Question

A 1-year-old child weighing 6 kg has acute gastroenteritis with sunken eyes and a skin pinch that goes back very rapidly (severe dehydration). What is the appropriate IV fluid management?

• A. RL infusion 120 ml in the first hour followed by 360 ml over the next 5 hours
• B. RL infusion 180 ml in the first hour followed by 420 ml over the next 5 hours
• C. RL infusion 180 ml in the first hour followed by 480 ml over the next 5 hours
• D. RL infusion 240 ml in the first hour followed by 360 ml over the next 5 hours

Hint:

Bolus 30 mL/kg, then 70 mL/kg over 5 hours for a 6 kg infant.

Answer 1

The Correct Option is B

Step 1: Severe dehydration is a medical emergency requiring immediate IV resuscitation with lactated Ringer's (RL) or normal saline.

Step 2: The initial bolus is 20 to 30 mL/kg. For this 6 kg child, 30 mL/kg gives \(30 \times 6 = 180\) mL in the first hour.

Step 3: After the bolus, an infusion of 70 mL/kg is given over 5 hours in children younger than 12 months. That is \(70 \times 6 = 420\) mL over the next 5 hours.

Step 4: Combining 180 mL in the first hour and 420 mL over 5 hours matches option 2, which is therefore correct; the other volume combinations do not fit the weight-based formula.