319.

Excellent overview, including pathophysiology of shock, types of shock and management.

Pope J & McBride J. Consultation with the Specialist: Respiratory Failure in Children. Pediatrics in Review 2004; 25(5): 160-167.

Review article on pathophysiology of respiratory insufficiency, and covers both acute and chronic respiratory failure and management.

Clinical Resources

Meningococcal vaccines in Canada: An update

Canadian Paediatric Society Position Statement (2017).

Wolfsdorf et al. Diabetic ketoacidosis in children and adolescents with diabetes. Pediatric Diabetes 2009; 10 (Suppl 12): 118-133.

International Society for Pediatric and Adolescent Diabetes (ISPAD) Clinical Practice Consensus Guidelines 2009 Compendium. Comprehensive article on diabetic ketoacidosis (DKA).

Pediatric Vital Signs.

Pedscases podcast on pediatric vital signs and link to pediatric vital signs reference chart.

Krishnamoorthy et al. Pediatric burn injuries. International Journal of Critical Illness & Injury Science (2012); 2(3): 128-134.

Overview of pediatric burns, including classification of burn, systemic effects, and goals of management.

Management of the paediatric patient with acute head trauma.

Canadian Paediatric Society Position Statement (2016).

Clinical Presentations