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Intravenous rehydration for gastroenteritis: how long does it really take?
Brenda J Bender1, Philip O Ozuah
1Department of Pediatrics, Albert Einstein College of Medicine, Children's Hospital at Montefiore, Bronx, NY 10467, USA.
Pediatric Emergency Care
|April 2, 2004
Summary
Intravenous (IV) hydration for pediatric dehydration in the emergency department (ED) takes longer than the recommended 4 hours for oral rehydration therapy. This study found IV treatment averaged 5.4 hours, challenging physician perceptions and highlighting barriers to oral rehydration use.
Area of Science:
- Pediatric Emergency Medicine
- Gastroenterology
- Clinical Hydration Therapy
Background:
- The American Academy of Pediatrics recommends oral rehydration therapy (ORT) for mild to moderate dehydration from viral gastroenteritis.
- ORT is underused in emergency departments (EDs) due to perceived lengthy treatment times compared to intravenous (IV) hydration.
- Physician perception of shorter ED duration for IV hydration is a significant barrier to ORT adoption.
Purpose of the Study:
- To evaluate the actual time spent by children receiving IV hydration for gastroenteritis in the ED.
- To test the hypothesis that IV hydration is completed in less than 4 hours.
Main Methods:
- A prospective case series of 549 children treated with IV hydration for dehydration in a pediatric ED.
- Treatment time was measured from physician room placement to patient discharge, excluding waiting room time.
- Data collected over consecutive 7-day periods during fall, winter, and spring.
Main Results:
- Mean treatment time for IV hydration exceeded 4 hours (mean = 5.4 hours; median = 5.0 hours).
- IV hydration treatment time was significantly longer than for other ED patients (5.4 vs. 1.2 hours).
- Average IV treatment times were 5.1 hours (fall), 5.5 hours (winter), and 4.7 hours (spring).
Conclusions:
- Contrary to physician perception, IV hydration for mild to moderate dehydration exceeds the 4-hour ORT recommendation.
- The study did not support the belief that IV hydration leads to shorter ED stays.
- Findings suggest that the perceived time barrier for ORT may be misaligned with actual ED treatment durations.