Dehydration Clinical Pathway, Emergency Department and Inpatient – Inpatient Management
Inpatient Management
Healthy Child Admitted with Dehydration
Reassess level of dehydration using Dehydration Assessment Tool
Mild Dehydration
Moderate/Severe Dehydration
Restore Euvolemia
- Give additional isotonic fluid bolus
- Address electrolyte abnormalities
Assess for ORT Readiness
No emesis in last 2 hrs
Child showing interest in taking POs
No emesis in last 2 hrs
Child showing interest in taking POs
Ready for ORT
Not Ready for ORT
- Discontinue IV fluids
- Initiate ORT or NG
- Advance to regular diet as tolerated
- Initiate/continue IV hydration
- Replace GI losses
- 1:1 with Isotonic fluids
Adequate PO
Inadequate PO
- Address volume deficit
- Consider IV/NG hydration
Discharge
- No improvement in 48 hrs, consider
- Alternate diagnosis
- Repeat electrolytes
- VS within normal
limits for age - PO intake > losses
- Urine output > 1 ml/kg/hr
- Improving frequency of emesis