Acute gastroenteritis

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HydrationChoose one

Abdominal examChoose one

Appendicitis signs presentChoose any

Appendicitis signs absentChoose any

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Acute gastroenteritis
• Well hydrated
• Abdominal exam without guarding or rebound
• Oral rehydration at home with pedialyte; antibiotics not indicated
• Zofran prescribed as needed for vomiting to help with oral rehydration
• Follow up as needed for worsening or concerns

Recommended supportive care with an emphasis on hydration with pedialyte in small, frequent sips; if vomiting, start with about a teaspoon every 5 minutes and increase as tolerated, with extra for each episode of vomiting or diarrhea. Usual diet as tolerated; avoid juice, soda, and sports drinks, and a bland-only diet is not needed. Return precautions given including decreased urination, not keeping fluids down, blood in stool, green vomit, severe belly pain, unusual sleepiness, new symptoms, prolonged symptoms, worsening symptoms, and other concerns. Caregiver expressed understanding and agreement with plan. Answered all questions.

What the sources cover

Dehydration assessment: none or mild
Moderate dehydration
Severe dehydration
Oral rehydration with ORS (Pedialyte) at home
Oral rehydration trial in clinic, tolerated
Sent to ED for IV fluids (severe, failed ORT, intractable vomiting)
Zofran given in clinic or prescribed
Ondansetron only > 4 y per IDSA (weak)
Probiotics may be offered
No antibiotics for watery diarrhea

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Bloody diarrhea or fever: stool studies sent
C. difficile testing after antibiotics
STEC: no antibiotics; HUS monitoring labs
Continue breastfeeding; usual diet; avoid sugary drinks; no BRAT/clear-only diet
Small frequent sips (5 mL every 5 minutes), increase as tolerated
Return: fewer wet diapers, can't keep fluids down, blood in stool, green vomit, severe belly pain, lethargy
Hand hygiene; child care exclusion until diarrhea resolves
Follow-up as needed or recheck in 1-2 days

Used to decide, kept out of the note

No loperamide or antimotility under 18

Return precautions in the template

decreased urinationnot keeping fluids downblood in stoolgreen vomitsevere belly painunusual sleepiness

Acute gastroenteritis

What the sources cover

Used to decide, kept out of the note

Return precautions in the template

Sources