Paediatricsmiddle twist
A 15-month-old boy presents with two days of vomiting and frequent watery stools. He is alert but subdued, with dry lips, mildly sunken eyes, heart rate 148/min and central capillary refill of two seconds; he weighs 10.2 kg, 500 g below his weight recorded two weeks earlier. After a dose of oral ondansetron he was offered oral rehydration solution 5 mL every few minutes for one hour, but pushed the syringe away and swallowed almost none. Which one of the following is the most appropriate next step in management?