Paediatric Gastroenteritis

See also Gastroenteritis under handouts

Overview 

Diagnostic features

Differential Diagnosis

Aetiology

RESUSCITATE

If shocked - poor cap refill/tachycardia

Check BSL - if < 2.6 mmol/L give 4ml/kg 10% dextrose

ASSESSMENT

Exclude other causes

Determine degree of dehydration

Predict organism

Contact history

Investigations

Signs Of Dehydration

  Clinical findings % bodyweight dehydrated
Mild Thirst
Dry mouth
Decreased tearing
< 5%
Moderate above
+ irritability or lethargy
+ skin turgor, sunken eyes/fontanelle
+ urine output
+ HR
5-10%
Severe above
+ drowsy/limp
+ pallor/peripheral cyanosis
+ anuric
+ BP
> 10%

Management

Aim to encourage oral intake if possible

Rehydrate

see Oral rehydration fluids

see Fluid management in paediatrics

Disposition

Admit

Discharge with instructions and GP review in 24 hrs if:

NB Persistent diarrhoea may occur due to temporarily acquired lactose intolerance