Paediatrics - Queensland Health - Queensland Government

Gastrointestinal problems
606
Management of dehydration in children flow chart [1]
Mild
Assist carers to give
child small amounts
of oral fluids
frequently
Continue
breastfeeding / bottle
feeding
Rehydration
Diagnosis of
Gastroenteritis in
doubt?
No
Significant
co-morbidities or risk
factors such as age
< 3 months, febrile
No
Vomiting
prominent?
No
Assess dehydration
Moderate
Consult MO
Requires urgent
rehydration
nasogastric / IV.
MO may organise
evacuation /
hospitalisation
• Approximate volumes [3]
-- less than 6 months as per MO order
-- 6 - 23 months 40 - 60 mL each hour
-- 2 - 5 years 60 - 100 mL each hour
-- 6 - 10 years 100 - 120 mL each hour
-- 11 - 16 years 120 - 160 mL each hour
Controlled copy V1.0
Yes
Yes
Yes
Consult MO
for input on
management
MO may
consider
ondansetron
wafer
Trial of oral
fluids 10 - 20 mL
/ kg for 1 hour
unless severe
dehydration
Severe
Consult MO urgently
who will organise
evacuation /
hospitalisation
IV / IO insertion
Commence bolus of
20 mL / kg
normal saline
• Breastfed infant [3]
-- continue breastfeeding on demand or at least every 2 hours
-- in between breastfeeds, water or oral rehydration solution may be offered
-- do not give solids if the child is vomiting
-- give solids when the vomiting has stopped or after 24 hours
-- if the baby is on solids introduce simple foods such as rice cereal, potato or
pumpkin - even if the diarrhoea is still present
Primary Clinical Care Manual 2011