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You are the resident covering an after-hours paediatric telephone line. The mother of a two-year-old boy rings about his second day of gastroenteritis. He was reviewed that morning, was mildly dehydrated, and was sent home on oral rehydration solution given by syringe, which he has been taking. He has had two wet nappies since lunchtime and is still drinking. She then describes several things that have happened in the past hour. Which one of the following makes it necessary for him to be reassessed in person tonight?
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