Pediatric Vomiting & Diarrhea | The EM & Acute Care Course

Pediatric Vomiting & Diarrhea by Ken Milne, MD

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Key Points and Recommendations

1. Oral rehydration therapy is comparable to intravenous fluids in children with mild to moderate dehydration.
2. Commercial electrolyte solutions vary widely in the composition and may lack enough sodium for dehydration.
3. Use of ondansetron can reduce failure rates in ORT patients.
4. Ondansetron does not increase the QTc on electrocardiograms in children.
5. More severe dehydration and higher triage scores are associated with ORT failure.
6. Starvation ketosis is not associated with increased failure in ORT.
7. Family members prefer IVF or ORT.
8. Most clinicians do not consider nasogastric rehydration therapy in dehydrated children.
9. IVF with dextrose does not change clinical outcomes compared to electrolyte only IVF therapy.
10. Ondansetron prescriptions do not impact return visits to the ED.

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