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P067: Ondansetron and rehydration in pediatric gastroenteritis

S. Léa, E. Laurier, M. Vasil, C. Giasson, S. Royer

Canadian Journal of Emergency Medicine, 2020

Abstract

Introduction: Gastroenteritis (GE) is one of the most common causes of emergency room visits, especially in pediatrics. The Canadian Paediatric Society and Choosing Wisely have issued high-grade recommendations to physicians working in the Emergency Department. It suggests, trying oral ondansetron followed by oral rehydration before installing venous rehydration in children with GE with adequate hydration or mild to moderate dehydration. This quality of medical care evaluation aims to determine if these recommendations were being applied for children aged 6 months to 12 years, with adequate hydration status or mild to moderate dehydration, who presented to the Chicoutimi emergency room between November 2016 and November 2018. Methods: Practice conformity was assessed according to two explicit criteria: prescription of oral ondansetron and appropriate mean of rehydration. A data collection tool was created and files were reviewed by investigators after standardization. Several secondary outcomes were assessed, including, among others, duration of symptoms, the number of vomiting and diarrhea. The hydration status was measured according to the capillary refill, feeling of skin to the touch, condition of buccal mucosa, tears, heart rate and mental status. These variables were analyzed to understand their impact on practice conformity. We excluded cases in which there was infections needing antibiotics, hypoglycemia, hemodynamic instability, no vomiting in the last 24 hours,…

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