Reye's Syndrome

WHAT YOU SHOULD KNOW

Causes

Signs/Symptoms

Risks

IF YOU'RE HEADING FOR THE HOSPITAL...

What to Expect While You're There

• Taking Vital Signs: These include your temperature, blood pressure, pulse (counting your heartbeats), and respirations (counting your breaths). A stethoscope is used to listen to your heart and lungs. Your blood pressure is taken by wrapping a cuff around your arm.
• Pulse Oximeter: To check the amount of oxygen in the blood, the child may be hooked up to a pulse oximeter (ox-IM-uh-ter). It is placed on an ear, finger, or toe and is connected to a machine that measures oxygen levels.
• Blood Tests: The child may need to have blood taken for tests. It can be taken from a vein in the hand or from the bend in the elbow. Several samples may be needed.
• Blood Transfusion: A transfusion may be needed if the child's red blood cell count is low (the condition called anemia). Although blood transfusions have been known to carry AIDS and hepatitis, the chance of this is about 1 in a million. Usually the dangers posed by severe anemia are far greater than the risk of AIDS or hepatitis.
• IV: A tube placed in your child's vein for giving medicine or liquids. This tube will be capped or connected to tubing and liquid.
• "Neuro" Signs: To measure the effect of the disease on the brain, the doctor will check the child's eyes and memory, and see how easily he or she can be awakened. Hand grasp and balance may also be checked.
• Heart Monitor: (Also called an electrocardiogram [e-LEK-tro-KAR-dee-o-gram] or EKG.) Three to five sticky pads are placed on different parts of the child's body. Each pad has a wire that is hooked to a TV-type screen or to a small portable box (telemetry unit) that shows a tracing of each heartbeat. The child's heart will be watched for signs of damage from the illness.
• EEG: Also called an electroencephalogram (e-LEK-troh-en-SEF-uh-lo-GRAM), this test measures electrical activity in the brain. Many sticky pads are placed on different parts of the child's head and connected to a machine that prints a paper tracing of brain-wave activity at each location.
• Lumbar Puncture: This procedure is also called a spinal tap. To detect bleeding or an infection in the brain or spinal cord, fluid is taken from the child's spine and sent to a lab for tests. The puncture can also be used to administer medicine to the nervous system.
• CT Scan: This test, also called a "CAT" scan, uses a special x-ray machine to take pictures of internal organs. Before taking this test, your child may be given dye through an IV in a vein. The dye helps the organs show up better in the pictures. People who are allergic to shellfish (lobster, crab, or shrimp) may be allergic to this dye. If your child has such an allergy, be sure to tell the doctor.
• Liver Biopsy: During this procedure, a small piece of liver tissue is removed and sent to a lab for tests. After cleaning the child's skin, the doctor will put numbing medicine into the area to reduce any pain. A needle is then passed through the abdominal wall, or between the ribs, and into the liver. A bandage will be put on the biopsy site after the tissue sample is taken.
• Medicines:
• Antibiotics: These medicines help fight bacterial infection. They may be given by IV, as a shot, or by mouth.
• Blood Thinners: These drugs keep dangerous clots from forming in the blood. They may first be given in your child's IV. Later they may be given by mouth or as a shot. Blood thinners make bleeding and bruising easier. To prevent bleeding from the gums, give the child a soft toothbrush.
• Brain Swelling Medication: Swelling can damage the brain, so your child may be given medicine to prevent or reduce swelling. It is usually given through an IV, but can be given as a shot.
• Foley Catheter: This is a tube that may be inserted into your child's bladder to drain the urine. The catheter makes people feel as though they have to urinate, but if the child relaxes, the catheter will take care of the problem. Warn the child to:
• Avoid pulling on the catheter because this will cause pain or bleeding.
• Avoid kinking the catheter because this will prevent the urine from draining.
• Avoid lifting the bag of urine above the catheter, which will allow the urine to flow back into the bladder and possibly cause an infection.
• Strict Intake/Output: Your doctors will probably want to know how much fluid the child is retaining. They may also need to know how much he or she is urinating. Nurses often call this "I&O."
• Keep track of exactly how much liquid the child drinks.
• Ask your doctor whether it's OK to flush the child's urine down the toilet.
• Ventilator: This is a special machine that can take over if the child's breathing fails. The machine is often connected to an endotracheal (END-o-TRAY-kee-ull) tube (ET tube) in the child's mouth or nose. It can also be hooked up to a tube called a trach (TRAYK) that is inserted through an incision in the front of the child's neck. Oxygen can then be given to your child by the ventilator.

After You Leave

• The child will need plenty of rest. However, he or she should be encouraged to do a little more each day. Allow the child to rest when tired.
• Don't give aspirin or any medicine containing aspirin if the child is less than 18 years old. Giving aspirin during a viral infection could cause another episode of Reye's syndrome.
• Always give medicine exactly as directed. If it doesn't seem to be helping, call the doctor, but continue using it until the doctor says otherwise. If the child is taking antibiotics, be sure to use them up, even if the child seems better.
• Give the child healthy foods from all 5 food groups: fruits, vegetables, breads, dairy products, meat and fish. This boosts energy and promotes faster healing.
• Make sure the child drinks 6 to 8 large glasses of liquid, such as water, juices, and milk, each day (unless your doctor recommends otherwise). Limit caffeinated beverages, such as coffee, tea, and soda.

Call Your Doctor If...

• The child is running a high temperature.
• Any new or different symptoms appear.

Seek Care Immediately If...

• The child becomes confused or sluggish, or starts behaving differently.