Fluid Therapy for Severe Dehydration
In pediatric patients, severe dehydration often manifests as signs of shock. Immediate, aggressive fluid resuscitation is life-saving.
1. Emergency Fluid Resuscitation (Plan C)
This follows the WHO guidelines for patients in shock due to severe dehydration.
| Age Group | First Phase (30 ml/kg) | Second Phase (70 ml/kg) |
|---|---|---|
| Under 12 months | 1 hour | 5 hours |
| 12 months and older | 30 minutes | 2.5 hours |
2. Key Clinical Principles
- Fluid Choice: Isotonic crystalloids like Ringer’s Lactate or Normal Saline (0.9% NaCl) are the fluids of choice.
- Reassessment: Reassess the patient after each phase. If the radial pulse is still weak or absent, repeat the first phase.
- Transition: As soon as the patient can drink (usually within 3–6 hours), start Oral Rehydration Solution (ORS) to complete the replacement.
NEET PG Hint: Remember the 1:2 ratio for the total volume administered in the two phases (30 ml/kg then 70 ml/kg). Always prioritize the ABCs (Airway, Breathing, Circulation). If the patient is not in shock but is severely dehydrated, ORS is still preferred if the patient is conscious and can tolerate it.