Patient selection: pediatric patient with recent acute gastroenteritis, with loss of 3-8% body weight
Parameters:
(1) uncertainty about diagnosis
(2) serum sodium in mmol/L
(3) rehydration
(4) concern about sending home
(5) stool culture
If there is uncertainty about the diagnosis, then additional testing should be performed.
If the serum sodium is elevated (> 150 mmol/L) then manage as severe dehydration.
Stool culture should be performed if indications present.
The patient is observed during rehydration.
(1) An attempt is made to rehydrate with oral rehydration solution (ORS) over 4 hours.
(2) If oral intake is insufficient to adequately rehydrate, then rehydration by nasogastric tube or intravenous infusion should performed.
(3) Fluid for maintenance should also be provided.
Criteria for discharge - all of the following:
(1) Adequately rehydrated.
(2) No concerns about discharge.
(3) No uncertainties about the diagnosis.
The patient should be observed or admitted until discharge criteria are met.
Caregivers should be educated about managing the patient prior to discharge, including instructions on when to return.
