A Practical Guide to Successful Rehydration

The clinical and epidemiological spectrum of acute gastroenteritis is likely to change dramatically in the face of rotavirus vaccination. Acute gastroenteritis will become less common and severe and other viruses may predominate, such as norovirus. Oral rehydration is generally underemployed in the management of gastroenteritis. A greater emphasis on “frontloaded” care in the waiting room, the use of newer antiemetics and more prescriptive oral fluid management will reduce the need for inpatient care. When this fails, nasogastric administration of fluids is a valuable but underutilized treatment. Nasogastric rehydration is as effective, quicker, and easier to employ than intravenous rehydration at the expense of a less pleasant but short procedural experience for the child. It should be strongly considered when the insertion of an intravenous cannula is anticipated to be difficult.