Inpatient Clinical Pathway for Healthy Child with Gastroenteritis/Dehydration

Mild Dehydration
RN notifies FLOC
FLOC confirms ORT readiness
Tolerates ORT
  • Advance to regular diet as tolerated
  • Breast milk, formula, solids
Discharge Criteria
  • Vital signs within normal limits for age
  • PO intake > losses
  • Urine output > 1 ml/kg/hr
  • Improving frequency of emesis
Fails ORT
  • Emesis and/or
  • PO refusal
Moderate/Severe Dehydration
  • RN notifies FLOC
  • FLOC confirms ORT readiness
Ready for ORT
Not Ready for ORT
  • Continue Q4 nursing assessments
  • Continue IV hydration
  • If no improvement in 48 hours
  • Consider
    • Alternate diagnosis
    • Repeat electrolytes
  • Oral Rehydration Therapy (ORT)
  • Preferred method, successful in treating healthy children with GE/dehydration.
    • Give 1-2 mL/kg, max 30 mL every 5 minutes
  • Differs from PO challenge which is offering ad
    lib fluids
  • Instructions for the Medical Team
  • ORT Record Sheet
  • NG Hydration/Feeds
  • Consider in patients with persistent GI losses from ongoing diarrhea.
    • Discuss with family
  • Review
  • NG vs. IVF PFE
  • Give Pedialyte® at maintenance rate + replacement of fluid losses
  • Advance to enteral formula as tolerated
Posted: June 2019
Revised: June 2021
Authors: A. Van Pelt, MD; K. Dellabadia MD; M. Greenfield, MD; J. Hart, MD; K. Granahan, BSN; B. Gallagher, BSN