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Diarrhoea and vomiting in under 5s (gastroenteritis)

A detailed Australian summary of diarrhoea and vomiting in under 5s (gastroenteritis), with source-attributed priorities, a practical workflow, safety escalation and state or territory implementation boundaries.

JurisdictionAustralia
Source check2026-08-20
Clinical reviewiatroX editorial team 路 Clinical editorial review 路 reviewed 2026-08-20 路 due 2027-08-20
AudienceHealthcare professionals practising in Australia
This is an iatroX educational summary of named Australia sources, not an official guideline. It does not replace the complete source documents, local policy, specialist advice or clinical judgement. RCH gastroenteritis is used as an explicitly Victoria implementation source. Verify the corresponding state or territory pathway before acting.

Scope

Assess stool and vomiting duration, blood, bile, travel and contacts, then grade dehydration from behaviour, perfusion, mucosa, eyes, urine and weight change. Use oral rehydration solution in frequent small amounts and continue breastfeeding and age-appropriate feeding; sugary drinks can worsen diarrhoea. This summary is limited to the population, decisions and escalation boundaries stated in the named source.
sources for this section:RCH gastroenteritis

The Bottom Line

  • Assess stool and vomiting duration, blood, bile, travel and contacts, then grade dehydration from behaviour, perfusion, mucosa, eyes, urine and weight change.
  • Use oral rehydration solution in frequent small amounts and continue breastfeeding and age-appropriate feeding; sugary drinks can worsen diarrhoea.
  • Ondansetron may support oral rehydration in selected children under the paediatric protocol but does not replace reassessment.
  • Reserve stool testing for blood, outbreak, travel, prolonged illness, immunocompromise or public-health indication and avoid routine antibiotics.
sources for this section:RCH gastroenteritis

Practical clinical workflow

1

Topic-specific assessment action

Assess stool and vomiting duration, blood, bile, travel and contacts, then grade dehydration from behaviour, perfusion, mucosa, eyes, urine and weight change.
2

Topic-specific diagnostic action

Reserve stool testing for blood, outbreak, travel, prolonged illness, immunocompromise or public-health indication and avoid routine antibiotics.
3

Topic-specific management action

Give caregivers exact fluid goals, vomiting strategies and return signs and confirm follow-up for young or socially vulnerable children.
4

Topic-specific follow-through

Blood or mucus with high fever raises bacterial or inflammatory disease and changes stool testing and antimicrobial decisions.
sources for this section:RCH gastroenteritis

Safety boundaries and escalation

  • Shock, bilious vomiting, peritonism, severe dehydration, altered responsiveness, suspected sepsis or inability to retain oral rehydration requires urgent hospital care.
  • Track weight and urine output and consider hypernatraemia when signs appear less dramatic than the degree of dehydration.
sources for this section:RCH gastroenteritis

Implementation

RCH gastroenteritis is a Victoria source. It supplies an Australian implementation example, not a national rule. Confirm the equivalent pathway, referral destination and medicine policy in the patient鈥檚 state or territory. Check current TGA product information for medicines. Offer culturally safe care and use the NACCHO鈥揜ACGP National Guide where Aboriginal and Torres Strait Islander preventive or chronic-care recommendations differ.
sources for this section:RCH gastroenteritis

Clinical use boundary

This independently written summary is not an official guideline. Check the linked source version, current TGA-approved product information where medicines are involved, and the applicable state, territory and local pathway at the point of care.

sources for this section:RCH gastroenteritis

Source documents

Use the linked source documents for complete recommendations, evidence grading, exclusions and implementation detail.

  1. The Royal Children鈥檚 Hospital MelbourneClinical Practice Guideline: GastroenteritisCurrent page checked 2026-08-20 路 accessed 2026-08-20
    view source
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