A 3-year-old with severe dehydration is lethargic, with cold hands and a thready pulse. What is the first step?
Answer and explanation
Correct answer: B. Give an intravenous isotonic crystalloid bolus of about 20 mL per kg and reassess
- Step 1: Lethargy, cold extremities and a weak pulse indicate shock from dehydration. Step 2. Shock needs rapid intravenous isotonic fluid in boluses with reassessment after each one. Answer: A 20 mL per kg isotonic bolus with reassessment. Why not the others: Oral fluids are too slow in shock. A very large bolus without review risks overload. Dextrose alone does not restore intravascular volume.
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