In this section
The Ketogenic Diet (KD) is a recognised treatment option for some
children with refractory epilepsy. The
diet has few side effects and is generally well tolerated. Many childhood illnesses can be managed at
When a child on a KD becomes unwell and presents to hospital, the
illness and it’s effect on the diet require assessment. Children on a KD will usually require
hospital review if they present with the following:
The aim of this guideline is to provide a medical, nursing and allied health framework
for decision making in relation to the management of the unwell child on KD
There are four key factors to the assessment of a child on KD therapy
who is acutely unwell presenting to hospital for management.
child’s medical status
patient’s level of hydration.
if patient is ketoacidotic
if patient has experienced change in usual level of ketosis
If serum Na+ between 135mmol/L and 145mmol/L:
Contact General Medical Consultant:
Excessive ketoacidosis needs to be managed by the
administration of extra carbohydrate.
Administer Maintenance 5% Dextrose and Normal Saline if
Medical or Endocrinology Consultant if high ketosis and child unwell.
Please remember to read the disclaimer.
development of this nursing guideline was coordinated by Jill Bicknell-Royle, Epilepsy Nurse Specialist, Neurology,
and approved by the Nursing Clinical Effectiveness Committee. Updated November 2015.