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Clinical pathway using rapid rehydration for children with gastroenteritis.
S J Phin1, M E McCaskill, G J Browne
1The Emergency Department, The Children's Hospital at Westmead, Westmead, New South Wales, Australia. susanp3@chw.edu.au
Journal of Paediatrics and Child Health
|July 31, 2003
Summary
A rapid rehydration clinical pathway significantly reduced hospital admissions for moderately dehydrated children with acute gastroenteritis. This approach also increased the number of children discharged from the emergency department within 8 hours.
Area of Science:
- Pediatric Emergency Medicine
- Gastroenterology
- Clinical Pathway Implementation
Background:
- Acute gastroenteritis is a common cause of dehydration in children presenting to emergency departments.
- Moderate dehydration requires effective and timely management to prevent complications and reduce healthcare resource utilization.
Purpose of the Study:
- To evaluate the efficacy of a clinical pathway employing rapid rehydration for pediatric patients with moderate dehydration due to acute gastroenteritis.
- To assess the impact of this pathway on emergency department admission rates and length of stay.
Main Methods:
- Prospective study with historical controls in a pediatric emergency department.
- Intervention involved a clinical pathway with rapid intravenous or nasogastric rehydration.
- Compared outcomes between 145 children in the intervention group and 170 historical controls.
Main Results:
- The intervention group showed a significantly lower admission rate (55.8% vs. 96.3%) compared to controls.
- A higher percentage of children in the intervention group were discharged within 8 hours (44.2% vs. 3.7%).
- No significant differences were observed in re-presentation rates or procedural rates.
Conclusions:
- A clinical pathway utilizing rapid rehydration is effective for managing moderately dehydrated children with gastroenteritis.
- This pathway successfully reduces emergency department admission rates and shortens patient stays.
- Rapid rehydration strategies can optimize care for pediatric gastroenteritis.