What is the recommended fluid replacement for a child older than one year with dehydration?

The recommended fluid replacement for a child older than one year with dehydration is based on the severity of the dehydration and the need to replenish lost fluids efficiently without causing fluid overload. The first step in the management of dehydration typically involves administering an initial bolus of fluids to quickly restore circulatory volume followed by a more gradual replacement of ongoing losses.

In this case, administering 30 ml/kg over the first half-hour allows for a rapid initial rehydration, which is critical for children who may present with signs of moderate to severe dehydration. This is followed by giving a total of 70 ml/kg over the next 2.5 hours, which supports the child's needs for both maintenance fluids and any ongoing losses that may occur.

This strategy aligns with established pediatric guidelines that emphasize the importance of an initial rapid bolus followed by a more sustained infusion. The combination of both phases effectively rehydrates the child and addresses their ongoing fluid requirements, minimizing the risks associated with dehydration.

Alternative options with different fluid volumes and rates do not align as closely with the recommended protocols for fluid resuscitation in pediatric patients, as they either overestimate or underestimate the typical fluid needs based on clinical practice guidelines.