Dehydration (peds)

Fluid Requirements

• 4-2-1 Rule (insensible losses only)
  • For 0-10kg: 4 mL/kg/hr
  • For 10-20kg: + 2 mL/kg/hr
  • For >20kg: + 1 mL/kg/hr
• Sodium
  • 3 mEq/kg/d
• Potassium
  • 2 mEq/kg/d

Treatment

1kg body wt = to 1 liter flluid

Oral rehydration soln should contain 60- 90 meq of Na and 2% dextrose. Can use pedialyte, rehydralyte or infalyte.

Home made solns:

- 1 litre water

- 8 teaspoons sugar

- 1 tsp salt

- can add banana or orange juice for potassium

- give Xcc q 5min

- if vomit, wait 10 min and do again

- try to achieve 50cc/kg over 3- 4 hr for mild- mod dehydration

- if diarrheal stool, add 10cc/kg extra

- for mod to severe dehydration, do 100cc/kg over 3- 4hrs

Can do ngt if refuses to take po's- 150 cc/ hr. If not vomiting can infuse faster at 25cc/kg/hr.

If fail, do IVF at 30- 40 cc/kg at minimum- replaces 3- 4% body wt

Source

6/06 MISTRY