Last reviewed: November 2017
Last updated: November  2017

Summary

Definition

History and exam

Key diagnostic factors

  • hx of gastroenteritis
  • age <3 years
  • hx of trauma or burns
  • thirst
  • capillary refill >3 seconds
  • decreased skin turgor
  • dry mucous membranes
  • abnormal mental status or activity level
  • tachycardia
  • abnormal urinary output
  • elevated respiratory rate or deep respirations

Other diagnostic factors

  • vomiting
  • diarrhea
  • abdominal pain
  • abnormal glucose test strip result
  • low core temperature or fever
  • abnormal BP
  • bruises or signs of neglect

Risk factors

  • vomiting and/or diarrhea
  • age <3 years
  • trauma
  • burns >10% of body surface area
  • type 1 diabetes mellitus
  • hx of poor oral intake
  • hx of diuretic use
  • vigorous and prolonged exercise

Diagnostic investigations

Investigations to consider

  • serum electrolytes
  • blood glucose
  • BUN/Cr
  • CBC
  • urinalysis
  • urine specific gravity
  • urine osmolality
  • urine microscopy and culture
  • blood culture
  • ABG
  • head CT scan
  • abdominal CT scan
Full details

Treatment algorithm

Contributors

Authors VIEW ALL

Associate Professor

Pediatrics

Case Western Reserve University

Associate Vice Chair of Education

Director of Subspecialty Training Programs

Department of Pediatrics Fellowship Director

Division of Pediatric Critical Care

University Hospitals Rainbow Babies & Children's Hospital

Cleveland

OH

Disclosures

KM declares that she has no competing interests.

Pediatric Critical Care Fellow

Division of Pediatric Critical Care Medicine

University Hospitals Rainbow Babies & Children’s Hospital

Cleveland

OH

Disclosures

MRC declares that she has no competing interests.

Dr Katherine Mason and Dr Marla R. Carter would like to gratefully acknowledge Dr Risha Moskalewicz, Dr Vincent J. Wang, Dr Naseem Sulayman, and Anne Stormorken, previous contributors to this monograph. VJW is an author of a number of references cited in this monograph. RM, NS, and AS declare that they have no competing interests.

Peer reviewers VIEW ALL

Assistant Professor of Pediatrics

Pediatric Critical Care Medicine

Emory University School of Medicine

Children's Healthcare of Atlanta

Atlanta

GA

Disclosures

JAS declares that she has no competing interests.

Consultant Paediatric & Neonatal Intensive Care Unit

Great Ormond St Hospital for Children

London

UK

Disclosures

JB is an author of a reference cited in this monograph.

Consultant Paediatric Anaesthetist

Department of Anaesthesia

Frenchay Hospital

Bristol

UK

Disclosures

AERY declares that she has no competing interests.

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