[Oral rehydration in pediatric emergencies. A Spanish survey].
OBJECTIVE
To analyze the approach of emergency pediatricians to acute dehydration and their theoretical knowledge of oral rehydration, to identify the situations in which they believe oral rehydration to be indicated and its use in daily practice, as well as to determine the disadvantages of oral solutions in emergencies.


METHODS
We designed a survey, adapted from several similar studies, to evaluate theoretical and practical features of rehydration. The survey was applied in 23 emergency facilities in Spain.


RESULTS
Two-hundred ninety questionnaires were included. A total of 59.3 % of the emergency pediatricians surveyed frequently used oral rehydration in acute dehydration and 10.3 % never used it. All (100 %) used it in mild dehydration (79.3 % if it was associated with vomiting), 70.3 % used it in moderate dehydration with vomiting and 22.8 % used it if it was associated with moderate diarrhea. The main disadvantages of oral rehydration were the number of visits (34.2 %), lack of space (16.6 %) and family distrust (16.2 %). Oral rehydration was used by 64.1 % of emergency pediatricians in children of all age groups and by 17.44 % only in children older than 3 months. A few (3.8 %) believed vomiting to be a contraindication; 26.9 % sometimes used an antiemetic drug and 73.8 % used a nasogastric tube to improve tolerance in the case of vomiting.


CONCLUSIONS
Oral rehydration is widely accepted, but knowledge of its indications and techniques for application could be improved. Its main contraindications are vomiting and/or moderate dehydration; in the case of the emergency infrastructure, its main disadvantage is lack of time and workload. A nasogastric tube is a useful option to avoid an intravenous line. Guidelines for the use of oral rehydration that would reduce obstacles such as lack of time and family distrust should be developed.
D002648:Child; D002675:Child, Preschool; D004632:Emergency Medical Services; D005440:Fluid Therapy / Q000706:statistics & numerical data*; D006801:Humans; D007223:Infant; D010818:Practice Patterns, Physicians'; D013030:Spain; D011795:Surveys and Questionnaires