What is the treatment for a 7kg dehydrated child?

Treatment for a 7kg Dehydrated Child

For a 7kg dehydrated child, administer 350-700 mL of oral rehydration solution (ORS) over 3-4 hours for mild to moderate dehydration, or immediate IV rehydration with 20 mL/kg boluses of isotonic fluids for severe dehydration until vital signs normalize. 1

Assessment of Dehydration Severity

• Assess the degree of dehydration based on clinical signs 2:

  • Mild dehydration (3-5% fluid deficit): increased thirst, slightly dry mucous membranes
  • Moderate dehydration (6-9% fluid deficit): loss of skin turgor, tenting of skin when pinched, dry mucous membranes
  • Severe dehydration (≥10% fluid deficit): severe lethargy, altered consciousness, prolonged skin tenting (>2 seconds), cool extremities, decreased capillary refill, rapid deep breathing

• The most useful signs for identifying dehydration include prolonged capillary refill time, abnormal skin turgor, and abnormal respiratory pattern 3

Rehydration Therapy Based on Severity

Mild Dehydration (3-5% fluid deficit)

• Administer 50 mL/kg of ORS over 2-4 hours (350 mL for a 7kg child) 2, 1
• Start with small volumes (1 teaspoon) using a teaspoon, syringe, or medicine dropper 2
• Gradually increase the amount as tolerated 1

Moderate Dehydration (6-9% fluid deficit)

• Administer 100 mL/kg of ORS over 2-4 hours (700 mL for a 7kg child) 2, 1
• Use the same administration technique as for mild dehydration 2

Severe Dehydration (≥10% fluid deficit)

• This is a medical emergency requiring immediate IV rehydration 2, 1
• Administer 20 mL/kg boluses of Ringer's lactate solution or normal saline until pulse, perfusion, and mental status normalize 2, 1
• Once stabilized, transition to oral rehydration therapy 1

Replacement of Ongoing Fluid Losses

• For a child under 10kg, administer 60-120 mL of ORS for each diarrheal stool or vomiting episode 1
• Alternative calculation: 10 mL/kg (70 mL for a 7kg child) for each watery stool and 2 mL/kg (14 mL for a 7kg child) for each vomiting episode 1

Practical Administration Tips

• For children with vomiting, start with very small volumes (5 mL) and gradually increase as tolerated 4
• If the child cannot drink but is not in shock, consider nasogastric administration at 15 mL/kg/hour (105 mL/hour for a 7kg child) 2, 4
• Continue rehydration as long as diarrhea or vomiting persists 1

Nutritional Management

• For breastfed infants, continue breastfeeding throughout the illness 1, 5
• For formula-fed infants, resume appropriate formula after initial rehydration 5
• Resume age-appropriate diet within 3-4 hours after rehydration is complete 1

Monitoring Response

• Reassess hydration status after 3-4 hours of therapy 2, 4
• If dehydration persists, reassess the fluid deficit and restart rehydration therapy 2
• If the child shows signs of worsening dehydration, severe lethargy, or inability to drink, escalate care immediately 1

Important Cautions

• Use only commercially available ORS formulations like Pedialyte 1
• Avoid apple juice, sports drinks, or commercial soft drinks for rehydration due to inappropriate electrolyte content and high osmolality 1, 4
• Avoid anti-diarrheal medications in children with acute diarrhea 1, 4