Dehydration (peds)

This page is for pediatric patients. For adult patients, see: dehydration

Background

1kg body wt = to 1 liter fluid

Clinical Features

• Decreased urine output
• Sunken fontanelle
• Most reliable:
  • Abnormal capillary refill
  • Abnormal respiratory pattern
  • Decreased skin turgor

Management

• Ondansteron for vomiting
• Mild to moderate dehydration: start with trial of oral rehydration therapy
  • Part of ACEP Choosing wisely
  • Provide ORS solution (e.g. Pedialyte) at 50 to 100 mL/kg over 2-4 hours in small doses q5min
  • If the child vomits, wait 15 minutes then try again
  • Provide additional ORS to replace ongoing GI losses
• Consider Fluid Repletion (IVF) only if severely dehydrated, not tolerating oral intake or failed oral rehydration therapy

See Also

• Fluid Repletion (IVF)
• Acute gastroenteritis (peds)
• Nausea and vomiting (peds)
• Diarrhea (peds)

External Links

• Pediatric Emergency Playbook Podcast: Subcutaneous Rehydration