Cards

HR bpm 155

SpO2 % 98

RR BrPM 42

Temp °C 36.4

NBP mmHg 60/48

A female patient, age 8 months old, is brought to the emergency department for vomiting and diarrhea. The child has vomited 11 times in the past 24 hours and has had 4 wet diapers and 8 dirty diapers in the past 24 hours. On exam the child is unrousable, vital signs are on the monitor, cap refill is 6 seconds and mucous membranes are sticky.

This child weighs 9 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