Try oral dehydration for pediatric patients

Children who are less than 10% dehydrated should not be subjected to the trauma of an IV insertion, argues Jennifer Dearman, RN, BN, charge nurse at the pediatric ED at Loma Linda (CA) University Medical Center and Children’s Hospital. "If fluids can be replaced slowly orally, you can sometimes avoid use of IV fluids," she says. "But it does takes time and patience from the nursing staff and parents."

The parent is given either a 10-cc syringe or a small medicine cup and Pedialyte and is instructed to give the child 10 ccs every five minutes. "If the child vomits, we wait another five minutes and start again. At this rate, the child would get two ounces in an hour," Dearman explains.

Usually when you administer fluid slowly, the child starts to feel better and can tolerate the fluids, so the rate can be increased after an hour or so, she says.

"However, this is not a formal guideline and is modified based on the situation," Dearman notes. "For example, sometimes we start with 5 ccs every five minutes for three doses and then increase the volume."