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Question:

You have a 15 month old, weighing 12 kg , with vomiting and diarrhea, moderately dehydrated based on physical exam, vitals, and clinical signs. How will you plan the oral rehydration therapy?

Answer:

Replace the child's deficit and rehydrate the child. Moderate dehydration approximates to about 10% loss which is 100ml/kg. This is 1200 ml based on a weight of 12 kg. If you have a pre-illness weight, you may use that instead. You need to give 300 ml/hr for the next 4 hours. This is 15 ml every 3 minutes. And remember, if the child is having continued losses, you need to replace those as well. Once rehydrated, start a normal diet as tolerated and continue to replace losses. If the child cannot tolerate this orally, an NG can be placed and the ORS can be given continuously and slowly at the rate of 300 ml/hr for 4 hours.


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