A 3-year-old boy weighing 15 kg has had two days of profuse vomiting and diarrhoea. On arrival he was drowsy w…

Question

A 3-year-old boy weighing 15 kg has had two days of profuse vomiting and diarrhoea. On arrival he was drowsy with cold mottled legs, capillary refill of five seconds, heart rate 180 beats per minute and blood pressure 74/40 mmHg. Intravenous access was obtained and he was given sodium chloride 0.9% 300 mL over ten minutes. He now opens his eyes to voice, but his capillary refill is four seconds and his heart rate is 172 beats per minute. Which one of the following should be undertaken next?

Accepted Answer

Give sodium chloride 0.9% 300 mL intravenously

Answer

Commence an adrenaline infusion

Answer

Give albumin 4% 300 mL intravenously

Answer

Intubate and commence mechanical ventilation

Answer

Start deficit and maintenance fluid at 100 mL per hour

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