pediatrics
Oral Rehydration
Administration of Oral Rehydration
Generally, 50 mL/kg is given over 4 hours for mild dehydration and 100 mL/kg for moderate dehydration. For each diarrheal stool, an additional 10 mL/kg (up to 240 mL) is given. After 4 hours, the patient is reassessed. If signs of dehydration persist, the same volume is repeated. Patients with Fluid replacement may require many liters of fluid per day. Vomiting usually should not deter oral rehydration (unless there is bowel obstruction or other contraindication to taking fluid by mouth) because vomiting typically abates over time. Small, frequent amounts are used, starting with 5 mL every 5 minutes and increasing gradually as tolerated. The calculated volume required over a 4-hour period can be divided into 4 separate aliquots. These 4 aliquots can then be divided into 12 smaller aliquots and given every 5 minutes over the course of an hour with a syringe if needed. In children with diarrhea, oral intake often precipitates a diarrheal stool, so the same volume should be given in fewer aliquots. Once the deficit has been replaced, an oral maintenance solution containing less sodium should be used. Children should eat an age-appropriate diet as soon as they have been rehydrated and are not vomiting. Infants may resume breastfeeding or formula. 