Dehydration
Dehydration
Clinical picture consistent with dehydration, requiring IV fluids, or electrolyte replacement
Moderate/severe dehydration of KNOWN correctable cause not otherwise requiring admission
Adequate follow up and social support at anticipated time of discharge
Unstable vital signs, or severe systemic illness
Chronic intractable nausea and vomiting
History of gastroparesis
Alternative high morbidity/acuity diagnosis as likely cause of dehydration
Significant lab abnormalities ( NA < 125 or > 145, K+ < 2.5 or > 5.0, Co2 < 18 or > 45, sCr > 3.0 or double prior baseline)
Unable to perform activities of daily living (ie walking, self-bathing, etc.)
IV fluids
Antiemetics prn
Loperamide PRN ONLY If patient has diarrhea, and is low risk for invasive pathogen (no fever, normal WBC, no risks for C. DIff)
Check mag and phos x1 if not ordered in ED
UA with micro if not already performed in the ED
Replace electrolytes as needed
PO challenge
Disposition
Stable and normal vital signs (HR< 100 with standing and no symptomatic orthostasis)
Ability to tolerate po fluids and medications
Correction of electrolyte abnormalities
Improvement of creatinine
Concerning Vital Signs or unresolved symptoms or persistent vomiting
Persistent acid/base, electrolyte, or renal function abnormality different from baseline
New or alternative diagnosis for dehydration needing hospitalization discovered
Does not or will not meet Home Disposition criteria after 18 hours of treatment
At the discretion of the ED physician, primary physician or consultant