Cards

HR bpm 176

SpO2 % 99

RR BrPM 44

Temp °C 36.3

NBP mmHg 62/41

A male patient, age 4 months old, is brought to the emergency department for vomiting and diarrhea. The child has vomited 8 times in the past 24 hours and has had 2 wet diapers and 5 dirty diapers in the past 24 hours. On exam the child is limp, vital signs are on the monitor, cap refill is 4 seconds and mucous membranes are sticky.

This child weighs 7 kgs.

Partially Correct

This child is severely dehydrated.

This child needs 20 cc per kilogram of normal saline IV now.

The child may need another fluid bolus subsequently.

Colletti JE et al. The management of children with gastroenteritis and dehydration in the emergency department. The Journal of Emergency Medicine 2010; 38(5) 686-698.

Evidence on the assessment of dehydration, methods of rehydration, and the utility of antiemetics in the child presenting with acute gastroenteritis

Moritz ML & Ayus JC. Intravenous fluid management for the acutely ill child. Current Opinion in Pediatrics 2011; 23, 186-193.

Oral rehydration therapy and early refeeding in the management of childhood gastroenteritis

Link: CPS Website