Evidence-based management of Complicated SAM (In-patient) according to Uganda Clinical Guidelines 2023

Initial Management

Admit. Prevent hypoglycaemia, keep warm. Give 1st dose Ampicillin 50 mg/kg IM + Gentamicin 7.5 mg/kg IM.

Hypoglycaemia (Conscious)

Give 50 ml of 10% glucose or sugar water (1 tsp sugar in 3 tbsp water) orally or NGT.

Hypoglycaemia (Unconscious)

Give IV 10% Glucose at 5 ml/kg stat.

Dehydration (ReSoMal)

Give ReSoMal 5 ml/kg every 30 mins for 2 hours, then 5-10 ml/kg/hr for 4-10 hours. DO NOT use standard ORS.

Electrolytes

Give extra Potassium (3-4 mmol/kg/day) and Magnesium (0.4-0.6 mmol/kg/day). DO NOT use diuretics.