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Diarrhea, Pediatric, Emergency Medicine

Reviewed 06/2017
 


Basics

Description

  • One of the most common pediatric complaints; 2nd only to respiratory infections in overall disease frequency for ED visits

  • Leading cause of illness and death in children worldwide

  • Acut...

Diagnosis

Signs and Symptoms

  • Frequent, loose stools

  • Signs of dehydration:

    • Watery

    • Bloody

    • Mucoid

    • Sometimes abdominal pain, fever, anorexia

    • Tenesmus

  • Signs of dehydration reflect degree of loss of total body wate...

Treatment

Initial Stabilization/Therapy

  • For severely dehydrated children in shock or near shock, IV or intraosseous access with 20 mL/kg 0.9% NS and 1 g/kg dextrose if hypoglycemic

  • Alternatively, fluids...

Follow-Up

Disposition

Admission Criteria

  • Surgical abdomen

  • Inability to tolerate oral fluids

  • 10% dehydration or greater

  • Suspected complicated Salmonella enteritis

  • Toxic-appearing child

Discharge Criteria

  • Impro...

Pearls and Pitfalls

  • History and PE assists in differentiating uncomplicated diarrhea from other, often more serious conditions in children.

  • Vast majority of children with acute diarrhea do not need ext...

Additional Reading

  • Canavan  A, Arant  BS Jr. Diagnosis and management of dehydration in children. Am Fam Physician.  2009;80(7):692–696.

  • Levy  JA, Bachur  RG, Monuteaux  MC, et al. Intravenous dex...

Codes

ICD9

  • 008.8 Intestinal infection due to other organism, not elsewhere classified

  • 008.61 Enteritis due to rotavirus

  • 787.91 Diarrhea

  • 008.63 Enteritis due to norwalk virus

  • 008.00 Intestinal infection due...

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