Action
- Strongly consider admission or transfer
- Discuss nasogastric or intravenous hydration with family if Urgent Care has capability
NG
- Start oral rehydration solution via nasogastric tube
- Give 50-100 mL/kg of oral rehydration solution over 3-4 hours
IV
- Place IV and administer 20 mL/kg normal saline (0.9% sodium chloride) bolus
- Strongly consider ordering electrolyte testing
Decision
Start a second oral challenge. Does patient tolerate oral fluids?
Yes
- Discharge home once tolerating oral rehydration solution well
- Give strict return precautions
No
- Admit for further hydration via NG tube or IV
