Question:
Does my child need IV fluids for mild to moderate dehydration (able to make saliva, tears, urinating normally or only mildly decreased, acting normally or irritated, pink skin)?
Answer:
No
MedHead Confidence Score: 7
Amount Saved: $3,000 ER visit with IV fluids
MedHead Message:
If your child has had a 1-2 day history of vomiting and/or diarrhea and is irritable and fussy, they are probably mildly dehydrated. Sips of Pedialyte to rehydrate are warranted, not an expensive IV at the local ER. Reserve the ER for if your child has weight loss, lethargic, breathing rapidly, incoherent, or not making urine. These children need to be seen right away for IV rehydration. About 90% of children can be treated with oral rehydration in the comfort of your own home. You may need to hydrate with AT LEAST 1000mL (about a quarter gallon) per day if your child is between 25 and 45 pounds. Over 45 pounds is 1,500mL daily to maintain fluid levels, and probably more.
References:
http://www.choosingwisely.org/clinician-lists/american-college-emergency-physicians-iv-fluids-for-mild-to-moderate-dehydration-in-children/ https://emedicine.medscape.com/article/801012-treatment?pa=0l7J%2BucJHi5lELyHhNbWLWVoqcVcUqRnny%2FeyoscHTm2ZXVaXqtGXEKCA%2BQBbqg8#d11
