sofidexFor patientsAre you a clinician? Clinical site

Warning-sign checks

Nutritional rickets: when to get help

Go through these in order and stop at the first one that applies. If you are reading this for someone else, answer for them.

  1. 1

    Is any of this happening now?

    Call 911

    Call emergency services for:

    • A seizure
    • Difficulty breathing or noisy breathing
    • Fainting, collapse, or inability to wake normally
    • Severe weakness with sudden deterioration

    These emergency symptoms are not the usual course of nutritional rickets, but they require immediate assessment.

    Other emergency signs, for anyone
    • Someone who is struggling to breathe, gasping, choking, or cannot get words out
    • Someone who has chest pain, tightness or pressure lasting more than a few minutes
    • Someone who has sudden weakness or drooping on one side of the face or body, slurred speech, or sudden confusion
    • Someone who is unconscious, or cannot be woken
    • Someone who is bleeding heavily and it will not stop with firm pressure
    • Someone who has had a seizure that will not stop, or does not wake up afterwards
    • Someone who has lips or skin that look pale, blue, grey or blotchy
    • Someone who you believe has taken an overdose or swallowed something poisonous
  2. 2

    Is any of this happening?

    Be seen today

    Seek urgent medical advice if the child develops repeated muscle cramps or spasms, marked weakness, or tingling around the mouth or limbs.

    These can be signs of low calcium.

  3. 3

    Does any of this apply?

    Book an appointment

    Arrange a routine medical appointment if a child has persistent bone pain, muscle weakness, slow growth, delayed movement skills, widened wrists or ankles, or a new change in leg shape.

The article also says

Medical review is also appropriate if a child has several risk factors for vitamin D or calcium deficiency, even when symptoms are mild.

Early changes can be difficult to recognise without an examination and blood tests.

Every sign above is quoted from the sofidex article on Nutritional rickets. If you are not sure, err upward — it is always reasonable to be checked.