A child's life may depend on obtaining emergency treatment in the nearest children's unit.
Advice to pediatricians, physicians and A&E doctors
Statistics indicate a better chance of survival when Reye's syndrome is diagnosed and treated in its earliest stages. The later the diagnosis the more advanced the coma and the chances of survival and full recovery are greatly reduced. It is also essential to investigate all patients with unexplained encephalopathy and hyperammonaemia for inherited metabolic disorders.
When brain dysfunction is so severe that the patient is drowsy and irritable, he or she will require the services of an intensive care unit for the specialist management required. This will be directed at correcting metabolic abnormalities and protecting the brain against irreversible damage caused by cerebral oedema.
The Royal College of Paediatrics and Child Health has endorsed the following relevant evidence-based guideline "The management of children and young people with an acute decrease in conscious level (2015)" – see Resources and Reports on this page.
For further information, search for "Decreased Consciousness" on the "RCPCH guidelines" website.
ADVICE ON INVESTIGATION AND CLINICAL MANAGEMENT
Contact for further information and advice:
Dr Mark Sharrard
0114 271 7000
For advice on further investigations if needed. contact:
"The on-call Consultant Clinical Scientist"
Dept. Clinical Chemistry
Sheffield Children's Hospital
Before treatment is started (which should be as soon as possible) blood should be taken immediately for liver function tests, prothrombin time, blood ammonia, blood sugar, and for investigation of Reye-like inherited metabolic disorders. Any urine passed should also be saved for investigation of these disorders. (Clinical Chemistry should be consulted).
Glucose infusions may stop some of the harmful effects of Reye's syndrome if they are given early enough. This should start immediately, even before the initial results are available.
Reye's syndrome can be successfully managed with a good outcome if diagnosed early and meticulously treated.
Next review: December 2019