What is the recommended management for a child with gastroenteritis who is showing signs of dehydration?

Use oral rehydration therapy (ORS) solution to rehydrate children, including those with hypernatraemia, unless intravenous fluid therapy is indicated ¹.

Give 50 ml/kg for fluid deficit replacement over 4 hours as well as maintenance fluid ¹.

Give the ORS solution frequently and in small amounts, and consider supplementation with their usual fluids if they refuse to take sufficient quantities of ORS solution and do not have red flag symptoms or signs ¹.

If a child remains shocked after the first rapid intravenous infusion of 10 ml/kg of 0.9% sodium chloride solution, immediately give another infusion and consider causes other than dehydration ¹.

Consider consulting a paediatric intensive care specialist if shock persists after the second infusion ¹.

When symptoms and/or signs of shock resolve, start rehydration with intravenous fluid therapy, using isotonic solutions such as 0.9% sodium chloride or 0.9% sodium chloride with 5% glucose, and monitor plasma sodium, potassium, urea, creatinine, and glucose regularly ¹.