Hypovolaemic shock

To treat hypovolaemic shock:

• Ringer's/CSL 20 ml/kg over 15 minutes
• Also treat hypoglycaemia

A second bolus may be given if required. After boluses, go to Step 2 of WHO Plan C.

After treating hypovolaemic shock, continue with the treatment for severe dehydration.

Severe dehydration

To treat severe dehydration:

• IV hydration CSL 100 ml/kg:
  • Step 1: 30 ml/kg:
    • Over 30 minutes if >1 year
    • Over 60 minutes if 1 year
  • Step 2: CSL 70 ml/kg
    • Over 2.5 h if >1 year
    • Over 5 h if <1 year
• Passing an NGT is preferable: give 120 ml/kg Oral Rehydration Solution (ORS) over 6 h instead of IV fluids

This is WHO Plan C.

After treating severe dehydration, continue with the treatment for some dehydration.

Some dehydration

To treat some dehydration:

• Rehydration is orally or NGT with ORS 75 ml/kg over 4 hours and continue feeding. This is WHO Plan B
• Refer to ETAT+ or WHO Pocket Book of Hospital Care for Children

After treating some dehydration, continue with the treatment for a child with no dehydration.

No dehydration

When there is diarrhoea but fewer than two signs of some dehydration:

• 10 ml/kg ORS after each stool and continue feeding. This is WHO Plan A