title: The effect of a rapid rehydration guideline on Emergency Department management of gastroenteritis in children.
abstract: This study evaluated the use and effect of a rapid rehydration guideline for the management of gastroenteritis in children 6months to 4years of age in an Emergency Department (ED). The guideline aims to facilitate rehydration within 4h of arrival to the ED, using oral or nasogastric fluids. Primary outcome measures were ED Length of Stay (LOS) and hospital admission rates. Documentation of physiological recovery and consistency of re-hydration regimes used were examined as secondary outcomes.
  
  
  METHODS
  A quasi-experimental design using the medical records of 235 children pre and post intervention was used. Descriptive statistics (frequencies, medians, interquartile ranges) were used to summarize the data. The pre and post-test groups were compared using Chi Square and the Mann Whitney U Test.
  
  
  RESULTS
  There was an increase in the ED LOS and in hospital admission rates post implementation of the rapid rehydration guideline in the ED. However, the time frame for initiation of rehydration therapy using oral or nasogastric routes improved post guideline implementation.
  
  
  CONCLUSIONS
  The need for improvements in the ED management of dehydration secondary to gastroenteritis has been highlighted providing potential benefits to patient care and outcomes.
authors.affiliation: School of Health Sciences (Division of Nursing and Midwifery), RMIT University, Australia.
authors.forename: Danielle
authors.initials: D
authors.lastname: Waddell
authors.affiliation: School of Health Sciences (Division of Nursing and Midwifery), RMIT University, Australia.
authors.forename: Ian
authors.initials: I
authors.lastname: McGrath
authors.affiliation: School of Health Sciences (Division of Nursing and Midwifery), RMIT University, Australia. Electronic address: Phillip.maude@rmit.edu.au.
authors.forename: Phil
authors.initials: P
authors.lastname: Maude
mesh_terms: D002675:Child, Preschool; D003681:Dehydration / Q000209:etiology / Q000628:therapy*; D004636:Emergency Service, Hospital; D005260:Female; D005440:Fluid Therapy / Q000379:methods*; D005759:Gastroenteritis / Q000150:complications*; D006801:Humans; D020896:Hypovolemia / Q000517:prevention & control; D007223:Infant; D007902:Length of Stay; D008297:Male; D017410:Practice Guidelines as Topic; D016896:Treatment Outcome
keywords: Deydration; Gastroenteritis; Hypotonic solutions; Hypovolemia; Paediatrics; Rehydration