Children with vomiting/ diarrhea constitute about 15% of the pediatric emergency admissions1. Children under the age of five are most infected with viral pathogens as Rota and Noro. The clinical manifestations of viral gastroenteritis include diarrhea, vomiting, fever, anorexia, headache, abdominal cramps and myalgia. The constellation of symptoms varies from day to day and from person to person. Illness usually begins 12 hours to four days after exposure and generally lasts for three to seven d
Conditions
Interventions
1. Arm 1: Intervention arm (= 'therapeutic decision rule'), to start early treatment in children with vomiting/diarrhea who are at risk for dehydration. The 3 options of the ‘model’:
A. 0-4% dehydrat
B. 5-10% dehydration: 80 ml/ kg ORS per probe in 3 hours
C. >10% dehydration: Consult physician
2. Arm 2: 'Usual care' (controls).
Sponsors
Dr. R. Oostenbrink
Department of General Paediatrics
Office Sp-1549
Dr. Molewaterplein 60
ErasmusMC Sophia Children's Hospital
P.O.Box 2060, 3000 CB Rotterdam
Tel: + 31 10 7036661 Fax: + 31 10 7036685
Eligibility
Inclusion criteria
Inclusion criteria: Children aged 1 month - 5 years, visiting the pediatric emergency department of the ErasmusMC-Sophia with acute vomiting/diarrhea.
Exclusion criteria
Exclusion criteria: 1. Chronic diarrhea (> 7 days); 2. Symptoms suggesting other focus (lower respiratory tract infections, urinary tract infections, joint problems etc.); 3. Children with pre-existing anatomical urogenital and/ or neurological abnormalities, renal/ pulmonary or cardiac disease; 4. Congenital or acquired immunodeficiency diseases and multiple disabled children.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Patient outcome: 1. Correct diagnosis (children with dehydration due to vomiting/diarrhea); 2. False positive errors (children without the target diagnosis incorrectly exposed to treatment); 3. False negative errors (children with the target diagnosis incorrectly refrained from treatment). | — |
Secondary
| Measure | Time frame |
|---|---|
| Process outcome: 1. Patient's consultation time; 2. Number of return visits emergency department; 3. Number of diagnostic tests and treatment; 4. Hospitalisation; 5. Costs of process outcomes. | — |
Contacts
Public ContactR. Oostenbrink
P.O.box 2060
Outcome results
None listed