Question: What is the correct volume of fluid to give?

Answer: The correct volume to give is:

• Fluid bolus: NS/RL 20 ml/kg
• Reassess
• Second fluid bolus NS/RL 20 ml/kg if little change

Special notes:

• In trauma give 10 ml/kg bolus only
• Give blood early if there is ongoing blood loss, or Hb <4 g/dl in severe malaria

Beware of aggressive fluid resuscitation in children with malaria, pneumonia and conditions associated with decreased levels of consciousness

2016 ETAT+ guidance states:

• A fast IV fluid bolus of 20 ml/kg should be given only to children <5y with severely impaired circulation caused by dehydration secondary to diarrhoea
• All other children with severely impaired circulation should receive this fluid IV fluid bolus over 2 hours
• Children presenting with surgical disease and burns, and those with severe malnutrition, are different