The Management of Children with Gastroenteritis and Dehydration in the Emergency Department

Management guidelines for acute infective diarrhoea / gastroenteritis in infants

“…The clinical signs of dehydration are variable; 30 the degree of dehydration is most accurately predicted with a combination of the observer's experience, 31,32 the measured acute weight loss, and the presence of metabolic acidosis. 33 Placed together, these allow an assessment of whether dehydration is mild, moderate or severe. In particular, capillary filling time must be noted: a capillary refill time (CFT) >3 seconds in a dehydrated child indicates the need for intravenous resuscitation in addition to rehydration.…”

Pediatric rapid fluid resuscitation

“…These patients may be amenable to enteral versus parenteral hydration and/or an antiemetic to facilitate rehydration. Many authors found that most routine laboratory testing is of little value in the uncomplicated patient with acute gastroenteritis [22,24,40,48 ]. There were seven studies that focused on enteral (oral or nasogastric) versus intravenous rehydration in the setting of acute gastroenteritis with moderate dehydration.…”

“…It highlights the reduced need for intravenous fluids after ondansetron administration for acute gastroenteritis in children. For patients with mild-to-moderate dehydration, a single dose of oral ondansetron may facilitate rehydration therapy by reducing ongoing losses [47,48 ]. Note that presentation with 10 or more episodes of vomiting 24 h prior to arrival is shown to be a significant predictor of repeat emergency department (ED) visits within 3 days [49 ].…”

A novel HPTLC method for quantitative estimation of biomarkers in polyherbal formulation

“…All children are probable to practice AGE in the earlier 3 years of life. AGE is epitomized by diarrhea, coupled with nausea, vomiting, fever, and abdominal pain [22]. Most cases of mild diarrhea are of viral etiology, while severe diarrhea, especially associated with fever, tends to be of bacterial etiology [23].…”