Dehydration Management in Pediatric Patients: Fluid Resuscitation Management in the Emergency Department

Background and Goal: Dehydration in children is a common condition among pediatric patients, particularly in emergency settings, and may lead to serious morbidity if left untreated. Rehydration of pediatric patients is significant in emergency settings, where early fluid resuscitation can have a dramatic influence on the outcome. The objective of the current study was to evaluate the severity, symptoms, characteristics, management, and consequences of dehydration in children presenting to the ED and emphasize the fluid resuscitation strategies.

Methods: Cross-sectional study of 85 children visiting the ED with dehydration in a period of 12 months of follow-up in different hospitals in Iraq from January 2024 to January 2025. All the patients were on IV resuscitation methods like (35.3% Oral Rehydration and 64.7% IV Crystalloids). All the patients had been administered IV types of fluids (normal saline, lactated Ringer's, and dextrose solution). The information was recorded for demographics, severity of dehydration, signs and symptoms, aetiology, lab reports, complications, days of stay, and parental satisfaction.

Results: The cohort was predominantly male patients (52.9%), and most were 4–12 months old (29.4%). Moderate dehydration occurred in 47.1% of the cases, with thirst (76.5%) and dry mucous membranes (70.6%) being the most common symptoms. Diarrhea and vomiting were the most common causes of dehydration (47.1%). Initial fluid resuscitation was primarily administered via IV crystalloid fluids (64.7%). Post-treatment assessment scores showed significant resolution of dehydration signs, expressed as reduced thirst (3.5 to 1.2) and dry mouth (2.5 to 1.0). The ED length of stay mean was <2 hours for 47.1% of the patients, and the parental overall satisfaction rate was also high, with 47.1% reporting being very satisfied with care.

Conclusion: Effective management of dehydration in children in the pediatric ED relies on prompt recognition of the symptoms and proper application of fluid resuscitation protocols. The success of the used protocols is confirmed by the high level of parental satisfaction. Medical education and training are ongoing in order to enhance dehydration management, which requires further research on the long-term follow-up results of in-hospital procedures.