Dehydration Clinical Pathway, Emergency Department and Inpatient – Initiate Oral Rehydration Therapy (ORT)
Dehydration Clinical Pathway, Emergency Department and Inpatient – Initiate Oral Rehydration Therapy (ORT)
Initiate Oral Rehydration Therapy (ORT)
ORT is the preferred method of rehydrating healthy children with dehydration secondary to gastroenteritis.
It works by stimulating glucose-mediated co-transport of sodium and water across the intestinal membrane
- Utilizing the correct electrolyte solution is critical for its success
- Provide 1-2 mL/kg, max 30 mL every 5 mins
- Differs from PO challenge which is offering ad lib fluids
NG Hydration/Feeds
- Give Pedialyte at maintenance rate + replacement of fluid losses
- Advance to enteral formula as tolerated
Preferred Fluids
- < 1 yr of age: Pedialyte
- > 1 yr of age: Gatorade
- 1/2 apple juice and 1/2 water
Total Volume to be Given Over 3-4 hrs
| Moderate Dehydration | 50 mL/kg |
|---|---|
| Moderate/Severe Dehydration | 100 mL/kg |
Ongoing Losses
| Aliquot volume to be given every 5 mins Increase volume for those with persistent losses during hospitalization |
|
|---|---|
| Mild/moderate dehydration | 1 mL/kg |
| Moderate/severe dehydration | 1-2 mL/kg |
| Double the aliquot volume as tolerated after the first 30 mins | |
| Maximum aliquot volume is 30 mL | |