This excellent 2:31 second Vimeo video, Assessing the Degree of Dehydration on Physical Examination, from Dr. Brad Sobolewski of pemcincinnati.com covers pediatric dehyation in a very short time.
Basically, it boils down to this:
With mild dehydration, the vital signs are all normal. In this case you can use oral rehydration.* If that fails you could consider subcutaneous rehydration.**
* Diarrhea and Dehydration BY SEAN FOX · MAY 10, 2013
* Oral Rehydration Therapy is Faster
BY SEAN FOX · PUBLISHED JANUARY 31, 2014 · UPDATED JULY 7, 2014
* Oral Rehydration Therapy for Acute GastroEnteritis
BY SEAN FOX · PUBLISHED SEPTEMBER 30, 2011 · UPDATED FEBRUARY 7, 2013
** Pediatric Subcutaneous Rehydration From Dr Tim Horeczko of Pediatric Emergency Playbook Posted on September 30, 2016 by Tom Wade MD
In moderate dehydration, the vitals signs will be [mildly?] abnormal. But beware, make sure that the patient is not actually in compensated shock – if there is any question then treat as compensated shock (meaning prompt vascular access and fluid boluses).*
* Intraosseous Access – A Critical Skill For ACLS, and PALS
Posted on May 12, 2016 by Tom Wade MD
* Intraosseous Devices For Infant and Pediatric IO Access
Posted on October 19, 2016 by Tom Wade MD
* Practicing Newborn Vascular Access With Liz, Newborn Pediatric Transport Nurse Of St. Vincent Hospital Posted on May 15, 2016 by Tom Wade MD
In severe dehydration, the patient is actually in compensated or decompensated shock and needs emergency treatment.*
* Intraosseous Access – A Critical Skill For ACLS, and PALS
Posted on May 12, 2016 by Tom Wade MD
* Intraosseous Devices For Infant and Pediatric IO Access
Posted on October 19, 2016 by Tom Wade MD
* Practicing Newborn Vascular Access With Liz, Newborn Pediatric Transport Nurse Of St. Vincent Hospital Posted on May 15, 2016 by Tom Wade MD
Now here are the slides from Dr. Sobolewski’s video:
