Acute Caremiddle twist
A 4-year-old boy weighing 16 kg has had profuse watery diarrhoea and vomiting for three days and has not passed urine since yesterday. In the emergency department he becomes unresponsive; there is no palpable central pulse and the monitor shows a slow broad complex rhythm without output. Chest compressions are started at fifteen compressions to two ventilations, intraosseous access is obtained and adrenaline is given by that route. The team leader identifies hypovolaemia as the likely reversible cause. Which one of the following volumes of sodium chloride 0.9% should be given as the initial fluid bolus?