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Oral rehydration counselling — GPhC CRA MCQ

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HardGastrointestinal TherapeuticsOral rehydration counsellingGPhC CRA

A 3-year-old with clinical dehydration but no shock or red-flag features persistently vomits correctly prepared low-osmolarity ORS when it is offered orally. The child remains haemodynamically stable. What is the next rehydration step to consider?

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Correct answer: D — Give the ORS by nasogastric tube and monitor the response

NICE advises frequent small amounts of low-osmolarity ORS for clinical dehydration and says to consider administration by nasogastric tube when a child cannot drink it or vomits persistently. Intravenous fluid is reserved for shock, deterioration despite oral rehydration with red-flag features, or persistent vomiting of ORS given orally or by nasogastric tube.

Reference: NICE CG84, Gastroenteritis in under 5s—recommendations 1.3.2.2 and 1.3.3.1: https://www.nice.org.uk/guidance/cg84/chapter/Recommendations