Hypernatraemic Dehydration

Resuscitate with the usual boluses of 10ml/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