Paeds Cases · nephrology-urology-fluids-and-electrolytes
Fluid maintenance and deficit replacement — OSCE
OSCE communication and clinical reasoning station for the parents of a child admitted with dehydration, explaining the fluid prescription, why the bag has changed from a clear hypotonic bag to a saline bag, the daily weight checks, and the safety-net for recurrence.
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You are the paediatric registrar. A 3-year-old girl, 14 kg, is admitted with gastroenteritis and assessed as about 7 percent dehydrated. She is not in shock and is passing urine. The team has started intravenous fluid. The parents want to understand how the doctors decided how much fluid to give, why the bag has salt and sugar and potassium in it rather than just water, why their daughter is weighed every morning, and what signs should bring them back in future. Explain clearly, check understanding, and agree a plan. [8]
References3ShowHide
- [1]Holliday MA; Segar WE The maintenance need for water in parenteral fluid therapy. Pediatrics, 1957.PMID 13431307
- [2]Feld LG; Neuspiel DR; Foster BA; et al Clinical Practice Guideline: Maintenance Intravenous Fluids in Children. Pediatrics, 2018.PMID 30478247
- [8]Moritz ML; Ayus JC Improving intravenous fluid therapy in children with gastroenteritis. Pediatr Nephrol, 2010.PMID 20309584