Dehydration Rescue Plan-HOW MUCH FLUID DOES IT TAKE???
To correct dehydration (or keep pace with severe ongoing losses), a child needs A LOT more fluid than usual. However, if a child’s stomach is upset, he or she is more apt to vomit after drinking a large quantity of fluid than a smaller quantity. Therefore, until the vomiting subsides the only way to get A LOT of fluid in is through drinking smaller amounts much more frequently.
Refer to the table below for an effective “rescue plan” based on these principles for children with severe gastroenteritis (vomiting and/or diarrhea happening every 2h or more) or who are already showing signs of dehydration. This plan is not appropriate for newborns, nor does it need to be used for children who have less frequent vomiting/diarrhea and are not yet dehydrated. Implemented properly, however, it can prevent hospitalization in 75% of children who would otherwise need IV fluid. The second column indicates the hourly fluid requirement of the child while sick, while columns 3, 4, and 5 indicate HOW that amount of fluid should be delivered over 24 hours.
CAUTION:if you try this plan at home, and by the fourth hour EITHER the vomiting is still frequent OR you are unable to get your child to take the specified amount, you should SEEK MEDICAL ATTENTION (call our office or go the the Children’s Hospital ER)- in this case your child needs fluid through an IV and may need to be hospitalized. Also, any child who is not clearly getting better by the second day should be brought in for a visit at our office.
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Gastroenteritis “Rescue” Plan: |
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| Age | Initial Hourly ORS Need (Pedialyte or equiv. until clearly improved) | First 3-4h (until no longer vomiting) |
Next 8-10h (ok now to also give small bites of solid food but still ORS only) |
Next 12 hours (if doing well fluid no longer has to be ORS) |
2nd Day (start to resume normal diet, fluid quota is reduced) |
| 3 – 6mo | 1½-2oz/hr | 10cc (2tsp) every 10-15min |
1½-2oz every hour | 3-4oz every 2 hours |
4-5oz every 3-4 hours |
| 6mo – 2yrs | 2-3oz/hr | ½oz (1tbsp) every 15min |
2-3oz every hour | 4-6oz every 2 hours |
5-6oz every 3-4 hours |
| 3-5yrs | 3-4oz/hr | 1oz (2tbsp) every 15-20min |
3-4oz every hour | 6-8oz every 2 hours |
8oz every 4 hours |
| 6-9yrs | 4-5oz/hr | 1½oz (3tbsp) every 20min |
4-5oz every hour | 8-10oz every 2 hours |
10oz every 4 hours |
| 9-12yrs | 5-6oz/hr | 1½oz (3tbsp) every 15min |
5-6oz every hour | 10-12oz every 2 hours |
12oz every 4 hours |
| 13+ years | 6-8oz/hr | 2oz (4tbsp) every 15-20min |
6-8oz every hour | 12-16oz every 2 hours |
16oz every 4 hours |