II. Indications: Urgent or emergent evaluation for red flag symptoms and signs
-
Fever
- Age <3 months: Temperature > 100.4 F (38 C)
- Age >3 months: Temperature > 104 F (40 C)
-
Caregiver report of Dehydration signs
- See Pediatric Dehydration
- Decreased tearing (sensitive parent reported marker for Dehydration)
- Decreased fluid intake
- Decreased Urine Output
- Age <1 year old: last urine >8 hours earlier
- Age >1 year old: last urine >12 hours earlier
- Dry mucous membranes
- Cyanosis
- Poor peripheral perfusion
- Mental status changes
- Lethargy
- Excessive irritability or inconsolable crying
- Altered Level of Consciousness
- Ill appearance
- Failure of Oral Rehydration Solution
- Persistent Vomiting
- Failure to improve with Oral Rehydration Solution
-
Inflammatory Diarrhea signs
- Tenesmus
- Bloody Diarrhea
-
Vomiting characteristics
- Bilious Vomiting
- Bloody Vomiting (Hematemesis)
- High-risk child
- Younger than 6 months of age or less than 17 pounds (7-8 kg)
- Premature Infant
- Chronic comorbidity
- Moderate to severe Diarrhea
- More than 10 stools per day
- Substantial volume
- Prolonged course longer than 2 weeks
- References
III. Indications: Routine clinical evaluation
- Recurrent Diarrhea or persistent Diarrhea >2 weeks
- Suggests parasitic Diarrhea
-
Inflammatory Diarrhea (Bacterial Diarrhea)
- Flecks or streaks of blood in stool
- Diarrhea for longer than 1 week
- Not indicated for only persistent soft stools
- Also consider Lactose-Free Diet
- Mucus or pus in stool
- Fever for longer than 72 hours
- Stool Incontinence
IV. Management: Home recommendations
- See Pediatric Diarrhea Management
- See Pediatric Diarrhea Fluid Replacement