Fluid deficit from gastroenteritis or reduced intake, graded by clinical signs into no, some, or severe dehydration.
Examination
- • Alertness, sunken eyes, mucous membranes
- • Skin turgor, capillary refill
- • Weight loss compared with recent weight
- • Urine output
Management
- • No dehydration: continue feeds, ORS 5–10 mL/kg after each loose stool
- • Some dehydration: ORS 75 mL/kg over 4 h
- • Severe: 20 mL/kg 0.9% saline bolus, repeat as needed, then deficit + maintenance
- • Zinc 10–20 mg daily × 14 days in gastroenteritis (endemic settings)
Clinical pearls
- • Use isotonic maintenance fluids with glucose — hypotonic fluids cause hyponatraemia
- • Ongoing bilious vomiting suggests obstruction, not gastroenteritis
Educational — verify locally.
