Pedemy All toolsAnswer one question at a time. The plan gives fluid type, rates and volumes for the weight entered. Tap any earlier answer to change it.
This calculator helps clinicians plan intravenous maintenance fluids and rehydration for children. Enter the weight and it gives the fluid type, hourly rates and volumes, whether the child needs simple maintenance fluids or treatment for dehydration from vomiting, diarrhea or poor intake.
For maintenance, it uses the Holliday–Segar rule (4 mL/kg/h for the first 10 kg, 2 mL/kg/h for the next 10 kg and 1 mL/kg/h above 20 kg, usual maximum 100 mL/h) with isotonic fluid containing 5% dextrose and 20 mEq/L KCl once the child passes urine. Infants under 28 days are directed to neonatal protocols, because the AAP 2018 guideline covers 28 days to 18 years. For dehydration, the Clinical Dehydration Scale scores appearance, eyes, mouth and tears: 0 is none, 1–4 is some (about 3–6%), 5–8 is moderate to severe, with a separate shock option. It then asks whether oral rehydration is possible.
Results range from home oral fluids, to oral rehydration of 50–100 mL/kg over 4 hours with ondansetron, to an IV bolus of 20 mL/kg followed by deficit plus maintenance over 24 hours, or rapid isotonic boluses for shock. It is based on the AAP maintenance IV fluid guideline (Feld et al., Pediatrics 2018) and the Clinical Dehydration Scale (Goldman et al., 2008).
The tool uses Holliday–Segar: 4 mL/kg/h for the first 10 kg, plus 2 mL/kg/h for the next 10 kg, plus 1 mL/kg/h above 20 kg, with a usual maximum of 100 mL/h (2.4 L/day). It suggests isotonic fluid with 5% dextrose and 20 mEq/L KCl once passing urine.
The tool follows the AAP 2018 recommendation of isotonic fluids with potassium and dextrose for children aged 28 days to 18 years, because hypotonic fluids raise the risk of hyponatremia. It suggests checking sodium, potassium and glucose at baseline and at least daily.
For some dehydration, the tool gives 50 mL/kg if mild or 100 mL/kg if moderate over 4 hours, in 5 mL sips every 1–2 minutes. Ongoing losses are added: 10 mL/kg per watery stool and 2 mL/kg per vomit. A single ondansetron dose can help from 6 months.
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