Pediatric Gastroenteritis in Emergency Medicine Follow-up

Updated: Oct 17, 2017
  • Author: Adam C Levine, MD, MPH; Chief Editor: Kirsten A Bechtel, MD  more...
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Follow-up

Further Outpatient Care

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  • Parents should be instructed to continue providing maintenance ORS fluids at home as needed. Breastfeeding and formula feeding should be continued for infants, and children should be encouraged to return to a regular diet as rapidly as possible.
  • Parents should be instructed to look for the various signs of dehydration outlined above, such as change in mental status, decreased urine output, sunken eyes, absence of tears, dry mucous membranes, and slow return of abdominal skin pinch.
  • Parents should seek medical attention if dehydration returns, oral intake is inadequate, or if their child develops worsening abdominal pain, fever >101°F, or prolonged diarrhea lasting longer than 14 days.
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Further Inpatient Care

Inpatient admission should be considered for all children with acute gastroenteritis in the following situations:

  • Signs of severe dehydration are present.
  • Caregivers are unable to manage oral rehydration or provide adequate care at home.
  • Substantial difficulties exist in administering ORS, such as intractable vomiting or inadequate ORS intake.
  • Failure of treatment occurs, such as worsening diarrhea or dehydration, despite adequate ORS intake.
  • Factors are present necessitating closer observation, such as young age, decreased mental status, or uncertainty of diagnosis.
  • Children with mild-moderate dehydration, age < 6 months, or high frequency of stools/vomits should be monitored in the emergency department for a minimum of 4-6 hours before discharge.
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Deterrence/Prevention

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  • The US Advisory Committee on Immunization Practices and the American Academy of Pediatrics recommend routine vaccination of US infants with rotavirus vaccine to protect against rotavirus gastroenteritis. [18]
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Patient Education

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