Abdominal films are not routinely needed. Consider obtaining flat plate and upright views of the abdomen when the clinical differential includes appendicitis, small bowel obstruction, peritonitis, or renal calculi. Children with gastroenteritis rarely require IV fluids in the prehospital setting. Severe shock, uncommon in the setting of gastroenteritis, warrants prehospital IV access. Oral replenishment has an important role in resuscitation particularly in the developing world where resources for IV volume replenishment are scarce.
Several solutions are available commercially.
Glucose should be given in addition to electrolytes due to the physiologic transport mechanisms for transmembrane fluid absorption mediated by glucose. Volume replenishment generally occurs over 8 hours. Children must be cooperative and have caregivers available to instruct and administer the oral fluids. ORT is not used routinely in Western EDs due to time constraints, but it is a major treatment modality in the developing world. It is effective for patients with severe volume depletion.