Dehydration

Key Conditions
Foundational Knowledge
Resources

Hyponatremia / hypernatremia
Mild / moderate / severe dehydration

Describe the fluid composition of the body, the body water compartments and the normal movement of fluids and electrolytes between compartments
Describe clinical signs and symptoms of dehydration
Describe principles of rehydration, both oral and intravenous

Overview & Foundational Knowledge

Ruth JL & Wassner SJ. Body composition: Salt and water. Pediatrics in Review 2006; 27(5), 181-187.

Review of the different body fluid compartments, the percentage of body fluid with different ages and the equilibrium between extracellular fluid and intracellular fluid. Listing of the daily requirements for sodium and a discussion of the relationship between serum sodium concentration and total body sodium content.

Clinical Resources

Shafiee MAS, Bohn D, Hoorn EJ & Halperin ML. How to select optimal maintenance intravenous fluid therapy. Q J Med 2003; 96, 601–610.

http://qjmed.oxfordjournals.org/content/96/8/601.full.pdf+html

Adult orientated but a good commentary about the risks of hyponatraemia and advice about the indications for fluid management.

Colletti JE et al. The management of children with gastroenteritis and dehydration in the emergency department. The Journal of Emergency Medicine 2010; 38(5) 686-698.

Evidence on the assessment of dehydration, methods of rehydration (IV versus oral), and the utility of antiemetics in the child presenting with acute gastroenteritis

Moritz ML & Ayus JC. Intravenous fluid management for the acutely ill child. Current Opinion in Pediatrics 2011; 23, 186-193.

Risk of acute hyponatremia in hospitalized children and youth receiving maintenance intravenous fluids.

Risk of acute hyponatremia in hospitalized children and youth receiving maintenance intravenous fluids

http://www.cps.ca/documents/position/acute-hyponatremia-in-hospitalized-children-and-youth

http://www.cps.ca/fr/documents/position/hyponatremie-aigue-chez-les-enfants-et-les-adolescents-hospitalises

Canadian Paediatric Society Practice Point (2016)

Great overview of the dangers of hyponatremia in the inpatient population in pediatrics

Meyers RS. Pediatric Fluid and Electrolyte Therapy. Journal of Pediatric Pharmacology and Therapeutics 2009; 14(4), 204–211.

Written for pharmacists but a nice simple overview of intravenous fluids.

Oral rehydration therapy and early refeeding in the management of childhood gastroenteritis

https://academic.oup.com/pch/article/11/8/527/4560375

Virtual Patients or Cases

Dehydration

https://www.pedscases.com/dehydration-children

Podcast and two quizzes related to dehydration in children.

Cards

Dehydration

Dehydration – Assessment

Canuc-Paeds physician authored, replayable cases

Dehydration

Dehydration – Treatment

Canuc-Paeds physician authored, replayable cases

Abdominal Pain & Abdominal Mass
Acutely Ill Child
Adolescent Health Issues
Altered Level of Consciousness
Bruising / Bleeding
Dehydration
Development / Behavioural / Learning Problems
Diarrhea
Edema
Eye Issues

Fever
Genitourinary Complaints
Growth Problems
Headache
Inadequately explained injury
Limp / Extremity Pain
Lymphadenopathy
Mental Health Concerns
Murmur
Neonatal Jaundice

Newborn
Pallor / Anemia
Rash
Respiratory distress / Cough
Seizure / Paroxysmal event
Sore Ear
Sore Throat / Sore Mouth
Vomiting
Well Child Care