diarrhea. It appears that “everyone in the house has it”, including the dedicated now also slightly peaked parents in front of you, who have been trying to keep him hydrated at home with juice, water, and an electrolyte solution. He has had
no fever, is otherwise behaving normally (except for some fussiness), his vomit
is non-bilious, and his diarrhea is frequent and watery. Although difficult to say given his current problems, his mother does not believe that he has urinated today.
The boy is otherwise healthy, born full-term, vaccinated, and has no medications or allergies.
On arrival, you see a tired but relatively well appearing infant with slightly dry
mucous membranes, normal abdominal and genitourinary exams, and an otherwise
unremarkable physical examination with reassuring vital signs.
After a trial of an oral antiemetic and small frequent aliquots of PO fluids, the
child continues to vomit.
Of the following options, which may be the most appropriate for this child?
A. Oral rehydration
B. Nasogastric tube hydration
C. Intraosseous hydration
D. Hypodermic hydration
In the meantime, a few quotes –
“When we can no longer change a situation, we are challenged to change ourselves.”
– Viktor Emil Frankl, M.D., Ph.D. (1905 – 1997), Austrian neurologist, psychiatrist, and Holocaust survivor
“For just when ideas fail, a word comes in to save the situation.”
– Johann Wolfgang von Goethe (1749 – 1832)