Hypernatraemic Dehydration

Resuscitate with the usual boluses of 20ml/kg 0.9% NaCl if child is shocked.

Thereafter, rapid correction can be dangerous – ideally oral rehydration should be used

Obtain baseline U&Es and blood glucose

If IV fluids are required:

  • Obtain urgent expert advice on fluid management
  • Commence isotonic fluids for deficit correction and maintenance (0.9% saline and 5% glucose)
  • Rehydrate slowly (normally over 48 hours)
  • Monitor serum sodium level frequently
    • Aim for a reduction of less than 0.5 mmol Na+/L per hour
  • Gradually attempt to introduce oral fluids early
  • If tolerated, complete rehydration with oral fluid therapy